bluuebunny/crossref_metadata_2025 huggingface dataset:
The Prevalence of Tobacco Smoking and Attitudes of Polish Pulmonologists towards Smoking
Authors: Czajkowska-Malinowska Małgorzata , Ciesielska Anna , Kruża Katarzyna , Jesionka Paweł
Published: June 2022

Introduction: Pulmonologists can play an important role in smoking prevention and control. The aim of this study was to assess smoking prevalence among Polish pulmonologists and physicians’ behaviour towards smoking patients. Material and methods: The study was performed in 2006 during national congress of Polish Respiratory Society. The survey was performed using a questionnaire including questions regarding age, sex, professional activities, specialty, academic degree and respondents’ nicotine status, attitude and activity towards smoking patients. Results: Questionnaires were filled in by 498 physicians: 160 (32.1%) men and 338 (67.9%) women, out of 852 participating physicians (58.5%) who received the questionnaire. There were 11.3% smokers (13.8% men and 10% women), 25.1% of surveyed physicians were ex-smokers, and 63.6% never smokers. 91.4% of respondents always ask patients if they smoke. 87.4% physicians always advise smoking cessation to their patients, but smoking cessation support is offered only by 48% of respondents. Almost half respondents use drugs in nicotine dependence treatment. Majority of respondents (81.1%) think that physician’s attitude influences patient’s behaviour. More than a half (55.7%) think that smoking by physicians is not in accordance with physician’s ethics. 91.4% support smoking ban in public places. Conclusions: This study found a lower prevalence of smoking among Polish pulmonologists compared with the general population, and with the previous surveys and demonstrated the impact of personal smoking on physicians’ attitudes towards smoking.
Interstitial Pneumonitis in a Patient Treated with Amiodarone—Case Report
Authors: Paczek Anna , Szturmowicz Monika , Wiatr Elżbieta , Burakowska Barbara , Fijałkowska Anna , Torbicki Adam
Published: June 2022

Amiodarone, antiarrhythmic drug of III class is used in patients with supraventricular and ventricular arrhythmias, often with coexisting congestive heart failure. Side effects of amiodarone treatment are observed in approximately 75% of patients. Most dangerous are the symptoms of amiodarone pulmonary toxicity occuring in 2–17% of patients. We present a patient with COPD, in whom interstitial pneumonitis with radiologic features of organizing pneumonia developed after one year of amiodaron treatment due to supraventricular and ventricular arrhythmias. The drug was stopped and steroids were introduced due to marked respiratory insufficiency. Regression of pulmonary symptoms and improvement of ventilatory parameters were observed after 3 months of treatment. Pathogenesis, diagnostic procedures and current methods of treatment of this jatrogenic disease are discussed.
Analysis of Prognostic Factors and Efficacy of Surgical Treatment for Non-small Cell Lung Cancer: Department of Surgery Ntldri (1998–1999)
Authors: Chabowski Mariusz , Orłowski Tadeusz , Rabczenko Daniel
Published: June 2022

Wprowadzenie: Postępowanie chirurgiczne stanowi podstawową metodę leczenia niedrobnokomórkowego raka płuca. Materiał i metody: W pracy przeprowadzono retrospektywną analizę skuteczności tego leczenia w grupie 431 chorych operowanych w Klinice Chirurgii Instytutu Gruźlicy i Chorób Płuc w Warszawie w latach 1998–1999. W 218 (50%) przypadkach wykonano lobektomię, w 21 (5%)—bilobektomię, w 188 (44%)—pneumonektomię, a w 4 (1%)—resekcję klinową. U 70 (16%) chorych rozpoznano stadium zaawansowania pIA, u 112 (26%)—pIB, u 22 (5%)—pIIA, u 110 (26%)—pIIB, u 88 (20%)—pIIIA, u 13 (3%)—pIIIB i u 16 (4%)—pIV. Wyniki: Wskaźnik 5-letniego przeżycia dla całej grupy wynosił 49.1%. Analiza statystyczna wykazała wyższy odsetek odległych przeżyć w grupie wiekowej do 50. rż. (p = 0.03), u płci żeńskiej (p = 0.01, HR = 0.63), w przypadku mniej rozległego zabiegu (lobektomia) (p < 0.005). Wskaźniki odległych przeżyć wykazywały znamienną zależność od stadium zaawansowania choroby nowotworowej (p < 0.005). Pięcioletnie przeżycie pacjentów w stadium IA wynosiło 81.7%, IB—62.2%, IIA—59.1%, IIB—38%, IIIA—21.3%, IIIB—8.3% oraz IV—8.3%. Typ histopatologiczny miał również znamienny wpływ na odległe przeżycia chorych (p < 0.005). Pięcioletnie przeżycie chorych na raka płaskonabłonkowego wynosiło 53.4%, na raka gruczołowego—38.3%, na raka wielkokomórkowego—37.5%, na rakowiaka—94.7%, a na pozostałe typy raka—39.1%. Wskaźnik odległego przeżycia zależał znamiennie od cechy T (p < 0.005). Obniżone wyjściowe stężenie hemoglobiny (p < 0.005, HR = 1.52) oraz przetoczenie masy erytrocytarnej w okresie pooperacyjnym (p = 0.03) były niekorzystnymi czynnikami rokowniczymi. Znamiennie gorsze rokowanie wykazano w przypadku cechy R1 lub R2 (p = 0.01) oraz cechy M1 (p < 0.005). Dodatkowo, w analizie wielowymiarowej Coxa wartość FEV1 poniżej 80% (HR = 1.46) była zmienną negatywnie wpływającą na odległe przeżycie, a brak objawów klinicznych choroby, z wyjątkiem kaszlu (HR = 0.73)—zmienną wpływającą korzystnie. Wnioski: W analizie jednowymiarowej wyłoniono następujące czynniki ryzyka: płeć męska, wiek powyżej 50. rż., obniżone stężenie Hb, zabieg operacyjny o poszerzonym zakresie, zaawansowane stadium, utkanie raka gruczołowego i wielkokomórkowego, cecha T, N, R i M oraz przetoczenie ME w okresie pooperacyjnym. Analiza wielowymiarowa Coxa wykazała następujące negatywne czynniki prognostyczne: obniżone wyjściowe stężenie Hb, wartość FEV1 poniżej 80%, zabieg operacyjny o poszerzonym zakresie (pneumonektomia), zaawansowane stadium raka, utkanie raka gruczołowego oraz następujące korzystne rokowniczo czynniki: płeć żeńska i brak objawów klinicznych, z wyjątkiem kaszlu.
Safety of Sputum Induction in Interstitial Lung Disease
Authors: Sobiecka Małgorzata , Kuś Jan
Published: June 2022

