Pneumonologia i alergologia polska最新文献

{"title":"Thrombocytopenia as a marker of outcome in patients with acute exacerbation of chronic obstructive pulmonary disease.","authors":"Mohammad Hossein Rahimi-Rad,&nbsp;Sheida Soltani,&nbsp;Masome Rabieepour,&nbsp;Shagayegh Rahimirad","doi":"10.5603/PiAP.2015.0056","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0056","url":null,"abstract":"<p><strong>Introduction: </strong>Thrombocytopenia (TP) is associated with poor outcome in patients who are critically ill with pneumonia, burns, and H1N1 influenza. To our knowledge, no similar study in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been conducted to date. The aim of this study was to determine the impact of platelet count on the outcome of patients with AECOPD.</p><p><strong>Material and methods: </strong>Patients admitted to our teaching hospital for AECOPD were divided into two cohorts, those with and without TP. The outcome of all patients was followed.</p><p><strong>Results: </strong>Of the 200 patients with AECOPD, 55 (27.5%) had TP. Of these, 14 (25.5%) died in the hospital, whereas of the 145 non-TP patents, 11 (7.5%) died (p-value = 0.001). There was a significantly higher transfer rate to the ICU and mechanical ventilation in TP patients. The mean platelet count was significantly lower in patients who died than those who were discharged (161,672 vs. 203,005 cell/μL; p-value = 0.017). There was negative correlation between duration of hospitalization and platelet count.</p><p><strong>Conclusion: </strong>TP was associated with poor outcome in AECOPD. TP could be considered as a marker for the assessment of inflammation and prognosis in AECOPD patients based on its cost-effective features.</p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34012887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis among the homeless and inmates kept in custody and in penitentiary institutions in the Silesia region.","authors":"Joanna Pendzich,&nbsp;Wanda Maksymowicz-Mazur,&nbsp;Jolanta Pawłowska,&nbsp;Łucja Filipczyk,&nbsp;Ilona Kulawik,&nbsp;Jerzy Zientek,&nbsp;Jerzy Kozielski","doi":"10.5603/PiAP.2015.0003","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0003","url":null,"abstract":"<p><strong>Introduction: </strong>There are more than 10 million prisoners in the world. Tuberculosis incidence is 10-100 times higher in prisoners than in the general population. Inmates have close contact with other prisoners and with prison workers and visitors, so tubercle bacilli may be easily spread. Most of the inmates come back to normal life and contact with the general population. The aim of the study was to assess active tuberculosis incidence among prisoners and homeless persons in the Silesia region.</p><p><strong>Material and methods: </strong>In total 897 people entered the study, of whom 720 were Silesian penitentiary system inmates, and 177 were homeless. BACTEC MGIT fast TB detection system and GenoType Mycobacteria Direct test were used. Drug susceptibility testing was done using SIRE KIT and PZA KIT.</p><p><strong>Results: </strong>Tuberculosis was diagnosed in 13 out of 897 persons (1.45%): in 11 out of 720 inmates (1.53%) and in 2 out of 177 homeless persons (1.13%). Data concerning drug susceptibility were obtained for 11 persons. M. tuberculosis strains isolated from eight persons were susceptible to four first-line antituberculosis drugs (streptomycin, isoniazid, rifampin, ethambutol), while M. tuberculosis strains isolated from three persons were drug-resistant. One out of three isolated strains was resistant to ethambutol, but susceptible to streptomycin, isoniazid, rifampin, and pirazynamide. The second strain was resistant to streptomycin and pyrazinamide but susceptible to isoniazid, rifampin, and ethambutol. The third strain was susceptible to rifampin but resistant to the other four tested drugs. According to the obtained data, culture-positive pulmonary tuberculosis was 100 times more frequent in the examined population than in the general population of the Silesia region in the same period of time.</p><p><strong>Conclusions: </strong>The health project enabled effective detection of tuberculosis in risk groups and should be continued in the following years. The set of the applied diagnostic methods allowed the detection of in the studied subpopulations people suffering from tuberculosis. Patients were treated with antituberculosis drugs that would stop them from spreading the disease to other people.</p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32966948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypertension in the course of diffuse parenchymal lung diseases - state of art and future considerations.","authors":"Monika Szturmowicz,&nbsp;Aneta Kacprzak,&nbsp;Katarzyna Błasińska-Przerwa,&nbsp;Jan Kuś","doi":"10.5603/PiAP.2015.0051","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0051","url":null,"abstract":"<p><p>Lung diseases are one of the most frequent causes of pulmonary hypertension (PH). The development of PH influences the course of lung disease, worsening the clinical symptoms and prognosis. According to the most recent publications, PH in the course of lung diseases develops as a result of both \"parenchymal\" and vascular pathology, in the patients with genetic predisposition. Prolonged