Advances in Respiratory Medicine

271 KiB

Open AccessCase Report

A Case of Systemic Melioidosis: Unravelling the Etiology of Chronic Unexplained Fever with Multiple Presentations

by Srujana Mohanty, Gourahari Pradhan, Manoj Kumar Panigrahi, Prasanta Raghab Mohapatra and Baijayantimala Mishra

Adv. Respir. Med. 2016, 84(2), 121-125; https://doi.org/10.5603/PiAP.2016.0012 - 19 Dec 2016

Cited by 4 | Viewed by 616

Abstract

Melioidosis, caused by the environmental saprophyte, Burkholderia pseudomallei, is an important public health problem in Southeast Asia and Northern Australia. It is being increasingly reported from other parts, including India, China, and North and South America expanding the endemic zone of the [...] Read more.

Melioidosis, caused by the environmental saprophyte, Burkholderia pseudomallei, is an important public health problem in Southeast Asia and Northern Australia. It is being increasingly reported from other parts, including India, China, and North and South America expanding the endemic zone of the disease. We report a case of systemic melioidosis in a 58-year-old diabetic, occupationally-unexposed male patient, who presented with chronic fever, sepsis, pneumonia, pleural effusion and subcutaneous abscess, was undiagnosed for long, misidentified as Pseudomonas aeruginosa infection elsewhere, but was saved due to correct identification of the etiologic agent and timely institution of appropriate therapy at our institute. A strong clinical and microbiological suspicion for melioidosis should be considered in the differential diagnosis of acute pyrexia of unknown origin, acute respiratory distress syndrome and acute onset of sepsis, especially in the tropics. Full article

375 KiB

Open AccessReview

Methods of Airway Resistance Assessment

by Tomasz Urbankowski and Tadeusz Przybyłowski

Adv. Respir. Med. 2016, 84(2), 134-141; https://doi.org/10.5603/PiAP.2016.0014 - 23 Mar 2016

Cited by 13 | Viewed by 1166

Abstract

Airway resistance is the ratio of driving pressure to the rate of the airflow in the airways. The most frequent methods used to measure airway resistance are whole-body plethysmography, the interrupter technique and the forced oscillation technique. All these methods allow to measure [...] Read more.

Airway resistance is the ratio of driving pressure to the rate of the airflow in the airways. The most frequent methods used to measure airway resistance are whole-body plethysmography, the interrupter technique and the forced oscillation technique. All these methods allow to measure resistance during respiration at the level close to tidal volume, they do not require forced breathing manoeuvres or deep breathing during measurement. The most popular method for measuring airway resistance is whole-body plethysmography. The results of plethysmography include among others the following parameters: airway resistance (R_aw), airway conductance (G_aw), specific airway resistance (sR_aw) and specific airway conductance (sG_aw). The interrupter technique is based on the assumption that at the moment of airway occlusion, air pressure in the mouth is equal to the alveolar pressure . In the forced oscillation technique (FOT), airway resistance is calculated basing on the changes in pressure and flow caused by air vibration. The methods for measurement of airway resistance that are described in the present paper seem to be a useful alternative to the most common lung function test—spirometry. The target group in which these methods may be widely used are particularly the patients who are unable to perform spirometry. Full article

189 KiB

Open AccessReview

What Factors May Influence Epidemiological Situation of Tuberculosis in Poland and in the World?

by Ewa Rowińska-Zakrzewska, Maria Korzeniewska-Koseła, Ewa Augustynowicz-Kopeć and Monika Szturmowicz

Adv. Respir. Med. 2016, 84(2), 126-133; https://doi.org/10.5603/PiAP.2016.0013 - 23 Mar 2016

Cited by 3 | Viewed by 636

Abstract

The authors present the review of factors influencing epidemiological situation of tuberculosis in Poland and in the world. The groups of increased risk of tuberculosis, and clinical conditions predisposing to activation of latent tuberculosis infection (LTBI) such as HIV, uremia, diabetes mellitus, transplantation [...] Read more.

