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.