Time filter

Source Type

Dolenc-Voljc M.,University of Ljubljana | Zolnir-Dovc M.,University Clinic of Respiratory and Allergic Diseases
Acta Dermatovenerologica Alpina, Pannonica et Adriatica | Year: 2010

Mycobacterium marinum infection is the most common atypical skin mycobacterial infection of increasing importance. It results from skin injury and contact with contaminated aquarium water, fish, or shellfish; it is only rarely related to swimming pool sources nowadays. Diagnosis should be confirmed by isolation and identification of the organism; however, this gold standard is difficult to achieve in practice. Therefore, the diagnosis is primarily based on clinical examination, histopathology, and response to therapy. Awareness of this infection is still low and diagnosis often delayed, as presented in this case of a young immunocompetent patient with M. marinum infection of a chronic course. The reasons for the delay in diagnosis are discussed and current diagnostic and treatment recommendations are reviewed. Source

Kristan S.S.,University Clinic of Respiratory and Allergic Diseases
Archivum Immunologiae et Therapiae Experimentalis | Year: 2013

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible; this airflow limitation is both progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gasses. COPD is undoubtedly an umbrella term, and it seems unlikely that all patients with COPD have the same underlying disease processes; thus, there is a need for differential treatment of different subgroups. A potential solution is to find modifiable biomarkers that can assist in drug development and distinguish subgroups of COPD. With the exception of lung function tests, there are currently no well-validated biomarkers or surrogate endpoints that can be used to establish the efficacy of a drug for COPD. This article discusses biomarkers of inflammation (fibrinogen, C-reactive protein, pulmonary and activation-regulated chemokine/CC-chemokine ligand-18, serum surfactant protein D, interleukin (IL)-6, IL-8 and tumor necrosis factor α, complement factor C5a), angiogenesis factors as a part of the pathogenetic aspect in this disease (vascular endothelial growth factor, angiogenin, and IL-8), and matrix degradation biomarkers. Troponin and natriuretic peptides are presented as biomarkers of cardiac involvement in the light of COPD comorbidities. Trials based on research on known clinical variables such as FEV1, BODE, and 6MWT in combination with biomarkers from lung and blood specimens will probably clarify part of the prognosis and natural history of the disease. This will also represent an additional step in COPD phenotyping and new treatment possibilities. © 2013 L. Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland. Source

Kosnik M.,University Clinic of Respiratory and Allergic Diseases | Subic T.,University Clinic of Respiratory and Allergic Diseases
Respiratory Medicine | Year: 2011

Antihistamines (AH) alleviate pruritus and decrease the incidence of hives in patients with chronic idiopathic urticaria (CU). However, some patients do not respond completely to this therapy. We hypothesized that some of them might benefit from the addition of leukotriene receptor antagonists (LA). We screened patients diagnosed and treated for CU and selected those that had symptoms despite antihistamine treatment. In a double-blind crossover study, patients took the leukotriene antagonist montelukast (10 mg per day) of placebo. Efficacy was assessed by a symptom score. In a group of 22 patients, the symptom score was not significantly different between periods using montelukast (48.8; 0-214) of placebo (68.5; 0-230). However in the subgroup of five patients with the most severe urticaria, defined as patients with symptom scores in the upper quartile at inclusion in the study, montelukast (41; 11 214) was superior to placebo (95.5; 48 230; p < 0.05), but only when using an in-house symptom score questionnaire and not when using a validated urticaria activity score questionnaire. We showed that in patients with antihistamine-resistant CU the addition of montelukast significantly diminished symptoms in only a small minority of patients. However, response to add-on montelukast was seen in the subgroup of patients with particularly severe disease. To confirm this observation, a study with a larger group of patients is warranted. © 2011 Elsevier Ltd. All rights reserved. Source

Kosnik M.,University Clinic of Respiratory and Allergic Diseases | Korosec P.,University Clinic of Respiratory and Allergic Diseases
Expert Review of Clinical Immunology | Year: 2015

Venom-specific immunotherapy (VIT) is considered for the treatment of patients with IgE-mediated systemic allergic reactions (SARs) after developing a Hymenoptera venom allergy. Tolerance is achieved in a majority of patients after only a few days or even hours of rush immunotherapy. After VIT discontinuation, the allergy returns in up to 15% of patients. During VIT, the majority of patients have local reactions at the site of venom injections. SARs to VIT are much more frequent in honeybee-treated patients than in wasp-treated patients. Increased baseline serum tryptase and increased allergen-specific sensitivity of basophils are other factors that might be associated with systemic reactions (SRs) during VIT. Severe SRs occur mainly during the build-up phase but can also occur in the maintenance phase of the VIT, even in patients with a well-tolerated dose-increase phase. Pre-treatment with humanized anti-IgE antibodies (omalizumab) is effective in patients with repeated SARs; however, this use of omalizumab is off-label. In highly exposed patients with a history of very severe reactions, there are virtually no absolute contraindications for VIT. © 2015 Informa UK, Ltd. Source

Rozman A.,University Clinic of Respiratory and Allergic Diseases Golnik | Rozman A.,University Clinic of Respiratory and Allergic Diseases | Camlek L.,University Clinic of Respiratory and Allergic Diseases | Marc-Malovrh M.,University Clinic of Respiratory and Allergic Diseases | And 2 more authors.
Respirology | Year: 2013

Background and objective Thoracoscopy with a semi-rigid instrument is a recent technique successfully used for diagnosing pleural diseases. However, there are concerns about the diagnostic adequacy of biopsy samples obtained by semi-rigid procedures when compared with rigid thoracoscopy. The purpose of this study was to compare the size, quality and diagnostic adequacy of biopsy specimens obtained at semi-rigid and rigid thoracoscopy in a prospective, randomized fashion. Methods Patients with pleural effusion of unknown origin and/or pleural irregularities suspicious for pleural malignancy were included after less invasive means of diagnosis had failed. All procedures were performed under local anaesthesia with intravenous sedation/analgesia with a single point of entry. Patients were randomly assigned to a rigid instrument procedure (Olympus EndoEYE WA50120A, forceps) or semi-rigid instrument procedure (Olympus LTF-160, FB-55CR-1 forceps). Results Eighty-four patients were randomized. Five of them were excluded because of lack of pleural space. Thirty-eight patients were assigned to a rigid and 41 to a semi-rigid procedure, with mean follow up 24.1 (±8.1) months after the procedure. The average size of the sample obtained by rigid thoracoscopy was 24.7 mm2 (±12.9), and 11.7 mm2 (±7.6) by semi-rigid thoracoscopy. There were no differences in the quality and interpretability of the specimens assessed by the pathologist. The diagnostic accuracy was 100% for the rigid procedure and 97.6% for the semi-rigid procedure. Conclusions The samples obtained by semi-rigid thoracoscopy were smaller, but of adequate quality. The diagnostic accuracy was comparable with that of rigid thoracoscopy in the evaluation of pleural disease. © 2013 Asian Pacific Society of Respirology. Source

Discover hidden collaborations