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Advances in Respiratory Medicine is published by MDPI from Volume 90 Issue 4 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Via Medica.

Adv. Respir. Med., Volume 89, Issue 5 (October 2021) – 19 articles , Pages 477-555

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6 pages, 312 KiB  
Review
Progressive Fibrosis in Interstitial Lung Diseases—Proposed Definition and Management
by Magdalena Maria Martusewicz-Boros and Wojciech Jerzy Piotrowski
Adv. Respir. Med. 2021, 89(5), 505-510; https://doi.org/10.5603/ARM.a2021.0103 - 28 Oct 2021
Viewed by 576
Abstract
Interstitial lung diseases may have an unpredictably progressive course, which is manifested as progression of pulmonary fibrosis, causing an increasing impairment of lung function affecting a poor prognosis. The possibility of an effective antifibrotic treatment is a chance for patients to slow down [...] Read more.
Interstitial lung diseases may have an unpredictably progressive course, which is manifested as progression of pulmonary fibrosis, causing an increasing impairment of lung function affecting a poor prognosis. The possibility of an effective antifibrotic treatment is a chance for patients to slow down the progression of the disease, perhaps even extend their life. For this reason, standardization of the definition as well as identification criteria for progressive fibrosis interstitial lung disease is a method for optimizing the management in this group of patients. Full article
2 pages, 368 KiB  
Case Report
Antitubercular Therapy—An Uncommon Side Effect
by Mayank Kapur, Nitesh Gupta, Neeraj Kumar Gupta, Shibdas Chakrabarti, Rohit Kumar and Pranav Ish
Adv. Respir. Med. 2021, 89(5), 544-545; https://doi.org/10.5603/ARM.a2021.0097 - 20 Oct 2021
Cited by 1 | Viewed by 457
Abstract
A 43-year-old female presented with complaints of chest pain, non-productive cough, shortness of breath, diarrhoea, loss of weight and appetite, and generalised malaise for a period of one month [...] Full article
9 pages, 2341 KiB  
Review
Pulmonary Blastoma: A Comprehensive Overview of A Rare Entity
by Ioannis Tsamis, Stavroula-Porfyria Chachali, Georgia Gomatou, Ioannis Trontzas, Maria Mitsogianni, Nikolaos Syrigos, Ioannis Vamvakaris and Elias Kotteas
Adv. Respir. Med. 2021, 89(5), 511-519; https://doi.org/10.5603/ARM.a2021.0085 - 20 Oct 2021
Cited by 4 | Viewed by 1318
Abstract
Introduction: Pulmonary blastoma is a rare malignancy, accounting for less than 0.5% of primary lung tumors. It belongs to the group of pulmonary sarcomatoid carcinomas, and it is typically characterized by a biphasic pattern of an epithelial and a mesenchymal component. Only [...] Read more.
Introduction: Pulmonary blastoma is a rare malignancy, accounting for less than 0.5% of primary lung tumors. It belongs to the group of pulmonary sarcomatoid carcinomas, and it is typically characterized by a biphasic pattern of an epithelial and a mesenchymal component. Only a few hundred cases have been reported worldwide. The aim of this study is to review and critically assess the literature regarding pulmonary blastoma. Material and methods: A narrative literature review of PubMed database from the inception of the database up to January 2021, limited to the English language, was conducted, using combinations of the following keywords: “pulmonary blastoma”, “biphasic pulmonary blastoma”, “sarcomatoid carcinoma”. Results: Pulmonary blastoma is composed of an epithelial and a mesenchymal malignant component. Regarding pathogenesis, the origin of the biphasic cell population remains elusive. Characteristic immunohistochemical stains are supportive of diagnosis.Clinically, the symptomatology is non-specific, while 40% of the cases are asymptomatic. It is diagnosed at a younger agecompared to other types of lung cancer, and it is often non-metastatic at diagnosis allowing for surgical treatment. Data on management and survival are scarce and mainly come from isolated cases. Advances on targeted therapy may provide novel treatment options. Given the rarity of the cases, multicenter collaboration is needed in order to establish therapeutic Guideliness. Full article
2 pages, 106 KiB  
Letter
Inhaled Budesonide for Mild COVID-19. Is There More to It Than Just Airways?
