bluuebunny/crossref_metadata_2025 huggingface dataset:
Interferon-Gamma Assay T-SPOT.TB in the Diagnostics of Latent Tuberculosis Infection
Authors: Borkowska Dagmara , Zwolska Zofia , Michałowska-Mitczuk Dorota , Korzeniewska-Koseła Maria , Zabost Anna , Napiórkowska Agnieszka , Kozińska Monika , Brzezińska Sylwia , Augustynowicz-Kopeć Ewa
Published: June 2022

Introduction: Diagnostics of latent tuberculosis infection (LTBI) has been based on a century-old tuberculin skin test (TST). However, a positive reaction can result not only from infection with Mycobacterium tuberculosis, but also from BCG vaccination or cross-reaction with nontuberculous mycobacteria. T-SPOT.TB assay is a new test to diagnose tuberculosis infection by measuring in vitro T-cell interferon-gamma release in response to two Mycobacterium tuberculosis-specific antigens: ESAT-6 and CFP-10. Material and methods: T-SPOT.TB assay was performed on samples of whole blood (n = 137) from March to September 2010. Tuberculin skin test was carried out in 96 participants. A positive TST result was considered to be an induration of 10 mm or more. Results: Of the 137 patients tested, T-SPOT.TB assay results were positive in 37 (27%), negative in 98 (71.5%) and indeterminate in only 2 (1.5%) persons. We analyzed T-SPOT.TB and TST results in 96 patients who were subjected to both tests. Concordance between T-SPOT.TB and TST results (a 10-mm skin reaction interpreted as positive) was 79%. Fifteen (15.6%) patients had a positive TST result and a negative T-SPOT.TB, and 5 (5.2%) patients had a negative TST result and a positive T-SPOT.TB. We observed a good correlation between positive T-SPOT.TB results and the diameter of induration of ≥15 mm in TST results. Conclusions: T-SPOT.TB offers a more accurate approach than TST in the identification of tuberculosis infection. The study showed that the test T-SPOT.TB is a good diagnostic tool in identifying persons with tuberculosis infection. For a full confirmation of this assessment, it is necessary to examine more cases.
Non-Invasive Ventilation in Poland—For Whom the Bell Tolls?
Authors: Nasiłowski Jacek , Zieliński Jan
Published: June 2022

In the 17th century the ringing of a church bell at an unusual time always signified some extraordinary event, summoning the entire local community to take action [...]
Variability in the Clinical Profile of Children with Asthma Referred to Allergy Clinic: A 10-Year Observation
Authors: Bąk-Walczak Ewa , Jerzyńska Joanna , Stelmach Iwona , Krakowiak Jan , Stelmach Włodzimierz
Published: June 2022

Background: Asthma is the most common chronic respiratory disease in the paediatric population. Underdiagnosis is a frequent phenomenon and is associated with undertreatment, which results in increased morbidity and mortality. The delay in the diagnosis of asthma reflects problems with the correct implementation of diagnostic goals set by the Global Initiative for Asthma (GINA). The aim of our study was to describe the clinical profile of children referred to the Clinic of Allergic Diseases and subsequently diagnosed with asthma. We evaluated the reasons for referral, demographic data and social data. Material and methods: We analysed a group of 907 children up to 18 years of age diagnosed with asthma at allergy clinic between 2000 and 2009. This was a cross-sectional study to assess the patients’ demographic, social and clinical data. Results: Our study revealed a shift in the clinical profile of children referred to allergy clinics over a period of ten years, subsequently diagnosed with asthma. The profile is characterised by a younger age, a higher incidence of recurrent infections and a lower incidence of wheezing and atopy as the reasons for referral to allergologists. Conclusions: The new clinical profile of children referred to allergologists reveals the necessity of conducting the costly differential diagnosis of asthma at specialist facilities. These data should be taken into account while developing new healthcare strategies in Poland.
Chemotherapy in the Management of Disseminated Thymoma: A Case Report and the Authors’ Own Experience
Authors: Mrochen-Domin Izolda , Chmielik Ewa , Starzyczny-Słota Danuta , Nowara Elżbieta , Sikora Marlena
Published: June 2022

Thymomas are tumours originating from the epithelial tissue of the thymus. While surgery is the mainstay of therapy in thymoma, chemotherapy may significantly improve the prognosis. Effective chemotherapy may be administered in the neoadjuvant setting (prior to surgery), in the adjuvant setting (following surgery), may be combined with radiotherapy or be used for palliation in disseminated disease. We report a case of a 66-year-old male with advanced thymoma who received second-line treatment with a good outcome.
Profilaktyka Przewlekłej Obturacyjnej Choroby Płuc
Authors: Górecka Dorota , Puścińska Elżbieta
Published: June 2022

Przewlekła obturacyjna choroba płuc (POChP) jest jednym z najważniejszych schorzeń społecznych. Jest przyczyną znacznej śmiertelności (znajduje się na czwartym miejscu najważniejszych przyczyn zgonów na świecie), odpowiada za znaczną chorobowość oraz przyczynia się do pogorszenia jakości życia chorych i ich najbliższych. Dzięki profilaktyce można zapobiec powstaniu choroby (profilaktyka pierwotna), nie dopuścić do jej postępu (profilaktyka drugorzędowa) oraz zapobiec wystąpieniu powikłań (profilaktyka trzeciorzędowa). Profilaktyka w POChP obejmuje działania skierowane na ograniczenie nałogu palenia tytoniu, zmniejszenie szkodliwych wpływów środowiska oraz stosowanie szczepień ochronnych.
Wskazówki Polskiego Towarzystwa Chorób Płuc dotyczące metod pozyskiwania, opracowywania oraz oceny płynu z płukania oskrzelowo-pęcherzykowego (BAL)
Authors: Chciałowski Andrzej , Chorostowska-Wynimko Joanna , Fal Andrzej , Pawłowicz Robert , Domagała-Kulawik Joanna
Published: June 2022