Introduction: Sputum induction (SI) is a safe and effective technique to study airway inflammation in asthma and chronic obstructive pulmonary disease (COPD). However, it has the potential to induce bronchospasm and fall in arterial oxygen saturation (SaO2) in some patients and the safety of the method in interstitial lung disease (ILD) has not been determined. The aim of this study was to examine the effect of SI procedure on spirometric results and SaO2 in patients with ILD. Materials and methods: We studied prospectively 59 patients (33 males, 26 females) with different ILD (36—sarcoidosis, 16—hypersensitivity pneumonitis, 7—idiopathic pulmonary fibrosis). Sputum was induced by 4 sequential 5 min inhalations of 5% saline solution and FEV1, FVC and SaO2 were measured at 5, 10, 15 and 20 minutes of induction. Results: The procedure was well tolerated, and none of the patients experienced excessive bronchoconstriction, defined as a fall in FEV1 of ≥20%. Nine patients (15%) had a fall in FEV1 of ≥10% from the baseline; a drop in FVC of ≥10% from the baseline was observed in 10 subjects. The mean (SD) maximum per cent fall in FEV1 was 6.3 ± 4.4%, and in FVC—6.4 ± 4.6%. The maximum per cent fall in FEV1 did not correlate with baseline FEV1% predicted (r = −0.099). SaO2 was measured in 42 patients. There was a very small fall in SaO2 at 5, 10, 15 and 20 min of induction, although statistically significant (baseline SaO2 = 96.7 ± 1.9% vs. 95.8 ± 2.4%, p = 0.002; vs. 96.1 ± 2.2%, p = 0.0114; vs. 95.7 ± 2.4%, p = 0.0016; vs. 95.9 ± 2.0%; p = 0.0038, respectively). No significant relationship was found between fall in FEV1, FVC or SaO2 after induction and diagnosis or smoking history. Conclusions: Sputum induction is safe and well tolerated in patients with ILD.
Rodzinne Występowanie Obturacyjnego Bezdechu Podczas Snu
Authors: Bielicki Piotr , Byśkiniewicz Krzysztof , Chazan Ryszarda
Published: June 2022

Pierwsze artykuły w literaturze fachowej opisujące objawy charakterystyczne dla obturacyjnego bezdechu podczas snu (OBPS) zaczęły się pojawiać już kilkadziesiąt lat temu, jednak dopiero w ciągu ostatnich kilkunastu lat znacznie wzrosło zainteresowanie środowisk lekarskich tym problemem [...]
Obturacyjny Bezdech Senny i Nadciśnienie Tętnicze
Authors: Gaciong Zbigniew , Wolf Jacek , Narkiewicz Krzysztof
Published: June 2022

Pacjenci z obturacyjnym bezdechem sennym (OBS) doznają powtarzających się epizodów zaburzeń snu i oddychania, czemu towarzyszą liczne nieprawidłowości funkcji układu krążenia [...]
Hipersomnie Pochodzenia Ośrodkowego
Authors: Szelenberger Waldemar
Published: June 2022

Wzmożona senność jest zjawiskiem fizjologicznym po długim czuwaniu, na przykład pod koniec dnia [...]
Ocena odpowiedzi humoralnej przeciwko antygenom prątka w popłuczynach oskrzelowo-pęcherzykowych u chorych na gruźlicę płuc potwierdzoną bakteriologicznie i metodami genetycznymi
Authors: Kozłowska Iwona , Filewska Małgorzata , Roży Adriana , Augustynowicz-Kopeć Ewa , Krawiecka Dorota , Broniarek-Samson Beata , Demkow Urszula
Published: June 2022

Introduction: The resistance to TB is cells-mediated but humoral response is common and may be correlated with the lack of effective local cellular defence mechanisms. The goal of the study was to evaluate IgG, IgA and IgM mediated humoral immune response against 38kDa plus 16kDa and 38kDa plus lipoarabinomannan (LAM) mycobacterial antigens in BALF from patients with culture confirmed and PCR positive pulmonary tuberculosis (TB) compared to non-tuberculous controls (NTB). Material and methods: 79 BALF samples (46 TB and 30 NTB) were examined. In 25 BALF samples from TB patients nucleic acids from M. tuberculosis were detected by PCR method. Commercially available ELISA—based assays against proteins 38kDa and 16kDa or 38kDa plus LAM were used. Three different dilutions of BALF: 1:1 and 1:10 were tested. Mean IgG level against 38 + LAM was significantly higher in TB group compared to control (p < 0.0001). No difference was observed between TB and NTB group in titer of IgM antibodies. Results: Sensitivity of the tests based on IgG anti38kDa + 16kDa was 49%, IgG anti38kDa + LAM—33%, IgA anti38kDa + LAM—100%, IgM anti38kDa + LAM—35%. Specificity of examined assays: IgA anti38kDa + LAM—13%, IgM anti38kDa + LAM—75%, IgG anti38kDa + 16kDa—87%, IgG anti38kDa + LAM—93%. The findings of the study indicate that TB is associated with the presence of detectable levels of antibodies in the BALF. Conclusions: Examined tests detecting IgG in BALF can be used in combination with other diagnostic methods to increase diagnostic accuracy of pulmonary TB.
Związek pomiędzy wybranymi wskaźnikami zapalenia dróg oddechowych a grubością błony podstawnej u chorych na astmę
Authors: Górska Katarzyna , Krenke Rafał , Kościuch Justyna , Przybyłowski Tadeusz , Domagała-Kulawik Joanna , Hildebrand Katarzyna , Baran Wojciech , Kujawa Marek , Chazan Ryszarda
Published: June 2022

