Eosinophilic COPD ― a distinct phenotype of the disease

  Chronic Obstructive Pulmonary Disease (COPD) has been traditionally associated with neutrophilic inflammation of the bronchi. Studies from the early 1990s demonstrated that eosinophils may also get into the lower airways of patients with COPD and their increased numbers can be noticed during exacerbations as well as stable disease. Eosinophilic phenotype of COPD is characterized by several unique features, i.e. a specific pattern of airway inflammation and distinct clinical course or susceptibility to corticosteroid treatment. In this paper, we present an up-to-date review of the literature on clinical characteristics of eosinophilic COPD, as well as the role of eosinophils as a biomarker-guided therapy in COPD.

Comorbidities in lung cancer

Comorbidity is the occurrence of concomitant disease in addition to an index disease of interest or the simultaneous occurrence of multiple diseases in an individual. Lung cancer is associated with age and smoking, and both age and smoking are strongly associated with comorbidity. Lung cancer is the most common malignancy in the world. Comorbidity, such as diseases of cardiovascular, pulmonary and other systems may influence prognosis in lung cancer as well as complicate its treatment. In this paper we tried to conclude the significance of the individual comorbidities in lung cancer and their impact on particular treatment method.Comorbidity is the occurrence of concomitant disease in addition to an index disease of interest or the simultaneous occurrence of multiple diseases in an individual. Lung cancer is associated with age and smoking, and both age and smoking are strongly associated with comorbidity. Lung cancer is the most common malignancy in the world. Comorbidity, such as diseases of cardiovascular, pulmonary and other systems may influence prognosis in lung cancer as well as complicate its treatment. In this paper we tried to conclude the significance of the individual comorbidities in lung cancer and their impact on particular treatment method

A debate: Can we recommend electronic cigarettes to our patients? Opinion 2

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.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

Concentration of 8-isoprostanes in the exhaled breath condensate as a marker of oxidative stress in patients with type 1 diabetes

Introduction: Type 1 diabetes is an insulin deficiency-based chronic disease. It leads to the development of hyperglycaemia,which plays a key role in the initiation and progression of tissue damage in patients with diabetes. This mostly results fromoxidative stress, whose increased severity is observed in this group of patients. Increased levels of 8-isoprostanes are seen inmany inflammatory diseases, including asthma, COPD and cystic fibrosis. These diseases demonstrated the usefulness of theexhaled breath condensate (EBC) for extracting material for markers of oxidative stress, including 8-isoprostanes. The purposeof this study was to assess the severity of oxidative stress measured with 8-isoprostane concentrations in the exhaled breathcondensate in healthy subjects and in patients with type 1 diabetes with and without vascular complications. Material and methods: 33 patients assigned to the control group, type 1 diabetes without complications group and type 1 diabetesgroup with advanced complications were included in the study. Retinopathy, nephropathy or neuropathy have been reportedas a criterion distinguishing between complicated and uncomplicated diabetes. EBC was obtained for each subject. 8-isoprostaneconcentrations were determined in serum and EBC by ELISA. Results and conclusions: Mean (± SD) blood levels of 8-isoprostane in patients with type 1 diabetes mellitus without complicationsand those with type 1 diabetes with advanced complications were significantly higher compared to the control group(178.17 [135.73] vs. 183.34 [200.41] vs. 47.13 [25.20] pg/ml; p < 0.05). The mean (± SD) concentration of 8-isoprostane in EBCwas lower in diabetic patients with type 1 diabetes with advanced complications than in patients with type 1 diabetes withoutadvanced complications and in the control group (8.32 [4.60] vs. 19.13 [22.35] vs. 28.17 [35.11] pg/ml; p < 0.05). Measurementof 8-isoprostanes in the EBC in patients with type 1 diabetes does not appear to be a good diagnostic tool for monitoring theactivity of oxidative stress in these patients

