bluuebunny/crossref_metadata_2025 huggingface dataset:
Catamenial Pneumothorax, Clinical Manifestations—A Multidisciplinary Challenge
Authors: Majak Peter , Langebrekke Anton , Hagen Ole , Qvigstad Erik
Published: June 2022

Introduction: Pleural endometriosis is a rare condition. Spontaneous, recurring pneumothorax occurring during menstruation, referred to as catamenial pneumothorax, is associated with pleural endometriosis. A multidisciplinary approach is needed for a successful result. Material and methods: During the last five years (2005–2010), we have treated six patients with menstruation related pneumothorax at Oslo University Hospital. The surgical treatment was performed by the thoracic surgery department but the medical follow-up was carried out by the gynecological and pulmonary medicine departments. Results: We report three of the patients treated. All three patients were premenopausal, aged 19–36, and had recurring, menstruation related, spontaneous pneumothorax, predominantly on the right side. The condition was treated by various surgical approaches, including chest tube drainage, video assisted thoracic surgery, chemical pleurodeses and thoracotomy. Conclusions: Spontaneous, recurring pneumothorax in women with no previous history of endometriosis can be the first manifestation of pleural endometriosis. The disorder requires surgical intervention, but early diagnosis and postoperative hormonal therapy are just as important for a successful outcome.
Kiedy zaczyna się uzależnienie od nikotyny?
Authors: Siemińska Alicja
Published: June 2022

Używanie tytoniu w krótkim czasie prowadzi do uzależnienia od nikotyny. Mechanizmy tego procesu pozostają nie do końca poznane, ważnym pytaniem jest także, w którym momencie uzależnienie się zaczyna. W artykule przedstawiono powszechnie przyjętą definicję uzależnienia od nikotyny (wg Diagnostic and Statistical Manual of Mental Disorders Fourth Edition i International Statistical Classification of Diseases and Health Related Problems Tenth Revision) oraz jej ograniczoną przydatność w wykrywaniu pierwszych objawów tego procesu. Omówiono także koncepcję wiążącą początek uzależnienia z utratą niezależności od palenia (tzw. teoria autonomii), wyniki badań w znacznym stopniu tę koncepcję potwierdzające oraz neurofizjologiczny model sensytyzacji-homeostazy rozwoju uzależnienia od nikotyny. Przedstawiono także wyniki badań na zwierzętach, potwierdzających wiele aspektów teorii sensytyzacji-homeostazy, mimo że samo zjawisko sensytyzacji nie zostało udowodnione u ludzi. Zwrócono także uwagę na przydatność testu Hooked on Nicotine Checklist w rozpoznawaniu pierwszych objawów uzależnienia od nikotyny w grupie młodzieży.
MDR, Pre-XDR and XDR Drug-Resistant Tuberculosis in Poland in 2000–2009
Authors: Kozińska Monika , Brzostek Anna , Krawiecka Dorota , Rybczyńska Małgorzata , Zwolska Zofia , Augustynowicz-Kopeć Ewa
Published: June 2022

Introduction: Tuberculosis (TB) is a curable disease and its spread can be prevented by using appropriate diagnostics methods and effective treatment. The obstacle to the rapid eradication of the disease from a population may be strainsresistant to essential and most effective antibiotics. In many places in the world MDR, pre-XDR and XDR-TB was reported. These forms of TB do not respond to the standard six-month treatment with first-line anti-TB drugs and the therapy should be conducted two years or more with drugs that are less potent, more toxic and much more expensive. Material and methods: This study included MDR-TB strains isolated from 297 patients in 2000–2009. To determine the XDR-TB population structure, the 19 isolates were genotyped by spoligotyping and MIRU-VNTR (mycobacterial interspersed repetitive units-variable number of tandem repeats) method. Results: Among 297 MDR-TB cases, 36 (12.1%) were pre-extensively drug-resistant (pre-XDR), 19 (6.4%) were XDR and 1 (0.3%) was pre-totally drug-resistant (pre-TDR). Four of the 19 XDR isolates exhibit a unique spoligopattern, while the rest 15 belonged to one of 5 clusters. The MIRU-VNTR analysis reduced the number of clustered isolates to 11. Conclusions: The study documented the emergence of pre-extensively and extensively drug-resistant tuberculosis in Poland among patients with multidrug-resistant TB. Genotyping methods showed clonal similarity among XDR strains and may suggest the possible transmission among patients with newly diagnosed and with recurrent TB.
World Spirometry Day
Authors: Tomalak Waldemar , Czajkowska-Malinowska Małgorzata
Published: June 2022

The most important world organizations forrespiratory medicine specialists: the European Re-spiratory Society (ERS), the American ThoracicSociety (ATS), the Asia-Pacific Respiratory Socie-ty (APRS), the Pan African Thoracic Society(PATS), the Latin American Thoracic Society(ALAT), the International Union Against Tubercu-losis and Lung Disease (IUATLD), and many others,declared 2010 to be ‘The Year of the Lung’ [...]
Diagnostic Value of Induced Sputum in Interstitial Lung Disease
Authors: Sobiecka Małgorzata , Kuś Jan , Jóźwik Adam , Demkow Urszula , Filewska Małgorzata , Szołkowska Małgorzata
Published: June 2022