Płukanie oskrzelowo-pęcherzykowe (BAL, bronchoalveolar lavage) nadal zajmuje bardzo istotną po-zycję w diagnostyce pierwotnych chorób płuc o różnym podłożu: infekcyjnych, śródmiąższowych, no-wotworowych oraz patologii płucnych występujących w przebiegu innych schorzeń, w tym układowych [...]
The Results of Molecular Epidemiologic Investigations in Patients Infected with Strains of the Genus Acinetobacter
Authors: Nowak Joanna , Pacholczyk Agnieszka , Petroniec Violetta , Dziedzicka Beata , Zwolska Zofia
Published: June 2022

Introduction: Acinetobacter spp. is an important opportunistic pathogen responsible for increasing number of nosocomial infections. The majority of infections are of epidemic origin, and treatment has become difficult because many strains are resistant to a wide range of antibiotics. The aim of this study was to investigate the local infections caused by various species of the genus Acinetobacter, occurring in the hospital wards IGiChP in periods of increased prevalence: August 2007 and February and March 2008. Material and methods: Twenty three strains of Acinetobacter spp. were isolated from 19 patients residing in the same period and the same hospital ward (2007–2013 strains from 11 patients, 2008–2010 strains from 8 patients). Acinetobacter isolates obtained from these patients were characterized by phenotypic methods and genotypically by arbitrarily primed PCR (AP-PCR). Results: All strains of Acinetobacter (n = 23) were multi-drug resistant. Used AP-PCR method showed 10 genotypes among the all strains. Acinetobacter spp. strains cultivated in 2007 and 2008 belonged to one genotype, came from patients hospitalized on the same wards, which confirms the transmission of infection in the patientís residence. Conclusions: The same genotype Acinetobacter baumannii strains isolated from two patients in 2007, and two patients in 2008, showed the presence of bacteria in the hospital environment. In the present study, we also established the usefulness of AP-PCR in molecular epidemiological investigations.
“Advances in Pneumonology”—Over 20 Years Long Tradition
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

“Advances in Pneumonology”—Over 20 Years Long Tradition [...]
Wolność wyboru to także odpowiedzialność za nieszkodzenie innym
Authors: Kozielski Jerzy
Published: June 2022

Rozpowszechnienie nałogu palenia tytoniu,datowane od początku ubiegłego stulecia, zmieni-ło postać i częstość występowania związanychz nim chorób [...]
Polskie Towarzystwo Chorób Płuc w latach 2006–2010
Authors: Pierzchała Władysław
Published: June 2022

Szanowni Koleżanki i Koledzy [...]
Markers of Fibrosis and Inflammation in Exhaled Breath Condensate (EBC) and Bronchoalveolar Lavage Fluid (BALF) of Patients with Pulmonary Sarcoidosis: A Pilot Study
Authors: Kowalska Anna , Puścińska Elżbieta , Czerniawska Justyna , Goljan-Geremek Anna , Czystowska Monika , Roży Adriana , Chorostowska-Wynimko Joanna , Górecka Dorota
Published: June 2022

Introduction: Sarcoidosis is a disease of unknown aetiology. Little is known of the predictive factors of fibrosis. It has been suggested that PAI-1, uPA, TGF-β1, VEGF, IL-8, TNF-α influence this process. The aim of the study was to assess airway inflammatory and fibrosis markers in EBC in sarcoidosis and the effects of fibreoptic bronchoscopy (FOB), bronchoalveolar lavage fluid (BALF), transbronchial lung biopsy (TBLB) and bronchial mu- cosa membrane biopsy on their production in the airways. Material and methods: The study group consisted of 11 patients (five women, six men, mean age 40 ± 9 yrs, mean ± SD) with sarcoidosis stage I–III. PAI-1 (ng/mL), uPA (ng/mL), TGF-β1 (pg/mL), VEGF (pg/mL), IL-8 (pg/mL), TNF-α (pg/mL) levels were measured in BALF and EBC collected before, and 48 h after, FOB. Results: No significant changes in EBC levels of VEGF, PAI-1, TGF-β1, TNF-α (respectively: 8.02 ± 4.97 pg/mL; 1.1 ± 1.2 ng/mL; 2909.7 ± 206.6 pg/mL; 10.7 ± 19.9 pg/mL) after FOB were observed when compared to baseline. In contrast, IL-8 concentration in EBC (pg/mL) decreased after FOB (0.073 ± 0.13 vs. 0.061 ± 0.1, p = 0.006) and was significantly lower than in BALF (BALF 0.95 ± 0.62, p < 0.05). Also, the mean level of VEGF was higher in BALF than in EBC both pre- and post- FOB (BALF 66.38 ± 36.95, EBC pre-FOB 6.75 ± 3.67 and EBC post-FOB 8.02 ± 4.97). A significant relationship between TNF-a in post-FOB EBC and BALF was also shown (β = 0.63, p = 0.04). Conclusions: FOB does not significantly affect levels of airway inflammation and fibrosis markers present in EBC before and after FOB; they were also comparable to the concentrations marked by BALF. The lack of correlation between marker levels in EBC and BALF indicates that these methods are not equivalent. Due to the possibility of repetition, and the less invasive, simpler method of the EBC test, it would seem reasonable to continue this research on a larger number of patients.
The Comparison between Two Methods for Typing of Nontuberculous Mycobacteria: High Pressure Liquid Chromatography and Molecular Assay Genotype Mycobacterium CM/AS
Authors: Safianowska Aleksandra , Walkiewicz Renata , Nejman-Gryz Patrycja , Chazan Ryszarda , Grubek-Jaworska Hanna
Published: June 2022