The authors present the review of factors influencing epidemiological situation of tuberculosis in Poland and in the world. The groups of increased risk of tuberculosis, and clinical conditions predisposing to activation of latent tuberculosis infection (LTBI) such as HIV, uremia, diabetes mellitus, transplantation of organs, treatment with glucocorticosteroids and with antibodies to TNF and to its receptors, were presented. The higher prevalence and worse prognosis of tuberculosis in elderly people was emphasised. The methods of LTBI recognition, according to recent recommendations, with special consideration to patients in immunosupression, were shown. Methods of treatment to prevent LTBI activation, according to WHO experts, were also presented. All data were discussed in relation to the actual epidemiological situation of tuberculosis in Poland. Full article

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Open AccessCase Report

Cough-Induced Lung Intercostal Hernia

by Joanna Kosałka, Katarzyna Wawrzycka-Adamczyk, Paweł Jurkiewicz, Wiesław Pawlik, Mamert Milewski and Jacek Musiał

Adv. Respir. Med. 2016, 84(2), 119-120; https://doi.org/10.5603/PiAP.2016.0011 - 23 Mar 2016

Cited by 5 | Viewed by 506

Abstract

A 73-year-old male with marked emphysema was admitted to the 2nd Department of Internal Medicine, University Hospital in Krakow because of chronic obstructive pulmonary disease (COPD) exacerbation. His medical history was significant for total laryngectomy due to laryngeal cancer in 2010. Full article

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Open AccessCase Report

Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Non Small Cell Lung Cancer: Case Presentation and Review of the Literature

by Ioannis Tomos, Aikaterini Vlami, Anna Karakatsani, Ioanna Korbila, Effrosyni D. Manali and Spyros A. Papiris

Adv. Respir. Med. 2016, 84(2), 116-118; https://doi.org/10.5603/PiAP.2016.0010 - 23 Mar 2016

Cited by 2 | Viewed by 544

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a systemic non inflammatory disease of unknown cause. It is characterized by the presence of osteophytes due to calcification and ossification of spinal ligaments and entheses. Moreover, diffuse idiopathic skeletal hyperostosis has [...] Read more.

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a systemic non inflammatory disease of unknown cause. It is characterized by the presence of osteophytes due to calcification and ossification of spinal ligaments and entheses. Moreover, diffuse idiopathic skeletal hyperostosis has been associated with a variety of metabolic disorders. However, to the best of our knowledge no association with non small cell lung cancer (NSCLC) has been reported so far. In the present study we report a case of a patient with NSCLC and DISH. Full article

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Open AccessCase Report

Primary Ciliary Dyskinesia in Six Patients with Bronchiectasis

by Mohammadreza Modaresi, Bamdad Sadeghi, Payam Mohammadinejad, Sayed Javad Sayedi, Farzad Masiha, Rohola Shirzadi, Gholamreza Azizi and Asghar Aghamohammadi

Adv. Respir. Med. 2016, 84(2), 109-115; https://doi.org/10.5603/PiAP.2016.0009 - 23 Mar 2016

Viewed by 597

Abstract

Introduction: Primary ciliary dyskinesia [PCD] is generally considered as a rare autosomal recessive disorder. Previous studies reported various prevalence of PCD among patients with bronchiectasis. Material and methods: Six PCD patients who were diagnosed during the investigation of 40 patients with bronchiectasis were [...] Read more.

Introduction: Primary ciliary dyskinesia [PCD] is generally considered as a rare autosomal recessive disorder. Previous studies reported various prevalence of PCD among patients with bronchiectasis. Material and methods: Six PCD patients who were diagnosed during the investigation of 40 patients with bronchiectasis were enrolled in this study. Ultra structural studies for both epithelium and cilia were performed, and the deformities in detailed electron microscopic images confirmed the diagnosis of PCD. Results: Four patients experienced the first symptoms shortly after the birth, 1 by the age of 1 and 1 by the age of 4 years. Except of 1 case that was diagnosed 2 months after the onset of disease, diagnosis delay was longer than 5 years in all patients. Consanguineous marriage was observed in the parents of all patients. Upper respiratory tract infections were documented for all patients. Conclusions: PCD should be considered as a probable underlying disorder in patients with bronchiectasis. Past medical history of otitis media and history of similar clinical findings in family members should raise suspicion toward PCD. Full article

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Open AccessArticle

Lifestyle Factors and Asthma in India—A Case-Control Study

by Mohammed Noufal Poongadan, Nitesh Gupta and Raj Kumar

Adv. Respir. Med. 2016, 84(2), 104-108; https://doi.org/10.5603/PiAP.2016.0008 - 23 Mar 2016

Cited by 6 | Viewed by 775

Abstract

Introduction: There has been a recent trend of increasing prevalence of asthma in developing countries; prevalence in the Indian population is reported to be 2%. The link between lifestyle factors and asthma has been mostly derived from western literature. The present study intended [...] Read more.