Introduction: Although induced sputum (IS) has recently been used in studies of interstitial lung disease (ILD), there havebeen few reports on studies investigating the usefulness of this method in the differential diagnosis of ILD. The aim of ourstudy was to determine the diagnostic value of differential cell counts and CD4+/CD8+ ratio in induced sputum frompatients with sarcoidosis and other ILDs. Material and methods: We enrolled 59 patients in the study (36 with sarcoidosis, 16 with hypersensitivity pneumonitis[HP] and seven with idiopathic pulmonary fibrosis [IPF]). Sputum was induced a minimum of seven days following BAL byinhalation of 5% NaCl solution for five minutes and repeated four times. Differential cell count was determined in Giemsastained cytospins by counting 400 mononuclear cells for specific cell types per slide. The analysis of T-cell subtypes wascarried out by flow cytometry. The potential for differentiating sarcoidosis from the other ILDs was checked by determiningthe predictive value for CD4+/CD8+ ratio or by using the object classification method based on the k-nearest neighbour(k-NN) rule. The variables used in the k-NN rule were the following parameters of IS: cell viability, total cell count,percentages of macrophages, lymphocytes, neutrophils, eosinophils, CD4+ lymphocytes and CD8+ lymphocytes, and theCD4+/CD8+ ratio. Results: Evaluation of IS was possible in 33 patients (15 with sarcoidosis, 11 with HP and seven with IPF). A CD4+/CD8+ratio in IS exceeding 2.6 had a sensitivity of 100%, and a specificity of 72% with the likelihood of establishing the correctdiagnosis while differentiating sarcoidosis from HP and IPF. On the other hand, when we used the k-NN rule, the likelihood ofestablishing the correct diagnosis was 79% (with an estimated classification error of 21%). Conclusion: Using the object classification method based on the k-NN rule in the differential diagnosis of sarcoidosis, HPand IPF on the basis of all the IS parameters is not associated with a higher likelihood of establishing the correct diagnosisthan the analysis of CD4+/CD8+ ratio alone.
Konsolidujące leczenie systemowe w zaawansowanym niedrobnokomórkowym raku płuca
Authors: Duchnowska Renata
Published: June 2022

Standardowym postępowaniem w zaawansowanym niedrobnokomórkowym raku płuca jest paliatywna chemioterapia, ale jej wyniki nie są zadowalające. W większości przypadków przeprowadza się kilka cykli leczenia, ponieważ nie ma dowodów, że przedłużanie go przynosi istotną kliniczną korzyść. W ostatnich latach duże zainteresowanie wzbudziło nowe podejście do leczenia podtrzymującego, polegające na jego kontynuowaniu z użyciem leków cytotoksycznych o udowodnionej skuteczności w II linii leczenia, takich jak docetaksel i pemetreksed lub leków molekularnie ukierunkowanych (erlotynib, gefitynib, cetuksymab i bewacyzumab). W pracy przedstawiono obecny stan wiedzy dotyczący tej strategii leczniczej, uwzględniający wyniki najważniejszych badań klinicznych z losowym doborem chorych oraz ich metaanaliz.
Is Prediction of the Allergic March Possible on the Basis of Nasal Cytology?
Authors: Nowacki Zygmunt , Neuberg Jolanta , Strzałka Krystyna , Szczepanik Magdalena , Szczepanik Renata , Mazurek Henryk
Published: June 2022

Introduction: The term allergic march has been used to describe natural evolution of the atopic disease in children, accompanied by the change in organ manifestation with time. The aim of the study was to analyze the role of the cellular components of the nasal cytology as a tool for prediction of atopic diseases and clinical symptoms preceding allergic march. Material and methods: In a retrospective manner out of a group of 1620 children, 146 symptomatic children (60 girls and 86 boys) meeting inclusion criteria (age below 4 years at first visit, symptoms suggesting allergy, nasal cytology performed at the beginning of observation, observation of at least 4 years) were included in analysis. Results: Mean age of children at time of enrollment was 27 months (SD 10 months). After 4 years allergic rhinitis (AR) was diagnosed in 85 children (58.2%), atopic eczema/dermatitis syndrome (AEDS) in 51 (34.9%) and asthma in 48 (32.9%). Non-allergic etiology was identified in 36 patients (22.5%). All patients with asthma suffered from AR. Significant differences between groups were found in number of eosinophils (p < 0.001), neutrophils (p < 0.001), and lymphocytes (p = 0.028) in cytological examination of nasal mucosa. In children with AR (alone or combined with other comorbidities) nasal eosinophilia was higher than in children with AEDS (18% v. 3%; p = 0.004) or non-allergic disease (18% v. 4%; p < 0.001). Nasal eosinophilia of at least 8% was predictive for development of AR (sensitivity 80%, specificity 95%). Conclusions: In children below 4 years nasal eosinophilia ≥ 8% was predictive for AR development. Allergic march was observed in children with AEDS or/and gastrointestinal allergy symptoms present at the beginning of observation. Nasal eosinophilia in small children might be predictive for the risk of allergic march.
The Influence of Inflammatory Process on the Ventilatory Impairment in Patients with Stable Chronic Obstructive Pulmonary Disease
Authors: Komnata Krystyna
Published: June 2022

Introduction: At present, COPD is known to be a systemic disease resulting from generalized inflammation which affects the function of many organs. Generalized inflammation is recognized from increased serum concentration of inflammatory cytokines. The aim of the present study was to investigate the influence of inflammatory process on the respiratory impairment in patients with stable chronic obstructive pulmonary disease. Material and methods: A group of 60 stable COPD patients (GOLD stages I–IV) participated in the study. Inclusion criteria were: confirmed diagnosis of chronic obstructive pulmonary disease, clinical stable state, established treatment which had not been changed for at least 3 months prior to the study or in the course of the study. Exclusion criteria included coexistence of other diseases and/or medication causing an increase of markers of inflammation. In all patients inflammatory markers (serum concentration of fibrinogen, hs-CRP, IL-6, TNF-α) were determined. In order to assess the stage of COPD, bodyplethysmography with bronchodilating test was conducted and lung hyperinflation parameters were assessed. Results: Analysis of relationship between markers of systemic inflammation and spirometry variables revealed a significant negative correlation between the level of hs-CRP and signs of hyperinflation; IC% of predicted value (rs = –0.29; p = 0.023) and IC/TLC (rs = –0.32; p = 0.014). The IC/TLC index also tended to be related to the concentration of fibrinogen. Higher fibrinogen concentrations were associated with lower IC/TLC values, albeit without statistical significance (rs = –0.23; p = 0.074). There was a positive relationship between serum concentration of TNF-α and arterial blood carbon dioxide pressure PaCO2 (r = 0.281; p = 0.03) as well as right ventricle systolic pressure RVSP in echocardiography (r = 0.332; p = 0.01). Conclusions: Severity of hyperinflation progression may be associated with the increase of inflammatory process in patients with stable COPD. Inflammatory process may have an adverse affect on the respiratory system increasing signifi- cantly static lung hyperinflation.
Doktor Marian Borsuk—Ordynator Oddziału Chirurgicznego Szpitala Wolskiego (1907–1923)
Authors: Grzegorczyk Franciszek
Published: June 2022