by Sahaj Rathi, Pranav Ish, Ashwini Kalantri and Shriprakash Kalantri
Adv. Respir. Med. 2021, 89(5), 552-553; https://doi.org/10.5603/ARM.a2021.0082 - 13 Oct 2021
Cited by 1 | Viewed by 545
Abstract
As healthcare systems in many countries buckle under the immense pressure of rising COVID cases, a drug which can reduce emergency visits would be a huge boon [...] Full article
2 pages, 113 KiB  
Letter
Clinical Studies Regarding COVID-19 in Belgium
by Jelle Stans and Melina Delanghe
Adv. Respir. Med. 2021, 89(5), 548-549; https://doi.org/10.5603/ARM.a2021.0065 - 13 Oct 2021
Viewed by 469
Abstract
The severe acute respiratory syndrome coro‑navirus 2 (SARS‑CoV‑2), causing coronavirus disease 2019 (COVID‑19), arrived in Belgium early February 2020 [...] Full article
2 pages, 578 KiB  
Case Report
Unilateral Multiple Thoracic Hydatid Cysts: A Rare Presentation
by El Hassane Kabiri, Massine El Hammoumi and Meryem Kabiri
Adv. Respir. Med. 2021, 89(5), 542-543; https://doi.org/10.5603/ARM.a2021.0096 - 13 Oct 2021
Viewed by 387
Abstract
Hydatidosis, when present in multiple thoracic locations, requires a synchronous or successive approach, which can lead to an increased risk of complications [...] Full article
2 pages, 695 KiB  
Case Report
Characteristic Imaging Finding and Spot Radiological Diagnosis in A Young Man with Acute Breathlessness and Chest Pain
by Mayank Mishra and Subodh Kumar
Adv. Respir. Med. 2021, 89(5), 538-539; https://doi.org/10.5603/ARM.a2021.0073 - 13 Oct 2021
Viewed by 410
Abstract
Septic pulmonary embolism (SPE) is a serious complication of fulminant bacteraemia, usually seen in immunocompromised persons or intravenous drug abusers [...] Full article
9 pages, 279 KiB  
Article
On-Admission versus In-Hospital Thromboembolism Due to COVID-19 Infection. What Is the Particular Characteristic of Those with Early Thrombotic Events?
by Somayeh Sadeghi, Elaheh Keivany, Maryam Nasirian and Peiman Nasri
Adv. Respir. Med. 2021, 89(5), 484-492; https://doi.org/10.5603/ARM.a2021.0083 - 13 Oct 2021
Cited by 2 | Viewed by 609
Abstract
Introduction: Increasing evidence has declared a hypercoagulable state in the coronavirus 2019 infection (COVID-19), while the etiology has remained a question. For the first time, the current study has aimed to compare the contributors of thromboembolism among those whose primary manifestations of [...] Read more.
Introduction: Increasing evidence has declared a hypercoagulable state in the coronavirus 2019 infection (COVID-19), while the etiology has remained a question. For the first time, the current study has aimed to compare the contributors of thromboembolism among those whose primary manifestations of COVID-19 were thrombosis vs the patients with a thrombotic event during the period of hospitalization. Material and methods: This case-control study has been conducted on 267 COVID-19 patients, including 59, 48, and 160 ones with an on-admission, in-hospital, and without a thrombotic event, respectively. The events were defined as deep vein thrombosis (DVT), ischemic cerebrovascular accidents (CVA), pulmonary thromboembolism (PTE), or acute myocardial infarction (AMI). The demographic, physical examination, clinical and laboratory assessments of the groups were compared. Results: The DVT (OR: 5.18; 95% CI: 1.01–26.7), AMI (OR: 11.1; 95% CI: 2.36–52.3), and arterial thrombosis (OR: 5.93; 95% CI: 0.63–55.8) were significantly associated with an on-admission thrombosis compared to those who presented in-hospital events. Lower levels of oxygen saturation were the only significant predictor index inversely associated with on-admission thrombosis compared to those with an event during the hospital admission period. Conclusion: PTE development was the most common in-hospital thrombotic event, whereas other thromboembolism types were remarkably more often among cases with on-admission events. Oxygen saturation was the only predictor of premature thrombosis that was inversely associated with outpatient events. Full article
2 pages, 121 KiB  
Letter
High-Dose Steroids for the Treatment of Severe COVID-19 Pneumonia: The Need of the Hour?
