Pneumonologia polska最新文献

In 31 subjects with an occupational exposure to dust pesticides the levels of PZ-peptidase, alpha-1-antitrypsin, alpha-2-macroglobulin were determined. A decrease of PZ-peptidase and an increase of alpha-1-antitrypsin, alpha-2-macroglobulin were found in comparison with a control group of 30 healthy volunteers.

The study material was made up of 20 patients with stage I pulmonary sarcoidosis in different state of activity. BAL was carried out through a bronchofiberscope using four aliquots 50 ml each, immediately aspirated after introduction into siliconized vials. BAL induced side effects were not seen. The returned fluid was centrifuged and the cell differential count was carried out. 11 patients (55%) demonstrated a high lymphocytic count. The degree of lymphocytosis did not correlate with abnormalities in respiratory function. The degree of lymphocytosis did slightly correlate with disease activity. Thus serial BAL studies might be useful in therapy monitoring. The high lymphocytosis should be carefully interpreted and can not be the only indication for instituting steroid therapy.

Pulmonary echinococcosis (hydatid disease) is not rare in endemic regions. In Poland it is rare, seen mainly in subjects returning from endemic areas. The intermediate host includes a variety of mammals-sheep, cows, and also humans. The definite host is the dog and is the main source of ova. A case of a 52 year old male is presented who lived in Argentina for a few years. Radiological examination disclosed two pulmonary cysts. Additionally one was also present in the spleen. The diagnosis was made basing of findings form radiological examinations. CT-scan, and serological studies. It was further confirmed during the surgical removal of the affected lung parenchyma. Leaving the spleen cysts is a risk factor it may be the source for further seeding of ova. Mebendazol therapy was instituted, which will be continued in the future. The patient will remain under observation.

Twenty-eight patients aged from 32 to 60 years, including 18 female and 10 male, were examined because of bronchial asthma suspicion. They were employed in different professions, but more of them worked as baker or nurse. An occupation time was from 11 to 32 years, but first symptoms of bronchial asthma were noticed after 7-28 (mean 14 yrs.) years of work. At all patients the exposure test (inhalatory challenge) with some substances selected by disease history was performed. This above mentioned substances were mechanically polluted in air to simulate an occupational circumstances. The exposure was persisted from 5 to 30 minutes, according to observed disease symptoms. Spirometric tests were performed in 2 and 30 minutes after exposure, but in baker group also in 4 and 8 hours. At 26 patients a decrease higher than 20% of starting values of FEV1 was determined. In most cases there were immediate reactions, and at baker group--dual reactions. At two examined subjects no response of bronchial tree was observed but only burning of mucosa and cutaneous pruritus. For this reason at this group a diagnose of allergy to examined substances was established. Other ones 26 patients were diagnosed as occupational bronchial asthma.

An analysis of the respiratory function of workers of a chemical factory producing Enolophos was carried out. All workers were included in the study-41 men (age range 23-59 years, mean working duration 4.9 years). In 48.8% chronic bronchitis was diagnosed. Spirometric analysis was carried out using an electronical spirometer with a steady volume plethysmograph. The following along with other pulmonary mechanics parameters were assessed: compliance, airway resistance. An increase of the FEV1%VC index was seen in 34.2% and RV/TLC in 40%. Compliance was increased in 30%. Airway resistance was increased especially in subjects with chronic bronchitis and a decrease in FEV1, FEV1%VC, FEF50, FEF25 rates. In patients with decreased erythrocyte acetylcholinesterase activity only increased airway resistance was seen. The duration of working in this factory did not affect respiratory function. The results demonstrate a harmful effect of Enolophos to the lungs and airways.

In 47 children after a 5 year remission of treated acute lymphoblastic leukemia respiratory function was assessed. In 11 a decrease of VC was found, while in 12 signs of obturation of lower airways were present. These results imply the presence of restrictive changes suggesting an interstitial lung disease. These children are at risk of developing a chronic pneumopathy.

The number of freshly registered sputum positive cases of pulmonary tuberculosis coexistent with diabetes mellitus was calculated from data of the Central Register of Tuberculosis in Poland. The incidence rate for this group in 1985 and 1986 was only 2.6%, while the calculated rate was only higher by 1/3 in comparison with rates of the general population. This leads to a conclusion that diabetes mellitus does not increase the risk of developing tuberculosis. Treatment did not differ from standard therapeutical regimes. Early results were comparable with those from a general population. The mortality rate analyzed in both years was three fold higher in the group with coexistent diabetes mellitus than in the general population treated for tuberculosis. This implies that tuberculosis coexistent with diabetes mellitus is a great clinical problem but epidemiologically is insignificant.