Lipoid pneumonia induced by aspiration of liquid paraffin.

INTRODUCTION: This case report describes a case of exogenous lipoid pneumonia (ELP) resulting from the inhalation of a lipoid substance. Lipoid pneumonia, also known as cholesterol pneumonia or golden pneumonia, is an uncommon inflammatory lung disease characterized by the presence of lipid-laden macrophages in the alveolar walls and lung interstitial tissue. Exogenous lipoid pneumonia occurs when substances containing lipids enter the airways through aspiration or inhalation, triggering an inflammatory response. CASE REPORT: The patient in this case study was an 83-year-old woman with hypertension and diabetes mellitus who had been using paraffin oil as a mouthwash for an extended period. The diagnosis of exogenous lipoid pneumonia was established based on the patient's history of exposure to liquid paraffin oil, typical radiological findings, and histopathological examination.

Difficulties in the treatment of recurring diffuse alveolar hemorrhage accompanying primary antiphospholipid syndrome: a case report and literature review.

Pulmonary embolism is the most common pulmonary manifestation of primary antiphospholipid syndrome (PAPS). However, PAPS may manifest in the respiratory system also due to non-thrombotic processes. In the following paper we present a case of PAPS-related diffuse alveolar hemorrhage (DAH). Because of sparse literature and a lack of randomized controlled trials, there are currently no recommendations regarding the optimal choice of steroid-sparing agent in treating PAPS-related DAH. In our patient, treatment with cyclophosphamide or mycophenolate mofetil along with low dose prednisone was ineffective, partially because of infectious complications, whereas addition of monthly intravenous immunoglobulin to mycophenolate mofetil and prednisone, appears to control the disease.

Serial Lung Ultrasonography to Monitor Patient With Diffuse Alveolar Hemorhage.

Diffuse alveolar haemorrhage (DAH) leads to acute respiratory failure. This is why it requires rapid diagnosis and implementation of appropriate treatment. The standard diagnosis of a patient with DAH includes laboratory tests, diagnostic imagining (X-ray of the chest, high-resolution computed tomography), and bronchoscopy with bronchoalveolar lavage. We present a description of 2 patients diagnosed with systemic connective tissue disease and DAH, monitored with the help of lung ultrasound. To our knowledge, this is the first description of the use of lung ultrasound in DAH in adult patients.

Tracheobronchopathia osteochondroplastica­case report and literature review.

Tracheobronchopathia osteochondroplastica (TBO) is a rare disease of unknown etiology characterised by a formation of multiple, cartilaginous and osteocartilaginous submucosal nodules in the trachea and major bronchi. The course of the disease is usually benign but the narrowing of the respiratory tract can lead to chronic non-specific clinical symptoms. We present a case of a 50-year old man with chronic exertional dyspnoea and stenosis of the trachea visible in imaging tests, in whom the symptoms were caused by TBO.

Factors influencing adherence to treatment in COPD patients and its relationship with disease exacerbations.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in the world. Systematic treatment of COPD decreases symptoms and reduces the frequency of exacerbations and hospitalisations because of the disease. It is estimated that only 50% of patients use prescribed drugs systematically. The aim of this study was to identify the factors which can influence adherence to treatment of the patients who were treated due to exacerbation of COPD. MATERIAL AND METHODS: A questionnaire probe was conducted on 49 patients hospitalised at the Regional Lung and Tuberculosis Hospital in Olsztyn, Poland due to COPD exacerbation. The assessed variables were: quality of life and adherence to treatment 30 days after discharge from hospital in relationship with demographic factors, social status, disease and hospitalisation course, and relief after systematic treatment. RESULTS: Most of the patients assessed their health condition as poor and the disease as limiting their everyday social and occupational activity. 30 days after discharge from hospital the adherence rate to therapy was only 67%. There was an association between systematic treatment and the rate of exacerbations (P = 0.045) and hospitalisations (P = 0.005) but also clinical benefit after long-term treatment (P = 0.023). There were no associations between adherence to treatment and sex, place of residence, education or occupation. CONCLUSIONS: Lack of systematic treatment is the main risk factor for COPD exacerbations and hospitalisation rate. A subjective sense of relief after drugs is a factor improving patients' compliance.

Transthoracic lung ultrasonography in pulmonary alveolar proteinosis - case report.

A pulmonary alveolar proteinosis (PAP) is a rare disease characterized by an accumulation of surfactant components in lung alveoli. In diagnosis and monitoring of the disease high resolution computed tomography (HRCT) is usually used. Unfortunately, repeated exposure to CT scanning may be associated with an increased risk of radiation. We present a patient in whom repeated transthoracic lung ultrasonography (TLUS) brought parallel to HRCT data in assessing PAP extent. It may indicate that TLUS might be potentially a relevant tool in monitoring of PAP.

Cellular composition of induced sputum in sarcoidosis.