Introduction: Airway inflammation and remodeling are well recognized features of asthma. Remodeling is usually regarded as a consequence of chronic inflammation, however there are also data suggesting that remodeling is a relatively independent process in asthma. Neither inflammation nor remodeling is a uniform process. Thus the precise relationship between markers of inflammation and different patterns of remodeling are still matter of investigations. The aim of the study was to assess the relationship between total and differential cell count in induced sputum (IS) and BALF, and thickness of the basement membrane (BM) in patients with stable asthma. Material and methods: 18 patients with asthma (M/F 9/9, mean age 36 ± 15 yrs). Duration of symptoms amounted to 12.7 ± 11.5 years. Patients who have not been treated with steroids for at least 3 months were enrolled to the study. All patients underwent sputum induction and fiberoptic bronchoscopy with BAL and bronchial biopsies. Total and differential cell counts were measured in induced sputum and BALF. Light-microscopic measurements of BM thickness were performed in hematoxylin-eosin stained slides of bronchial wall specimens with semi-automatic software analysis. Results: Mean BM thickness was 12.9 ± 2.8 μm (range: 8.5–20.7 μm). Total sputum cell count was 3.4 ± 2.7 × 106 cells/mL, whereas in BALF 9.7 ± 10.2 × 106 cells/mL. There was no correlation between differential cell count in induced sputum and BALF. No significant correlations between BM thickness and total and differential cell count in IS and BALF were observed. There also was no correlation between BM thickness and length of asthma duration or degree of the disease. Conclusions: There was no relationship between BM thickness and total number of cells nor number of eosinophils in BALF and/or IS.
Obraz radiologiczny przewlekłych zmian oskrzelowych i płucnych u dzieci z wybranymi pierwotnymi niedoborami odporności
Authors: Szczawińska-Popłonyk Aleksandra , Samolewska Ewa , Bręborowicz Anna
Published: June 2022

W niniejszej pracy zaprezentowano zagadnienia związane z objawami klinicznymi pierwotnych niedoborów odporności u dzieci. Ze względu na częstą lokalizację narządową zmian w układzie oddechowym w tej grupie schorzeń szczególną uwagę poświęcono przewlekłej chorobie oskrzelowo-płucnej z uwzględnieniem jej przebiegu klinicznego i obrazu radiologicznego w wybranych przypadkach klinicznych.
Wpływ bronchofiberoskopii na stężenia tlenku azotu w wydychanym powietrzu
Authors: Kaczmarczyk Grzegorz , Ziora Dariusz , Kozielski Jerzy
Published: June 2022

Wstęp: Stężenie tlenku azotu w wydychanym powietrzu (eNO) jest nieinwazyjnym parametrem przydatnym w ocenie stanu zapalnego dróg oddechowych, w szczególności użytecznym do monitorowania astmy. Celem pracy była ocena, czy występuje stan zapalny drzewa oskrzelowego mierzony wydalanym eNO wywołany wykonaniem bronchofiberoskopii (BF). Materiał i metody: U 41 chorych (wiek 29–74 lat) stężenie eNO zmierzono aparatem Sievers 280 Nitric Oxide Analyzer przed BF i 24 godziny po niej. W grupie kontrolnej (12 zdrowych osób w wieku 22–65 lat) stężenie eNO również oznaczono 2-krotnie z 24-godzinną przerwą między pomiarami. Wyniki: W grupie badanej średnie stężenie eNO przed BF (15.0 ± 8.0 ppb) było znamiennie większe (p < 0.05) niż w grupie kontrolnej (6.9 ± 5.6 ppb). W grupie badanej nie zaobserwowano znamiennej statystycznie zmiany stężenia eNO po BF (15.0 ± 8.0 vs. 17.0 ± 7.9 ppb). Procedury przeprowadzone w trakcie BF, takie jak: płukanie oskrzelowe, szczoteczkowanie oskrzelowe lub biopsja oskrzela, nie wpłynęły na eNO u badanych chorych. W grupie kontrolnej średnie wartości eNO przed badaniem i po 24 godzinach od badania były podobne (6.9 ± 5.6 ppb vs. 7.1 ± 5.9). Odpowiednio zmiany eNO po 24 godzinach obserwacji (spadki i wzrosty), wyrażone jako procent części na miliard (% ppb), także były podobne w obu pomiarach u badanych chorych i w grupie kontrolnej. Wnioski: Bronchofiberoskopia i związane z nią procedury nie wpływają w istotny sposób na stężenia NO w wydychanym powietrzu.
Surowicze markery w samoistnym włóknieniu płuc
Authors: Ziora Dariusz
Published: June 2022

W niniejszej pracy omówiono przydatność wybranych markerów surowiczych (m.in. KL-6, SP-A, SP-D, IL-8, MCP-1, CYFRA-21) istotnych dla rozpoznania, monitorowania lub prognozowania przebiegu samoistnego włóknienia płuc.
XVIII Spotkanie Polskiej Grupy European Respiratory Society15–18 marca 2007 roku, Korbielów
Authors:   Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

Celem pracy była ocena rozpowszechnienia nałogu palenia tytoniu wśród lekarzy pulmonologów w Polsce i określenie wpływu palenia lekarza na jego praktykę kliniczną podczas kontaktów z palącym pacjentem [...]
Detection of Mutation in NAT II Gene as a Method of Determination of Izoniazyd (INH) Acetylation Type in Human Population
Authors: Augustynowicz-Kopeć Ewa , Zabost Anna , Kozińska Monika , Brzezińska Sylwia , Zwolska Zofia
Published: June 2022

Introduction: Isoniazid (INH) is a drug widely used in the treatment of tuberculosis. INH is metabolized to acetylisoniazid by N-acetyltransferase (NAT) in the liver. The rate of INH acetylation is genetically determined. NAT isozymes are encoded at 2 loci; one encodes NAT1, formerly known as the monomorphic form of the enzyme, while the other encodes the polymor- phic NAT2, which is responsible for individual differences in the ability to acetylate certain compounds. The objective of the present study was to apply the genotyping of the fast and slow acetylators for personalized therapeutic dose. Material and methods: Plasma concentrations of INH were determined with biological method in the authors modification. This method warrants high accuracy and secured repeatable results. Genomic DNA was isolated from the blood samples. DNA extracted by Blood DNA Kit and amplified by PCR by Spurr [1] with two primers. PCR product was cut separately with 4 different restriction enzymes: Dde1, Kpn1, Tag1, and BamH1. Results: Four different NAT 2 alleles were detected in the study population. The presence of any 2 mutant alleles defines the slow-acetylator genotype, whereas rapid acetylators have 1 or 2 wild-type NAT2*4 alleles. Conclusions: On the basis of our results we suggest the using of NAT 2 genotyping for discrimination of the fast and slow acetylators in monitoring of tuberculosis therapy.
Pneumatocele w trakcie długotrwałej obserwacji chorego na zespół hiper IgE (zespół Hioba)
Authors: Nowicka Urszula , Wiatr Elżbieta , Kupis Włodzimierz , Burakowska Barbara , Folcik Krystyna , Orłowski Tadeusz , Roszkowski-Śliż Kazimierz
Published: June 2022

