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Background. Chronic obstructive pulmonary disease (COPD) is associated with various comorbidities, which influence the course of COPD and worsen prognosis. Objectives. The aim of this study was to analyze the comorbidities in a cohort of COPD patients in Poland during 12 months of observation. Material and methods. A total of 444 COPD patients (median age: 66.1 years) in all stages of airflow limitation severity were enrolled. Medical histories and a questionnaire concerning comorbidities were analyzed at baseline and after 12 months (data of 267 patients available). Anthropometric data, pulmonary function, and body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE index) were assessed. Results. No comorbidities were reported in 9 patients (2.0%), 101 patients (22.7%) had 1-2 comorbidities, 243 (54.7%) had 3-5, and 91 (20.6%) had more than 5 comorbidities. Cardiovascular diseases (CVDs) were the most frequent ones, followed by peptic ulcer, obstructive sleep apnea (OSA), diabetes, gastroesophageal reflux disease (GERD), and osteoporosis; 11 patients had a history of lung cancer. Cachexia was observed in 11 cases, overweight in 136 cases and obesity in 139 cases. The incidence of CVDs increased with time. The number of comorbidities correlated with the body mass index (BMI) and the number of hospitalizations for extra-pulmonary causes, but not with airflow limitation. The BODE index score increased with the number of comorbidities. Conclusions. In a cohort of Polish COPD patients, the most frequent comorbidities were CVDs. The number of comorbidities affected the BODE index, but not airflow limitation. The BODE index is better than forced expiratory volume in 1 s (FEV1) in the rating of COPD patients' condition. The BMI correlated with the number of comorbidities as well as the number of hospitalizations for extra-pulmonary causes. [ABSTRACT FROM AUTHOR]

Introduction: Chlamydia pneumoniae is an obligatory human pathogen involved in lower and upper airway infections, including pneumonia, bronchitis. Asymptomatic C. pneumoniae carriage is also relatively common. The association of C. pneumoniae infections with the chronic obstructive pulmonary disease (COPD) course is unclear.Objectives: The aim of the study was to investigate the association between chronic C. pneumoniae infection and clinical features of COPD, markers of inflammation and metabolic dysfunction.Patients and Methods: The study included 59 patients with stable COPD who had no, or had ≥2 acute exacerbations during last year. The level of IgA and IgG antibody against C. pneumoniae, IL-6, IL-8, resistin, insulin, adiponectin and acyl ghrelin was measured in serum by enzyme-linked immunosorbent assay (ELISA).Results: No differences in clinical and functional data were observed between COPD patients without serological features of C. pneumoniae infection and chronic C. pneumoniae infection. The level of anti C. pneumoniae IgA significantly correlated with IL-8, IL-6, resistin concentration in group of frequent exacerbators. IgG level correlated negatively with acetyl ghrelin and body mass index (BMI) in patients without frequent exacerbations, in contrast to frequent COPD exacerbation group where significant correlations between IgG level and BMI was demonstrated. Serum IL-6 correlated positively with resistin and insulin and negatively with adiponectin in group of patients with serological features of chronic C. pneumoniae infection only.Conclusions: Our study showed that chronic C. pneumoniae infection does not influence the clinical course of COPD in the both study groups. Chronic C. pneumoniae infections might be associated with a distinct COPD phenotype that affects metabolic dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: The role of bacterial infections in acute exacerbations of chronic obstructive pulmonary disease (COPD) is widely examined. Denture plaque in patients with COPD is an example of bacterial and fungal biofilm, which is a reservoir of potentially pathogenic respiratory tract microorganisms. Poor denture hygiene might cause acute exacerbations of COPD.Objective: Assessment of prevalence of respiratory tract pathogens in denture plaque in stable patients with COPD and it influence on oral ontocenoses depending upon the therapy.Materials and Methods: The study was based on the clinical assessment of oral mucosa and denture hygiene in 53 patients with COPD with mean age of 70 ± 18 years and 14 generally healthy participants with mean age of 65 ± 14 years. Microbiological and mycological tests were performed by culturing direct denture swabs.Results: The study showcased the presence of potential pathogenic micro-organisms in denture plaque of 48 patients with COPD (90%) and nine healthy subjects (64.3%). Yeast-like fungi prevailed in denture surface swabs of 40 (75%) in patients with COPD and 8 (57%) in cases of control group. In 66% of patients, various degree of oral mucosa inflammation prevailed.Conclusions: Denture plaque could be a potential source of bacterial and fungal infections in patients with COPD. [ABSTRACT FROM AUTHOR]

Adiponectin is the lipocyte factor having the association with the cardiovascular system. Adiponectin concentration depends of BMI, it decreases with increase BMI. Obstructive sleep apnea (OSA) is connected with obesity and cardiovascular disorders. The aim of this study was to estimate the serum adiponectine concentration in patients with OSA. Material: 36 persons were included into the study. The control group consisted of 8 snoring man, study group consisted of 26 male patients with OSA Methods: Adiponectin was measured by ELISE methods using the BioVendor's Human Adiponectine kit. We also measured serum concentration of leptine, lipids, CRP, creatinine, uric acid, fibrinogene and glucose. Results: The serum concentrations of adiponectin (µg/mL) in patients with OSA compared with control group were respectively 10,55±3,41 vs 9,00±4,04 µg/mL (p>0,05). There was only one positive significant correlation between adiponectin concentration and uric acid (r=-0,49). In the study group there was no differences between group with AHI <50 and AHI >50 : 10,52±4,45 vs 10,71±2,33 µg/mL. Conclusion: 1) There was no differences in serum concentration between study and control group. 2) There was no differences in adiponectin concentration between group with AHI<50 and AHI>50. 3) Serum adiponectin concentration positive correlated with serum uric acid concentration. 4) The conclusion about OSA influence on serum adiponectin concentration needs to enlarge the study group [ABSTRACT FROM AUTHOR]