Introduction: The GenoType Mycobacterium CM and the GenoType Mycobacterium AS (HAIN Lifescience, Germany) were evaluated for the ability to differentiate mycobacterial species of clinical isolates. Serial use of the both assays is aimed to identify 38 different molecular patterns, of which 24 patterns can be assigned to single species, 10 patterns are allocated to two or more Mycobacterium species, and 4 patterns correspond to Mycobacterium species and gram-positive bacteria with a high G + C content. The analysis of mycolic acids by high pressure liquid chromatography (HPLC) was the reference method. Materials and methods: A set of 127 nontuberculous mycobacterial isolates on Loewenstein-Jensen media, derived from different patients between 1999 and 2007, was analyzed. The strains were primary classified by HPLC following the diagnostic procedure, and retyped by GenoType Mycobacterium CM/AS. Results: In total, results obtained by both methods were interpretable for 113 strains. Concordant results were obtained for 105 (93%) mycobacterial strains. One out of 8 incorcondantly classified strains, which was classified as M. abscessus/M. chelonae by HPLC, displayed a pattern of M. tuberculosis complex by a molecular method. Eleven clinical strains were differentiated only by one of used methods, either by HPLC (6 strains) or by GenoType CM/AS (5 strains). Three strains were not classified at all. Conclusions: Our results show that the GenoType Mycobacterium CM/AS system represents a useful tool to identify mycobacterial clinical isolates. The molecular system is as rapid and reliable as the HPLC, but much easier to perform and more friendly for the environment.
Recurrence of Endobronchial Lipoma
Authors: Opoka Lucyna , Lewandowska Katarzyna , Langfort Renata , Rudziński Piotr
Published: June 2022

Benign tumours of the lung and endobronchial tree are uncommon. Endobronchial lipomas are extremely rare, with an incidence ranging from 0.1 to 0.5% of all lung tumours. Endobronchial lipomas originate from fat cells located in the peribronchial (and occasionally the submucosal) tissue of the main bronchi. This paper presents the case of a patient in whom, four years after transbronchial resection of an endobronchial lipoma, recurrence of the lesion in the same lung was confirmed. The diagnosis was made on the basis of a CT scan, which detected lesions with previously identified morphology.
Zalecenia Polskiego Towarzystwa Chorób Płuc rozpoznawania i leczenia przewlekłej obturacyjnej choroby płuc (POChP)
Authors: Pierzchała Władysław , Barczyk Adam , Górecka Dorota , Śliwiński Paweł , Zieliński Jan
Published: June 2022

Pierwsze krajowe Zalecenia Postępowania w przewlekłej obturacyjnej chorobie płuc (POChP) powstały w 1998 roku z inicjatywy prof. Jana Zielińskigo i prof. Józefa Małolepszego oraz dr. Władysława Pierzchały przy wsparciu organizacyjnym firmy Boehringer Ingelheim i pracy twórczej zespołu autorów Polskiego Towarzystwa Ftyzjopneumonologicznego [...]
Active Detection of COPD in Poland in the Second Decade of XXI Century
Authors: Zieliński Jan , Bednarek Michał , Górecka Dorota
Published: June 2022

W następnym, piątym zeszycie “Pneumonolo-gii i Alergologii Polskiej” publikowane będąuwspółcześnione zalecenia rozpoznawania i leczenia przewlekłej obturacyjnej choroby płuc (POChP) [...]
Simultaneous Detection of Tumour Cells and Positive Genetic Test Results for Mycobacterium tuberculosis in Pleural Effusion
Authors: Czystowska Monika , Stokłosa Anna , Szczepulska-Wójcik Ewa , Maszkowska-Kopij Krystyna , Opoka Lucyna , Skoczylas Agnieszka , Górecka Dorota
Published: June 2022

Pleural effusion is a frequently observed lesion in the course of respiratory diseases such as inflammatory process and cancer metastasis. Its cause may be either tuberculosis (the most common extrapulmonary location is the pleura) and malignant disease of the pleura. Confirmation of tuberculosis is often troublesome. The primary site of cancer may be als difficult to find despite the application of difficult diagnostic methods. Below we present history of 79-year old female in whom carcinomatous cells and positive result of PCR for Mycobacterium tuberculosis in pleural fluid were discovered simultaneously suggesting the tuberculosis and cancer of unknown primary origin.
VII Ogólnopolska Sesja Naukowa Studenckiego Towarzystwa Naukowego Warszawskiego Uniwersytetu Medycznego “Problemy zapobiegania chorobom płuc” Warszawa, 20 marca 2010 roku
Authors: Leszczyk Marcin , Miłkowska Paulina , Domagała-Kulawik Joanna
Published: June 2022

Choroby układu oddechowego są bardzo powszechne, stanowią poważny problem zdrowotny, będąc jedną z głównych przyczyn zgonów [...]
Interstitial Lung Disease in the Course of Surfactant Protein C Deficiency Coexisting with Primary Immunodeficiency—A Case Report
Authors: Szczawińska-Popłonyk Aleksandra , Bręborowicz Anna , Langfort Renata
Published: June 2022

Interstitial lung diseases in children are a diverse group in terms of aetiology and pathogenesis. Differential diagnosis shouldinclude infectious, immune, and metabolic disorders and hereditary surfactant protein C deficiency. We report a case ofinterstitial lung disease in the course of surfactant protein C deficiency and primary humoral immunodeficiency, providing adetailed discussion of the clinical, radiological, and histological findings.
Patients with Chronic Obstructive Pulmonary Disease in the Primary Care Setting
Authors: Siatkowska Hanna , Kozielski Jerzy , Ziora Dariusz
Published: June 2022

