Advances in Respiratory Medicine

206 KiB

Open AccessCase Report

Tropical Pulmonary Eosinophilia: Effect of Addition of Corticosteroids after Failure of Diethylcarbamazine Therapy

by Manu Madan, Pawan Gupta, Richa Mittal and Sunil K. Chhabra

Adv. Respir. Med. 2017, 85(1), 51-54; https://doi.org/10.5603/ARM.2017.0010 - 13 Feb 2017

Cited by 5 | Viewed by 575

Successful response in diethylcarbamazine (DEC) therapy in tropical pulmonary eosinophilia (TPE) is not universal with a 20–40% failure rates in chronic cases. Corticosteroids have been used in such patients. However, their role in management remains ill-defined. A patient of TPE with incomplete clinical, [...] Read more.

Successful response in diethylcarbamazine (DEC) therapy in tropical pulmonary eosinophilia (TPE) is not universal with a 20–40% failure rates in chronic cases. Corticosteroids have been used in such patients. However, their role in management remains ill-defined. A patient of TPE with incomplete clinical, haematological and physiological response to a standard 3 weeks DEC therapy received additional corticosteroids for the next two cycles, after which complete remission occurred. However, there was a relapse two months later with evidence of a chronic state requiring further treatment with corticosteroids with good response. Full article

300 KiB

Open AccessCase Report

Interstitial Pneumonia with Autoimmune Features (IPAF) and Radiological Findings Suggestive of Lymphocytic Interstitial Pneumonia (LIP)—Case Report

by Alicja Płóciniczak, Joanna Goździk-Spychalska and Halina Batura-Gabryel

Adv. Respir. Med. 2017, 85(1), 46-50; https://doi.org/10.5603/ARM.2017.0009 - 13 Feb 2017

Cited by 2 | Viewed by 666

Abstract

Interstitial pneumonia with autoimmune features (IPAF) is a term to describe individuals with both interstitial lung disease (ILD) and combinations of other clinical, serologic, and/or pulmonary morphologic features, which presumably originate from an underlying systemic autoimmune condition, but do not meet current rheumatologic [...] Read more.

Interstitial pneumonia with autoimmune features (IPAF) is a term to describe individuals with both interstitial lung disease (ILD) and combinations of other clinical, serologic, and/or pulmonary morphologic features, which presumably originate from an underlying systemic autoimmune condition, but do not meet current rheumatologic criteria for a defined connective tissue disease (CTD). Predominantly, interstitial pneumonia arises in the course of an established CTD, but it is not so rare for the ILD to be the first, and possibly the one and only manifestation of a latent CTD. Lymphocytic Interstitial Pneumonia (LIP) is an uncommon disease, characterized by infiltration of the interstitium and alveolar spaces of the lung by lymphocytes, plasma cells and other lymphoreticular elements. The cause of LIP is still unknown but it could be also a manifestation of CTD. Clinically, it is highly variable, from spontaneous resolution to progressive respiratory failure and death despite glucocorticoid treatment. Since there are no recent standards for the management of LIP, the disease is treated empirically. We report a case of a HIV-negative 54-year-old woman, who was suspected of LIP according to clinical features and radiological findings. Positive laboratory results were highly suggestive of underlying autoimmune process, but did not fulfil the criteria of any particular CTD. Because of severe general condition of the patient, immunosuppressive treatment was started immediately, without further invasive diagnostics including lung biopsy, which is required for a definitive diagnosis. We present two-year observation of the patient with all our doubts concerning clinical proceedings. Full article

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Open AccessReview

A Debate: Can We Recommend Electronic Cigarettes to Our Patients? Opinion 2

by Michał Poznański, Tadeusz Pietras and Adam Antczak

Adv. Respir. Med. 2017, 85(1), 40-45; https://doi.org/10.5603/ARM.2017.0008 - 13 Feb 2017

Cited by 2 | Viewed by 493

Abstract

Electronic cigarettes are more and more frequently used to deliver nicotine. They are used both by the users of regular cigarettes and those who to date have not smoked. The literature about potential impact of electronic nicotine delivery systems on health is constantly [...] Read more.