Marian Stanisław Borsuk urodził się w 1860 roku w majątku Dowcewicze [...]
Skuteczność i bezpieczeństwo indakaterolu—Nowego długodziałającego β₂-mimetyku
Authors: Chazan Ryszarda
Published: June 2022

U chorych na astmę rekomenduje się obecnie terapię skojarzoną: glikokortykosteroid wziewny plus β₂-mimetyk długodziałający (LABA), a u chorych na przewlekłą obturacyjną chorobę płuc różne grupy długodziałających leków rozkurczowych. U chorych, u których występują objawy, należy zawsze rozważyć leczenie długodziałającymi lekami rozszerzającymi oskrzela. Wprowadzenie leków, które można stosować jeden raz dziennie, poprawia stosowanie się do zaleceń i jest preferowaną przez większość chorych metodą leczenia. Nowy LABA—indakaterol—cechuje się szybkim początkiem i długim czasem działania. Skuteczność i bezpieczeństwo indakaterolu oceniano w licznych badaniach klinicznych. Wyniki tych badań wskazują na efektywność, szeroki zakres terapeutyczny i dobrą tolerancję leku.
The Prevalence of Stroke in Patients with Obstructive Sleep Apnoea
Authors: Rudnicka Anna , Pływaczewski Robert , Jończak Luiza , Górecka Dorota , Śliwiński Paweł
Published: June 2022

Background: Previous population and clinical studies have confirmed the relationship between stroke and obstructive sleep apnoea (OSA). Our previous study on the epidemiology of sleep-disordered breathing among the inhabitants of Warsaw, conducted on 676 subjects aged 56.6 ± 8.2 years in whom polysomnography was performed and OSA was confirmed in 76 cases (11.3%) with the mean apnoea-hypopnoea index (AHI) of 25.3 ± 16.1, revealed a low prevalence of stroke in subjects with OSA (2 subjects [2.6%]) and in subjects without OSA (20 subjects [3.4%]). The aim of the study was to evaluate the prevalence of stroke in newly diagnosed patients with OSA qualified for continuous positive airway pressure (CPAP) treatment. Material and methods: We investigated 342 patients (263 men and 79 women) aged 55.4 ± 10.1 years with severe disease (AHI 39.7 ± 22.5) and considerable obesity (body mass index [BMI] 35.0 ± 6.6 kg/m2). A history of stroke was confirmed in 16 patients prior to the initiation of CPAP (4.7%; Group 1). Group 2 (subjects without a history of stroke) comprised 326 subjects (95.3%). Results: Multiple regression analysis revealed a significant correlation between stroke and the time spent in desaturation below 90% at night (T90) during polysomnography (b = –0.22, p = 0.009), diabetes mellitus (b = 0.16, p = 0.006), Epworth sleepiness score (b = 0.14, p = 0.02), and coronary artery disease (b = 0.14, p = 0.03). Conclusions: A correlation was demonstrated between stoke in patients with OSA (before CPAP treatment) and overnight and daytime oxygenation, diabetes mellitus, daytime sleepiness, and coronary artery disease. The incidence of stroke in the study population was low (4.7%) and similar to that observed in previous population studies.
Obstructive Sleep Apnea in Patient with Prader-Willi Syndrome
Authors: Czystowska Monika , Skoczylas Agnieszka , Rudnicka Anna , Kazanecka Barbara , Plywaczewski Robert , Śliwiński Paweł , Górecka Dorota
Published: June 2022

Prader-Willi syndrome (PWS) is a genetic disorder caused by loss of function of genes situated within the 15q11-q13 region of chromosome 15. The disorder is characterized by central obesity, short stature, dysfunction of several hypothalamic centers. These symptoms lead to progressive metabolic, respiratory, circulatory and orthopedic complications. Because of the etiology of the disorder there is no known causal treatment. Patients should comply with dietary restrictions and behavioral modifications as it may reduce the risk of obesity related diseases. In this paper we present a case 34-years old obese patient with PWS who was diagnosed with obstructive sleep apnea, and whom CPAP treatment was offered.
May the Force Be with Antileukotriene Drugs
Authors: Szczeklik Andrzej
Published: June 2022

W 1979 roku na Kongresie Prostaglandynowym w Waszyngtonie, Bengt Samuelsson przedstawił budowę chemiczną i drogi powstawania leukotrienów [...]
Pleural Sarcoidosis—In Three Patients
Authors: Fijołek Justyna , Wiatr Elżbieta , Gawryluk Dariusz , Langfort Renata , Bestry Iwona
Published: June 2022

Three patients with pleural sarcoidosis are reported. Pleural effusion in two patients and a massive pleural thickening that mimicked a tumour were observed. Histological examination of pleural biopsies revealed sarcoidosis. None of the patients received treatment. No recurrence of the pleural effusion was observed after a year of follow-up and the massive pleural thickening remained stable.
Przewlekła obturacyjna choroba płuc a choroby układu sercowo-naczyniowego
Authors: Passowicz-Muszyńska Ewa , Gostkowska-Malec Anna , Jankowska Renata , Piesiak Paweł
Published: June 2022