Hepatocyte growth factor in exhaled breath and BAL fluid in sarcoidosis

Wstęp: Wątrobowy czynnik wzrostu (HGF) jest silnym mitogenem stymulującym wzrost komórek nabłonka pęcherzyków płucnych. Wyższe stężenia HGF w różnych materiałach biologicznych stwierdzono między innymi w zespole ostrej niewydolności oddechowej (ARDS), u chorych po przebytym zapaleniu płuc i po pneumonektomii. Niekorzystnym zejściem sarkoidozy jest włóknienie płuc. Wątrobowy czynnik wzrostu mógłby być przydatny jako marker pozwalający na rozpoznanie chorych obarczonych ryzykiem włóknienia płuc. Celem pracy była ocena: 1) czy HGF jest wykrywalny w popłuczynach oskrzelowo-pęcherzykowych (BAL) i kondensacie powietrza wydechowego (EBC); 2) czy stężenia HGF w BAL-u i kondensacie chorych na sarkoidozę różnią się od stężeń osób zdrowych; 3) czy istnieją korelacje z parametrami aktywności i wybranymi czynnikami rokowniczymi. Materiał i metody: Zebrano kondensat od 64 i popłuczyny oskrzelowo-pęcherzykowe od 30 chorych na sarkoidozę. Grupę kontrolną stanowiły osoby zdrowe (n = 15 dla EBC, n = 9 dla BAL). Wątrobowy czynnik wzrostu oznaczono immunoenzymatycznie. Wyniki: Stężenia HGF w kondensacie przekroczyły próg detekcji u 62% badanych (56% chorych i 87% zdrowych) i we wszystkich próbkach BAL. Nie stwierdzono różnic w stężeniach w EBC i BAL pomiędzy osobami chorymi i zdrowymi. Nie stwierdzono korelacji pomiędzy HGF w EBC/BALF a stopniem radiologicznym, parametrami czynności płuc, czasem trwania choroby, liczbą nawrotów, odsetkiem limfocytów w BAL, stężeniem enzymu konwertującego angiotensynę i wapnia w surowicy, utratą dobową wapnia z moczem. Wnioski: Wątrobowy czynnik wzrostu jest wykrywalny w BAL i EBC. Jednak brak różnic pomiędzy chorymi na sarkoidozę i osobami zdrowymi oraz brak korelacji z markerami aktywności i czynnikami rokowniczymi uniemożliwiają jego zastosowanie w diagnostyce i monitorowaniu sarkoidozy.Introduction: Hepatocyte growth factor (HGF) is a strong mitogen stimulating lung epithelial cell growth. Elevated levels of HGF have been reported in various biological materials of patients with acute respiratory distress syndrome and in patients recovering from pneumonia or pneumonectomy. Sarcoidosis may be complicated by lung fibrosis. Consequently, HGF could be considered a new biomarker identifying patients with a higher risk of lung fibrosis. The aim of the study was to verify whether: 1. HGF is measurable in bronchoalveolar lavage fluid (BALF) and exhaled breath condensate (EBC); 2. HGF in BALF or EBC is impaired in sarcoidosis; and 3. HGF correlates with chosen activity and prognostic markers. Material and methods: Sixty-four EBC and 30 BALF of sarcoid patients, and 15 and 9 of healthy controls, respectively, were collected for the measurement of HGF using an ELISA test. Results: HGF was detectable in 62% of EBC samples (56% sarcoidosis and 87% of controls) and in all the BALF samples. EBC and BALF concentrations were not different in comparison to the controls. Moreover, no correlation was found between EBC/BALF concentrations and radiological stage, lung function tests, duration of disease, number of relapses, BALF lymphocytes, serum ACE, or serum and urine calcium concentrations. Conclusions: HGF is detectable in BAL and EBC. However, it does not distinguish sarcoidosis patients from healthy subjects. The above, as well as the lack of correlations with various parameters of disease activity and severity rule out EBC/ /BALF HGF as a biomarker for sarcoidosis monitoring

Debata. Czy możemy polecać e-papierosy naszym pacjentom? Opinia 2

Elektroniczne papierosy są coraz częściej używanym sposobem dostarczania nikotyny. Sięgają po nie zarówno użytkownicy papierosów tradycyjnych, jak i osoby do tej pory niepalące. Cały czas pojawiają się nowe artykuły traktujące o potencjalnym wpływie elektronicznych systemów dostarczających nikotynę na zdrowie. Szczególne obawy budzi toksyczność związków chemicznych i pierwiastków dostarczanych wraz z dymem z tych urządzeń. Okazuje się, że produkty, których kreowany medialnie wizerunek jest pozytywny, wcale takimi nie są. Co więcej, ich używanie może skutkować nie tylko uszczerbkiem dla zdrowia, ale i śmiercią.Elektroniczne papierosy są coraz częściej używanym sposobem dostarczania nikotyny. Sięgają po nie zarówno użytkownicy papierosów tradycyjnych, jak i osoby do tej pory niepalące. Cały czas pojawiają się nowe artykuły traktujące o potencjalnym wpływie elektronicznych systemów dostarczających nikotynę na zdrowie. Szczególne obawy budzi toksyczność związków chemicznych i pierwiastków dostarczanych wraz z dymem z tych urządzeń. Okazuje się, że produkty, których kreowany medialnie wizerunek jest pozytywny, wcale takimi nie są. Co więcej, ich używanie może skutkować nie tylko uszczerbkiem dla zdrowia, ale i śmiercią

Preliminary report on the microvertebrate faunal remains from the late triassic locality at Krasiejów, SW Poland

