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Palliative and hospice care plays a major role in the treatment of patients with advanced chronic obstructive pulmonary disease (COPD). The treatment involves pharmacotherapy and nonpharmacological methods such as smoking cessation, which may require the implementation of pharmacotherapy, increase levels of physical activity if possible, rehabilitation, oxygen therapy, dietetic recommendations, vaccination against influenza and pneumococci. Patients with COPD, who have dyspnoea despite optimal bronchodilating treatment, with progression of disease leading to exacerbations which require hospitalization or hospital emergency intervention. The aim of the palliative care is the treatment of pain, dyspnoea, cough, chronic fatigue syndrome, anxiety and depression, prevention of exacerbations of disease, as well as, comprehensive psychosocial and spiritual support of patients and caregivers. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a fourth cause of mortality worldwide. The 20% of COPD patients in Poland suffer from advanced disease. COPD usually gets gradually worse over time. In advanced COPD prognosis is bad. The main goal of management patients with advanced COPD is reducing symptoms: shortness of breath, cough, fatigue and often occurring depression and anxiety. The treatment prevents acute exacerbations of the disease. Exacerbations are the cause of the decrease of the quality of life and the risk factor of death. World Health Organization recommends in chronic diseases to integrate the action of the medical and the non-medical stuff (welfare and volunteers). Medical University of Gdansk developed ‘Pomeranian Model of Integrated Care for Patients with advanced COPD'. The main goal of it was to decrease the number of exacerbations (especially requiring the hospitalization) and in result, limit the cost of care, improve the quality of life of patients with advanced COPD and to help them to cope with disease. [ABSTRACT FROM AUTHOR]

Establishing the risk of death from the chronic obstructive pulmonary disease is not easy on account of a variable course of illness. The existence of different COPD phenotypes and variable escalation of systemic changes cause the prognosis to be uncertain. It is a key problem because the doubt in determining the terminal phase of the disease makes the communication between the doctor and the patient difficult. It's worth pointing to the typical features of the terminal COPD phase and the significance of the disease aggravation that has been highlighted in recent years. [ABSTRACT FROM AUTHOR]

Increased blood eosinophilia can be presented as the primary or secondary disease. The differential diagnosis of asthmatic patients with hypereosinophilia should consider eosinophilic lung disease, including Churg-Strauss syndrome and allergic bronchopulmonary aspergillosis. In the paper we present three cases of patients referred to the Department of Allergology and Lung Disease, Medical University of Gdansk, for eosinophilia accompanied by asthma. [ABSTRACT FROM AUTHOR]

Since 2013 in Poland it has been possible to treat patients with severe allergic asthma with omalizumab - a monoclonal antibody. The treatment is reimbursed by the National Health Found. The article explains the rules applied in qualifying patients to the treatment with omalizumab. Moreover, indications, contraindications and rules for monitoring patients with severe asthma treated with omalizumab are presented. [ABSTRACT FROM AUTHOR]