by Abhishek Tandon and Vedansh Chandra
Adv. Respir. Med. 2021, 89(5), 550-551; https://doi.org/10.5603/ARM.a2021.0084 - 06 Oct 2021
Viewed by 408
Abstract
Ever since the results of the RECOVERY trial [...] Full article
2 pages, 448 KiB  
Case Report
Sclerosing Pneumocytoma Accompanied with Dilated Air-Containing Space
by Kengo Nishino, Kesato Iguchi, Norio Takayashiki and Hiroaki Satoh
Adv. Respir. Med. 2021, 89(5), 540-541; https://doi.org/10.5603/ARM.a2021.0061 - 28 Sep 2021
Viewed by 441
Abstract
Sclerosing pneumocytomas are one of the most common benign lung tumors [...] Full article
7 pages, 1507 KiB  
Article
Persistence of Post-COVID Lung Parenchymal Abnormalities during the Three-Month Follow-Up
by Ali Bin Sarwar Zubairi, Anjiya Shaikh, Syed Muhammad Zubair, Akbar Shoukat Ali, Safia Awan and Muhammad Irfan
Adv. Respir. Med. 2021, 89(5), 477-483; https://doi.org/10.5603/ARM.a2021.0090 - 28 Sep 2021
Cited by 3 | Viewed by 691
Abstract
Introduction: COVID-19-associated pulmonary sequalae have been increasingly reported after recovery from acute infection. Therefore, we aim to explore the charactersitics of persistent lung parenchymal abnormalities in patients with COVID-19. Material and methods: An observational study was conducted in patients with post-COVID [...] Read more.
Introduction: COVID-19-associated pulmonary sequalae have been increasingly reported after recovery from acute infection. Therefore, we aim to explore the charactersitics of persistent lung parenchymal abnormalities in patients with COVID-19. Material and methods: An observational study was conducted in patients with post-COVID lung parenchymal abnormalities from April till September 2020. Patients ≥ 18 years of age with COVID-19 who were diagnosed as post-COVID lung parenchymal abnormality based on respiratory symptoms and HRCT chest imaging after the recovery of acute infection. Data was recorded on a structured pro forma, and descriptive analysis was performed using Stata version 12.1. Results: A total of 30 patients with post-COVID lung parenchymal abnormalities were identified. The mean age of patients was 59.1 (SD 12.6), and 27 (90.0%) were males. Four HRCT patterns of lung parenchymal abnormalities were seen; organizing pneumonia in 10 (33.3%), nonspecific interstitial pneumonitis in 17 (56.7%), usual interstitial pneumonitis in 12 (40.0%) and probable usual interstitial pneumonitis in 14 (46.7%). Diffuse involvement was found in 15 (50.0%) patients, while peripheral predominance in 15 (50.0%), and other significant findings were seen in 8 (26.7%) patients. All individuals were treated with corticosteroids. The case fatality rate was 16.7%. Amongst the survivors, 32.0% recovered completely, 36.0% improved, while 32.0% of the patients had static or progressive disease. Conclusion: This is the first study from Southeast Asia that identified post-COVID lung parenchymal abnormalities in patients who had no pre-existing lung disease highlighting the importance of timely recognition and treatment of this entity that might lead to fatal outcome. Full article
2 pages, 1312 KiB  
Case Report
A Young Female with Polycythemia: Pearls in the Lung
by Avneet Garg, Vinita Jindal, Khushdeep Singla and Manjot Kaur
Adv. Respir. Med. 2021, 89(5), 546-547; https://doi.org/10.5603/ARM.a2021.0077 - 27 Sep 2021
Viewed by 428
Abstract
A 35 year-old female presented to the Pulmonary Medicine OPD with a history of progressive dyspnea, malaise, weakness and easy fatigability for the last 5–6 month [...] Full article
4 pages, 1569 KiB  
Case Report
Nintedanib-Mediated Improvement in CT Imaging in Pulmonary Fibrosis Associated with Systemic Scleroderma