INTRODUCTION: The aim of this study was to evaluate the cellular composition of induced sputum (IS) in sarcoidosis and its role in assessing the disease activity. The safety of the procedure was also determined. MATERIAL AND METHODS: Sputum induction by inhalation of hypertonic saline was performed. Twenty-one samples from the healthy controls, 32 from patients with active disease, and 33 from subjects with inactive disease were analysed. RESULTS: The percentage of lymphocytes in IS was significantly higher in active sarcoidosis than in inactive disease and the control group (9.7% vs. 3.1% vs. 2.9%), and was the highest in the patients with parenchymal changes and active disease (13.3%). The percentage of macrophages was significantly lower in active sarcoidosis than in normal subjects (76.8% vs. 83.4%). It was also significantly lower in IS in active disease and stages II and III than in both subgroups with active and inactive stage I of sarcoidosis. There were no significant differences in the IS cell percentages between the whole sarcoidosis group and the controls. Sputum induction was well tolerated and stopped only four times, two of them because of dyspnoea or the decrease of PEF. The symptoms were well reversible after administering salbutamol. CONCLUSIONS: Sputum induction by inhalation of hypertonic saline is safe, but the evaluation of IS differential cell counts is not useful in sarcoidosis diagnosing. However, it could be used in assessing the activity of the disease, especially in patients with interstitial lung changes.

The osteocalcin gene rs1800247 polymorphism in Kashubian population.

Osteocalcin is the most important noncollagenous protein component of the bone. Polymorphisms of osteocalcin gene were reported to be associated with bone mineral density. However, this relation was only confirmed in some populations. In this study presence of C/T polymorphism in osteocalcin gene (rs1800247) was determined in Kashubian population (northern Poland). The frequencies of variants were CC 9 %, TC 31 %, and TT 60 %, with no significant differences between genders. The genotypes were in Hardy-Weinberg equilibrium.

[Pulmonary actinomycosis - a case report]. / Promienica pluc - opis przypadku.

Pulmonary actinomycosis is a rare disease caused by Actinomyces sp. Its symptoms and radiological findings are not characteristic, so the diagnosis might be difficult to establish. We report a case of a 59 year old male, who developed bronchopulmonary Actinomycosis due to poor dental hygiene. The infectious process affected lung parenchyma and infiltrated chest wall causing multifocal sternal osteolisis and multiple cutaneous fistulas. The radiological findings sugested neoplasmatical process. The diagnosis was based on histopatological findings of fistular scrapes. The material contained Actinomyces colonies. Afler 6 months of antibiotic therapy the patient's state improved and the cutaneous fistulas healed. Radiological finding revealed partial resolution of the lung infiltration.

[Invasive aspergillosis of the paranasal sinuses, lung and brain]. / Inwazyjna grzybica kropidlakowa zatok przynosowych, pluc i mózgowia.

A case of invasive aspergillosis (IA) of paranasal sinuses, lung and brain with a fulminant fatal outcome is reported. A 43-year-old man with a history of skin carcinoma of the nasal region and a course of systemic corticosteroids, presented with symptoms of lung infection. Aspergillus fumigatus was cultured from respiratory and nasal samples. Erosion of adjacent bones of the nasal cavity was acknowledged, but no sinus surgery was performed. A computed tomography of the thorax showed thick-walled cavities of different sizes with air and scarce fluid levels in both lungs. Treatment with voriconazole was administered. The patient deteriorated in the ensuing 2 weeks because central nervous system involvement was observed. No aggressive surgical resection was performed and the patient died 2 weeks later. IA was not confirmed by histopathology because no necropsy was performed.

[Isolated sarcoidosis of upper respiratory tract--a description of 2 cases]. / Izolowana sarkoidoza górnych dróg oddechowych--opis 2 przypadków.

Sarcoidosis is a granulomatous disease of unknown etiology. In sarcoidosis almost all organs can be involved but the disease most often affects the lungs and intrathoracic lymph nodes. Isolated extrapulmonary organs involvement occurs very seldom. We present two cases of sarcoidosis limited to upper respiratory tract--a young woman with laryngeal sarcoidosis and recurrent throat pain, and a woman with disease of the sinuses and pharynx and clinical symptoms of chronic sinusitis poorly responsive to conventional treatment.

