Pneumonologia i alergologia polska
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Pneumonol Alergol Pol · Jan 2009
Editorial Comment[Management of COPD by chest physicians in Poland].
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Interstitial lung diseases (ILD) constitute a large group of disorders characterized by various etiology and pathogenesis. Inflammation and pulmonary fibrosis are the most important processes in the course of ILD. Disease causes the decrease of the gas diffusion in the lungs and provokes hypoxia. ⋯ The mechanism of angiogenesis in ILD is not clear yet. New data concerning participation of neoangiogenesis in pathogenesis of ILD created target for new drugs. Thalidomide, a strong antiangiogenic drug was used successfully in the some cases of ILD.
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Pneumonol Alergol Pol · Jan 2009
Comparative Study[Relationship between airway basement membrane thickness and lung function tests in patients with asthma].
Airway remodeling is a characteristic feature of asthma. It is believed that airway remodeling affects lung function and bronchial hyper-responsiveness. Therefore, the relationship between remodeling and lung function is still a matter of extensive research. However, the results of many studies are inconsistent. The aim of the study was to assess the relationship between lung function parameters and basement membrane (BM) thickness in patients with asthma. ⋯ In our group of asthma patients, mean BM was significantly thickened. No relationship between BM thickness and lung function tests, including hyper-responsiveness, was found.
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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. ⋯ 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.
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Pneumonol Alergol Pol · Jan 2009
Review[Combined pulmonary fibrosis and emphysema - case report and literature review].
We describe the case of a 61-year-old male patient, in which the search for the cause of chronic respiratory failure, severe pulmonary hypertension and secondary erythrocytosis resulted in a diagnosis of combined pulmonary fibrosis and emphysema (CPFE). This is a unique, recently characterised syndrome with upper-lobe emphysema and pulmonary fibrosis of the lower lungs. The cause is unknown, but one of the main risk factor remains smoking. ⋯ Diagnosis was based on chest computer tomography, which revealed upper lobe emphysema and lower lobe ground glass changes and honeycombing. Severe pulmonary hypertension (SPAP 80 mm Hg) was confirmed by echocardiography and right cardiac catherisation. The patient received long-term oxygen therapy, inhaled corticosteroid and Ca-blocker.