Electronic cigarettes are more and more frequently used to deliver nicotine. They are used both by the users of regular cigarettes and those who to date have not smoked. The literature about potential impact of electronic nicotine delivery systems on health is constantly growing. Particular concern is expressed about toxicity of chemical compounds and elements delivered with the vapour of electronic cigarettes. It turns out that products that have positive image in media, actually are not so beneficial. Furthermore, they not only may cause damage to health but also death. Full article

146 KiB

Open AccessReview

A Debate: Can We Recommend Electronic Cigarettes to Our Patients? Opinion 1

by Tadeusz M. Zielonka

Adv. Respir. Med. 2017, 85(1), 35-39; https://doi.org/10.5603/ARM.2017.0007 - 13 Feb 2017

Cited by 2 | Viewed by 484

Abstract

A discussion about disadvantages of electronic cigarettes (e-cigarettes) has recently broken out. There are even opinions that they are as harmful as regular cigarettes. However, this has not been proved, and theoretical premises suggest that e-cigarettes should be definitely less harmful as while [...] Read more.

A discussion about disadvantages of electronic cigarettes (e-cigarettes) has recently broken out. There are even opinions that they are as harmful as regular cigarettes. However, this has not been proved, and theoretical premises suggest that e-cigarettes should be definitely less harmful as while using them, tobacco is not burned and harmful substances, in particular carcinogens are not produced. Certain premises assume that e-cigarettes may be used as a new form of nicotine replacement therapy, but this has not been confirmed yet. Therefore, further research into harmfulness and safety of the use of e-cigarettes is required. This paper presents solely reasons for the possibility of recommending e-cigarettes to people addicted to nicotine. Full article

190 KiB

Open AccessReview

Thyroid Gland in Chronic Obstructive Pulmonary Disease

by Joanna Miłkowska-Dymanowska, Adam J. Białas, Paulina Laskowska, Paweł Górski and Wojciech J. Piotrowski

Adv. Respir. Med. 2017, 85(1), 28-34; https://doi.org/10.5603/ARM.2017.0006 - 13 Feb 2017

Cited by 8 | Viewed by 959

Abstract

The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients [...] Read more.

The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases. Full article

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Open AccessArticle

Corticosteroids and Hip Fracture Risk in Elderly Respiratory Patients: EPIC-Greece Cohort

by Anna Karakatsani, Michail Katsoulis, Eleni Klinaki and Antonia Trichopoulou

Adv. Respir. Med. 2017, 85(1), 22-27; https://doi.org/10.5603/ARM.2017.0005 - 13 Feb 2017

Cited by 3 | Viewed by 751

Abstract

Introduction: In an ageing population the prevalence of osteoporosis and chronic respiratory diseases is expected to increase in the near future. Interestingly, several forms of corticosteroids, drugs implicated in osteoporosis pathogenesis, are prescribed to respiratory patients without taking into consideration their age [...] Read more.

Introduction: In an ageing population the prevalence of osteoporosis and chronic respiratory diseases is expected to increase in the near future. Interestingly, several forms of corticosteroids, drugs implicated in osteoporosis pathogenesis, are prescribed to respiratory patients without taking into consideration their age and risk for osteoporotic fractures. The aim of this study was to investigate the risk for hip fracture of the elder individuals who are taking corticosteroids for respiratory disease, including inhalers. Material and methods: Data on incident hip fractures were collected through the active follow-up for all individuals participating in the Greek segment of the European Prospective Investigation into Cancer and Nutrition (EPIC-Greece) study who were 60 years or older at recruitment and reported “a doctor’s diagnosis” of respiratory disease. Socio-demographic, life-style, health status data and use of corticosteroids were recorded from the baseline and follow-up questionnaires. Cox regression models were applied to estimate hazard ratios (HRs) adjusting for relevant confounders. Results: We observed an increase in hip fracture risk with corticosteroid intake overall (HR: 1.68, 95% CI: 0.85–3.34). Increased risk persisted when we restricted our analysis to participants taking any form of corticosteroids for obstructive lung disease (HR: 1.40, 95% CI: 0.64–3.06) and to those using only inhalers (HR: 1.58, 95% CI: 0.71–3.50). However, these positive associations did not reach the nominal level of significance probably due to the small number of participants with hip fractures during follow-up. Conclusion: Hip fracture risk should be taken into consideration when recommending corticosteroids to the elder respiratory patients, including inhalers. Full article