by Kengo Nishino, Yuika Sasatani, Gen Ohara, Katsunori Kagohashi and Hiroaki Satoh
Adv. Respir. Med. 2021, 89(5), 528-531; https://doi.org/10.5603/ARM.a2021.0072 - 27 Sep 2021
Cited by 2 | Viewed by 535
Abstract
Nintedanib is an antifibrotic drug that has an inhibitory effect on growth factor tyrosine kinases. In patients with idiopathic pulmonary fibrosis and systemic scleroderma-associated interstitial pneumonia (SSc-IP), nintedanib has been effective in suppressing the decline in forced vital capacity over time and the [...] Read more.
Nintedanib is an antifibrotic drug that has an inhibitory effect on growth factor tyrosine kinases. In patients with idiopathic pulmonary fibrosis and systemic scleroderma-associated interstitial pneumonia (SSc-IP), nintedanib has been effective in suppressing the decline in forced vital capacity over time and the onset of acute exacerbation of interstitial pneumonia. Here, we report a SSc-IP patient who showed an improvement on CT images following nintedanib treatment. To our knowledge, this is the first report of such a case. Although SSc-IP patients are very rare, additional clinical experience and understanding will be required to prove the therapeutic benefit of nintedanib in these cases in relation to improved chest images. Full article
8 pages, 287 KiB  
Article
Influence of Obstructive Sleep Apnea on Right Heart Structure and Function
by Michał Harańczyk, Małgorzata Konieczyńska and Wojciech Płazak
Adv. Respir. Med. 2021, 89(5), 493-500; https://doi.org/10.5603/ARM.a2021.0095 - 27 Sep 2021
Cited by 6 | Viewed by 612
Abstract
Introduction: Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder associated with increased cardiovascular morbidity and mortality. This study aimed to investigate heart structure and function and their correlation with the degree of OSAS and sleep indexes in patients diagnosed [...] Read more.
Introduction: Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder associated with increased cardiovascular morbidity and mortality. This study aimed to investigate heart structure and function and their correlation with the degree of OSAS and sleep indexes in patients diagnosed with OSAS. Materials and methods: A cohort of 77patients (48 males, aged 58.1 ± 11.0 years, body mass index [BMI] = 32.4 ± 6.2) admitted to the hospital due to suspected OSAS was examined using echocardiography and polysomnography. Results: Patients with moderate-to-severe OSAS compared to patients without diagnosed OSAS or with mild OSAS had greater right ventricular outflow tract (RVOT) dimensions (32.6 ± 3.6 vs. 30.9 ± 2.4 mm; p < 0.05), larger right atrial area (RAA; 21.1 ± 4.8 vs. 17.2 ± 3.2 mm; p = 0.002), greater right ventricular mid-cavity diameter (RVD; 35.5 ± 7.0 vs. 32.2 ± 4.7 mm; p = 0.02), and diminished tricuspid annular plane systolic excursion (TAPSE, 21.9 ± 4.5 vs. 25.8 ± 4.4 mm; p = 0.04), while there were no significant differences in tissue doppler imaging (TDI) parameters (S’ and E’) and in valvular regurgitation gradient for both groups. Moreover, significantly greater RVOT dimensions (31.6 ± 2.6 vs. 30.9 ± 3.0 mm, p = 0.04), RVD (39.3 ± 7.0 vs. 32.7 ± 5.2 mm, p = 0.003), and RAA (21.4 ± 4.4 vs. 18.1 ± 4.2 mm, p = 0.02) as well as reduction in TAPSE (20.9 ± 5.3 vs. 25.0 ± 4.3 mm, p = 0.01) were observed in patients having ≥ 10 episodes of obstructive apnea (OA) per hour. Conclusions: In moderate-to-severe OSAS patients, right ventricular (RV) enlargement was observed together with RV dysfunction as measured by TAPSE. Examination using TDI is not superior to standard echocardiography for the detection of heart pathology in OSAS patients. Right heart pathology is present predominantly in patients with obstructive apnea. Full article