Leukotriens are very important mediators of the allergic diseases. Montelucast derived by lipoxygenation of arachidonic acid with 5-lipoxygenaze activaiting protein. Leukotrienes act by leukotriene receptors one for LTB4 and second for cys-LTs (LTC4 i LTD4). Montelukast and zafirlucast belongs to leukotriene receptors antagonists. These drugs have antiinflammatory effect in lung tissue. They decrease eosinophil blood and sputum count, reduce ECP concentration, increase IL-10 concentration in the blood and reduced exhaled NO as well. Leukotriene inhibitors may improve concomitant symptoms of seasonal rhinitis. Clinical benefits have been demonstrated until the addition of anti-leukotrienes to the patients with poor asthma control. They are effective in aspirine asthma and in inhibiting exercise induced asthma. Actually there is new indication for montelukast-allergic rhinitis in asthma patients. It can be used in monotherapy and also together with antihistamines drugs and nasal corticosteroids. [ABSTRACT FROM AUTHOR]

We present the case of 67 years man with Mycobacterium fortuitum pneumonia Mycobacterium fortuitum is a rapidly growing nontuberculous mycobacterium (NTM) classified in the Runyon group IV, mycobacteria. It has been found everywhere as in soil, dust, rivers, lakes and tap water. M fortuitum can cause infection as the local cutaneous disease and joint infection, osteomyelitis, and ocular diseaseas well. It is an uncommon cause of NTM lung disease. Disseminated disease, occurs almost exclusively in the setting of severe immunosuppression, especially AIDS. [ABSTRACT FROM AUTHOR]

Background. According to the ERS/ATS recommendations (2005) FEV6 (forced expiratory volume in 6 second) measurement seems to be more reproductible than the measurement of FVC. However, some patients may not be able to produce prolonged (i.e. minimum 6s) expirations. Aim of the study. Evaluate the forced expiration time (FET) and the possibility to calculate FEV6, as recommended by ERS/ATS, in patients with asthma. Material and methods. The study group consisted of 399 patients with asthma (240 F, 159M), in the mean age 47,24±18,87 years. Spirometry was performed with the standard protocol according to the ERS/ATS guidelines (Lungtest 1000, MES, Poland). Results. The value FET≥6s was obtained only in 76 subjects (19,0%); 60 patients (15,0%) achieved FET<3s. In this group the obturation have 70 patients (the severe and very severe 20 ones). In the group with FET>6s the statistical important correlation were found between FEV6 and FEV1; FVC and age. Conclusion. 1. Calculation of FEV6 based on spirometry is possible in the limited group of patients and therefore it is difficult to verity if its measurement is more reproducible than the measurements of FVC. 2. In asthmatic patients with airflow limitation FET>6s is achieved more frequently than in patients with no changes in spirometry. 3. Patients education may play the important role in the better technical quality of spirometry. [ABSTRACT FROM AUTHOR]

Reversibility test to bronchodilatator is one of the characteristic feature for asthma. The aim of the study was to estimate if improve the value of FEV1 or FVC is more common in reversibility test in asthma patients. Material and method. The study group consisted of 94 patients with asthma (60F, 34 M) in mean age (x=51,52±19,75years) The measurements of FEV1 and FVC were estimated before and 15 minutes after inhalation of 400µg of salbutamol. The lung function tests were carried out by means of Lung 1000 ( MES Poland). Results: The mean values of FEV1 and FVC(ex) and FVC(in) before and after salbutamol inhalation were: 1,84±0,93l (62,64±18,26%) vs 2,28±1,09l (77,88±21,45%) (p<0,05) and 2,99±1,21 (86,35±19,84%) vs 3,46±1,31 (99,84±18.05%) (p<0,05) and 2,81±1,21l (80,50±19,03%) vs 3,66±4,54l (92,32±17,20%) (p<0,05). In all study group increased of FEV1 or FVC or FEV1+FVC were observed respectively in 23 (24,5%), 34(36,2%) and 37(39,3%) cases. In the male (n=34) and female (n=60) group FEV1 or FVC or FEV1+FVC were: 10 (29,4%) vs 13(21,7%); 15(44,2%) vs 20(33,3%), 10(29,4%) vs 27(45%) subjects. In group younger (n=46) and older 50 years (n=48) FEV1 or FVC or FEV1+FVC was: 18 (39,3%)vs 4(8,3%); 9 (19,6%) vs 23(47,9%); 19 (41,3%) vs 21 (43,8%). Conclusion: 1. In all study group the most common was increase the value of both FEV1 and FVC. 2. In male the most common was increase of FVC but in female FEV1+FVC, in younger group FEV1+FVC but in older FVC. [ABSTRACT FROM AUTHOR]