Zespół hiper IgE (zespół Hioba) jest rzadkim, wielonarządowym schorzeniem charakteryzującym się występowaniem triady objawów: podwyższone stężenie immunoglobulin IgE, nawracające infekcje układu oddechowego i zatok (najczęściej o etiologii gronkowcowej) oraz występowanie już od dzieciństwa zimnych ropni skóry. W niniejszej pracy przedstawiono przypadek 21-letniego chorego z zespołem hiper IgE, zdiagnozowanego w wieku 6 lat na podstawie występowania hiperimmunoglobulinemii E oraz nawrotnych infekcji płucnych oraz skórnych. Obecnie powodem przyjęcia do szpitala były powikłania zapalenia płuc pod postacią pneumatocele, które nie uległo regresji pomimo zastosowania dożylnej antybiotykoterapii. Konieczne okazało się wykonanie zabiegu chirurgicznego. Przebieg pooperacyjny był powikłany wystąpieniem posocznicy (Staphylococcus aureus).
POChP—Choroba Zbyt Rzadko Rozpoznawana Nie Tylko we Wczesnym Okresie
Authors: Zieliński Jan
Published: June 2022

Przewlekła obturacyjna choroba płuc (POChP) jest chorobą bardzo rozpowszechnioną [...]
Analysis of Occurrence of DRB and DQ Alleles in Sarcoidosis and Tuberculosis from Northern Poland
Authors: Dubaniewicz Anna , Moszkowska Grażyna
Published: June 2022

Introduction: Sarcoidosis is a multisystem disorder of unknown etiolgy. Pathologic similarities between SA and tuberculosis (TB) suggest M. tuberculosis antigen(s) as causative agents. It seems likely that in the genetically different predisposed hosts, the same antigen(s) may cause the development of sarcoid or tuberculous immune response. Aim: The aim of this study was to compare the frequency of occurrence of HLA class II alleles in SA, TB and in the healthy individuals. Material and methods: To test a difference in haplotypes associated with both diseases, we compared the distribution of DQA1 and DQB1 alleles in 45 SA patients, 62 TB patients and in 143 healthy volunteers, using a PCR-SSP “low (DRB1, DQB1) and high (DQA1) resolution” method. Results: Our results revealed that DRB1*03, DRB1*11, DQB1*02 i DQA1*0501 in Stage I of SA with Löfgren’s syndrom (Ls) and DRB1*15, DQA1*0102, DQA1*0103 in Stage II of SA were more common, whereas DRB1*16, DRB1*04, DRB1*08, DQB1*02, DQB1*03, DQB1*05, DQA1*0102, DQA1*0301 in Ls and DQB1*02, DQB1*03, DQB1*05, DQA1*0102, DQA1*0301 in Stage II were less common than in the controls but after Bonferroni correction occurrence of DRB1*04, DQB1*02, DQB1*03, DQB1*05 and DQA1*0102, DQA1*0301, DQA1*0501 was significantly differ. In TB group, DRB1*16, DRB1*14, DQB1*05 i DQA1*0303 were more frequent and DRB1*11, DQB1*02, DQA1*0201, DQA1*0505 less frequently present as compared to the controls, but after correction DRB1*16, DQB1*02, DQB1*05, DQA1*0303, DQA1*0505 were significantly different. In SA, DRB1*11, DQB1*02 i DQA1*0201, DQA1*0501, DQA1*0505 in Ls and DRB1*15, DRB1*11, DQA1*0102 in Stage II were more common and DRB1*16, DRB1*04, DRB1*14, DQB1*03, DQB1*05, DQB1*06, DQA1*0301, DQA1*0302, DQA1*0303 in Ls and Stage II were less frequent than in the TB group. DQB1*02, DQA1*0501 (Ls) and DRB1*15 (Stage II) were more frequently present in SA than in TB, even after Bonferroni correction. Conclusions: In summary, we identified associations of HLA class II alleles in SA and TB with expression pattern specific and different for each group. In most cases, in SA patients frequency of HLA class II alleles occurrence is opposite to the frequency in TB patients.
The Epidemiology of Lung Cancer
Authors: Kosacka Monika , Jankowska Renata
Published: June 2022

Lung cancer is currently most frequently diagnosed neoplasm in males and the fifth most frequent cancer in females. In developed countries only breast cancer is diagnosed more often in women. Worldwide, lung cancer is the most common cause of cancer mortality in males and females. In the Europe lung cancer accounts for 21% of all cancer cases in males and 29% of all cancer deaths. The rapid increase in lung cancer incidence was observed the since beginning of the XX century till 1990–1994. The incidence in males decreased recently, but still increases in females, especially in young women. The changes in frequency of various histological subtypes of lung cancer are observed too. Despite many clinical trials, modern diagnostic techniques and improved supportive care, the prognosis remains unfavourable and long-term survival almost did not change. In Poland the incidence of lung cancer in 2002 was 81.9/100,000 in males and 22.2/100,000 in females. In both genders 1-year and 5-year survivals time are one of the shortest in Europe.
Small-Cell Lung Cancer Diagnostic and Therapeutic Recommendations of Polish Lung Cancer Group
Authors: Krzakowski Maciej , Orłowski Tadeusz , Roszkowski Kazimierz , Reinfuss Marian , Olszewski Włodzimierz , Ramlau Rodryg , Kowalski Dariusz , Konopa Krzysztof , Jassem Jacek , Jankowska Renata , Kozielski Jerzy , Wojtukiewicz Marek , Drosik Kazimierz , Koralewski Piotr
Published: June 2022