[The effects of pulmonary rehabilitation on the quality of life in patients with COPD]. / Wplyw rehabilitacji na jakosc zycia u chorych na przewlekla obturacyjna chorobe pluc.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, hospitalization and disability among lung diseases. Its chronic, progressive nature and acute exacerbations influence the quality and expectancy of life of COPD patients. The pulmonary rehabilitation is a basic non-pharmacological intervention in COPD and its role is increasing in recent years. The goal of this work was to evaluate the impact on quality of life patients undergoing 3 weeks pulmonary rehabilitation program. MATERIAL AND METHODS: 132 patients with COPD were admitted to pulmonary rehabilitation program; 70 completed the 3 weeks long program. Pulmonary function tests, exercise endurance, quality of life (St. George's Respiratory Questionnaire) were measured at baseline, 3 weeks, and 3 months. RESULTS: There was significant improvement in quality of life in St. George's Respiratory Questionnaire and exercise endurance (treadmill) measured at 3 weeks and at 3 months. Parameters of lung function tests did not improved after completion of rehabilitation. CONCLUSIONS: 3 weeks pulmonary rehabilitation program of patients with COPD was effective in improving exercise endurance and the quality of life. The improvement was noted as well at 3 months post rehabilitation.

[Analysis of deaths caused by obstructive pulmonary diseases in Pomerania province in 2001-2004]. / Analiza zgonów z powodu obturacyjnych chorób pluc w latach 2001-2004 w województwie pomorskim.

INTRODUCTION: Lung diseases, especially COPD, are one of the leading causes of death. The aim of the study was to assess mortality caused by COPD, asthma and cor pulmonale in the years 2001-2004 in the Pomerania province. MATERIAL AND METHODS: Death certificates of patients who died of asthma, COPD or cor pulmonale registered in Regional Health Centre were analyzed. RESULTS: The mortality rate for COPD was 14.02/100 000, asthma 2.04/100 000 and cor pulmonale 2.4/100 000 inhabitants. Mortality rate from COPD increased from 12.5/100 000 found in 2001 to 15.6/100 000 found in 2004 (p = 0.005). The number of deaths was higher in the winter time. The peak mortality was found in patients 65 years old. 71% of COPD and cor pulmonale patients died in the hospital, whereas 75% of asthma deaths occurred at home (p = 0.0001). CONCLUSIONS: The mortality rates from chronic respiratory diseases in the analyzed population are comparable to data found in other studies. The alarming result is the increase in the number of COPD deaths and high percentage of asthma patients who die at home.

[Anti neutrophil cytoplasmatic antibodies-positive vasculitis as a complication of hyperthyreosis treatment with propylthiouracil]. / Zapalenie naczyn z obecnoscia przeciwcial przeciwko cytoplazmie granulocytów jako powiklanie leczenia nadczynnosci tarczycy propylotiouracylem.

This paper describes a patient treated for 12 months with propylthiouracil for multinodular toxic goiter who developed vasculitis. The clinical picture consisted of nasal septal necrosis, pulmonary infiltrations and skin rash. Patient's serum were positive for anti neutrophil cytoplasmatic antibodies (c-ANCA). Histopathological examination revealed the presence of small vessel vasculitis without granuloma formation. This condition resulted in patient's critical state with respiratory failure and severe cardiovascular complications. The article also contains a brief review of available literature concerning this very rare complication. Conclusion. Propylthiouracil, a widely-used medicine, can cause severe life-threatening complication. It is associated with propylthiouracil-induced immunological disturbances.

[Assessment of hemoptysis etiology among patients hospitalized in Pneumonology Departament of Medical University of Gdansk in the years 1998-2002]. / Analiza przyczyn krwioplucia u chorych hospitalizowanych w Klinice Chorób Pluc i Gruzlicy Akademii Medycznej w Gdansku w latach 1998-2002.

A retrospective analysis of 3400 clinical records of patients hospitalized in Pneumonology Department of Medical University of Gdansk between 1998-2002 year was performed. 431 (12,7%) of them was admitted to hospital because of hemoptysis. The cause of hemoptysis was determined in 380 (82,2%) cases. The most common diagnosis was neoplasm--174 cases (40,4%), between them squamous cell carcinoma (47,7%). In 51 cases (11,8%) the etiology of hemoptysis was undetermined.

[Addison's diseases caused by adrenal tuberculosis--case report]. / Przypadek pierwotnej niewydolnosci kory nadnerczy o etiologii gruzliczej.

A case of adrenal tuberculosis with acute Addison's disease is described. The disease manifested acute as suprarenal crisis. Metastatic and autoimmunological (antisuprarenal antibodies were not found) etiology was excluded. Computed tomography demonstrated calcifications in both, enlarged adrenals. After antituberculosis treatment and corticosteroid therapy we observed significant improvement in our patient's condition.

[Sarcoidosis--clinical features, diagnosis and treatment]. / Sarkoidoza--obraz kliniczny, diagnostyka i leczenie.

Sarcoidosis is a multisystem disorder of unknown aetiology. Pathologically it is characterized by the presence of non-caseating epithelioid-cell granulomas in the lungs, intrathoracic lymph nodes and other affected organs. The clinical course of sarcoidosis is widely variable, ranging from asymptomatic but abnormal findings in chest radiography to progressive multiorgan disease, which leads to fibrosis with organ failure and functional impairment. The aim of this article is to familiarize physicians with clinical features and treatment of this disease.