Przewlekła obturacyjna choroba płuc (POChP) jest wiodącą przyczyną zachorowalności i umieralności na świecie. Chorzy na POChP należą do grupy zwiększonego ryzyka chorób sercowo-naczyniowych, osteoporozy i raka płuca. Chociaż pewne związki między POChP a miażdżycą mogą być wynikiem palenia papierosów, to dane epidemiologiczne sugerują, że upośledzenie funkcji płuc jest niezależnym od palenia tytoniu czynnikiem ryzyka śmierci z powodu chorób serca i naczyń. Zjawisko to może być spowodowane wspólnym uwarunkowaniem genetycznym, a także wpływem ogólnoustrojowej reakcji zapalnej u chorych na POChP na przyspieszony rozwój miażdżycy naczyń. W pracy przytoczono również wstępne dane dotyczące możliwości modyfikacji przebiegu POChP poprzez zastosowanie statyn.
Rozrosty neuroendokrynne płuc. Histologiczne spektrum podtypów, aktualne poglądy dotyczące rozpoznawania i leczenia
Authors: Langfort Renata , Rudziński Piotr , Burakowska Barbara
Published: June 2022

Rozrosty neuroendokrynne w płucach stanowią specyficzną grupę zmian, głównie nowotworowych, charakteryzujących się wspólną morfologią, budową ultrastrukturalną, reakcjami immunohistochemicznymi i biologią molekularną. W ciągu ostatnich lat klasyfikacja nowotworów neuroendokrynnych płuc wielokrotnie ulegała zmianom. Obecnie wyodrębniono 4 typy nowotworów neuroendokrynnych, wśród których znalazły się rakowiaki typowe i atypowe, raki wielkokomórkowe neuroendokrynne oraz raki drobnokomórkowe. Nowotwory neuroendokrynne stanowią około 20% pierwotnych złośliwych guzów kwapłuc. Wśród nich największy procent stanowią raki drobnokomórkowe (13–17%). Właściwe rozpoznanie histopatologiczne, określenie stopnia zaawansowania klinicznego i patologicznego choroby są istotne ze względu na różny przebieg, rokowanie i odmienne postępowanie terapeutyczne. Rakowiaki i raki wielkokomórkowe neuroendokrynne są zwykle leczone operacyjnie, natomiast raki drobnokomórkowe—chemioterapią. Rakowiaki, zwłaszcza typowe, należą do grupy złośliwych nowotworów neuroendokrynnych o dobrym rokowaniu, nawet w przypadkach, w których stwierdza się przerzuty w okolicznych węzłach chłonnych. Raki wielkokomórkowe neuroendokrynne i drobnokomórkowe odpowiadają postaciom o niezwykle agresywnym przebiegu, złym rokowaniu i o podobnym czasie przeżycia. Zarówno badania molekularne, jak i genetyczne wskazują na udział odmiennych mechanizmów leżących u podstaw rozwoju rakowiaków oraz raków wielkokomórkowych neuroendokrynnych i drobnokomórkowych płuca. W związku z tym proponowana jest klasyfikacja nowotworów neuroendokrynnych w zależności od wzrastającego stopnia złośliwości. Najlepiej rokująca grupa typowych rakowiaków odpowiadałaby nowotworom neuroendokrynnym o niskim stopniu złośliwości (G1), atypowe rakowiaki—nowotworom o pośrednim stopniu złośliwości (G2), a raki wielkokomórkowe neuroendokrynne i drobnokomórkowe stanowiłyby grupę nowotworów neuroendokrynnych o wysokim stopniu złośliwości (G3).
Mikrobiologiczna diagnostyka zakażeń układu oddechowego wywoływanych przez pałeczki Legionella pneumophila
Authors: Rokosz Natalia , Rastawicki Waldemar , Zasada Aleksandra , Baczewska-Rej Milena
Published: June 2022

Pałeczki Legionella pneumophila są jednym z czynników wywołujących zapalenie płuc u ludzi, które ze względu na niecharakterystyczne objawy kliniczne trudno jest odróżnić od innych zakażeń dróg oddechowych. Obecnie diagnostyka legionelozy opiera się na badaniach fenotypowych (hodowla, poszukiwanie swoistych przeciwciał w surowicy ludzkiej, antygenu w próbkach materiału klinicznego) oraz badaniach genotypowych, takich jak metoda PCR (reakcja łańcuchowej polimerazy). W niniejszym artykule przedstawiono krótki opis metod diagnostycznych stosowanych w identyfikacji i zapobieganiu potencjalnym zakażeniom wywoływanym przez pałeczki L. pneumophila na terenie Polski.
Leptin Serum Levels in Cachectic and Non-Cachectic Lung Cancer Patients
Authors: Weryńska Bożena , Kosacka Monika , Gołecki Marcin , Jankowska Renata
Published: June 2022

Introduction: Leptin, protein taking part in body mass regulation, might play a role in cancer cachexia development. The aim of the study was to measure leptin serum levels in cachectic, non-cachectic lung cancer patients, healthy controls and to correlate leptin concentration with nutritional status markers. Material and methods: 40 lung cancer patients were enrolled into the study: 20 with cachexia, 20 without cachexia, and 10 healthy controls. Leptin serum concentration, body mass, BMI, arm circumference and skin triceps fold thickness were measured in each subject. Results: Serum leptin level in cachectic cancer patients was significantly lower than in non-cachectic and healthy controls. Leptin concentration correlated with body mass, arm circumference and skin triceps fold thickness. Conclusions: Cachectic lung cancer patients have significantly lower serum leptin concentrations than non-cachectic patients and healthy controls which may suggest, that leptin does not play an important role in cancer cachexia development. Leptin levels positively correlate with good nutritional status markers. Non-cachectic lung cancer patients have similar leptin serum levels as healthy controls.
Zakażenia Chlamydiowe w Astmie. Leczenie Makrolidami
Authors: Kosińska Magdalena , Kraus-Filarska Maria
Published: June 2022