Introduction: Numerous factors may influence the asthma course during pregnancy, potentially elevating the risk of specific pregnancy complications. This study aimed to evaluate non-allergic factors influencing asthma and to assess perinatal outcomes between asthmatic and non-asthmatic pregnancies in the population of the Pomeranian Voivodeship region of Poland., Methods: The mixed cohort study was performed with 83 pregnant asthmatic patients aged 18-38 years. The control group consisted of 83 patients without asthma diagnosis or symptoms. A specially designed questionnaire was used to evaluate asthma course and perinatal outcomes. An Asthma Control Test (ACT) adapted for pregnancy was performed on enrollment. Asthma severity was assessed according to GINA guidelines., Results: In 19 cases (22.80%), patients quit their regular treatment after pregnancy was confirmed. Respiratory tract infection occurred in 23 patients (27.71%) and had been statistically significantly more frequent among patients with partially and uncontrolled asthma (χ 2 =8.504, p<0.05). No statistically significant difference was found between infection episodes and perinatal complications. The incidence of cesarean section was significantly higher among patients with asthma (χ 2 =16.37, p<0.01), particularly in patients with severe asthma (χ 2 =7.07, p<0.05) and uncontrolled asthma (χ 2 =6.7, p<0.05). Apgar score was statistically significantly lower in patients with severe asthma (χ 2 =20.37, p<0.05)., Conclusions: Respiratory tract infections and adequate asthma treatment are the most important modifiable factors in preventing perinatal complications associated with asthma., Competing Interests: The authors have each completed and submitted an ICMJE form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. I. Damps-Konstańska reports receiving Norway Grant and Polish Ministry of Health - TeleCareCOPD to her and her institution. She also reports receiving consulting fees from AstraZeneca, receiving payments for lectures from AstraZeneca, GSK, Sanofi and Chiesi for manuscript writing and educational materials for asthmatic patients from Medycyna Praktyczna.She also received support for attending to COPD Summit AZ (Munich 2021 and Lisboa 2023). Furthermore, she reports having a leadership role of the Committee for discharge card for patients after exacerbation of COPD. M. Chełmińska reports receiving payment for lectures from AstraZeneca and GSK., (© 2024 Rey A. et al.)

For the past several years the number of women suffering from chronic obstructive pulmonary disease (COPD) has been steadily increasing. This fact prompts the debate which factors, in addition to considerably increasing prevalence of cigarette smoking among young women, are responsible for these epidemiologic changes. Differences in the natural history and prognosis of COPD in females and males are presented in the paper, as well as the number of potential ethiopathogenetic and pathophysiologic factors influencing these variations. Among them, differences in the COPD risk factors spectrum in both genders and in airways anatomy are pointed out, and the mechanisms responsible for greater women's susceptibility to components of cigarette smoke, which reflect genetic (enzyme polymorphisms), epigenetic (diminished DNA methylation) and hormonal (estrogens) influences on xenobiotics metabolism. Further, sex-related differences regarding COPD phenotypes (chronic bronchitis vs. emphysema), immunological markers and clinical manifestation of disease are underlined in the paper. More frequent coexistence of anxiety and depression, COPD exacerbations and worse quality of life in women are also emphasized. Other differences, pointed out by authors include autoimmunological conception of pathogenesis of COPD (greater female susceptibility to produce autoantibodies), risk factors of disease exacerbation and, at last, response to certain forms of COPD treatment (nicotine replacement therapy, long-term oxygen therapy).

We present case of 67-years-old, non-smoking woman with unilateral hyperlucent lung syndrome. She has diagnosed asthma and since 1997 she has been treated with inhaled corticosteroids and long-acting beta-agonists without improvement. She complained of a cough, shortness of breath, pulmonary function test reveal irrvesibility airflow obstruction. The routine X-ray chest showed unilateral hyperlucent left lung. Ct-angiography has shown unilateral hypoplasia of pulmonary artery. It indicates that in all cases of uncontrolled asthma should be considered another or coexisting diagnosis.

Introduction: The aim of the study was to assess the quality of life of patients with asthma who were well and poorly controlled., Material and Methods: 70 patients with diagnosed asthma, aged from 18 to 40, were included into the study between November 2005 and February 2006 at the Specialist Hospital in Chojnice and Allergy out-patient Clinic of Medical University of Gdańsk. The diagnosis and stage of asthma, as well as the assessment of the control of disease was performed by the physician. Quality of life was assessed with the use of St. George Respiratory Questionnaire (SGRQ). Statistical analysis was made with the use of computer statistical program Statistica., Results: According to GINA in 26 patients mild asthma was diagnosed, in 31 - moderated and in 13 - severe disease. 41 patients were assessed as well controlled and 29 - as poorly controlled. Older age and longer duration of the disease were related to severe asthma, p = 0.01 and p = 0.003, respectively. In well controlled patients overall score for SGRQ was 48.86, whereas in poorly controlled was - 74.4. There was a significant difference between the overall quality of life in well and poorly controlled patients with asthma, p = 0.0001. This difference was found in all three domains: for symptoms, activity and impact on life, p = 0.014, p = 0.035 and p = 0.003, respectively., Conclusions: Quality of life is strongly dependent on the control of symptoms in asthmatic patients.