Fossil vertebrate remains from the Keuper unit in the vicinity of the village of Krasiejów have been analyzed for almost two decades. However, the main goal of these works was focused mainly on large vertebrates. Here the authors present the first description of microvertebrate fossils from that site. The collection of around 5,000 specimens is mainly comprised of teeth and scales. The most numerous remains belong to osteichthyans: dipnoans (Ptychoceratodus and cf. Arganodus), palaeoniscids, semionotids, redfieldiids and chondrichthyans, such as Lonchidion sp., which is the first indisputable record of that genus in the Upper Triassic of Poland and the first shark at the Krasiejów locality. Tetrapod fossils consist of temnospondyl amphibians, rhynchocephalian lepidosauromorphs and archosauromorphs. Among them, temnospondyl amphibian remains are the most numerous and are represented mostly by Metoposaurus. However, on the basis of diversity in tooth morphotypes, the occurrence of other taxa cannot be excluded. Rhynchocephalians are composed of 7 fragmentary jaw morphotypes with dentition, which could indicate high taxonomic diversity (cf. Planocephalosaurus, cf. Diphydontosaurus and cf. Clevosaurus). The most varied fossil group was assigned to the archosauromorphs. The authors can distinguish at least 19 teeth morphotypes, which show similarities to the dentition of: protorosaurians (cf. Tanystropheidae), pseudosuchians (cf. Protecovasaurus, cf. Revueltosaurus), early crocodylomorphs and basal sauropodomorph dinosaurs. The first occurrence of a theropod dinosaur and cynodonts at the Krasiejów locality is also recorded. However, their remains are very rare. These new records show a high taxonomic diversity at the Krasiejów locality that contributes to our deeper understanding of Late Triassic ecosystem of Poland.publishersversionpublishe

Inflammatory Markers: Exhaled Nitric Oxide and Carbon Monoxide During the Ovarian Cycle

Nitric oxide (NO) production and carbon monoxide (CO) production are increased in inflammatory lung diseases. Although there are some pieces of evidence for hormonal modulation by estrogen, little is known about exhaled NO and CO during the ovarian cycle. In 23 subjects, we measured exhaled NO and CO by an online analyzer. Significantly higher levels of exhaled NO were found at the midcycle compared with those in the premenstrual period or during menstruation. Higher levels of CO were after ovulation and reached a peak in the premenstrual phase. The lowest levels of CO were observed in the first days of the estrogen phase. In males, there was no significant variation in exhaled NO and CO. Exhaled NO and CO levels vary during the ovarian cycle in women, and this fact should be taken into account during serial measurements of these markers in the female population

Diagnostic potential of contrast-enhanced ultrasound (CEUS) in the assessment of spleen and liver granulomas in the course of sarcoidosis

 WSTĘP: Celem pracy była analiza potencjału diagnostycznego ultrasonografii wzmocnionej kontrastem (CEUS) w wykrywaniu zmian ogniskowych w wątrobie i śledzionie u pacjentów cierpiących z powodu sarkoidozy.MATERIAŁ I METODY: Przeanalizowano wyniki badań obrazowych w grupie 21 pacjentów leczonych z powodu postaci płucnej sarkoidozy, poszukując cech zajęcia wątroby i śledziony. Wszyscy uczestnicy to pacjenci w stadium nieaktywnej choroby, którzy są monitorowani co 6 miesięcy w Klinice Pulmonologii i Alergologii. Oprócz wykonywanego co 2 lata HRCT (high-resolution computed tomography) pacjentów poddano wstępnemu badaniu ultrasonograficznemu brzucha i jeżeli istniało podejrzenie sarkoidozy systemowej, zlecano tomografię komputerową jamy brzusznej i/lub rezonans magnetyczny oraz CEUS.WYNIKI: U 18 pacjentów z postacią płucną sarkoidozy wyniki badań obrazowych nie wykazały zajęcia narządów miąższowych. U 3 pacjentów użycie CEUS pozwoliło na wykrycie zmian w wątrobie i śledzionie, co potwierdziły badania TK i/lub RM.WNIOSKI: CEUS ma potencjał, aby stać się bezpiecznym i niezawodnym narzędziem przesiewowym w poszukiwaniu zmian systemowych u pacjentów z sarkoidozą. Może być również skuteczną metodą monitorowania efektów terapii.  INTRODUCTION: The aim of this study was to analyze the diagnostic potential of contrast enhanced ultrasound (CEUS) for the recognition of focal lesions of the spleen and liver in patients suffering from sarcoidosis.MATERIAL AND METHODS: We analyzed the outcome of diagnostic imaging in a group of 21 patients treated for pulmonary sarcoidosis, searching for the systemic infiltration of the liver and/or spleen. All the participants are patients with inactive disease, who are monitored every 6 months at the Pulmonology Clinic. Apart from the check-up high-resolution computed tomography (HR-CT) — every 2 years, patients underwent an initial ultrasound examination (US) and if there was a suspicion of systemic infiltration, abdominal CT and/or magnetic resonance imaging (MRI) and CEUS were performed.RESULTS: In 18 patients suffering from pulmonary sarcoidosis diagnostic imaging revealed no systemic infiltration. In three patients, the use of CEUS exposed the presence of lesions in the parenchymal organs. In all cases, the images from CEUS were consistent with those from CT/MRI.CONCLUSIONS: CEUS has the potential to become a reliable and safe screening tool for systemic infiltration in patients with sarcoidosis. It may also be an important method of monitoring the effects of therapy.