Pneumonologia i alergologia polska
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Pneumonol Alergol Pol · Jan 2016
ReviewThe effect of omalizumab on eosinophilic inflammation of the respiratory tract in patients with allergic asthma.
Bronchial asthma is characterised by high levels of immunoglobulin E (IgE) and overproduction of pro-inflammatory cytokines, including interleukins IL-4, IL-13 and IL-5 needed for, amongst other things, the production of IgE and the differentiation, maturation, migration and survival of eosinophils. Eosinophils are one of the most important cells in allergic inflammation. Their presence in tissue is linked to the persistence of inflammatory infiltrate, tissue damage and remodelling. ⋯ Clinical studies have confirmed that the very effective treatment in these cases is therapy with omalizumab - an anti-IgE monoclonal antibody. The paper discusses the efficacy of omalizumab in reducing eosinophil number in peripheral blood and in the airways of asthmatic patients based on basic, clinical, observational studies and case reports. The significance of omalizumab therapy in asthma control and mechanisms that regulate the effects of omalizumab on eosinophils are evaluated.
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Pneumonol Alergol Pol · Jan 2016
ReviewPulmonary arterial hypertension: a current review of pharmacological management.
Pulmonary hypertension (PHTN) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventricular failure and death. At present there is no cure for pulmonary arterial hypertension (PAH); however over the past decade targeted pharmaceutical options have become available for the treatment of PAH. ⋯ Once the establishment of a diagnosis of PAH is made therapeutic options may be a possibility based on a diagnostic algorithm and disease severity of the PAH patient. There are different classes of medications available with different mechanisms of actions which net a vasodilatory effect and improve exercise tolerance, quality of life as well and survival.
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Pneumonol Alergol Pol · Jan 2016
ReviewUsefulness of lung ultrasound in diagnosing causes of exacerbation in patients with chronic dyspnea.
Dyspnea is a non-specific symptom that requires fast diagnostics, accurate diagnosis and proper treatment. The most common causes of dyspnea include exacerbation of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Distinction between these two medical conditions seems to be critical in diagnostics of emergencies. ⋯ Therefore looking for additional diagnostic tool seems to be justified and necessary. Transthoracic lung ultrasound assessment is a simple and easily accessible examination, enabling the early and explicit diagnostics of pulmonary oedema and its distinction from other, non-cardiac causes of dyspnea. This review outlines the current knowledge on the subject of transthoracic lung ultrasound (TLUS), particularly in respect of its clinical usefulness in distinction of causes of dyspnea exacerbation.
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Pneumonol Alergol Pol · Jan 2015
ReviewSelected molecular events in the pathogenesis of sarcoidosis - recent advances.
Sarcoidosis is an orphan inflammatory disorder that can virtually affect any organ or system in the body, although the lungs and lymph nodes are most frequently involved. Sarcoidosis is believed to derive from an interaction between environmental and genetic agents. Many studies emphasize a strong association between certain human leukocyte antigen (HLA) alleles and sarcoidosis susceptibility. ⋯ This review summarizes recent advances in the identification of novel molecular markers that may play a role in different stages of disease, such as the acute phase of inflammation, granuloma formation and fibrosis. Furthermore, this article elucidates the role of both TGF-b/Smad and (HIF)-1a-VEGF-ING-4 signaling pathways in the development of sarcoidosis. The potential epigenetic regulation of the processes occurring in sarcoidosis by miRNA is also discussed.
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Pneumonol Alergol Pol · Jan 2015
Multicenter Study Comparative Study Observational StudyUsage and usability of one dry powder inhaler compared to other inhalers at therapy start: an open, non-interventional observational study in Poland and Germany.
Inhalation is the preferred route of drug administration for patients with asthma or COPD. It is generally predicted that there is a high error rate in inhaler usage, especially at the therapy start. The primary objective of this study was the validation of a questionnaire that can be used for assessing a successful inhalation technique, patient satisfaction as well as the compliance in daily practice.The secondary objective was to examine the "real-life" usage of one inhalation device in comparison with other devices at the start of the therapy. ⋯ The results of this study show that investigators found EH easy to teach, the patients found it easy to use and their satisfaction with the device was high in comparison to other inhalation devices. Thus EH can be matched to many patients already at the therapy start. In addition, the high consistency of the received data and large association of the assessment of the inhaler usage and the general assessment of the inhaler indicate that the used questionnaires were appropriate tools to examine usage and usability of inhaler devices in adult patients and children.