Small-cell lung cancer is characterized by an aggressive clinical course with high tendency for early dissemination. At presentation, patients are usually symptomatic and with hilar or mediastinal mass at radiography. Staging should be focused on identifying any evidence of distant spread. Chemotherapy including cisplatin and etoposide is a cornerstone of treatment for all patients. Limited-stage disease should be managed by chemotherapy combined with concurrent chest irradiation. All patients who achieve complete response should be considered for elective cranial irradiation. Surgical treatment may be used in highly selected patients with TNM stage I disease, and surgery should always be combined with chemotherapy. Extensive-stage disease should be managed by multi-agent chemotherapy alone. Long-term survivorus should undergo careful monitoring for development of a second primary tumour.
Gastroesophageal Reflux Disease (GERD) In Patients with Obstructive Sleep Apnoea Syndrome (OSAS)
Authors: Hawryłkiewicz Iwona , Pływaczewski Robert , Dziedzic Dariusz , Czerniawska Justyna , Górecka Dorota
Published: June 2022

Gastroesophageal refl ux disease (GERD) is a common cause of chronic cough, heartburn, epigastric or retrosternal discomfort, chest pain and abdominal pain or esophagitis. Our patients with OSAS seldom mani-fest GERD symptoms. We suspected that obesity and high pressure in abdominal cavity may induce acid gastro-esophageal refl ux in these patients. The aim of the study was to test the hypothesis that obesity, cigarettes smoking or ventilatory and gas exchange abnormalities provoke GERD. We studied 21 consecutive patients with severe OSAS (mean AHI 44.9 ± 23.8) before CPAP treatment, all with-out GERD clinical symptoms. Standard polysomnography, gastroscopy and 24-h oesophageal pH monitoring was performed. There were 6 females, 15 males, mean age 57 ± 9 years, mean BMI 38 ± 6 kg/m2. All patients presented with normal spirometric and gas exchange values (mean VC 3.64 ± 1.23 l, 90% of normal, mean FEV1 2.61 ± 0.95 l, 83% of normal, mean FEV1%VC 72%, mean PaO2 68.1 ± 7.7 mmHg, mean PaCO2 40.8 ± 5.8 mmHg, mean pH 7.42 ± 0.02). GERD was diagnosed in 14 patients. Patients with GERD were younger, more often were cigarettes smokers (5/14). We did not fi nd statistically signifi cant differences between severity of OSAS, BMI, ventilatory or gas exchange parameters and GERD.
Safety of Influenza Vaccination in Asthmatics
Authors: Kmiecik Tomasz , Sęk Karolina , Górski Paweł
Published: June 2022

The common cause of exacerbations in asthmatics are viral infections. Infl uenza infection especially increases the risk of respiratory exacerbations. The ACIP report puts asthma among indications to regular infl uenza vaccinations. In practice, many physicians doubt in effectiveness and safety of vaccination in patients suffering from allergy. It caused such procedures were not included in asthma guidelines published by other authors. Our study confi rmed the safety of infl uenza split vaccine vaccination in asthmatics. We proved that vaccination had not any infl uence on asthma control in 14-day period after injection. We showed also high frequency of, mostly local, side effects. These events were generally mild and transient.
Tobacco Smoking among the First-Year Medical Students
Authors: Siemińska Alicja , Jassem Joanna M. , Uherek Maja , Wilanowski Tomasz , Nowak Radosław , Jassem Ewa
Published: June 2022

The studies have shown that despite studying medicine the rate of tobacco smokers among students is still high. Moreover, in Poland the incidence of smoking is increasing among the youngsters. The study was designed to assess the rate of smokers among the fi rst-year students of two consecutive courses at the Medical University of Gdańsk and defi ne their attitudes towards tobacco smoking. The voluntary, multiple-choice questionnaires were distributed among 412 students. The rate of response was 100%. Twenty one percent of responders were current smokers (17% females and 28% men), whereas 7% declared previous smoking. There was no correlation between incidence of smoking among students and their parents (p = 0.11). 61% of smokers declared the will to give up their habit and of those 94% were aware of the negative impact of cigarettes on their health. In the group which did not declare the will to quit smoking only 75% knew what the impact of cigarettes on their health was; p = 0.02. Only 23% of smokers considered anti-nicotine therapy effective. Almost a half of smokers considered nicotine replacement therapy ineffective for them in quitting cigarette smoking. Conclusion: The rate of smokers among the first-year medical students is lower than in general population, but it is still relatively high. However more than a half of smokers wants to give up their habit. Of those who are not willing to, 25% is not aware of the cigarettes’ impact on their health. These results call for further anti-nicotine actions.
Lack of Correlation between Exhaled Nitric Oxide (eNO) And Clinical Indicators of the Disease Activity and Quality of Life in Mild and Moderate Asthmatics
Authors: Tworek Damian , Bocheńska-Marciniak Małgorzata , Kupczyk Maciej , Kupryś-Lipińska Izabela , Kuna Piotr
Published: June 2022

The measurements of exhaled nitric oxide (eNO) are simple and useful method of assessment of infl am-mation in asthmatics’ airways. One of the causes of its limited application in clinical practice is a number of factors infl uencing the results of measurements.The aim of the study was to determine the usefulness of eNO measurements in assessing the infl ammation in a heterogeneous, in relation to atopic and smoking status, group of patients.Materials and methods: 120 subjects suspected of having asthma participated in this study. During 2 weeks the patients noted daily asthma symptoms and daily use of rescue medication. After 14 days health related quality of life (HRQL) was determined by means of Asthma Quality of Life Questionnaire (AQLQ), eNO levels were mea-sured and airways reversibility test was performed. Results: Preliminary diagnosis of asthma was confi rmed in 84 patients on the basis of positive result of airways reversibility test. Among them, 21 subjects (25%) were smokers and 60 (71.4%) were atopic. No correlation was found between eNO and daily asthma symptom score, daily use of rescue medication, percent of airway reversibility after β2-agonist and HRQL. Conclusion: eNO measurements in a heterogeneous, in relation to atopic and smoking status, group of patients are of limited value in clinical assess-ment of asthma activity.
History Pages
Authors: Zieliński Jan
Published: June 2022