4 pages, 183 KiB  
Communication
Prediction of Three-Month Readmission Based on Haematological Parameters in Patients with Severe COPD Exacerbation
by Eduardo Garcia-Pachon, Carlos Baeza-Martinez, Sandra Ruiz-Alcaraz and Justo Grau-Delgado
Adv. Respir. Med. 2021, 89(5), 501-504; https://doi.org/10.5603/ARM.a2021.0076 - 24 Sep 2021
Cited by 4 | Viewed by 708
Abstract
Introduction: Approximately one-third of patients hospitalised for an exacerbation of chronic obstructive pulmonary disease (COPD) are readmitted to the hospital within 90 days. It is of interest to identify biomarkers that predict relapse in order to prevent readmission in these patients. In [...] Read more.
Introduction: Approximately one-third of patients hospitalised for an exacerbation of chronic obstructive pulmonary disease (COPD) are readmitted to the hospital within 90 days. It is of interest to identify biomarkers that predict relapse in order to prevent readmission in these patients. In our prospective study of patients admitted for COPD exacerbation, we aimed to analyse whether routine haematological parameters can help predict the three-month readmission risk. Material and methods: 106 patients were included, of whom 23 were female (22%). The age (mean ± SD) was 73 ± 10 years, and the forced expiratory volume in 1 second (FEV1) was 44 ± 15%. The haematological parameters were obtained from the first blood test result during admission. The variables were as follows: red cell distribution width, mean platelet volume (MPV), platelet (PLT) count, neutrophil to lymphocyte ratio, PLT to lymphocyte ratio, MPV to PLT ratio, and eosinophil count. Patients were differentiated into two groups for each haematological parameter according to median value, and the percentage of readmissions in each of the groups was recorded. Results: Twenty-five patients (24%) were readmitted to hospital within three months of discharge. Only the difference in low-MPV and high-MPV patients was significant (37% vs. 10%, p = 0.001). The predictive capacity for three-month readmission measured by the area under the curve (AUC) did not show clinically applicable values; the best result was for MPV (AUC 0.64). In the remaining values, the AUC was between 0.52 and 0.55. Conclusion: Routine haematological parameters proposed as prognostic biomarkers in COPD obtained at the moment of hospital admission were not useful for predicting three-month readmission. Full article
137 KiB  
Letter
Airway Management in Personal Protective Equipment Conditions
by Zubaid Rafique, Luiza Szarpak, Francesco Chirico and Łukasz Szarpak
Adv. Respir. Med. 2021, 89(5), 554-555; https://doi.org/10.5603/ARM.a2021.0078 - 11 Aug 2021
Viewed by 415
Abstract
Airway management is one of the key skills that medical personnel should master, especially by emergency medical service teams [...] Full article
2026 KiB  
Article
Pulmonary Actinomycosis Complicated by Fistula of the Chest Wall
by Ewa Łyżwa, Izabela Siemion-Szcześniak, Małgorzata Sobiecka, Aneta Kacprzak, Agnieszka Winiarska, Małgorzata Szołkowska, Krzysztof Karuś and Witold Tomkowski
Adv. Respir. Med. 2021, 89(5), 532-537; https://doi.org/10.5603/ARM.a2021.0071 - 16 Jul 2021
Cited by 4 | Viewed by 579
Abstract
Actinomycosis is a rare disease caused by Actinomyces spp. The clinical and radiological picture of the disease is uncharacter-istic, which delays the diagnosis and can lead to complications. We present a case of pulmonary actinomycosis complicated by a chest wall fistula in a [...] Read more.
