Anna Doboszyńska

Spirometry Day: A Means to Enhance Social Knowledge on Respiratory Diseases

The chapter presents the results of pulmonary function tests conducted as part of the Polish Spirometry Day of 2011, an initiative aimed at increasing the awareness of causes, symptoms, and delayed effects of common respiratory diseases, in particular of bronchial asthma and chronic obstructive pulmonary disease, and at demonstrating the role of regular examinations, especially in higher risk groups. The results show that there was a relatively substantial group of persons, 11.2 % of the population sample studied, not being aware of a respiratory disease they had. Furthermore, the results show that quite often, 12.4-16.0 % of the population studied, obstruction was diagnosed in persons who did not have any spirometry tests done before, despite some respiratory symptoms that should raise the attention of general practitioners to perform such tests.

Synchronous multiple primary lung cancers in a 65-year old heavy smoker. Case report

Here we present a 65-year old ex-smoker with history of recent surgery for vocal cord tumor (histology: moderate grade intraepithelial neoplasia), who reported to the pulmonary outpatient clinic for the nodular lesions in the left lung seen on chest X-ray. Subsequent chest CT scan revealed focal lesion of 18 mm in diameter with spicular margins located in the right upper lobe, another irregular cyst with septa, 62 × 58 mm in the right lower lobe, and calcified nodule in the left lung, no enlarged lymph nodes or pleural effusion was seen. He underwent upper right lobe resection and wedge resection of the lower right lobe. Histological examination revealed adenocarcinoma in the right upper lobe with lymph node metastasis (pT2aN2M0). Examination of the right lower lobe showed squamous cell carcinoma (pT2bN0M0). He was subsequently treated with adjuvant chemotherapy and radiotherapy. During 20 months of the follow-up, he remained in good health with no signs of the disease progression. Patients with synchronous multiple primary lung cancers have significantly less favorable outcome than those with single primary lung malignancies, although it can be considerably improved with radical surgical treatment. Basing on the above case report, we discussed diagnostic and therapeutical scheme in patients with the primary multiple lung cancers, and have analyzed epidemiological data and some aspects of MPM etiology.

Multiple primary lung cancer: A literature review

Nowadays, lung cancer is a leading cause of death in both men and women worldwide. There is no clear explanation for its mortality rate. However, it is already known that genetic and environmental factors as well as oncological treatment are involved. As the incidence of lung cancer soars, the number of patients diagnosed with multiple primary lung cancers (MPLC) is also rising. While differentiating between MPLC and intrapulmonary metastasis of lung cancer is important for treatment strategy and prognosis, it is also quite complicated, particularly in the cases with similar histologies. It is also important not to delay the diagnosis. The aim of this paper was to discuss MPLC in general, and the differentiation between MPLC and intrapulmonary lung cancer metastasis in particular. Based on a review of statistical data and the current literature, we discuss the diagnostic criteria and the molecular, genetic and radiographic methods used to distinguish between MPLC and intrapulmonary metastases.

Spirometry testing among the homeless

BACKGROUND Many literature reports have indicated the fact that the percentage of active smokers among the homeless is high, often several times higher than that of the general population. The homeless are known to have worse spirometric parameters than the general population. OBJECTIVES The question of what the principal and exclusive cause of airway obstruction among the homeless is remains unanswered. Verification of the above-mentioned hypothesis is possible by comparing the spirometric parameters in homeless people with those in the general population, based on the data related to subgroups with similar tobacco smoke exposure, which are homogenous in terms of sex, race and age. MATERIAL AND METHODS The spirometric parameters in 58 homeless male smokers were compared with those in 55 male smokers living normal lives. Neither group differed in age, duration of smoking or the number of pack-years. All of the subjects were Caucasian. RESULTS The mean values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/ FVC, both corrected and expressed as absolute figures, were lower amongst the smoking homeless men than amongst men living normal lives. In 27.59% of the homeless subjests not receiving treatment for lung diseases, airway obstruction was identified. CONCLUSIONS Our results suggest that smoking is not the only cause of the worse spirometric parameters found among the homeless.

Ocena jakości życia chorych na przewlekłą obturacyjną chorobę płuc w zależności od stopnia zaawansowania choroby według GOLD

Wstep. Przewlekla obturacyjna choroba pluc (POChP) jest jedną z glownych przyczyn chorobowości i śmiertelności na calym świecie. Nowy podzial zaawansowania choroby wedlug GOLD odzwierciedla indywidualny wplyw choroby na pacjenta, co jest bardzo istotne w praktyce, gdyz na jej podstawie ustala sie jego leczenie oraz dalsze postepowanie terapeutyczne. Cel pracy. Ocena jakości zycia chorych w zalezności od stopnia zaawansowania choroby wedlug GOLD. Material i metody. Badaniem objeto 136 chorych w Samodzielnym Publicznym Zespole Gruźlicy i Chorob Pluc w Olsztynie. Badani mieli rozpoznaną w karcie leczenia przewleklą obturacyjną chorobe pluc (J44) na podstawie zalecen GOLD. W badaniu posluzono sie analizą dokumentacji medycznej wraz z wynikiem badania spirometrycznego z szpitalnego systemu CliniNET. Wykorzystano Kwestionariusz SGRQ-C, Test Oceny Przewleklej Obturacyjnej Choroby Pluc oraz Zmodyfikowaną Skale Duszności mMRC. Wyniki i wnioski. W badanej grupie chorych najmniej liczną grupe stanowily osoby nalezące do kategorii zaawansowania choroby GOLDc. Nowa klasyfikacja spowodowala, ze niektorzy chorzy z poprzedniej klasyfikacji GOLD 2007 z lagodną, umiarkowaną i ciezką postacią zostali zaklasyfikowani do najciezszej kategorii GOLDD. Chorzy z kategorii GOLDc ocenili swoją jakości zycia znacznie lepiej niz chorzy w kategorii GOLDB. Wykazano, ze wraz ze wzrostem stopnia zaawansowania choroby nastepuje pogorszenie jakości zycia chorych. Nowa klasyfikacja zaawansowania choroby wedlug GOLD podnosi świadomośc, ze do trafnej oceny nalezy brac pod uwage wiele roznych elementow oceny stanu zdrowia. Nalezy pamietac, ze w kazdym stopniu zaawansowania choroby jakośc zycia chorych na POChP moze sie mieścic w zakresie od dośc dobrego do bardzo zlego.

Wpływ palenia tytoniu na jakość życia chorych na przewlekłą obturacyjną chorobę płuc

Background. Research conducted on the quality of life of patients are becoming more common as a valuable complement to data of clinical assessment of the patient and the effectiveness of the therapeutic process. The aim of the study is to assess the quality of life and symptom severity in patients with COPD as well as an attempt to assess the impact of the current status of smoking on quality of life. Material and methods. The study included 97 patients diagnosed with COPD. Resources used: COPD Assessment Test (CAT), The modified Medical Research Council dyspnea scale (mMRC), St. George’s Respiratory Questionnaire for COPD Patients (SGRQ-C) and author’s questionnaire. Results. There is a strong positive correlation between the SGRQ and CAT (r = 0.64, p 0.05 Respondents avowed by smoking status did not differ significantly between each other by comparing the severity of dyspnoea F = 2.95; p > 0.05. Those who never smoked did not obtain significantly better results in the SGRQ than current or former smokers F = 0.20; p > 0.05. Conclusions. Patients included in the study were complaining of poor quality of life and a significant worsening of pulmonary symptoms and signs of disease. The current smoking status does not affect the quality of life in that group.