Introduction: There has been a recent trend of increasing prevalence of asthma in developing countries; prevalence in the Indian population is reported to be 2%. The link between lifestyle factors and asthma has been mostly derived from western literature. The present study intended to study relationship if any, between life style factors and asthma in a representative Indian population. Material and methods: The study is a case-control study performed for a period of one year, between 2014 and 2015. 125 asthma and correspondingly age and sex matched healthy controls were recruited for the purpose of study. A self-reported questionnaire has been prepared based on routine lifestyle habits of Indian population. Results: The hours of TV watching and hours of sleep were significantly higher in asthma patients, and also duration of sports activity showed inverse relation with asthma. Smoking, tobacco, chewing as well as alcohol consumption were higher in asthma patients in comparison to controls, though neither was statistically significant. The mental stress as assessed on scale of 1−10, was significantly higher in asthma patients (p < 0.001). Asthma patients had significantly lower travel duration/week (p < 0.05). Conclusions: The present study concluded increased TV watching, increased mental stress, reduced hours of physical activity and travel may be correlated with asthma in India. With growing evidence of increasing association of asthma and sedentary lifestyle, it is imperative to reduce acquaintance to as well as incidence of these factors through public health policies, which may impact prevalence of asthma in Indian population. Full article

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Open AccessArticle

Prospective, Population-Based Surveillance of the Burden of Streptococcus pneumoniae in Community-Acquired Pneumonia in Older Adults, Chrzanów County, Poland, 2010 to 2012

by Rafal Harat, Ronika Alexander, Sharon Gray, Elane M. Gutterman, Justyna Pluta, Michael Pride, Sebastian Shite, Joanna Fijolek and Jolanta Kozub

Adv. Respir. Med. 2016, 84(2), 95-103; https://doi.org/10.5603/PiAP.2016.0007 - 23 Mar 2016

Cited by 1 | Viewed by 625

Abstract

Introduction: Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest X-ray−confirmed CAP (CXR+CAP), S pneumoniae-positive CAP, S pneumoniae-positive CXR+CAP, and S. pneumoniae serotype distribution among [...] Read more.

Introduction: Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest X-ray−confirmed CAP (CXR+CAP), S pneumoniae-positive CAP, S pneumoniae-positive CXR+CAP, and S. pneumoniae serotype distribution among 46,000 at-risk adults aged ≥ 50 years residing in Chrzanów County, Poland. Material and methods: From January 2010 to January 2012, all facilities providing ambulatory and inpatient care enrolled all consenting resident patients with suspicion of CAP. Chest X-rays, urine, blood, and sputum samples were analyzed. Annualized incidence rates were determined. Presence of S pneumoniae-positive CAP and/or S. pneumoniae serotype distribution was determined using the urine antigen detection assay (capable of detecting the serotypes in the 13-valent pneumococcal conjugate vaccine [PCV13]), BinaxNOW^®, and/or microbiology cultures. Results: Among 5055 enrolled patients, 1195 (23.7%) were diagnosed with CAP and 1166 (23.4%) had CXR+CAP. S. pneumoniae was detected in 144 (12.1%) and 131 (11.2%) patients from the CAP and CXR+CAP cohorts, respectively. Annualized incidence rates of CAP, CXR+CAP, S pneumoniae-positive CAP, and S. pneumoniae-positive CXR+CAP were 12.8, 12.5, 1.6, and 1.4 per 1000 residents, respectively. Among CXR+CAP patients, 39.7% were aged 50 to 64 years and 60.3% were aged ≥ 65 years. Incidence rates generally increased with age. The most common serotypes in S. pneumoniae-positive CXR+CAP patients were 3 (n = 15), 23F (n = 10), 18C (n = 9), and 9V (n = 6). Conclusions: CAP due to PCV13 serotypes is a source of morbidity among adults >50 years and may be reduced by greater access to pneumococcal vaccines. Full article