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most important public health problems due to its high prevalence, progressive nature, and costs of treatment and care. Material and methods: We enrolled 1026 patients in our study (86.3% of the registered patients) to assess the incidence and severity of COPD, the degree of underdiagnosis, the association with smoking, and the presence of co-morbidities. Results: COPD was diagnosed in 8.1% of the subjects over the age of 40, most of whom were current or former smokers (90.3%). More than half of the subjects (61.3%) presented with mild disease, 35.5% with moderate disease, and 3.2% with severe disease. The development of COPD is most affected by the number of pack-years and age. In women, the development of COPD is associated with a smaller number of pack-years. Conclusions: We found that COPD is underdiagnosed in the primary care setting, as only 1% of the subjects carried the correct diagnosis. One of the reasons why COPD goes underdiagnosed is that doctors do not perform spirometry often enough. Cardiovascular disease is significantly more prevalent in patients with COPD.
Clinical Application of Pulmonary Function Tests in Preschool Children
Authors: Wojsyk-Banaszak Irena , Bręborowicz Anna
Published: June 2022

Pulmonary function tests are routinely used in the assessment of respiratory system in older children and adults. They have not made their way into wide clinical practice in preschool children and infants, mainly due to poor cooperation in this age group. This review discusses the use of various pulmonary function tests in preschool children in clinical setting. Issues relevant for clinical practice comprising but not limited to expressing results, within-occasion repeatability and between occasion reproducibility of various tests as well as choosing reference data are described. This paper also examines the most frequent respiratory disorders in preschool children and potential impact of pulmonary function tests results on clinical management in these patients.
The Underdiagnosis and Undertreatment of Asthma—A General Population Study of the Inhabitants of the Lodz Province in Poland
Authors: Kupryś-Lipińska Izabela , Elgalal Anna , Kuna Piotr
Published: June 2022

Introduction: Hundreds of studies investigating the epidemiology of asthma in various populations have been conducted in the past 30 years, yielding a large body of interesting data, including data on prevalence and risk factors. Less information is, however, available on the accurate diagnosis of asthma and its correct treatment. Epidemiological studies of the prevalence of asthma in the general population was conducted between 1998 and 2000 in the Lodz Province in Poland. The present analysis is an evaluation of the detectability and treatment of this disease. Material and methods: The study group consisted of 1522 randomly selected residents of the Lodz Province aged 3 to 80 years. The demographics and medical history were collected using standardised questionnaires. All the respondents underwent skin prick tests and screening spirometry. Additional diagnostic tests were performed in doubtful cases. Results: Complete data collected from 1340 subjects (1057 adults and 283 children) were included in the analysis. The prevalence of asthma was calculated at 7.3% in adults and 8.5% in children. The accurate diagnosis of asthma had not been made in 71% of symptomatic children and 49% of the adults. Forty-eight percent of adult asthmatics had not used any antiasthmatic medication in the previous 12 months. Subjects suffering from asthma had most commonly used the following drugs in the previous 12 months: β2-agonists (46.8%), anticholinergics (13%), inhalation glucocorticoids (36.4%), oral glucocorticoids (16.9%), parenteral glucocorticoids (3.9%), xanthine derivatives (33.8%) and cromones (11.7%). Conclusions: The results of this study reveal shortcomings in the healthcare system which require appropriate actions aimed at early diagnosis and improvement of allergy treatment before the patient’s health deteriorates irreversibly.
Common Variable Immunodeficiency Mimicking Granulomatous Diseases Needs to Fulfill Diagnostic Criteria. Commentary to the Article of Modrzewska K. et al. “Common Variable Immunodeficiency in a Patient with Suspected Sarcoidosis”
Authors: Gonzalez-Granado Luis Ignacio
Published: June 2022

I have read with great interest the case reported by Modrzewska K., Wiatr E., Langfort R., Oniszh K., Roszkowski-Śliż K. in the journal [...]
Diagnostic Utility of the Molecular Assay Genotype MTBC (HAIN Lifescience, Germany) for Identification of Tuberculous Mycobacteria
Authors: Safianowska Aleksandra , Walkiewicz Renata , Nejman-Gryz Patrycja , Chazan Ryszarda , Grubek-Jaworska Hanna
Published: June 2022

Introduction: The GenoType system (HAIN Lifescience, Germany) offers new perspectives of detecting the tuberculous and non-tuberculous mycobacteria at the molecular level. The system compromises five independent tests that could be performed either on direct specimens or isolated strains, to identify the strains and test the resistance against rifampin and isoniazid. Up to now, non GenoType test was applied in Poland. The aim of the study was an evaluation the accuracy of GenoType MTBC test in speciation of the clinical isolates, previously classified as M. tuberculosis complex by HPLC analyze of mycolic acids. Material and methods: 161 clinical isolates, derived from the TB patients hospitalized in the Warsaw Medical University Hospital between 1999 and 2007 were assayed. Results: On the basis of the hybridization patterns, all 161 studied strains were identified as M. tuberculosis/M. canettii. Conclusions: 1. The GenoType MTBC test (HAIN Lifescience, Germany) precisely recognizes M. tuberculosis complex. The 100% accordance in speciation of M. tuberculosis by the GenoType MTBC test as compared to HPLC method was demonstrated. The GenoType MTBC test can replace HPLC in detection of tuberculous mycobacteria in clinical isolates. 2. As the GenoType MTBC test performs well, the other tests of GenoType system may be considered to be verified indiagnostic procedure of mycobacterial infection.
Choroby i Stany Przebiegające z Podwyższonym Stężeniemimmunoglobuliny E w Surowicy
Authors: Nowicka Urszula
Published: June 2022