Zakażenia drobnoustrojami atypowymi, w tym Chlamydophila pneumoniae, mogą odgrywać znaczącą rolę w przebiegu astmy. Wykazano wpływ infekcji chlamydiowej na ciężkość zaostrzeń astmy oraz nasilenie objawów w astmie przewlekłej. Grupą leków o dużej aktywności przeciwbakteryjnej skierowanej przeciwko drobnoustrojom atypowym są makrolidy, które charakteryzują się również właściwościami przeciwzapalnymi i immunomodulującymi. Ich zastosowanie u chorych na astmę może się wiązać z dodatkowymi korzyściami terapeutycznymi. Mechanizmy działania tych antybiotyków nie są jednak do końca wyjaśnione i wymagają dalszych badań.
Neurofibromatosis Type 1 in an Adult Diagnosed by a Pulmonologist
Authors: Gawlewicz-Mroczka Agnieszka , Mastalerz Lucyna , Niżankowska-Mogilnicka Ewa
Published: June 2022

Neurofibromatosis type 1 (NF1), referred to as von Recklinghausen’s disease, is a genetic disorder triggered by mutation of the NF1 gene, resulting in a lack of neurofibromin, which leads to abnormalities found in the peripheral nervous system and central nervous system, as well as in other organs. The disease is diagnosed early, usually in childhood by pediatricians. However, in some cases, the disease is clinically silent and remains undiagnosed or is recognized in the late adulthood. We report a case study of a 32-year-old female, who was referred to the pulmunologist with a suspicion of a lung tumor. The patient was admitted to the Pulmonology Department to investigate further the subpleural mass localized in the left lung found by chance in a chest X-ray. Physical examination revealed café-au-lait spots on her skin, several subcutaneous nodules which were confirmed by a histopathology to be consistent with neurofibroma. Further diagnostic testing, such as chest CT, PET and ophthalmological examination, led to diagnosis of neurofibromatosis type 1 with pulmonary involvement.
Smoking Habits in a Family Physician’s Practice
Authors: Maciejewski Janusz , Bednarek Michał , Korzybski Damian , Zieliński Jan
Published: June 2022

Introduction: Poland is the one of the countries in the European Union with the highest prevalence of smokers. The involvement of family physicians in smoking cessation activity could improve this situation. The aim of this study was to estimate smoking habits, their intensity and nicotine dependence in a family physician’s practice (urban and rural population). An additional aim was to estimate smoking habits in relation to the presence of smoking-related disease, gender, location and motivation to stop smoking. Material and Methods: This study was part of an investigation into the prevalence and severity of chronic obstructive pulmonary disease (COPD) in the same population. Statistical analysis of questionnaires about smoking and history of respiratory diseases, Fagerström’s nicotine dependence test and a motivation to quit test were performed. Results: Questionnaires were filled in by 1960 subjects (87% of those eligible). There were 29.6% current smokers, 24.9% ex-smokers, and 45.5% never-smokers. There were 39.4% current smokers among men, and 23.3% among women. Current smokers were more numerous in the rural population. 54% of women urban dwellers and 73% of women from rural population never smoked. There were no significant differences in the motivation to stop smoking or in the nicotine dependence among smokers with and without COPD nor according to the severity of COPD. Conclusions: Smoking habits among the studied population were comparable with national and regional data. The intensity of smoking habits among female town dwellers is especially alarming.
Multidrug Resistance Tuberculosis—Current Problems
Authors: Kruczak Katarzyna , Niżankowska-Mogilnicka Ewa
Published: June 2022

The rising occurrence of multidrug-resistant tuberculosis (MDR-TB), defined as resistance to at least isoniazid and rifampicin, is a serious worldwide problem. The treatment of MDR-TB with alternative chemotherapy is difficult due to side-effects and treatment duration. It is also very expensive and sometimes unsuccessful. DOTS and DOTS-Plus strategy are necessary to achieve a good tuberculosis control.
End Stage Chronic Obstructive Pulmonary Disease
Authors: Ambrosino Nicolino , Gherardi Marco , Carpenè Nicoletta
Published: June 2022

Many patients with chronic obstructive pulmonary disease (COPD) die each year as those with lung cancer but current guidelines make few recommendations on the care for the most severe patients i.e., those with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure. Only smoking cessation and long term oxygen therapy (LTOT) improve survival in COPD. Although non invasive positive pressure ventilation (NPPV) may have an adjunctive role in the management of chronic respiratory insufficiency there is little evidence for its use in the routine management of stable hypercapnic COPD patients. At difference, several prospective, randomised, controlled studies, systematic reviews and meta-analyses show good level of evidence for clinical efficacy of NPPV in the treatment of acute on chronic respiratory failure due to acute exacerbations of COPD. NPPV is also alternative to invasive ventilation for symptom relief in end stage COPD. Surgical interventions for end stage COPD like bullectomy, different modalities of lung volume reduction surgery and lung transplantation are likely to be of value to only a small percentage of patients. Nevertheless, there are specific indications, which, when added to pulmonary rehabilitation will further advance exercise capacity and quality of life. As in other chronic diseases when severity of disease increases along the natural history, therapy aimed to prolong life becomes less and less important in comparison to palliative therapy aimed to relieve symptoms. The most effective treatments for dyspnoea are bronchodilators, although also opiates may improve dyspnoea. Supplemental oxygen reduce exertional breathlessness and improve exercise tolerance in hypoxaemic COPD patients. There are difficulties in treating with antidepressant the frail and elderly COPD patients. Good clinical care can prevent or alleviate suffering by assessing symptoms and providing psychological and social support to the patients and their families.
Strategies to Reduce Dynamic Hyperinflation in Chronic Obstructive Pulmonary Disease
Authors: Casaburi Richard
Published: June 2022

The chief complaint of many patients with chro-nic obstructive pulmonary disease (COPD) is thatthey are no longer able to carry out or maintain anactivity of which they were previously capable [...]
Long-Term Oxygen Therapy: State of the Art
Authors: Casaburi Richard
Published: June 2022

Long-term oxygen therapy is well establishedas an important part of our therapeutic options forsevere COPD [...]
Reducing the Burden of Chronic Respiratory Diseases
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

Reducing the burden of chronic respiratory diseases [...]
Long-Term Remission after Erlotinib Therapy in an Elderly Patient with Advanced Non-small Cell Lung Cancer. Case Report and Conclusions for Clinical Practice
Authors: Duchnowska Renata , Siemiątkowska Anna , Grala Bartłomiej , Smoter Marta
Published: June 2022

Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR)—gefitinib and erlotinib—have recently been used as a therapeutic option in advanced non-small cell lung cancer (NSCLC) patients relapsing after first- or second-line chemotherapy. We report here a case of long-term remission in an elderly, non-smoking woman with advanced NSCLC after chemotherapy failure, who was selected for erlotinib therapy using demographic and clinical criteria. Based on this example and on the literature data we discuss the need for careful patient selection for this new therapeutic method.
Rola Interleukiny 18 w Patogenezie Astmy Oskrzelowej i Innychchorób Alergicznych Oraz Aktywacji Bazofilów i Mastocytów
Authors: Kamiński Marek , Kłoda Karolina , Pawlik Andrzej
Published: June 2022

Interleukina 18 (IL-18) jest prozapalną cytokiną produkowaną przez szereg komórek, biorącą udział w patogenezie chorób o podłożu zapalnym jak na przykład astma atopowa. Wykazano, że IL-18 wpływa na limfocyty T, wywołując nadwrażliwość drzewa oskrzelowego oraz rozwój stanu zapalnego. Ponadto stymuluje limfocyty Th1 do wydzielania cytokin i chemokin stymulujących nacieki w drogach oddechowych i odczyn zapalny. Pobudza także mastocyty i bazofile biorące udział w odczynie atopowym. Astma atopowa jest chorobą charakteryzującą się eozynofilowymi naciekami w drogach oddechowych wraz z remodelingiem, nadmiernym wydzielaniem śluzu oraz wysokimi stężeniami IgE w surowicy. Wyniki ostatnich badań wykazały, że w patogenezie astmy rolę odgrywa także odpowiedź immunologiczna typu Th2 związana z atopią oraz rozwojem stanu zapalnego przy udziale IgE oraz prozapalnych cytokin, jak na przykład Il-18. W niniejszym opracowaniu omówiono rolę IL-18 w aktywacji mastocytów i bazofili oraz patogenezie chorób atopowych.
Assessment of Acute Phase Proteins as Prognostic Factors in Patients Surgically Treated for Non-Small Cell Lung Cancer
Authors: Kasprzyk Mariusz , Dyszkiewicz Wojciech , Zwaruń Damian , Leśniewska Kinga , Wiktorowicz Krzysztof
Published: June 2022

Introduction: The aim of the study was to assess quantitative acute phase protein (APP) level changes in patients with non-small cell lung cancer (NSCLC) subjected to radical resections, as well as their influence on long-term survival. We analysed the correlation between quantitative APP changes and the histological type of the carcinoma, as well as the TNM stage and grade. Materials and methods: The study group comprised 46 patients subjected to surgical treatment of NSCLC during the period between 2003 and 2004. Average patient age amounted to 61 years (ranging between 45 and 77 years). The most frequent histological types of cancer were: squamous cell lung cancer (24 patients) and adenocarcinoma (17 patients). The majority of patients were diagnosed with stage II B (15 patients) and III A (14 patients). We evaluated the levels of the following APP: C-reactive protein (CRP), α1-acid glycoprotein (AGP), α1-antichymotrypsin (ACT), α1-antitrypsin (AT), α2-macroglobulin (M), ceruloplasmin (Cp), haptoglobin (Hp), and transferrin (Tf) by means of rocket immunoelectrophoresis (Laurell’s method). Results: The level of AT was significantly higher in patients with adenocarcinoma, as compared to other histological types of cancer. In the case of patients with squamous cell lung cancer, significantly higher M and Cp levels were observed. We found no correlation between the APP level and tumour grading. The levels of five APP: CRP, AGP, ACT, M and Cp were significantly higher in the group of patients with T3 or T4 category, while N1 or N2 patients presented with significantly higher concentrations of AT, CRP and Hp. Multivariate analysis confirmed the influence of the following factors on long-term survival: N stage, histological type of cancer and preoperative serum levels of AGP and Hp. Conclusions: The serum concentration of some acute phase proteins can correlate with the more aggressive clinical course of non-small cell lung cancer (NSCLC). Patients with adenocarcinoma and local lymph node metastases present with significantly higher levels of AT. Thus, it seems that the elevated preoperative levels of AGP and Hp might unfavourably influence long-term survival. The above-mentioned proteins might prove useful as prognostic factors when assessing the risk of neoplastic recurrence following surgical management.
Alergiczny nieżyt nosa—Problem epidemiologiczny, ekonomiczny i społeczny XXI wieku
Authors: Rutkowski Ryszard , Kosztyła-Hojna Bożena , Rutkowska Joanna
Published: June 2022

Nieżyt nosa może być spowodowany przez różnorodne czynniki alergiczne i niealergiczne. Powstaje również w wyniku ich jednoczesnego oddziaływania na błonę śluzową nosa. Alergiczny nieżyt nosa występuje u około 10–25% populacji ludzkiej, co powoduje, że jest uznawany za najczęstszą alergiczną chorobę świata. Spośród dzieci z alergicznym nieżytem nosa aż 30% choruje na sezonowy nieżyt nosa, a tylko u 10% stwierdza się postać całoroczną nieżytu. W Polsce, w grupie badanej przez Bręborowicza i wsp., alergiczny nieżyt nosa obserwowano u 16.7% dzieci w wieku 6–7 lat, natomiast w badaniach Emeryka i wsp. całoroczny nieżyt występował u 3.6%, a sezonowy u 6.2% dzieci w wieku 8–15 lat. Alergiczny nieżyt nosa—podobnie do innych chorób—powoduje określone koszty bezpośrednie, pośrednie i ukryte. W 2002 roku w Stanach Zjednoczonych koszty bezpośrednie wynosiły około 4.195 miliarda dolarów, a koszty pośrednie osiągnęły wartość około 665 milionów dolarów, co w sumie dawało kwotę 4.863 miliarda dolarów. Alergiczny nieżyt nosa często występuje z licznymi chorobami układu oddechowego, co istotnie zwiększa koszty leczenia ponoszone przez chorego oraz straty finansowe państwa. Rzutuje także niekorzystnie na sytuację społeczną chorych, istotnie pogarszając jakość życia pacjentów i ich rodzin.
Bacterial Immunostimulants—Mechanism of Action and Clinical Application in Respiratory Diseases
Authors: Roży Adriana , Chorostowska-Wynimko Joanna
Published: June 2022

