Pneumonologia polska最新文献

Rheumatoid changes in the lungs are seen in 30% of cases of rheumatoid arthritis. Three cases with different patterns of pulmonary involvement in the course of rheumatoid arthritis (RA) are presented. In all cases pleural involvement was seen, in two subjects since the beginning, in the remaining in the course of developing interstitial lung disease. In two cases the dominant changes in the respiratory system were interstitial pneumonitis. In one case the interstitial pneumonitis took a fulminating course, being resistant to treatment with prednisone, endoxan, penicillamine. In the third case, the interstitial pneumonitis was of chronic character, despite the fact that the subject did not receive any treatment, it did not progress. In the first case the main features were pulmonary cavities. The could have evolved from necrosis of rheumatoid nodules or vessel changes.

A case of Wegener's granulomatosis in a 54 year old female is presented. The disease course was fulminating, the necrotic process involving lungs, gingiva, skin, trachea, producing finally a tracheo-esophageal fistula. Therapy with cyclophosphamide and prednisone produced resolution of all organ involvement except for the tracheo-esophageal fistula.

The aim of the study was to evaluate the + bronchoscopy in monitoring of therapy in SCLC. Sixty patients were included in the study. The number of bronchoscopies ranged from 1 to 4. Evaluation was based on endoscopical analysis and pathomorphological examination of the biopsied material. In 30% of the studied patients bronchoscopy had decisive influence on therapy, irrespective of clinical and radiological criteria. The authors point out, that presence of cancer cells in bronchial aspirates, even in patients with normal endoscopical findings is a decisively poor prognostic factor.

The significance of smoking habits and long age of parents on lung function in a large population of elderly people (559 males and 1073 females) living in the city of Cracow were analyzed. The lung function parameters correlated negatively with age of analyzed subjects (males and females). Mean values of FVC in men from long living families were 400 ml higher in comparison with other subjects, while the mean FEV1 was 330 ml higher. Such differences were not seen in females. Smoking also affected negatively lung function in the analyzed subjects. Chronic cough and sputum production did not hamper lung function, if such variables as age, height and smoking habits were not included in the analysis.

The course of pulmonary tuberculosis was analyzed in 34 females older than 70 years and 30 women, age range 35-55 years (mean 43.8 yrs) treated between 1.01.1985 and 31.12.1988 in the Pulmonological Department of the Szczecin Medical Academy. Pulmonary tuberculosis in females aged more than 70 years was diagnosed basing mainly on clinical grounds (82%), positive sputum (88%) and advanced radiological changes. In 25% evidence of the middle lobe syndrome was found--all sputum positive. In the control group such findings were not seen. In almost all patients of this group 4 drug therapy was instituted. Streptomycin was tolerated the poorest. The therapeutical course was similar in both groups. Pulmonary tuberculosis in the studied group was usually diagnosed in the advanced stage. The population of females of 70 years and older is an important epidemiological risk factor.

Records of 1,010 bronchofibroscopies were reviewed. Patients were examined with diagnostic and therapeutic indications, of which 6.8% were asthmatics. In most of them typical findings were seen signs of inflammation with thick, mucous secretions. In patients with status asthmaticus (0.6% of the analyzed population) bronchofibroscopy was carried out under life threatening conditions, the endoscopes being introduced through an intubation tube. Large volumes of secretions were evacuated producing more suitable conditions for further therapy and an improvement of the patients clinical condition. The authors believe that their data suggest the use of more invasive therapeutical methods in bronchial asthma.