Immunoglobulina E (IgE), po raz pierwszy opisana w 1967 roku, występuje w surowicy w najniższym stężeniu spośród wszystkich krążących immunoglobulin. Stężenie IgE jest niskie przy urodzeniu, ale stopniowo wzrasta, osiągając szczyt około 10.–15. roku życia. U osób z predyspozycją do atopii stężenie IgE wykazuje zwykle wcześniejszy stopniowy wzrost. Od drugiej do ósmej dekady życia jej stężenie obniża się. Podwyższenie stężenia IgE w surowicy jest zwykle łączone z obecnością chorób atopowych. Istnieje jednak wiele innych zespołów chorobowych, w przebiegu których może występować podwyższone surowicze stężenie IgE (m.in. w zakażeniach, chorobach nowotworowych, niedoborach immunologicznych, chorobach skóry i chorobach zapalnych). W pracy omówiono stany i choroby przebiegające z podwyższonym stężeniem IgE w surowicy.
Antiphospholipid Syndrome—An Update on Diagnosis and Treatment
Authors: Szturmowicz Monika
Published: June 2022

Antiphospholipid syndrome (APS) was described by Hughes et al in 1986 and then by Harris et al in 1987. The symptoms of disease are related to the presence of autoantibodies directed against plasma and serum proteins that form complexes with phospholipids of cell membranes. The immunologic process involving vascular endothelium, thrombocytes and coagulation factors is responsible for enhancement of procoagulation mechanisms and as a result—venous and arterial thrombosis. Actual criteria of recognition of APS were published in 2006 as a result of 11th International Congress on Antiphospholipid Antibodies which was taking place in 2004 in Sydney. Multiorgan symptoms of disease, criteria of recognition and methods of treatment were discussed in the present paper.
The Usefulness of Induced Sputum Examination in the Diagnostic Evaluation of Selected Chronic Inflammatory Diseases of the Respiratory Tract
Authors: Sozańska Ewa , Barczyk Adam , Biedroń-Machura Marta , Pierzchała Władysław
Published: June 2022

Introduction: Based on the normal values for inflammatory cell counts in induced sputum produced by healthy individuals living in the region of Silesia, Poland, we assessed the usefulness of cytological examination of induced sputum in the diagnostic evaluation of asthma, chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Material and methods: We analyzed the results of examinations performed in 96 healthy individuals (controls), 42 patients with asthma, 49 with COPD and 30 with chronic bronchitis. We performed spirometry with salbutamol reversibility testing and examination of induced sputum in all the subjects. Those without contraindications underwent methacholine challenge testing. Results: We found a significantly elevated percentage of eosinophils in all the patient groups compared to the controls (p < 0.00001). Median values were 10.3% for asthma, 1.5% for COPD, 1.6% for chronic bronchitis and 0.3% for the controls. We found statistically significant differences in the mean neutrophil percentages in induced sputum between healthy individuals and asthma patients, COPD patients and chronic bronchitis patients (p < 0.05). The median values were 45.75%, 38.1%, 77.5% and 58.1%, respectively. The percentage of subjects with positive eosinophil counts (>2.8%) in the sputum of patients with asthma, COPD, chronic bronchitis and in the controls was 85%, 38%, 20% and 6%, respectively. Conclusions: 1. Cytological examination of induced sputum is a good test supporting the diagnostic evaluation of chronic inflammatory diseases of the respiratory tract. 2. The percentage of eosinophils in induced sputum exceeding 2.8% is a very good indicator of asthma.
Medical Students’ Attitudes towards Tobacco Smoking at the First and Sixth Year of Their Studies 2002–2008
Authors: Siemińska Alicja , Jassem-Bobowicz Joanna , Uherek Maja , Wilanowski Tomasz , Nowak Radosław , Jassem Ewa
Published: June 2022

Introduction: The prevalence of smoking among medical students indicates that studying medicine is an insufficient protection from tobacco use. The aim of the study was an analysis of medical students’ attitudes towards smoking at the first and sixth year of their studies. Material and methods: A questionnaire on tobacco smoking was distributed among medical students of the study year 2002–2008 at the first and sixth year of their studies. The questionnaire used on the sixth year students included additional questions designed to assess changes in their attitudes towards smoking during their studies, to ask their opinion of the teaching of diagnostics and treatment of tobacco dependence (TD), and to discover how they evaluated their knowledge of the issue. The numbers of students who participated at the two points of the study were 287 and 175 respectively. Results: Students in their sixth year significantly less frequently smoked cigarettes regularly than those starting their medical education (13% v. 21%; p = 0.022). However, 20% of smokers started smoking during their studies. The proportion of smokers saying they were not embarrassed by their smoking habit was significantly lower among sixth-year students compared to first-year students (31% v. 70%; p = 0.0006), as were the numbers who said they wanted to quit smoking (91% v. 61%). Those who wished to undergo treatment for TD (54% v. 22%) were significantly higher among sixth year students group (p = 0.013 and p = 0.001, respectively). More than half (57%) the sixth-year students claimed that they had no knowledge of the diagnostics and treatment of TD, or that their knowledge on this issue was poor or very poor. In the opinion of 43% of students, the medical curriculum was not a good source of knowledge on TD. Conclusions: Medical studies induce positively students’ attitudes towards smoking. However, a proportion of individuals start smoking during studies, which may suggest dominance of genetic influences on smoking initiation in this period of life. In sixth-year students’ opinion, medical studies are not a sufficient source of knowledge on TD.
Peritoneal Tuberculosis Mimicking Ovarian Cancer—Diagnostic Difficulties. A Report of Two Cases
Authors: Zamłyński Jacek , Olejek Anita , Oleś Ewa , Stęplewska Katarzyna , Krzywiecki Andrzej , Myrcik Grażyna , Bodzek Piotr , Paliga-Żytniewska Marta , Gajewska Alicja
Published: June 2022

