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Quanjer P.H.,Erasmus Medical Center | Weiner D.J.,Childrens Hospital of Pittsburgh | Pretto J.J.,John Hunter Hospital Newcastle | Pretto J.J.,University of Newcastle | And 2 more authors.
European Respiratory Journal | Year: 2014

The aim of this study was to determine the added value of measuring the forced expiratory flow at 25-75% of forced vital capacity (FVC) (FEF25-75%) and flow when 75% of FVC has been exhaled (FEF75%) over and above the measurement of the forced expiratory volume in 1 s (FEV1), FVC and FEV1/FVC ratio. We used spirometric measurements of FEV1, FVC and FEF25-75% from 11654 white males and 11113 white females, aged 3-94 years, routinely tested in the pulmonary function laboratories of four tertiary hospitals. FEF75% was available in 8254 males and 7407 females. Predicted values and lower limits of normal, defined as the fifth percentile, were calculated for FEV1, FVC, FEV1/FVC ratio, FEF25-75% and FEF75% using prediction equations from the Global Lung Function Initiative. There was very little discordance in classifying test results. FEF25-75% and FEF75% were below the normal range in only 2.75% and 1.29% of cases, respectively, whereas FEV1, FVC and FEV1/FVC ratio were within normal limits. Airways obstruction went undetected by FEF25-75% in 2.9% of cases and by FEF75% in 12.3% of cases. Maximum mid-expiratory flow and flow towards the end of the forced expiratory manoeuvre do not contribute usefully to clinical decision making over and above information from FEV1, FVC and FEV1/FVC ratio. Copyright © ERS 2014. Source


Debska G.,Andrzej Frycz Modrzewski Cracow University | Mazurek H.,National Tuberculosis and Lung Diseases Research Institute
Patient Preference and Adherence | Year: 2015

Background: The aim of this study was to determine the effects of clinical factors, physical activity, and sociodemographic variables on 1-year changes in health-related quality of life (HRQoL) in Polish adolescents and adults with cystic fibrosis (CF). Method: The study included 67 subjects with CF (mean age 21.1±5.1 years; range 14–37 years; 34 males and 33 females). The Cystic Fibrosis Quality of Life Questionnaire was used at baseline and after 1 year. Lung function data, body weight, and body height were extracted from medical records. Clinical assessment was performed with the Shwachman–Kulczycki scale. Results: The highest scores in both HRQoL examinations came from the domains of physical and social functioning, and the lowest from future concerns, body image, and career concerns. No significant changes of Cystic Fibrosis Quality of Life Questionnaire scores were documented over a period of 1 year. Patients with better baseline spirometry results more frequently reported an improvement in the treatment issues (subjects with FEV1 > 50% of predicted, P=0.020) and in the career concerns (patients with FVC > 50% of predicted, P=0.039). The improvement in the career concerns also depended upon daily physical activity (P=0.024), which was shown to modulate future concerns (P=0.032), along with place of residence and living conditions (P=0.003). Moreover, the time elapsed from the last pulmonary exacerbation was related to the change in social functioning (P=0.026). Conclusion: When planning treatment, attention should be paid to interventions which may improve HRQoL. Systematic chronic therapy improves lung function, related to treatment issues and career concerns. Maintaining good physical condition and activity may positively influence future and career concerns. Special attention must be devoted to patients living in rural areas and enduring difficult living conditions, as they are especially vulnerable to deterioration in future concerns. © 2015 Dębska and Mazurek. Source


Szolkowska M.,National Tuberculosis and Lung Diseases Research Institute
Applied Immunohistochemistry and Molecular Morphology | Year: 2016