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Open AccessArticle

The Effects of Health Education Given by Nurses to COPD Patients on the Daily Oxygen Concentrator Usage Time

by Uğur Doğan and Nimet Ovayolu

Adv. Respir. Med. 2017, 85(1), 15-21; https://doi.org/10.5603/ARM.2017.0004 - 13 Feb 2017

Cited by 8 | Viewed by 792

Abstract

Introduction: Long-term oxygen therapy is the most effective method which has been shown to prolong the lifespan in people with COPD. The aim of the study was to investigate the effects of health education given by nurses to patients with COPD on [...] Read more.

Introduction: Long-term oxygen therapy is the most effective method which has been shown to prolong the lifespan in people with COPD. The aim of the study was to investigate the effects of health education given by nurses to patients with COPD on the daily oxygen concentrator (OC) usage time. Material and methods: The study was carried out in a State Hospital, Turkey, between July and November 2015. After given consent to the study, participants were divided into intervention and control groups by simple random sampling method. Then data forms were filled during face-to-face interview. Firstly, the data describing patients’ arrival times were collected retrospectively. Afterwards, the patients from the intervention group were educated through educational booklets prepared by the researchers. They were phoned in the weeks 4, 8 and 12th for problems they might have encountered during the use of OC. After the 14th week, data forms of patients from the both groups were filled again; the results were compared with previous clinical findings. Data were analysed using SPSS 15.0 for Windows. Results: It was determined that 95.5% of patients did not get information about the use of OC. Daily OC usage time (hour) by patients in the intervention group firstly amounted to 5.69 ± 3.90, later on to 11.94 ± 4.73 (p < 0.05). Whereas when clinical findings concerning pre- and post educational periods were compared; a significant improvement in PaO₂, PaCO₂, FEV₁ and SaO₂ of patients in the intervention group (p < 0.05) was shown, contrary to the control group. Conclusions: It may be recommended that patients receive continuous education and close monitoring of their results. Full article

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Open AccessArticle

E-Smoking among Students of Medicine—Frequency, Pattern and Motivations

by Grzegorz M. Brożek, Mateusz Jankowski, Jan Zejda, Agnieszka Jarosińska, Agnieszka Idzik and Piotr Bańka

Adv. Respir. Med. 2017, 85(1), 8-14; https://doi.org/10.5603/ARM.2017.0003 - 13 Feb 2017

Cited by 25 | Viewed by 1389

Abstract

Introduction: E-smoking has become a public health problem. The objectives of this study were to assess the prevalence of e-cigarette and tobacco cigarette use; to compare the patterns of smoking; to assess the attitudes and motivations for e-cigarette use. Material and methods [...] Read more.