infection (especially viral one) may be an additional promoting factor. Right heart catheterization (RHC), which is an invasive procedure, is the only objective method of diagnosing PH. According to the latest recommendations, the management algorithm of PH and coexisting interstitial lung disease is based on RHC and the results of pulmonary function tests. Majority of the patients develop mild PH in the course of advanced lung disease. Best treatment of underlying lung pathology combined with long term oxygen treatment is recommended in this group. In case of severe PH (mean resting pulmonary artery pressure (mPAP) ≥ 35 mm Hg) the alternate cause of PH has to be sought. PAH-specific drugs use should be limited to patients with severe PH participating in clinical trials. In this review, the value of various non-invasive methods (echocardiography, radiological examination, exercise capacity and brain natriuretic peptides assessment) in the process of screening for PH is presented, and the results of recent randomized clinical trials with PAH-specific drugs in patients with diffuse parenchymal lung diseases are discussed. </p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34278672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Middle lobe syndrome: an extraordinary presentation of endobronchial tuberculosis.","authors":"Tinu Garg,&nbsp;Kamal Gera,&nbsp;Ashok Shah","doi":"10.5603/PiAP.2015.0062","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0062","url":null,"abstract":"<p><p>Tuberculous infection of the tracheobronchial tree, termed as endobronchial tuberculosis (EBTB), is more common in young adults and females. This clinical entity is poorly understood and the diagnosis is frequently delayed as sputum smears are often negative for acid fast bacilli and the chest radiograph can be normal, resulting in diagnostic confusion. Bronchoscopy continues to play a key role in its diagnosis. Though atelectasis is not uncommon in these patients, EBTB presenting as a middle lobe syndrome (MLS) has rarely been documented. MLS refers to chronic or recurrent collapse of the right middle lobe and has a myriad of causes. The pathogenesis of this entity too is not fully established. We report this exceptional clinical manifestation in a 19-year-old male, who presented for evaluation of respiratory symptoms for 6 months along with constitutional complaints. Imaging suggested the presence of MLS and bronchoscopy established the diagnosis of endobronchial tuberculosis. GeneXpert evaluation of bronchial aspirate detected Mycobacterium tuberculosis. Histopathology confirmed the presence of granulomatous lesions. Subsequently, the cultures of bronchial aspirate and post-bronchoscopy sputum grew M. tuberculosis. Appropriate therapy with anti-tuberculosis drugs resulted in a remarkable symptomatic and radiological improvement. EBTB presenting as a MLS is a distinct rarity. </p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34012893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Luck's always to blame\": silent wounds of a penetrating gunshot trauma sustained 20 years ago.","authors":"Ioannis Tomos,&nbsp;Effrosyni D Manali,&nbsp;Stylianos Argentos,&nbsp;Thomas Raptakis,&nbsp;Spyros A Papiris","doi":"10.5603/PiAP.2015.0063","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0063","url":null,"abstract":"<p><p>Gunshot tracheal injuries represent life-threatening events and usually necessitate emergent surgical intervention. We report a case of an exceptional finding of a patient with retained ballistic fragments in the soft tissues of the thorax, proximal to the right subclavian artery and the trachea, carrying silently his wounds for two decades without any medical or surgical intervention. The bullet pellet on the upper part of the trachea seen accidentally in the chest computed tomography, was also found during bronchoscopy. In short \"luck's always to blame\". </p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34012894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polish Respiratory Society guidelines for the methodology and interpretation of the 6 minute walk test (6MWT).","authors":"Tadeusz Przybyłowski,&nbsp;Waldemar Tomalak,&nbsp;Zenon Siergiejko,&nbsp;Dariusz Jastrzębski,&nbsp;Marta Maskey-Warzęchowska,&nbsp;Tomasz Piorunek,&nbsp;Emil Wojda,&nbsp;Piotr Boros","doi":"10.5603/PiAP.2015.0048","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0048","url":null,"abstract":"283 Assoc. Prof. Tadeusz Przybyłowski, MD, PhD Prof. Waldemar Tomalak, MD, PhD Prof. Zenon Siergiejko, MD, PhD Prof. Dariusz Jastrzębski, MD, PhD Dr Marta Maskey-Warzęchowska, MD, PhD Assoc. Prof. Tomasz Piorunek, MD, PhD Dr Emil Wojda, MD, PhD Assoc. Prof. Piotr Boros, MD, PhD Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Poland Department of Physiopathology of the Respiratory System, Rabka-Zdrój Branch of the Institute of Tuberculosis and Lung Diseases, Poland Laboratory of Respiratory Diagnostics and Bronchoscopy, Medical University of Białystok, Poland Department of Lung Diseases and Tuberculosis, Medical University of Silesia, Poland Department of Pulmonology Allergology and Pulmonary Oncology, Poznań University of Medical Sciences, Poland Department of Lung Diseases, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland Department of Physiopathology