The correlation between the worse outcome of thymomas and expression of podoplanin (D2-40 antibody) in neoplastic cells has been proved in recent studies. We investigated the expression of podoplanin in thymic epithelial tumors of different histologic types and stages resected in our institution. The presence and type of reaction (membranous or cytoplasmic) with D2-40 antibody were assessed. Analyzed group consisted of 72 tumors: 3 type A, 19 type AB, 5 type B1, 24 type B2, 4 type B3, 2 micronodular, 1 metaplastic, and 9 combined B2B3 thymomas and 5 thymic carcinomas. Positive reaction with D2-40 was detected in 7 cases (37%) of AB type, 2 (40%) of B1, 28 (85%) of B2, 3 (23%) of B3, and 1 case (100%) of metaplastic thymoma. All positive B2 and 2 cases of B3 thymomas revealed membranous type of reaction, whereas other subtypes showed less conspicuous cytoplasmic reactivity. A correlation between B2 thymoma and membranous type of reaction was statistically significant (P<0.0001). There was also a slight relationship between cytoplasmic type of reaction and AB or B1 thymomas (P=0.0256). No correlation was detected between D2-40-reactivity and stage (P=0.4) or myasthenic symptoms (P=0.21). In conclusion, membranous type of reaction with D2-40 antibody in thymomas is highly specific for B2 subtype, but antipodoplanin immunoreactivity has no relationship with the tumor stage. Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved. Source


Radzikowska E.,National Tuberculosis and Lung Diseases Research Institute
Lung | Year: 2015

Lymphangioleiomyomatosis (LAM) is a rare multisystem disease, occurs in women, usually premenopausal, caused by the proliferation of neoplastic smooth muscle-derived cells. Mutations in the tuberous sclerosis complex genes, lead to the activation of mammalian target of rapamycin kinase (mTOR), results in proliferation of LAM cells, its increasing motility, and survival. Polycystic lung destruction, extensive involvement of lymphatic channels, chylothorax, chyloperitoneum, and renal angiomyolipomas can develop in LAM patients. The new, promising treatment strategies have been recently introduced due to discovery of the genetic and molecular mechanisms of LAM. Comprehension of the disease pathogenesis has resulted in the implementation of other therapeutic agents such as mTOR inhibitors, VEGF-D inhibitors, statins, interferon, chloroquine analogs, cyclin-dependent kinase inhibitors, matrix metalloproteinase inhibitors, aromatase inhibitors, and their combinations. The mTOR inhibitors appear to be the most important, and the efficacy of sirolimus in LAM treatment has been proved. The article discussed the new control studies with mTOR inhibitors, doxycycline, simvastatin, and combination of them in LAM patients. © 2015, Springer Science+Business Media New York. Source


Korzeniewska-Kosela M.,National Tuberculosis and Lung Diseases Research Institute
Przegla̧d epidemiologiczny | Year: 2013

To evaluate the main features of TB epidemiology in 2011 in Poland and to compare with the corresponding EU data. Analysis of case- based clinical and demographic data on TB patients from Central TB Register, of data submitted by laboratories on anti-TB drug susceptibility testing results in cases notified in 2011, data from National Institute of Public Health- National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report "Tuberculosis surveillance in Europe 2011". 8478 TB cases were reported in Poland in 2011. The incidence rate was 22.2 cases per 100,000, with large variability between voivodeships from 12.8 to 37.0. The mean annual decrease of TB incidence in 2007 - 2011 was 0.4%. 7515 cases had no history of previous treatment i.e. 19.7 per 100,000. The number of all notified pulmonary tuberculosis cases was 7879 i.e. 20.6 per 100,000. The proportion of extrapulmonary tuberculosis was 7.1% (599 cases). TB was diagnosed in 111 children (1.3% of all cases, incidence 1.9). The incidence of tuberculosis increased with age to 41.9 among patients 65 years old and older. The mean age of TB patients was 53.3 years. The incidence among men i.e. 31.0 was more than two times higher than among women i.e. 14.0. The incidence in rural population was slightly lower than in urban, respectively 21.9 and 22.4. Bacteriologically confirmed cases (5327) constituted 67.6% of all pulmonary TB cases. The number of smear positive pulmonary TB cases was 2916 (37.0% of all pulmonary cases). There were 38 foreigners registered among all cases of tuberculosis in Poland and 204 cases registered among prisoners. There were 41 patients with MDR-TB (0.8% of 4993 cases with DST results). TB was initial AIDS indicative disease in 26 cases. There were 575 deaths due to tuberculosis in 2010 (1.5 TB deaths per 100,000). Mortality among males--2.5--was four times higher than among females--0.6. In Poland the incidence of tuberculosis is higher than the average in EU countries. In 2011 the highest incidence occurred in older age groups and was higher in men. Positive characteristic also when compared with the situation in many EU countries is the low incidence of tuberculosis in children and the low percentage of patients with drug-resistant tuberculosis. Source

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