W bieżącym numerze Pneumonologii i Alergologii Polskiej publikowane są dwa wspomnienia związane z historią Szpitala Wolskiego, którego spadkobiercąjest Instytut Gruźlicy i Chorób Płuc w Warszawie przy ul. Płockiej 26 [...]
Dr med. Mateusz Fonberg (1840–1880)—Świadek Narodzin Szpitala Wolskiego w Warszawie
Authors: Broczek Katarzyna
Published: June 2022

tomowe dzieło pt.: Chemia z zastosowaniem do sztuk i rzemiosł (Wilno, 1825–1827), stając się współ-twórcą polskiej terminologii chemicznej [...]
Sprawozdanie z 10th International Conference on Bronchoalveolar Lavage, 17–20 czerwca 2006 r., Coimbra (Portugalia)
Authors: Chciałowski Andrzej , Chorostowska-Wynimko Joanna , Domagała-Kulawik Joanna
Published: June 2022

Zgodnie z wieloletnią tradycją, w dniach 17–20 June 2006 roku w Coimbrze w Portugalii odbyła się 10th International Conference on Bronchoalveolar Lavage [...]
CHOROBY ŚRÓDMIĄŻSZOWE
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

Cechą charakterystyczną sarkoidozy jest akumulacja w miejscach aktywnego procesu chorobowego limfocytów T CD4+ [...]
BEZDECH SENNY
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

Nykturia (≥2 epizodów oddawania moczu w nocy) jest częstym objawem obturacyjnego bezdechu sennego [...]
Significance of Virological Diagnostics for the Effective Treatment of Hosptalized Patients Infected with Influenza Virus
Authors: Machała Magdalena , Wiatr Elżbieta , Gawryluk Dariusz , Brydak Lidia B.
Published: June 2022

In the case of influenza disease there is no possible to make unquestionable diagnosis only on the basis of clinical picture. Therefore, virological laboratory diagnostics is important, especially in hospitalized patients and those who highly risk post-influenza complications and severe course of the disease. Virological diagnostic tests for influenza and positive result obtained in these tests allow to use effective antiviral-antiinfluenza drugs as new generation drugs: oseltamivir and zanarnivir and also old generation drugs: amantadine and rimantadine. Since these antivirals are effective only in the case of influenza infection, diagnostic tests should be performed previously. Present methods allow to obtain the result of the test within less than l hour to 8 h. This is of great importance, because the administration of the drug within 36 h from the onset of symptoms is one of the factors condition­ing the effectiveness of antiviral therapy. In the present paper there are described four cases of hospitalized patients in whom the infection with influenza virus was confirmed by immunofluorescence test and RT-PCR, and then the antiviral-antiinfluenza drugs were immediately introduced. This antiviral therapy in a short time resulted in the improvement of patients' condition and allowed to discharge them from the hospital. Antiviral-antiinfluenza drugs together with virological diagnostics are the effective tool in the case of patients not vaccinated against influenza, who were infected with influenza virus and fell ill.
Increased Levels of RANTES in Induced Sputum of Chronic Asthma but Not in Seasonal Grass Pollen-Induced Rhinitis
Authors: Barczyk Adam , Sozańska Ewa , Farnik Malgorzata , Stępniak-Ziółkiewicz Iwona , Nizio-Mąsior Joanna , Pierzchała Władysław
Published: June 2022

Backgroud: Allergic rhinitis is one of risk factors for development of allergic asthma. Meth­ods: 9 patients with asthma, 16 patients with seasonal allergic rhinitis (SAR) due to grass or rye pollen sensiti­zation and 17 healthy control subjects were recruited to the study. SAR patients were identified by history, skin­prick test, specific lgE and positive nasal allergen challenge. Every subject underwent the methacholine bronchial provocation test and sputum induction. Levels of RANTES were measured in supernatant of induced sputum. Results: Increased percentage of eosinophils in induced sputum in asthma compared to control group (p = 0.01) but not in SAR patients compared to healthy subjects (p = 0.13) were found. Similarly, asthmatic patients (p = 0.01) but not SAR patients had increased levels of RANTES in sputum compared to healthy subjects. Conclusion: Increased levels of RANTES in induced sputum of patients with chronic asthma but not in SAR patients indicate that RANTES is important in pathogenesis of chronic airway inflammation.
Adenosine Deaminase Activity in Tuberculous and Malignant Pleural Effusions
Authors: Safianowska Aleksandra , Krenke Rafał , Dmowska-Sobstyl Barbara , Bogacka-Zatorska Elżbieta , Domagała-Kulawik Joanna , Chazan Ryszarda
Published: June 2022

Measurement of pleural adenosine deaminase activity (ADA) is a useful diagnostic tool for tuberculous pleurisy, but false-positive findings from non-tuberculous effusions have been reported. In order to improve diagnostic value of ADA it is recommended to estimate activity of both ADA1 and ADA2 izoenzymes or 2′-deoxyadenosine/adenosine activity ratio. In order to evaluate ADA as a diagnostic parameter total ADA, with adenosine as a substrate, and 2’-deoxyadenosine/adenosine activity ratio were measured in tuberculous and malignant pleural effusions. Altogether, 26 pleural exudates (11 tuberculous and 15 malignant) were selected. ADA either with adenosine or 2’-deoxyadenosine was determined by colorimetric method of Giusti. Each pleural fluid sample was diluted prior to the assay (1:8) to avoid enzyme inhibition which was observed in nondiluted pleural effusions. The ADA level reached the diagnostic cut-off set for tuberculous effusions (40 U/L) in every 11 tuberculous exudates with the mean value of 85.3 ± 47.1 U/L; in 9 of these the 2′-deoxyadenosine/adenosine ratio was less than 0.45. In the malignant group of patients, no one ADA level exceed 40 U/L, being estimated at 10.6 ± 7.7 U/L (p < 0.001). In 10 of these 15 exudates the 2′-deoxyadenosine/adenosine ratio was undetectable, in four it was less than 0.45 and only in one it was over 0.45.We concluded that ADA measured by the Giusti method proceeded by the dilution 1:8 of the pleural effusion samples very good differentiates tuberculous from malignant pleurisy, without the necessity to determine the 2′-deoxyadenosine/adenosine ratio The investigation needs to be continued on the more numerous groups of patients.
Diagnostic Utility of Pleural Fluid Eosinophilia
Authors: Nasiłowski Jacek , Krenke Rafał , Przybyłowski Tadeusz , Abouchaz Bassem , Dmowska-Sobstyl Barbara , Droszcz Wacław , Chazan Ryszarda
Published: June 2022

