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Doubkova M.,Klinika Nemoci Plicnich a Tuberkulozy | Moulis M.,Ustav Patologie | Skrickova J.,Klinika Nemoci Plicnich a Tuberkulozy
Vnitrni Lekarstvi | Year: 2015

Common variable immunodeficiency disorder belongs to the most common primary human immunodeficiencies and it is characterized by primary defective immunoglobulin production. Hypogammaglobulinemia manifests in every age, usually in adult people. There is no gender predisposition. The prevalence is 1:25 000-1:50 000. The ethiopathogenesis of the majority of CVIDs is unknown. The main clinical respiratory symptoms include recurrent respiratory infects, especially bacterial etiology, sinusitis, bronchitis, pneumonia, leading to bronchiectasis and lung fibrosis. Interstitial lung fibrosis and granulomatosis often manifest at diagnosis of CVID and they are negative prognostic factors of the disease.


Afatinib (Giotrif®) is the first irreversible inhibitor of EGFR and other ErbB receptors (HER1-4) that has been approved for the treatment of patients with distinct types of epidermal growth factor receptor (EGFR) mutation-positive locally advanced or metastatic non-small cell lung cancer (NSCLC). It is an oral, once daily targeted therapy, based on the results of two large, randomized phase III clinical trials. Compared to standard chemotherapy Afatinib demonstrated an overall survival benefit for patients with the most common type of EGFR mutation (exon 19 deletion/L858R) and improve symptoms of the disease and the quality of life. The most common drug-related adverse events, especially diarrhoea and skin disorders are predictable, generally manageable and reversible.


Doubkova M.,Klinika Nemoci Plicnich a Tuberkulozy | Binkova I.,Klinika Nemoci Plicnich a Tuberkulozy | Skrickova J.,Klinika Nemoci Plicnich a Tuberkulozy
Studia Pneumologica et Phthiseologica | Year: 2013

Familial idiopathic interstitial pneumonia (IIP) is defined as disease observed in 2 or more members of the same family. The inheritance pattern of IIP is not clear, but it seems to be autosomal dominant with incomplete penetrance. The most frequent phenotype in familial IIP is idiopathic pulmonary fibrosis / usual interstitial pneumonia (IPF/UIP). Accurate epidemiological data are unavailable but the estimated prevalence of IIP is 0.5-3.7 % of all IPF cases. Presented are two IIP cases within one family (a mother and a son). Each patient had a different form, extent and outcome of IIP.


Doubkova M.,Klinika Nemoci Plicnich a Tuberkulozy | Skrickova J.,Klinika Nemoci Plicnich a Tuberkulozy
Studia Pneumologica et Phthiseologica | Year: 2013

Patients having connective tissue disease (CTD) suffer from a broad spectrum of respiratory complications including interstitial lung diseases (ILD). ILD can often be the main feature of CTD or may precede it and thus mimic idiopathic interstitial pneumonia. This review summarizes current knowledge regarding ILD in CTD patients.


Doubkova M.,Klinika Nemoci Plicnich A Tuberkulozy | Skrickova J.,Klinika Nemoci Plicnich A Tuberkulozy
Prakticky Lekar | Year: 2010

Dyspnoea is a common and important symptom, not only caused by respiratory diseases. Dyspnoea is a subjective experience of absence of breathing. It arises when the respiratory system cannot fully function. Differential diagnosis of dyspnoea is extensive; we have to distinguish the respiratory cause of dyspnoea (chronic obstructive pulmonary disease, chronic bronchitis, bronchial asthma, pneumonia, pneumothorax, tumor, pleural effusion, interstitial lung diseases), cardiovascular cause (heart attack, ischemic heart disease, arrhythmia, heart failure, lung embolism), and other causes (otorhinolaryngology causes, metabolic acidosis, infection of central nervous system, anemia, psychogenic dyspnoea). In elderly patients suffering from many diseases, dyspnoea is particularly caused by a combination of factors. In this situation we have to choose an interdisciplinary approach to patients. Treatment and prognosis depends on the nature of the disease causing dyspnoea.


Doubkova M.,Klinika Nemoci Plicnich a Tuberkulozy | Tomiskova M.,Klinika Nemoci Plicnich a Tuberkulozy | Skrickova J.,Klinika Nemoci Plicnich a Tuberkulozy
Studia Pneumologica et Phthiseologica | Year: 2014

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease of unknown etiology that occurs mostly in young smokers, with the age at diagnosis between 20 and 40 years. Reported is a case of a young heavy smoker with spontaneous resolution of PLCH after smoking cessation.