Actinomycosis is a rare disease caused by Actinomyces spp. The clinical and radiological picture of the disease is uncharacter-istic, which delays the diagnosis and can lead to complications. We present a case of pulmonary actinomycosis complicated by a chest wall fistula in a 43-year-old man with advanced tooth decay. The patient was admitted to our Department due to a chest wall fistula with bloody discharge. A few months earlier, he was treated with antibiotics for pneumonia. Since then, weakness, exertional dyspnoea, and weight loss had been observed. On admission, increased inflammatory markers were found in laboratory tests. Chest computed tomography (CT) revealed right-sided encapsulated pleural fluid collection containing gas bubbles, pleural thickening, anterior thoracic wall soft tissues thickening and subcutaneous fat stranding. CT suggested an empyema or a breast either pleural malignancy. The picture suggested a breast or pleural tumour to differentiate with an empyema. Videothoracoscopy was performed, the histological examination of the collected samples revealed granulation tissue and bacterial colony of a morphology corresponding to Actinomyces spp. Pulmonary actinomycosis was diagnosed. Antibiotic therapy according to the Guideliness was initiated and dental treatment was recommended. Healing of the fistula and significant regression of lesions in the right lung were achieved. Although it is a rare disease, actinomycosis should be considered in the differential diagnosis of any chronic infiltrative lung lesions. Full article
517 KiB  
Case Report
A Very Unusual Case of Interstitial Lung Disease
by Vikas Marwah, Robin Choudhary, Deepu Peter and Gaurav Bhati
Adv. Respir. Med. 2021, 89(5), 524-527; https://doi.org/10.5603/ARM.a2021.0068 - 15 Jul 2021
Viewed by 396
Abstract
Cotton dust exposure has been implicated in causing diseases like byssinosis and obstructive airway diseases like COPD and asthma. Long-term exposure to cotton dust causing interstitial lung disease and pulmonary fibrosis has been sparsely reported in the literature. Here, we report a case [...] Read more.
Cotton dust exposure has been implicated in causing diseases like byssinosis and obstructive airway diseases like COPD and asthma. Long-term exposure to cotton dust causing interstitial lung disease and pulmonary fibrosis has been sparsely reported in the literature. Here, we report a case of an individual with long-term cotton dust exposure who presented with typical symptoms of interstitial lung disease and was managed conservatively. Full article
790 KiB  
Case Report
Bronchoscopic Extraction of Multiple Endobronchial Broncholiths in A Patient with Active Pulmonary Tuberculosis
by Venkata Nagarjuna Maturu, Raghavender Reddy Annela and Narendra Kumar Narahari
Adv. Respir. Med. 2021, 89(5), 520-523; https://doi.org/10.5603/ARM.a2021.0052 - 15 Jul 2021
Viewed by 453
Abstract
Broncholithiasis is an unusual clinical condition characterized by the presence of calcified or ossified material within the airways. Multiple endobronchial broncholithiasis during active infection with tuberculosis is an extremely uncommon presentation. Bron-choscopy plays an important role in the diagnosis and management of broncholithiasis. [...] Read more.
Broncholithiasis is an unusual clinical condition characterized by the presence of calcified or ossified material within the airways. Multiple endobronchial broncholithiasis during active infection with tuberculosis is an extremely uncommon presentation. Bron-choscopy plays an important role in the diagnosis and management of broncholithiasis. Currently, there are no specific Guideliness for the management of broncholithiasis. Here, we present a Case Report where multiple broncholiths were successfully removed in a staged manner via rigid bronchoscopy. Full article
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