Tuberculosis, and particularly its extrapulmonary location, still causes diagnostic difficulties. In 2007, 7.3% of newly registered cases of tuberculosis in Poland were located extrapulmonarily. Peritoneal tuberculosis is often misdiagnosed as ovarian cancer due to similar symptoms such as: abdominal pain, abdominopelvic masses, ascites and elevated CA-125 serum concentration. We present reports of two patients with suspected ovarian cancer at admission. The patients’ complaints, as well as elevated serum levels of CA-125, suggested ovarian cancer. Chest X-rays showed a normal picture in one case and minimal fibrotic changes in the other. The results of additional tests were uncharacteristic. Based on the data obtained by diagnostic laparoscopy, observed clinical symptoms and the intraoperative picture, which all suggested ovarian cancer, a resection (total abdominal hysterectomy and bilateral salpingo-oophorectomy) was performed in both cases. Histological evaluation of biopsy specimens revealed peritoneal tuberculosis in both cases.
Niegenomowy mechanizm działania glikokortykosteroidów
Authors: Grzanka Alicja , Jarząb Jerzy
Published: June 2022

W pracy przedstawiono aktualną wiedzę dotyczącą mechanizmów działania glikokortykosteroidów (GK). Zgodnie z klasycznym modelem działania, określanym jako genomowy, GK wpływają (bezpośrednio lub pośrednio) na transkrypcję i translację genów kodujących mediatory procesu zapalnego. Aktualne badania podkreślają jednak znaczenie nietranskrypcyjnych oddziaływań GK, które ujawniają się szybko—od kilkunastu sekund do kilkunastu minut. W niegenomowym mechanizmie działania GK zasadniczą rolę odgrywają interakcje z receptorami GK zlokalizowanymi w cytoplazmie, ale przede wszystkim w błonie komórkowej, które aktywują wiele szlaków sygnałowych kinaz (MAPK, Src, PI3K) i kanałów jonowych, a także szlaki sygnałowe związane z receptorami sprzężonymi z białkiem G. Udowodniono także przekaz sygnału bez udziału receptora dla GK. Odkrycie niegenomowego mechanizmu GK pozwala lepiej zrozumieć ich przeciwzapalne i immunosupresyjne działanie.
Mikroangiopatia płucna w przebiegu cukrzycy
Authors: Kuziemski Krzysztof , Górska Lucyna , Jassem Ewa , Madej-Dmochowska Aleksandra
Published: June 2022

Cukrzyca jest schorzeniem metabolicznym, charakteryzującym się przewlekłą hiperglikemią oraz nieprawidłową przemianą węglowodanów, białek i tłuszczów. To zaburzenie metabolizmu wynika z upośledzonego wydzielania insuliny, niewłaściwego oddziaływania insuliny na tkanki lub współistnienia obu mechanizmów jednocześnie. Długotrwała cukrzyca prowadzi do rozwoju mikroi/ lub makroangiopatii, co może wywierać niekorzystny wpływ na czynność wielu narządów. Mikroangiopatia dotyczy szczególnie narządu wzroku (retinopatia), nerek (nefropatia) i obwodowego układu nerwowego (neuropatia). Mało poznany pozostaje wpływ mikroangiopatii cukrzycowej na czynność płuc. Nieliczne dostępne badania donoszą o ograniczeniu rezerw wentylacyjnych układu oddechowego i upośledzeniu pojemności dyfuzyjnej płuc dla tlenku węgla u chorych na cukrzycę zarówno typu 1, jak i 2. Może to świadczyć o uszkodzeniu bariery pęcherzykowo-włośniczkowej w płucach w przebiegu cukrzycy. W pracy przedstawiono przegląd dostępnego piśmiennictwa dotyczącego mikroangiopatii płucnej i jej wpływu na stan czynnościowy układu oddechowego.
Recenzja książki prof. dr hab. Lidii Bernadety Brydak "Grypa. Pandemia grypy—Mit czy realne zagrożenie?"
Authors: Deptuła Wiesław
Published: June 2022

To trzecie już wydanie monografii na temat grypy autorstwa profesor Lidii Bernadety Brydak [...]
D-dimer in Diagnosis and Treatment of Pulmonary Embolism
Authors: Fijałkowska Anna
Published: June 2022

D-dimer level estimation, specific fibrin degradation product, is a permanent part of diagnostic strategies of pulmonary embolism (PE). Approximetly 30% of a suspected non-high risk PE can be ruled out with high sensitive D-dimer test when pre-test clinical probability is non-high. Recent guidelines underline that only very sensitive DD assays can be used. The main limitation of DD tests is relatively low specificity especially in hospitalized population, in elder patients, with cancer and in pregnancy. New indication for DD test mentioned in current guidelines is estimation of risk of recurrence after withdrawal of anticoagulant. Negative DD test identify patients with low risk of recurrence.
100 Years of Sanatorium in Rudka—Report of Celebration of Anniversary
Authors: Zielonka Tadeusz M.
Published: June 2022

Sto lat nieprzerwanej działalności na rzecz pacjentów z chorobami płuc to wielki jubileusz, który jest ważnym wydarzeniem dla całego środowiska pneumonologicznego [...]
Author’s Response to Commentary of T.M. Zielonka “Smoking and Interstitial Lung Disease?”
Authors: Wiatr Elżbieta
Published: June 2022

Przedstawiony komentarz stanowi uzupełnienie opublikowanej pracy [...]
Chronic Obstructive Pulmonary Disease and Risk of Infection
Authors: Lange Peter
Published: June 2022