of the Respiratory System, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland Reviewers: Prof. Ryszarda Chazan, MD, PhD Prof. Władysław Pierzchała, MD, PhD Prof. Wacław Droszcz, MD, PhD Prof. Adam Antczak, MD, PhD","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34278669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The statement of the Polish Society of Allergology experts on the treatment of difficult-to-treat asthma.","authors":"Anna Bodzenta-Łukaszyk,&nbsp;Andrzej M Fal,&nbsp;Ewa Jassem,&nbsp;Marek L Kowalski,&nbsp;Piotr Kuna,&nbsp;Maciej Kupczyk","doi":"10.5603/PiAP.2015.0052","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0052","url":null,"abstract":"<p><p>The main objective of asthma treatment is to control symptoms of the disease; however, despite the availability of guidelines and many groups of medications, the degree of control of this condition is insufficient. In difficult-to-treat asthma, the optimal control cannot be achieved due to reasons independent of the disease. Factors worsening asthma control include: inadequate treatment plan (low therapy adherence and compliance), inappropriate inhalation technique, insufficient symptom control using the available classes of medications, incomplete response to treatment (non-responders, steroid-resistance), incorrect diagnosis of asthma or comorbidities, and environmental factors. In order to achieve the optimal asthma control, it is recommended to: take therapeutic decisions with the patient, assess the probability of non-compliance, perform detailed diagnostics and initiate treatment of concomitant diseases, carry out differential diagnosis of conditions mimicking asthma, educate the patient as to the inhalation technique and check it, eliminate unfavourable environmental factors, and modify current treatment. New treatment options for patients with asthma include: ultra-long-acting beta2-agonists, long-acting muscarine receptor antagonists (LAMA), monoclonal antibodies, and non-pharmacological interventions. The only LAMA approved for treatment of asthma is tiotropium bromide. The analyses performed demonstrated a high efficacy of tiotropium in terms of improved lung function parameters and prolonged time to the first asthma exacerbation. It is recommended as an add-on therapy at asthma treatment steps 4 and 5 according to GINA (Global Initiative for Asthma) 2014. The optimal asthma control is important from the medical as well as the economical point of view. </p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34278673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheobronchopathia osteochondroplastica—case report and literature review.","authors":"Maria Porzezińska,&nbsp;Alicja Janowicz,&nbsp;Piotr Janowiak,&nbsp;Bogumiła Cynowska,&nbsp;Adam Sternau,&nbsp;Rafał Pęksa,&nbsp;Jan Marek Słomiński,&nbsp;Ewa Jassem","doi":"10.5603/PiAP.2015.0021","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0021","url":null,"abstract":"<p><p>Tracheobronchopathia osteochondroplastica (TBO) is a rare disease of unknown etiology characterised by a formation of multiple, cartilaginous and osteocartilaginous submucosal nodules in the trachea and major bronchi. The course of the disease is usually benign but the narrowing of the respiratory tract can lead to chronic non-specific clinical symptoms. We present a case of a 50-year old man with chronic exertional dyspnoea and stenosis of the trachea visible in imaging tests, in whom the symptoms were caused by TBO. </p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33116207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tiotropium and its efficacy in the treatment of COPD.","authors":"Maciej Kupczyk,&nbsp;Paweł Szepiel,&nbsp;Piotr Kuna","doi":"10.5603/PiAP.2015.0037","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0037","url":null,"abstract":"<p><p>Exacerbations of chronic obstructive pulmonary disease (COPD) have a negative effect on the clinical course and outcome of the disease thus causing considerable social and economic burden. As the natural course of the disease may vary, the treatment should take into account an individual approach to a patient. The appropriate treatment makes it possible to control the symptoms, improves effort tolerance and decreases the risk of exacerbations and death. Tiotropium is a muscarinic receptor antagonist, which is taken once daily, in maintenance therapy, in every stage of the disease progress. The efficacy of tiotropium in regards to exacerbations of chronic obstructive pulmonary disease has been evaluated in many clinical trials against placebo and several different active comparators. This review presents the results of those studies with the main goal to evaluate the efficacy of treatment with tiotropium in terms of prevention and course of exacerbations. </p>","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5603/PiAP.2015.0037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33366369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaphylaxis.","authors":"Jerzy Kruszewski","doi":"10.5603/PiAP.2015.0028","DOIUrl":"https://doi.org/10.5603/PiAP.2015.0028","url":null,"abstract":"","PeriodicalId":20258,"journal":{"name":"Pneumonologia i alergologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33247802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}