Diagnostic utility of eosinophilic pleural effusion (EPE) is still the matter of controversy. Some earlier studies have showed that pleural fluid eosinophilia considerably reduces the probability of malignancy, while some later analyses were not able to confirm such an observation. To evaluate the diagnostic significance of EPE the retrospective study of all patients with pleural effusion (PE) managed in our hospital between 1995 and 2001 has been undertaken. We analyzed 915 patients with PE and 1086 pleural effusions subjected to a biochemical, cytological and bacteriological examinations. We identified 72 (7.9%) patients with EPE and 82 EPEs liquid (7.5%) among them. The group of patients with EPE consisted of 41 (57%) males and 31 (43%) females; average age 62.2 year (range 21.0–94.0). Etiologic distribution showed the largest subgroup were patients with malignant EPE (n = 28, 38.9%) followed by idiopathic EPE (n = 12, 16.7%) and parapneumonic EPE (n = 11, 15.3%). Looking for predictors of malignancy in EPE we found some differences between malignant and nonmalignant EPE: patients with malignant EPE were older (67.9 ± 13.6) then patients with nonmalignant EPE (58.7 ± 15.6; p < 0.015), and have higher percentage of lymphocytes in PE (47.9 ± 16.9 vs. 37.9 ± 18.9; p < 0.03). Similarly we noticed some differences between two largest groups (malignant and idiopathic PE). Patients with malignant PE were older (67.9 ± 13.6 vs. 53.9 ± 13.6 yrs; p = 0.005), had lower pleural fluid eosinophilia (25.2 ± 15.3% vs. 41.4 ± 21.0%; p = 0.01) and higher percentage of lymphocyte in PE (47.9 ± 16.9 vs. 29.6 ± 19.1%; p = 0.004). We conclude that pleural fluid eosinophilia cannot be considered as predictor of nonmalignant etiology. The older age and the higher number of lymphocytes in EPE might suggest malignant etiology of pleural effusion.
Holter ECG Monitoring during Research Bronchofiberoscopy in Patients with Asthma
Authors: Krenke Rafał , Przybyłowski Tadeusz , Niemczyk Michał , Górska Katarzyna , Hildebrand Katarzyna , Kościuch Justyna , Chazan Ryszarda
Published: June 2022

Bronchoscopy is a very useful tool in asthma research studies. The study was undertaken to evaluate the effect of bronchoscopy, BAL and bronchial biopsies on heart rate and arrhytmias in patients with asthma. Twenty patients (12 M, 8 F, mean age 39.6 ± 16.3 yrs) with asthma (mean FEV1 81 ± 19.5% pred.; mean FEV1%VC 69 ± 12.3%) participated in the study. Holter ECG monitoring was performed twice: before (1 or 2 days) and on the day of bronchoscopy. Heart rate and cardiac arrhythmias were compared to prebronchoscopy recording at four separate time intervals: during bronchoscopy, first postbronchoscopic hour, second postbronchoscopic hour andtotal 24 h. There were no significant differences between mean heart rate at the time of bronchoscopy (88.5 ± 14.1 min−1 vs. 83.7 ± 11.9 min−1), first and second postbronchoscopic hour (80.9 ± 15.8 min−1 vs. 85.7 ± 13.7 min−1 and 82.6 ± 13.6 min−1 vs. 80.6 ± 11.6 min−1) as well as total 24 h (76.1 ± 11.2 min−1 vs. 75.9 ± 9.4 min-1) as compared to prebronchoscopic recordings. Max. heart rate during bronchoscopy was higher as compared to the corresponding time of prebron-choscopic recording (134.5 ± 11.5 min−1 vs. 122.5 ± 19.6 min−1, p < 0.05). No differences in the number and type of ventricular (VA) and supraventricular arrhythmias (SVA) between the pre- and peribronchoscopic monitoring were observed. Positive correlation between the age and the number of VA during bronchoscopy has been found. Conclusion: Bronchoscopic procedures in asthma patients do not increase the risk of cardiac arrhythmias. Some factors influencing the heart rate and number of VA during bronchoscopy can be identified.
Influence of Nasal Continuous Positive Airway Pressure on Response to Exercise in Patients with Obstructive Sleep Apnea Syndrome
Authors: Przybyłowski Tadeusz , Bielecki Piotr , Kumor Marta , Hildebrand Katarzyna , Maskey-Warzęchowska Marta , Wiwała Joanna , Kościuch Justyna , Korczyński Piotr , Chazan Ryszarda
Published: June 2022

Obstructive sleep apnea syndrome (OSAS) patients are at risk of cardiovascular complications. The aim of this study was to assess the effect of treatment with continuous positive airway pressure (CPAP) on the response to symptom limited exercise test. Methods: twenty nine OSAS patients (1 F, 28 M), mean age 50.7 ± 9.7 yrs with body mass index of 32.6 ± 4.5 kg/m2 participated in the study. OSAS was diagnosed by overnight polysomnography. Incremental cardiopulmonary exercise test (CPET) on a treadmill was performed twice: before and after 2–3 weeks of regular treatment with CPAP. Results: mean apnea + hypopnea index (AHI) before therapy was 57.6 ± 12 h−1. CPAP treatment did not change peak oxygen consumption (VO2max) (38.3 ± 9.0 vs. 38.9 ± 6.9 mlO2/kg/min, p = ns) or peak heart rate (153.4 ± 21 min−1 vs. 155.5 ± 22 min−1, p = ns). There were no significant changes in ventilation or gas exchange variables. However, a decrease in peak systolic blood pressure from 194.5 ± 24 mmHg to 186.7 ± 27.9 mmHg (p < 0.05) with CPAP treatment was found. During recovery a decrease in heart rate (at 1st minute and minutes 3–6) and mean arterial pressure (MAP) (minutes 4–7) with CPAP treatment was observed. Significant correlations between VO2max and AHI (r = −0.38, p < 0.05); MAP at peak exercise and: AHI, mean oxygen saturation (SaO2) during sleep, minutes of sleep with SaO2 < 90% (T90); MAP at recovery (minutes 3–8) and T90 before CPAP treatment were also noted. Conclusions: OSAS patients are not limited on exercise. Treatment with nasal CPAP attenuates circulatory response to incremental exercise on a treadmill.
Efficacy and Safety of Levofloxacin Treatment of Community—Acquired Pneumonia in Hospitalized Patients
Authors: Karwat Krzysztof J. , Grabczak Magdalena , Chazan Ryszarda
Published: June 2022