This review article focuses on the risk of infections in patients with chronic obstructive pulmonary disease (COPD). Throughout the years there have been a number of studies describing the risk of pulmonary infections in patients with COPD, whereas only few studies have focused on the risk of infection outside the lungs. With increasing severity of COPD the risk of respiratory tract infection also increases. The impairment of the innate immune system is most likely responsible for both the colonization of respiratory tract with bacteria and for an increased risk of infection with new strains of bacteria causing acute exacerbations. Also lung infections like pneumonia, lung abscess and empyema are more often seen in patients with COPD than in healthy subjects. With regard to extrapulmonary infections, it seems that COPD patients are not at higher risk of infection compared with subjects without COPD. It is concluded that COPD is significantly associated with an increased risk of various respiratory tract infections, but not with infections outside the respiratory system.
The Usefulness of CD203c Expression Measurement on Basophils after Activation with Grass Pollen and Dermatophagoides pteronyssinus Antigens. Preliminary Study
Authors: Potapińska Olga , Górska Elżbieta , Zawadzka-Krajewska Anna , Kulus Marek , Wąsik Maria , Demkow Urszula
Published: June 2022

Introduction: 'Gold standard' in the diagnosis of atopic disease are skin prick tests and specific IgE evaluation. Well-established in vitro tests, such as the histamine release test, the leukotriens release test and the flow cytometric basophil activation test can be very helpful in diagnostics, especially when the skin prick test is contraindicated. The aim of this study was to evaluate the usefulness of antigen CD203c expression, as a marker of basophil activation by grass pollen or D. pteronyssinus antigens. Material and Methods: Peripheral blood from 13 allergic patients and nine healthy volunteers was analysed. Basophils activation was measured by the breakdown of antigen CD203c expression with Allergenicity Kit (Beckman Coulter), using Cytomics FC 500 flow cytometer (Beckman Coulter). Results: The sensitivity was 92,3% and specificity of test was 100%. 50.95 ± 15.7% of basophils (median 49.7%, 1.91–72.42%) were activated after grass pollen stimulation in atopic patients sensitised to this allergen, in comparison to 1.91% (0.00–7.96%) in control patients (p = 0.002). The percentage of activated basophils after D. pteronyssinus antigens stimulation was 40.6 ± 25.2% in allergic patients, compared to only 2.51 ± 1 96% of basophils from non-atopic controls (p = 0.0003). Basophils from 21 patients responded after anti-IgE stimulation (44.1 ± 18.9%), and none of the analysed samples was activated after PBS stimulation (2.03 ± 1.19%, p < 0.0001). Conclusions: These results demonstrate that basophil activation test based on antigen CD203c expression is very accurate in the diagnosis of atopic diseases.
The Epidemiology of Atopic Dermatitis in the General Population of the Lodz Province’s Citizens
Authors: Kupryś-Lipińska Izabela , Elgalal Anna , Kuna Piotr
Published: June 2022

Introduction: It is estimated that 12–26% of the European population is suffering from atopic dermatitis. The aim of the study was to determine the prevalence of atopic dermatitis in the general population of the Łódź province in Poland and to attempt to identify the risk factors for this disease. Material and Methods: We investigated a randomly selected group of 1522 inhabitants of the Łódź province aged between 3 and 80 years. The demographic and anamnestic data were collected by means of standardised questionnaires. Skin prick testing was performed with 10 aeroallergens commonly occurring in Poland. Results: We analysed complete data sets from 1340 (283 children and 1057 adults). The prevalence of atopic dermatitis was estimated at 9.2% in children and 0.9% in adults. Family history of atopy and exposure to tobacco smoke were found to be strong risk factors of atopic dermatitis (OR 3.69 and 3.40, respectively). The difference in the prevalence of atopic dermatitis between inhabitants of the city centre and inhabitants of rural areas was observed only in adults, while children inhabiting both types of area were characterised by the same high prevalence rate. We found that 38% of the children and 10% of the adults had not been correctly diagnosed with atopic dermatitis prior to this epidemiological study. Conclusions: The results of our epidemiological study show that atopic dermatitis has become a significant health, social and economic problem. The equalisation of the prevalence rates of atopic dermatitis in inhabitants of rural and urban areas may reflect an increase in the prevalence of other atopic diseases in this population and the disappearance of differences between rural and urban areas.
Dilemmas in the Curative Treatment of Lung Cancer in the Elderly Patients
Authors: Kępka Lucyna
Published: June 2022

Patients aged 70 years and older accounted for 42% of all lung cancer deaths in Poland in 2005. Although the incidence of lung cancer in elderly people is growing in Poland, like in other developed countries, the standards of treatment for this subset of population are not well established. Prospective elderly-specific trials concerning curative treatment are lacking. The results from prospective trials including elderly participants show similar effectiveness as in younger population at the expense of higher toxicity. Selection bias may limit the ability to generalize results of clinical trials to the entire population of elderly people. Methods of curative treatment (surgery, radiotherapy, chemotherapy as adjuvant for non-small cell lung cancer and basic treatment for limited-stage small cell lung cancer) are discussed. Some treatment options and modifications of standard strategies which are particularly promising in elderly patients, as VADS surgery, stereotactic radiotherapy or abbreviated treatment for SCLC, are presented.
Tuberculosis after Renal Transplantation
Authors: Korzeniewska Anna , Dyła Tomasz , Kosacka Monika , Jankowska Renata
Published: June 2022

Renal transplant recipients carry a relatively high risk of developing tuberculosis (TB). In most cases, active TB is the result of reactivation of a latent infection and is located in the lungs. In these patients, clinical presentation of TB can often be atypical and there is a high risk of dissemination and high mortality rates. Therefore, the use of invasive procedures for proper diagnosis is recommended, as well as anti-tuberculosis therapy instituted whenever there is a strong suspicion of TB on clinical grounds, even without microbiological evidence. The treatment of active TB in renal transplant recipients should be the same as in the general population. To avoid graft rejection, blood levels of calcineurin inhibitors should be monitored closely. Prophylaxis is recommended for high-risk patients.
Treatment Outcomes in Culture-Positive Pulmonary Tuberculosis
Authors: Siemion-Szcześniak Izabela , Kuś Jan
Published: June 2022