Immunity towards bacteria might be achieved as a result of natural processes following infection, or as a consequence of medical intervention including vaccination, administration of immunoglobulins or therapy with immunostimulants derived from bacteria. Bacterial immunostimulants (ISs) containing bacterial lysate (OM-85 BV, LW 50020) or components of bacterial cells (ribosomal extracts) were shown to induce a non-specific response (i.e., intensification of phagocytosis) but also to orchestrate both cellular (B, T cell stimulation) and humoral responses (antibodies and proinflammatory cytokines production). Therefore, the duality of their immunomodulatory activity mimics or, to a certain extent, repeats the immune response evoked by the intrusion of a pathogen into the human body, which is initially non-specific, but subsequently becomes specific. However, their clinical efficacy in the prevention of respiratory tract infection (RTI) is still debated. This article reviews their mechanism of action, as well as the available clinical data, discussing the pros and cons of their use in the prevention of RITs in children and adults.
Historia Europejskiego Towarzystwa Klinicznej Fizjologii Oddychania i Europejskiego Towarzystwa Oddechowego
Authors: Radwan Leszek , Kowalski Janusz
Published: June 2022

W drugiej połowie XX wieku nastąpił znaczny rozwój klinicznej fizjologii oddychania [...]
Protein C System in Patients with Idiopathic Pulmonary Fibrosis—Preliminary Report
Authors: Kiziewicz Anna , Żekanowska Ewa , Cieśliński Krzysztof , Góralczyk Krzysztof
Published: June 2022

Introduction: The natural anticoagulant—activated protein C system plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. The purpose of this study was to evaluate the concentration of protein C (PC), protein S (PS), thrombomodulin (TM), selectin E (sSelE), and thrombin–antithrombin complex (TAT) in patients with idiopathic pulmonary fibrosis (IPF). Material and methods: Study grup consisted of 11 patients aged 51.5 ± 8.62 years with idiopathic pulmonary fibrosis and 20 healthy adults as control. Concentration of PC, PS TM, sSelE and TAT in plasma with ELISA method was assessed. Results: We observed significantly lower plasma concentration of PC (98.24 ± 16.17% vs. 130.59 ± 19.03%), PS (71.31 ± ± 12.95% vs. 93.47 ± 18.63%), TM (2.67 ± 0.40 ng/ml vs. 3.99 ± 1.16 ng/ml) and significantly higher level of TAT complex (Me = 4.00 mg/ml vs. 2.20 mg/ml) and sSelE (Me = 36.40 ng/ml vs. 22.84 ng/ml) in patients with idiopathic pulmonary fibrosis as compared to controls. Conclusions: In presented pilot study we observed decreased activity of protein C system and increased thrombin generation in peripheral blood of patients with idiopathic pulmonary fibrosis.
XIX Spotkanie Polskiej Grupy European Respiratory Society 6–9 Marca 2008 r., Ustroń
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

Fe2+ znajduje sie w centrum aktywnym białka hemowego [...]
Światowy Sojusz przeciwko Przewlekłym Chorobom Układu Oddechowego
Authors: Bousquet J. , Dahl R. , Khaltaev N.
Published: June 2022

Hundreds of millions of people of all ages suffer from chronic respiratory diseases which include asthma and respiratory allergies, chronic obstructive pulmonary disease, occupational lung diseases and pulmonary hypertension. More than 500 million patients live in developing countries or in deprived populations. Chronic respiratory diseases are increasing in prevalence. Although the cost of inaction is clear and unacceptable, chronic respiratory diseases and their risk factors receive insufficient attention from the healthcare community, government officials, media, patients and families. The Fifty-Third World Health Assembly recognised the enormous human suffering caused by chronic diseases and requested the World Health Organization (WHO) Director General to give priority to the prevention and control of chronic diseases, with special emphasis on developing countries. This led to the formation of the WHO Global Alliance against Chronic Respiratory Diseases (GARD). GARD is a voluntary alliance of organisations, institutions and agencies working towards a common vision to improve global lung health according to local needs. GARD is developed in a stepwise approach using the following three planning steps: estimate population need and advocate action; formulate and adopt policy; and identify policy implementation steps.
Druga Polsko-Francuska Konferencja Pneumonologów, Bydgoszcz, 19–20 października 2007 roku
Authors: Zieliński Jan
Published: June 2022

W dniach 19 i 20 października 2007 roku, w Bydgoszczy, odbyła się Druga Polsko-Francuska Konferencja Pneumonologów poświęcona omówieniu wybranych zagadnień o dużej wadze medyczno-społecznej w dziedzinie chorób płuc [...]
Effects of Smoking on the Cellular Mechanisms in the Respiratory System
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

Devastating effects of smoking on the respiratory system are commonly acknowledged. However, detailed knowledge of the responsible mechanisms is insufficient to allow early diagnosis and effective treatment of the smoking-related pathologies. This paper presents a review of key processes occuring in the smokers’ lungs, particularly these responsible for the persistent inflammatory response and neoplastic transformation.
The Coexistence of the Impaired Exercise Tolerance in Patients with Obstructive Sleep Apnea with Gastroesophageal Reflux
Authors: Hawryłkiewicz Iwona , Dziedzic Dariusz , Pływaczewski Robert , Górecka Dorota
Published: June 2022