Introduction: E-smoking has become a public health problem. The objectives of this study were to assess the prevalence of e-cigarette and tobacco cigarette use; to compare the patterns of smoking; to assess the attitudes and motivations for e-cigarette use. Material and methods: All 1700 students from Faculty of Medicine (Medical University of Silesia) were invited to questionnaire based cross-sectional study about the frequency and attitudes towards the use of traditional and electronic cigarettes. Results: The data were obtained from 1318 medical students (response 77.5%) aged 22.1 ± 2.2 years. Traditional tobacco smoked 18.1%, e-cigarettes 1.3% and 2.2% were dual smokers. The overall frequency of e-smokers was 4.9% among men and 2.8% among women (p = 0.05). Compared to tobacco users in e-smokers duration of smoking was shorter (p < 0.001), the intensity of smoking was larger (p = 0.01), the number of e-cigarettes smoked daily was higher (p < 0.001). Dual smokers more frequently used tobacco cigarettes than e-cigarettes (p = 0.01) but smoked more e-cigarettes daily (p = 0.003). The choice of e-liquid depended on the flavour (50.0%), nicotine concentration (21.7%) and price (7.6%). No-nicotine e-cigarettes were used by 6.5% smokers. Dual smokers more frequently chose e-liquids with high nicotine concentration (p = 0.01). Motivations leading to e-smoking were: quitting tobacco (58.7%), less harmful impact on health (43.5%) and the price (34.8%). E-smoking as safe for health was perceived by 6.0% of respondents (35.5% in e-smokers vs. 4.9% in non e-smokers; p < 0.001). Conclusion: Among students of medicine, e-smoking is apparently less popular than smoking tobacco cigarettes. Respondents considered e-cigarettes to be harmful and addictive. Full article

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Open AccessArticle

The Content of Mucin MUC-2, -3 and -4 Antigens in the Bronchial Mucosa Membrane of Chronic Obstructive Pulmonary Disease Patients during Acute Exacerbation—Initial Report

by Svetlana Kovalenko and Andrey Dorofieiev

Adv. Respir. Med. 2017, 85(1), 3-7; https://doi.org/10.5603/ARM.2017.0002 - 13 Feb 2017

Cited by 3 | Viewed by 687

Abstract

Introduction: Changes in mucin production and dyscrinia are common features of inflammation in chronic obstructive pulmonary disease (COPD). Immunohistochemical assessment of MUC-2, MUC-3, MUC-4 expression in the integumentary epithelium, goblet cells, the epithelium of mucous glands and stroma fusiform cells of the [...] Read more.

Introduction: Changes in mucin production and dyscrinia are common features of inflammation in chronic obstructive pulmonary disease (COPD). Immunohistochemical assessment of MUC-2, MUC-3, MUC-4 expression in the integumentary epithelium, goblet cells, the epithelium of mucous glands and stroma fusiform cells of the bronchial mucosa of COPD patients during an infectious and noninfectious exacerbation was performed. Material and methods: 30 patients with stage III COPD were enrolled to the study. Patients were divided into 2 groups: group A—14 patients with non-infectious acute exacerbation of COPD (AECOPD) and group B—16 patients with infectious AECOPD. Fiberoptic bronchoscopy (FBS) and in vivo bronchial biopsy of bronchial mucosa were implemented to determine the extent and nature of bronchial inflammation. The optical density of specific color in bronchial structures was assessed using immunohistochemical staining to MUC-2, -3 and -4 antigens by means of primary monoclonal antibodies to these proteins, and visualization system Dako EnVision + System, Peroxidase (AEC). Results and conclusions: We detected that in different types of bronchial mucosa epithelial cells, during acute infectious exacerbation, a decrease of antigens MUC-2 and MUC-3 expression of a various degree may occur. This phenomenon in the stroma fusiform cells in AECOPD may be a sign of epithelial-mesenchymal transition, that may play a role in the development of an inflammatory process and progression of fibrosis in COPD. Full article

54 KiB

Open AccessEditorial

Are E-Cigarettes Good or Bad?

by Paweł Górski

Adv. Respir. Med. 2017, 85(1), 1-2; https://doi.org/10.5603/ARM.2017.0001 - 13 Feb 2017

Cited by 3 | Viewed by 474

Abstract

The first generation of e-cigarettes appeared on the EU market in 2006 and soon after it was introduced in the United States. It seems to be very difficult to compare health effects of all of the three generations [...] Full article

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Adv. Respir. Med., Volume 85, Issue 1 (February 2017) – 10 articles , Pages 1-54

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