The aim of this prospective study was to determine the efficacy and safety of levofloxacin in the treatment of community-aquired pneumonia (CAP) in outpatient with ineffective antibiotic management, requiring hospitalization. The examined group included 25 patients (11 M, 14 F) of mean age 70 ± 17.5 years with abnormalities in X-ray on admission to hospital. Risk factors for pneumonia and previous antibacterial therapy were analyzed. In the hospital they were treated for 7 days with levofloxacin 500 mg twice a day administred intravenously. Body temperature, blood cell count, ESR, CRP, AST, ALT, LDH, CPK, creatine, urea, potassium, sodium, ABG, and ECG were measured on admission and in the 3-rd and 7- th day of therapy. The chest X-rays were performed and analyzed on hospital discharge. 18 patients were aged > 65 yrs, cardiovascular diseases co-existed in 14, COPD in 9, smoking habit in 12, renal failure in 3, diabetes in 3 and alkohol addiction in 1 cases. On admission 4 patients had respiratory failure, 10 hypoxaemia. During therapy a decrease of body temperature (p < 0.001), concentration of CRP (p < 0.004) and LDH (p < 0.03), CPK (p < 0.04) and increase of PaO2 (p < 0.012) were observed. The changes of other parameters were not statistically significant. We did not observe any changes in ECG. On discharge from the hospital in 16 patients complete regression and in 6 patients partial regression of lesions in chest X-ray examination were observed. In 3 patients levofloxacin therapy was noneffective: in 2 because of persistent high body temperature after 3 days of treatment and in 1 patients because of recurrent of fever. Adverse events were mild. Transient exacerbation of renal failure was observed in 3 patients. Our study demonstrates that levofloxacine ni dose 2 × 500 mg given intravenously for 7 days is effective and safe in treatment of CAP in patients with previously ineffective antibacterial therapy.
Effect of Phosphodiestrase 4 Inhibitor (Rolipram)on Experimental Allergic Asthma-Guinea Pig Model
Authors: Nejman-Gryz Patrycja , Grubek-Jaworska Hanna , Glapiński Jarosław , Chazan Ryszarda
Published: June 2022

Selective phosphodiesterases (PDE) inhibitors are the new group of antiasthmatic drugs, which integrate antiinflammatory activity with bronchoconstriction counteraction. Selective inhibitors of phosphodiesterase type 4 are used as alternative or assist drugs in treatment of respiratory system diseases. So far glucocorticosteroids remain the most efficient and widely used medicine in the treatment of asthma. However application of glucocorticosteroid is greatly limited because of numerous side effects, what induce to permanent search for new antiasthmatic drugs. Examination new substances are executed on animal models. Guinea pig model is widely used to research course of asthmatic reaction. This model is especially convenient on the ground of that: lung is major shock organ, airway respond to histamine, animals demonstrated early asthmatic reaction (EAR) and late asthmatic reaction (LAR), eosinophils flow in bronchoalveolar space during LAR. In ovalbumin (OA) sensitized guinea pigs hypersensitivity reaction breaks out as a result of OA provocation. Aims of our experiments, execute on guinea pig model were to determine the influence of rolipram (PDE 4 inhibitor) on modulation experimental asthmatic reaction and comparison activity of rolipram versus dexamethasone in attribution to chosen parameters of allergic reaction such as: lung resistance, influx of protein and inflammatory cells in airways, and mastocytes degranulation. Experiments were made on guinea pigs sensitized and provoked with ovalbumin The obtain data indicate that rolipram was effective in reduction the rise of lung resistance during EAR, restricted influx of eosinophils to bronchoalveolar space between 1.5 and 24 h after provocation, and reduced increase of histamine concentration in bronchoalveolar lavage fluid (BALf). Rolipram had no influence on number of neutrophils present in BALf. Dexamethasone in double dose of 1.2 mg/kg effectively bordered the growth of lung resistance during EAR, and broke influx of eosinophils and neutrophils to bronchoalveolar space.
Chronic Obstructive Pulmonary Disease Needs Adjectives: “Guiltless” COPD, “Asthma Like” and “Emphysemal” COPD
Authors: Droszcz Wacław
Published: June 2022

The author proposes an extension of terminology of COPD by introducing to certain situations the adjectives “guiltless” (for patient who never smoked) , “asthma like” (for patients with symptoms with reversible bronchoconstriction and eosinophilia) and emphysemal COPD. The aim of this proposal is better understanding of certain events in the disease and subsequently proper treatment.
Przypadek naczyniaka chłonnego w śródpiersiu
Authors: Górska Katarzyna , Zielonka Tadeusz M. , Żukowska Małgorzata , Korczyński Piotr , Chazan Ryszarda
Published: June 2022

47-year-old women was admitted to the clinic for diagnosis of an incidentally X-ray detected enlargement of the medistinum shadow. In the past, the patient had been operated for lymphangioma of the right forearm. Chest computer tomography (CT) showed an abnormal mass in the front mediastinum with spherical structures, which density could indicate high-protein contents. In the right mammarian gland an oval cyst (23–15 mm), similar in character to the lesion in the mediastinum was found. The lymphangiomatic character of the lesion with the extension up to the superior aperture of the thorax was confirmed with magnetic resonans imaging (MRI). Due to the extensive changes and lack of symptoms, the patient was disqualified for surgical treatment and remains under further observation.
Breast Carcinoma and Anaplastic Gastric Carcinoma with Pleural Metastases in Patient after Mastectomy 30 Years Ago
Authors: Kościuch Justyna , Zielonka Tadeusz M. , Ziółkowski Bartosz , Domagała-Kulawik Joanna , Bogacka-Zatorska Elżbieta , Chazan Ryszarda
Published: June 2022

We describe a case of two simultaneous malignancies–anaplastic gastric carcinoma with pleural metastases and left breast carcinoma. These malignancies were recognized in 78–year old woman after right mastectomy performed 30 years ago. Additionaly, during diagnostic procedures rectal polypus found during colonoscopy occurred to be adenoma tubulovillosum. Her parents died from malignancies–mother from gastric cancer and father from pulmonary carcinoma. One should remember that there is always possibility of simultaneous development of more than one primary malignancies in one patient and neoplastic disease is an important cancer risk factor. This observation confirms the important role of genetic factors in the pathogenesis of malignant diseases.