Doubkova M.,Klinika Nemoci Plicnich a Tuberkulozy | Binkova I.,Klinika Nemoci Plicnich a Tuberkulozy | Skrickova J.,Klinika Nemoci Plicnich a Tuberkulozy
Studia Pneumologica et Phthiseologica | Year: 2011

Sarcoidosis is a multisystem granulomatous disease of unknown origin with pulmonary and extrapulmonary manifestations. Patients with sarcoidosis can suffer from cancer of any etiology. In medical literature, there are many reports with ambiguous results concerning the relationship between sarcoidosis and malignancies. Although some studies indicated that malignancies were more frequent in sarcoidosis patients than in the general population, more valid analyses did not reach this conclusion. According to retrospective meta-analyses, sarcoidosis usually precedes the diagnosis of malignancy. The aim of the study was to evaluate the incidence and prevalence of malignancies in our sarcoidosis patients. We performed a retrospective analysis in our cohort of 170 sarcoidosis patients. We compared the incidence and prevalence of malignancies in sarcoidosis patients with the incidence and prevalence of malignancies throughout our population (Czech National Oncology Registry data). The data from the years 2005-2007 were analyzed. The analysis included only patients with sarcoidosis diagnosed prior to malignancy, or patients with malignancy discovered simultaneously with sarcoidosis. The calculated prevalence rates of malignant diseases in patients with sarcoidosis were as follows: 813/100 000 (2005), 2 739/100 000 (2006), and 2941/100 000 (2007). In the Czech population, the prevalence of all malignant diseases in the years 2005-2007 was 3 552-3 865/100 000. In patients with sarcoidosis, the calculated incidence of malignancies in the monitored period were: 0 (2005), 2054/100 000 (2006), and 588/100 000 (2007). The incidence of all malignant diseases in the Czech Republic was 698-738/100 000. We did not prove the statistically significant difference in the incidence and prevalence of malignancies between sarcoidosis patients and general population.


Interstitial lung diseases, also called difuse parenchymal lung disorders, are characterized by a variable degree of inflammatory and fibrotic changes affecting interstitial spaces, air spaces and alveolar walls. New knowledge about these diseases led in 2013 to create a new classification of one of the subgroups of interstitial lung diseases called idiopathic interstitial pneumonias (IIPs). IIPs are divided into major, rare and unclassifiable. Major IIPs are subdivided into chronic IIPs, smoking-related IIPs and acute/ subacute IIPs. Idiopathic pulmonary fibrosis (IPF), the most common and severe form IIP, with a poor prognosis. IPF is characterised by progressive respiratory failure resulting from a relentless fibrosis leading to destruction of the lung architecture. Knowledge of the disease, along with the possibility of new treatment modalities increases the likelihood of early diagnosis, affecting the course of the disease and improves quality of life.


Doubkova M.,Klinika Nemoci Plicnich a Tuberkulozy | Skrickova J.,Klinika Nemoci Plicnich a Tuberkulozy
Studia Pneumologica et Phthiseologica | Year: 2015

Interstitial lung diseases, also called diffuse parenchymal lung disorders, are characterized by a variable degree of inflammatory and fibrotic changes affecting the interstitial spaces, air spaces and alveolar walls. New knowledge about these diseases led in 2013 to creation of a new classification of one of the subgroups of interstitial lung diseases called idiopathic interstitial pneumonias. The 2013 classification brought about many changes that may contribute to a more accurate diagnostic and therapeutic algorithm. Idiopathic interstitial pneumonias (IIPs) are divided into major, rare and unclassifiable. Major IIPs are subdivided into chronic, smoking-related and acute/subacute IIPs. A new clinical entity called pleuroparenchymal fibroelastosis has been described.


Lennerova Z.,Klinika Nemoci Plicnich A Tuberkulozy | Skrickova J.,Klinika Nemoci Plicnich A Tuberkulozy
Studia Pneumologica et Phthiseologica | Year: 2016

Chronic obstructive pulmonary disease (COPD) is defined as a preventable and treatable disease. Yet in 1990, COPD was the 6th leading cause of death, estimated to rank third by 2020. This suggests that the disease is underdiagnosed and undertreated. Moreover, COPD is associated with considerable costs. According to data from the Global Initiative for Chronic Obstructive Lung Disease (GOLD), approximately 6 % of all healthcare expenses are used to treat respiratory diseases. Of that, approximately 56 % (36.6 billion euros) are used to treat COPD. The article also provides information on trends in the prevalence, mortality and comorbidities of COPD both worldwide and in the Czech Republic.

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