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Open AccessArticle

Low DLCO in Idiopathic Pulmonary Arterial Hypertension—Clinical Correlates and Prognostic Significance

by Monika Szturmowicz, Aneta Kacprzak, Monika Franczuk, Barbara Burakowska, Marcin Kurzyna, Anna Fijałkowska, Agnieszka Skoczylas, Stefan Wesołowski, Jan Kuś and Adam Torbicki

Adv. Respir. Med. 2016, 84(2), 87-94; https://doi.org/10.5603/PiAP.2016.0006 - 23 Mar 2016

Cited by 9 | Viewed by 970

Abstract

Introduction: Decreased diffusing capacity of the lung for carbon monoxide (DLCO) is observed in some idiopathic pulmonary arterial hypertension (IPAH) patients, but its clinical significance is uncertain. We aimed to assess clinical correlates and prognostic significance of low DLCO in IPAH patients. Material [...] Read more.

Introduction: Decreased diffusing capacity of the lung for carbon monoxide (DLCO) is observed in some idiopathic pulmonary arterial hypertension (IPAH) patients, but its clinical significance is uncertain. We aimed to assess clinical correlates and prognostic significance of low DLCO in IPAH patients. Material and methods: In the group of 65 IPAH patients the cut off value for low DLCO was set up based on histogram as < 55% of predicted value. Demographic data, exercise capacity, lung function tests, hemodynamic parameters and survival of the patients were compared depending on DLCO value. Results: Low DLCO was found in 18% of the patients, and it was associated with male sex, older age, worse functional status and exercise capacity, and higher prevalence of coronary artery disease. Low DLCO carried a 4-fold increase of death risk in 5-year perspective. Conclusions: Low DLCO was a marker of worse functional capacity and increased risk of death in studied IPAH patients. Full article

181 KiB

Open AccessArticle

The Clinical Differences of Asthma in Patients with Molds Allergy

by Krzysztof Kołodziejczyk, Andrzej Bożek, Jerzy Jarząb and Radosław Gawlik

Adv. Respir. Med. 2016, 84(2), 81-86; https://doi.org/10.5603/PiAP.2016.0005 - 23 Mar 2016

Cited by 8 | Viewed by 645

Abstract

Introduction: Bronchial asthma is an increasing problem worldwide. The course of bronchial asthma is dependent on the type of inducing allergens. The differences between the clinical features of asthma in patients with monovalent allergies to molds and with other allergies were explored. Material [...] Read more.

Introduction: Bronchial asthma is an increasing problem worldwide. The course of bronchial asthma is dependent on the type of inducing allergens. The differences between the clinical features of asthma in patients with monovalent allergies to molds and with other allergies were explored. Material and methods: Randomly selected 1910 patients (924 women and 986 men) between 18−86 years in age were analyzed according to type of allergy and asthma. The diagnosis of asthma was confirmed on the basis of GINA criteria, physical examination and spirometry. Allergy diagnosis was confirmed on the basis of medical history, a positive skin prick test and the measurement of serum-specific IgE to inhalant allergens, using an extended profile of mold allergens. Results: Patients with monovalent allergies to molds (4% of analyzed group) had significantly more frequent diagnoses of asthma than patients in the other group (53% vs. 27.1−32.4%, p < 0.05). Patients with allergies to Alternaria alternata had an odds ratio of 2.11 (95%CI: 1.86−2.32) for receiving a diagnosis of bronchial asthma. They had less control over their asthma, which was more severe compared to patients with other allergies. Patients with asthma and allergies to mold had significantly more frequent exacerbation of asthma requiring systemic corticosteroids and/or hospitalization. They used a significantly greater mean daily dose of inhaled steroids compared to other patients. Conclusions: Patients with monovalent IgE allergies to molds are at a higher risk for asthma than patients with other allergies. Their asthma is often more intense and less controlled compared to that of patients with other types of allergies. Full article

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Adv. Respir. Med., Volume 84, Issue 2 (March 2016) – 10 articles , Pages 81-141

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