Pneumonologia i alergologia polska
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Pneumonol Alergol Pol · Jan 2012
Comparative Study[Virtual bronchoscopy and bronchofiberoscopy--a comparison of diagnostic value in assessment of centrally localized lung tumor].
Virtual bronchoscopy (VB) is a new, noninvasive diagnostic technique which allows visualizing trachea and bronchi. Virtual images are created on the basis of data derived from helical CT scans using special protocol. A reconstructed, virtual image of the bronchial tree is very similar to that seen during conventional bronchofiberoscopy (FOB). The aim of the study was to compare VB images of the bronchi with those coming from FOB and evaluate diagnostic value of VB in centrally localized lung tumor. ⋯ The results indicate that virtual bronchoscopy is highly sensitive and specific diagnostic method, a clinically valuable for the evaluation of lung tumor with a central location.
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Pneumonol Alergol Pol · Jan 2012
Review Case ReportsBenign pulmonary metastasizing leiomyoma uteri. Case report and review of literature.
Benign metastasizing leiomyoma (BML) is a rare condition in middle-aged women with a history of uterine leiomyomata. It is characterized by the proliferation of, usually multiple, smooth muscle nodules. Approximately 100 cases have been reported in the literature, and the lungs were the most common site of metastases. We report a case of 52-year-old obese woman (BMI 31), hospital worker, smoker, admitted to the hospital with exertional dyspnoea, night sweats, loss of weight, and productive cough. Hysterectomy for a uterine leiomyoma was performed 9 years earlier. ⋯ Two years later pulmonary lesions have been stable; however, she has put on weight. Subsequently the patient has developed deep vein thrombosis with pulmonary embolism. Anticoagulant treatment was introduced, with some improvement.
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Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic systems of the body. The diagnosis of sarcoidosis is established on the basis of compatible clinical and radiologic findings, supported by histologic evidence in one or more organs of noncaseating epithelioid-cell granulomas. A diagnosis of sarcoidosis is reasonably certain without biopsy in patients who present with Löfgren's syndrome. In confirmation of sarcoidosis scale lymph node biopsy, endobronchial biopsy, mediastinoscopy, blind tranbronchial needle aspiration and transbronchial lung biopsy or broncho-alveolar lavage were used with diagnostic yields between 60-85%. At present in stage I and II of sarcoidosis the novel technics such as Endoscopic ultrasound-guided, fine-needle aspiration of intrathoracic lymph nodes (EBUS-FNA) and esophageal ultrasound-guided fine-needle aspiration (EUS-FNA) are performed. The combination of these two methods has been reported to provide a diagnostic yield of above 83-90% with about 100% specificity and may obviate the need for mediastinoscopy.
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For the past several years the number of women suffering from chronic obstructive pulmonary disease (COPD) has been steadily increasing. This fact prompts the debate which factors, in addition to considerably increasing prevalence of cigarette smoking among young women, are responsible for these epidemiologic changes. Differences in the natural history and prognosis of COPD in females and males are presented in the paper, as well as the number of potential ethiopathogenetic and pathophysiologic factors influencing these variations. ⋯ Further, sex-related differences regarding COPD phenotypes (chronic bronchitis vs. emphysema), immunological markers and clinical manifestation of disease are underlined in the paper. More frequent coexistence of anxiety and depression, COPD exacerbations and worse quality of life in women are also emphasized. Other differences, pointed out by authors include autoimmunological conception of pathogenesis of COPD (greater female susceptibility to produce autoantibodies), risk factors of disease exacerbation and, at last, response to certain forms of COPD treatment (nicotine replacement therapy, long-term oxygen therapy).
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Pneumonol Alergol Pol · Jan 2012
Trials of bilevel positive airway pressure - spontaneous in patients with complex sleep apnoea.
Patients with complex sleep apnoea (CompSAS) have obstructive sleep apnoea and experience persistent central apnoeas when exposed to positive airway pressure. Elevated loop gain is one of the postulated mechanisms of CompSAS. We speculated that bilevel positive airway pressure - spontaneous (BPAP-S), by producing relative hyperventilation, may more readily produce CompSAS activity than continuous positive airway pressure (CPAP). If found to do so, a trial of BPAP-S might be a simple way of identifying patients with elevated loop gain who are at risk for CompSAS. ⋯ BPAP-S was not more effective than CPAP in stimulating complex sleep apnoea activity.