Pulmonary hypertension leading to right heart failure can be related to primary lung disease or hypoventilation. Idiopathic pulmonary hypertension is a progressive disease with poor prognosis. Therapy of idiopathic pulmonary hypertension includes: oxygen, calcium channel blockers, diuretics, anticoagulants, prostanoids, endothelin receptor antagonists and phosphodiesterase-5 inhibitors. Patients with pulmonary arterial hypertension (PAH) and pulmonary hypertension due to chronic thrombotic or embolic disease should be treated with vasodilatators. The potent vasodilatators are: prostacyclin PGI2, prostacyclin analogue and endothelin receptor antagonists. For patients with idiopathic PAH classified as NYHA III (New York Heart Association) bosentan is recommended, whereas for patients classified as NYHA IV--epoprostenol. Combination therapy is an emerging therapeutic option in PAH. In BREATH-2 (Bosentan Randomised Trial of Endothelin Antagonist Therapy for PAH) study the efficacy and safety of combining bosentan and epoprostenol given orally was investigated. No significant difference was established between treatment groups in 6-minutes walking distance or NYHA functional class. However other study investigating the combination of bosentan and prostacyclin analogue showed clinical improvement. Additional bosentan therapy may also reduce the epoprostenol dose and therefore decrease its side-effects. Interventional procedures: atrial septostomy and lung transplantation are indicated in patients with advanced NYHA class III and IV symptoms and refractory to available medical treatment. However, currently no management potent enough to cure pulmonary arterial hypertension is available. The introduction of new class of drugs allowed for the improvement of quality of life and overall survival. The choice of drug depends on a variety of factors including accessibility, approval status and patient's preferences.

Unlabelled: Eosinophil Cationic Protein (ECP) is released from activated eosinophils during the inflammation process., The Aim: of the study was to evaluate levels of ECP in serum of patients with perennial rhinitis (with and without asthma) and atopic dermatitis allergic to Dermatophagoides farinae and Dermatophagoides pteronyssinus. Further it was designed to compare ECP levels in patients treated with allergen-specific immunotherapy (IT) and in patients treated symptomatically., Material and Methods: The study group included 94 patients allergic to house dust mite: 42 patients with perennial rhinitis not treated with IT, 24 patients with perennial rhinitis and/or asthma treated with IT and 28 patients with atopic dermatitis. In the control group were 21 healthy volunteers. In the group treated with IT questionare of efficacy and safety was performed., Results: The serum level of ECP was measured using immunofluorometric assay. In the group with perennial rhinitis treated with IT mean level of ECP was 6,5 ug/l, whereas in the group not treated with IT--15,78 microg/l (p=<0.05). In patients with atopic dermatitis ECP level was the highest--23,04 microg/l +/- 4,98 and was significantly different than in the group of healthy volunteers-- 7,2 microg/l +/- 1,1 (p=0,0048)., Conclusions: Serum ECP concentration may be prognostic factor in specific immunotherapy.

Malignant mesothelioma of the pleura is a rare neoplasm with a poor prognosis. Noncharacteristic clinical signs, radiological features and similarity to other neoplasma (adenocarcinoma) in a microscopical evaluation lead to often diagnostic problems. Thoracoscopy followed by biopsy is routinely performed and is considered a main diagnostic procedure. Microscopic samples are usually examined by immunohistochemical analysis. In this report, presented is a case of malignant pleural mesothelioma, in which final diagnosis was delayed because of difficulties in diagnosis based on thoracoscopic biopsy.