Introduction: The aim of the study was to evaluate treatment outcomes in sputum culture positive patients with tuberculosis in three Polish provinces (Warsaw, Gdansk and Siedlce Provinces) in 1995 and again in 2000. We also assessed whether the implementation of the Directly Observed Therapy Short Course (DOTS) strategy in the former Gdansk Province led to improved outcomes compared to the outcomes observed in 1995, when this strategy was not being followed. Material and methods: We started the study by reviewing microbiology registers covering the years 1995 and 2000 from all the tuberculosis laboratories in three provinces (Warsaw, Gdansk and Siedlce Provinces) and identified sputum culture positive patients. We then reviewed inpatient and outpatient medical records of patients who had been with pulmonary tuberculosis diagnosed and confirmed by bacteriology in 1995 and 2000. Treatment outcomes were evaluated in accordance with the World Health Organisation (WHO) recommendations and classified as: cure, treatment completed, default, treatment failure, death or other. Results: A total of 708 patients were included in the study: 373 diagnosed in 1995 and 335 diagnosed in 2000. According to the WHO criteria, the treatment success rate (the sum of cures and treatment completions) in 1995 and 2000 was 58.8% and 54.0%, the default rate was 15.5% and 17.9%, the failure rate was 2.4% and 2.7% and the death rate was 5.6% and 6.3%, respectively. The rate of outcomes classified as “other” was 18.2% and 22.1%, respectively. Following the implementation of the DOTS strategy in Gdansk Province, treatment outcomes in significantly improved in 2000 compared to the year 1995. The treatment success rate was 89.6% vs. 69.3% (p = 0.0037), the default rate was 0.0% vs. 14.7% (p = 0.0005) and the death rate was 0.0% vs. 9.3% (p = 0.0184). Conclusions: The treatment success rate (the rate of cures and treatment completers) in 1995 and 2000 was 58.8% and 54.0% and was lower than that recommended by WHO (at least 85%). The results demonstrated that the treatment outcomes in the former Gdansk Province in 2000, following the implementation of the DOTS strategy, were significantly better than those in 1995, when the strategy was not being followed. Treatment success was observed in 89.6% and 69.3% of the patients, respectively (p = 0.0037).
PROGRAM SZCZEGÓŁOWY
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

From Chronic Obstructive Pulmonary Disease (COPD) to Chronic Systemic Inflammatory Syndrome (CSIS) [...]
Nowe możliwości diagnostyki utajonego zakażenia prątkiem gruźlicy
Authors: Kruczak Katarzyna , Niżankowska-Mogilnicka Ewa
Published: June 2022

Dotychczas jednym z ważnych narzędzi diagnostycznych zakażenia prątkiem gruźlicy był skórny odczyn tuberkulinowy—jest on jednak mało swoisty i mało czuły. W niniejszym artykule omówiono nowe testy w diagnostyce utajonej infekcji gruźliczej oraz czynnej postaci choroby. Zasada ich działania opiera się na pomiarze interferonu gamma (IFN-γ) wydzielanego przez limfocyty T po stymulacji przez antygeny swoiste dla prątka gruźlicy: ESAT-6, CFP-10. Omówiono czułość i swoistość testów QuantiFERON-TB Gold oraz T-SPOT.TB zarówno w zakażeniu, jak i w czynnej postaci choroby, porównanie ich z tuberkulinowym testem skórnym oraz problem niezgodności wyników otrzymanych za pomocą tych testów.
Adult Form of Pompe Disease
Authors: Ziółkowska-Graca Bożena , Kania Aleksander , Zwolińska Grażyna , Niżankowska-Mogilnicka Ewa
Published: June 2022

Pompe disease (glycogen-storage disease type II) is an autosomal recessive disorder caused by a deficiency of lysosomal acid α-glucosidase (GAA), leading to the accumulation of glycogen in the lysosomes primarily in muscle cells. In the adult form of the disease, proximal muscle weakness is noted and muscle volume is decreased. The infantile form is usually fatal. In the adult form of the disease the prognosis is relatively good. Muscle weakness may, however, interfere with normal daily activities, and respiratory insufficiency may be associated with obstructive sleep apnea. Death usually results from respiratory failure. Effective specific treatment is not available. Enzyme replacement therapy with recombinant human GAA (rh-GAA) still remains a research area. We report the case of a 24-year-old student admitted to the Department of Pulmonary Diseases because of severe respiratory insufficiency. Clinical symptoms such as dyspnea, muscular weakness and increased daytime sleepiness had been progressing for 2 years. Clinical examination and increased blood levels of CK suggested muscle pathology. Histopathological analysis of muscle biopsy, performed under electron microscope, confirmed the presence of vacuoles containing glycogen. Specific enzymatic activity of α-glucosidase was analyzed confirming Pompe disease. The only effective method to treat respiratory insufficiency was bi-level positive pressure ventilation. Respiratory rehabilitation was instituted and is still being continued by the patient at home. A high-protein, low-sugar diet was proposed for the patient. Because of poliglobulia, low molecular weight heparin was prescribed. The patient is eligible for experimental replacement therapy with rh-GAA.
Wskazówki metodologiczne Polskiego Towarzystwa Chorób Płuc odnośnie do wykonywania i oceny plwociny indukowanej
Authors: Chmielowicz Beata , Obojski Andrzej , Barczyk Adam , Sozańska Ewa , Kycler Zdzisława , Demkow Urszula , Domagała-Kulawik Joanna
Published: June 2022

W miarę rozwoju metod diagnostycznych pojawia się potrzeba tworzenia precyzyjnych zasad wykonywania badań [...]
Choroby Śródmiąższowe Związane z Paleniem Tytoniu
Authors: Wiatr Elżbieta
Published: June 2022

Wśród chorób związanych z paleniem tytoniu znajdują się choroby o ustalonym związku przyczynowo-skutkowym, jak POChP czy rak płuca [...]