Introduction: Gastroesophageal reflux (GERD) is a frequent disease in patients with obstructive sleep apnea (OSA). The aim of the study was to evaluate possible correlation between the impairement of exercise tolerance and GERD. Material and methods: We examined 18 patients with OSA, mean AHI—44 ± 22; 6 females, 12 males, mean age 55 ± 9 years. All patients were treated for metabolic disorders and for hypertension or coronary artery disease. In all patients gastroscopy was performed with 24h pHmetry and 6MWT. Results: In 12 patients GERD was found, in 14 patients esophagitis was diagnosed (among them there were 3 patients without GERD). Patients with GERD were younger (53 ± 7 vs. 59 ± 11 years) and more obese (BMI—38 ± 5 vs. 36 ± 9 kg/m2). During 6MWT the distance covered was shorter (in % of normal values) in GERD subjects: 78 ± 17 vs. 86 ± 22%) and desaturation was deeper (91 ± 3 vs. 94 ± 3%). Conclusions: Despite some tendencies the relationship between GERD and impairement of exercise tolerance in OSA patients was not statistically significant. Perhaps study in larger group of subjects will be more reliable.
Mycobacterial Infection Caused by Mycobacterium avium in Allogenic Bone Marrow Transplant Recipient with Concomittant Bronchiolitis Obliterans as a Manifestation of Graft Versus Host Disease—Case Report and Review of the Literature
Authors: Buraczewska Agnieszka , Kempisty Anna , Kuś Jan , Bartosiewicz Małgorzata
Published: June 2022

Patients after organ transplantations are at risk for mycobacteriosis development. Frequency of the mycobacterial infection after bone marrow transplantation (BMT) is not as high as one could expect. It ranges from 0.4 to 4.9%. We present a case of a female patient after allogenic BMT as a treatment of chronic myelogenous leucaemia, with bronchiolitis obliterans as a symptom of graft versus host disease (GvHD), treated with corticosteroids and infected with Mycobacterium avium. She was admitted to the hospital with dyspnoea, cough with large amount of sputum production and subfebrile status. She had partial respiratory insufficiency and obturative disturbances of respiration (FEV1 0.67 l i.e., 22% of normal) with decline of VC (2.23 l i.e., 64% of normal). The high-resolution computed tomography (HRCT) revealed multifocal infiltrations and bronchiectases in the upper and middle pulmonary fields, which were absent in the previous HRCT taken 3 years earlier. In the bronchial secretion acid-fast bacilli were found by smear and culture. The isolate was classified as Mycobacterium avium complex (MAC) by high performance liquid chromatography (HPLC). The patient was treated with clarithromycin, ciprofloxacin, isoniazide (INH), ethambutol (EMB), amikacin, but M. avium was still present in the sputum after 3 months. Treatment was continued in her parent hospital, where after a few months her sputum became negative for M. avium. But she died over a year later from progressive respiratory insufficiency in the course of bronchiolitis obliterans. The patient was in the group of high risk for mycobacterial infection development and the course of her illness was typical. We decided however to present the case as the topic seems to be quite neglected in the literature.
Znaczenie Chirurgii Bariatrycznej w Leczeniu Pacjentów z Obturacyjnym Bezdechem Podczas Snu
Authors: Paluszkiewicz Rafał , Kalinowski Piotr
Published: June 2022

Otyłością patologiczną określa się znaczny nadmiar masy ciała, który odpowiada wartościom wskaźnika masy ciała (BMI, body mass index) ≥ 40 kg/m2 [...]
Ocena wpływu chemioterapii na czas przeżycia i wybrane objawy wpływające na jakość życia chorych na niedrobnokomórkowego raka płuca w IIIB i IV stopniu zaawansowania
Authors: Rolski Janusz , Zemełka Tomasz , Jasiówka Marek , Czyżewicz Grzegorz , Kojs-Pasińska Ewelina
Published: June 2022

Introduction: The study presents treatment results of 168 patients with non small cell lung cancer in stage IIIB and IV treated since year 2002 to 2006 in Oncological Center in Cracow. Material and methods: Four regimens of chemotherapy: EP (cisplatin, vepesid), MVP (mitomycin C, vinblastin, cisplatin), PN (cisplatin,vinorelbin) and PG (cisplatin, gemcytabin) were used. Results: Average survival time in group treated with MVP regimen was 7.8 months (median 4.3 months), PG 7.1 months (median 7.3 months), EP 10.2 months (median 7.5 months), PN 14.1 months (median 9.8 months). Differences in median survival time were not significant. Average time to progression in group treated with MVP regimen was 3.5 months (median 2.6 months), PG 5.2 months (median 5.8 months): EP 6.6 months (median 5.2 months), PN 6.7 months (median 5.6 months). Improvement in control of symptoms regarding dyspnea, pain and cough was reached in 60%, 38.7% and 60% of patients respectively. There were no significant differences between chemotherapy regimens regarding improvement in symptoms control. Conclusions: Cisplatin + vinorelbin regimen can be recommended as standard method because of the best treatment results.
Sygnalizacja zależna od histonów w farmakoterapii przewlekłej obturacyjnej choroby płuc
Authors: Mróz Robert , Noparlik Jacek , Chyczewska Elżbieta , Braszko Jan , Hołownia Adam
Published: June 2022

Chronic obstructive pulmonary disease (COPD) is a 4th major cause of morbidity and mortality worldwide. Cigarette smoking and oxidative/nitrosative stress leading to chronic inflammation is considered as a major cause of COPD but up to now, details of molecular pathways responsible for development of disease are unknown. Recent reports indicate the role of disruption in histone function in promoting synthesis of inflammatory cytokines through increased gene transcription which underlies disease development. Core histone acetylation/deacetylation regulate their transcription activity and drug induced changes of its intensity may be an interesting field of further research. In this article the opinions about the role of steroids as inhibitors of the inflammatory process as well as resistance to steroids have been presented. Findings from studies which aimed to explore the anti-inflammatory activity of drugs such as theophylline and N-acetylcysteine and their ability to suppress oxidative stress may suggest the usefullness of these drugs in causative treatment of COPD. However, further studies are necessary to confirm these findings.