Search results

1

Analysis of the SMAD4 gene in asthma

100%

Miletic A., Petrovic-Stanojevic N., Radojkovic D., Nikolic A.

Open Medicine

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2014

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vol. 9

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issue 6

811-813

EN

Considering the importance of the TGF-β signaling pathway for normal lung function and especially its roles in inflammation and tissue remodeling, key features of asthma pathology, it can be assumed that these molecules may harbor mutations in asthmatics. The aim of this study was to analyze the SMAD4 gene in patients with asthma. Analysis has encompassed exons 10, 11, 12 and 13 encoding the carboxy-terminal (MH2) domain of the SMAD4 protein, where mutations most frequently occur. The study included 50 patients (20 men and 30 women) with asthma aged between 17 and 73 years (average age 45.2±15.6 years). Polymerase chain reaction (PCR) was used to amplify exons 10, 11, 12 and 13 of the SMAD4 gene and the obtained PCR products were subjected to direct DNA sequencing. No nucleotide changes were found in any of the analyzed exons in either of the subjects. Based on the results of this study, it seems that mutations in the carboxy-terminal (MH2) domain of the SMAD4 are not present in asthmatic patients. Future research should be directed at the analysis of the complete gene, including regulatory elements, in order to resolve the exact role of SMAD4 in asthma.

2

Occam’s razor reveals a hidden Churg-Strauss syndrome

80%

Nenna R., Mennini M., Petrarca L., Mastrogiorgio G., Magliocca F., Bonamico M.

Open Medicine

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2012

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vol. 7

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issue 3

358-361

EN

A 28 year-old caucasian lady, with nine years of uncontrolled bronchial asthma, rhinosinusitis and mild upper limb paresthesia, came to our attention to be followed for coeliac disease (CD). She had a biopsy performed elsewhere which proved the diagnosis five years before. Since there was no clinical improvement on a strict gluten-free diet, we re-evaluated the slides of her duodenal biopsies and we found an overestimation of the duodenal lesions due to the wrong orientation of the specimens. Moreover, she had never had positive CD-related antibodies and she was negative for DQ2/DQ8 MHC Class II heterodimers. Months later, she referred she was suffering from diffuse joint pain, epistaxis and a substantial weight loss. A few days later she was hospitalized because of a sudden onset of dyspnea, peripheral edema and pleural effusion. Her echocardiogram showed global left ventricular hypokenesia with an ejection fraction of 24%. The patient was discharged with a diagnosis of dilated cardiomyopathy and NYHA Class II. After a large spectrum of haematological exams, the diagnosis of Churg Strauss Syndrome (CSS), a rare multisystemic small-vessel necrotizing vasculitis, was confirmed by the presence of four/five out of six diagnostic American College of Rheumatology classification criteria (Asthma, Eosinophilia >10%, Neuropathy, Non-fixed pulmonary infiltrates, Paranasal sinus abnormality and Biopsy containing a blood vessel with extravascular eosinophils). Our patient had been under-diagnosed by pulmonologist and by gastroenterologists although she presented the criteria required for CSS diagnosis. Our case report emphasizes that often seemingly unrelated symptoms can be caused by a single rare clinical complex.

3

Manifestation peculiarities of idiopathic chronic eosinophilic pneumonia

80%

Danila E., Norkūnienė J., Nargėla R., Žurauskas E., Šatkauskas B., Aleksonienė R.

Open Medicine

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2010

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vol. 5

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issue 1

75-82

EN

Chronic eosinophilic pneumonia is a rare interstitial lung disorder, which causes diagnostic difficulties. Often the disease is diagnosed correctly after several weeks or months following initial presentation. The aim of the study was to prospectively evaluate peculiarities of manifestation of idiopathic chronic eosinophilic pneumonia (ICEP), which may allow to improving early diagnosis. Twenty patients with ICEP were involved in this investigation. The cases of acute eosinophilic pneumonia and cases of chronic eosinophilic pneumonia of known origin were excluded. To define archetypal signs of the idiopathic chronic eosinophilic pneumonia, 3 comparable groups were selected. They were the group of 50 patients with community-acquired pneumonia (COP); the group of 21 asthmatic patients with COP, and the cluster of 10 patients with morphologically confirmed cryptogenic organizing pneumonia (OP). Clinical and radiological manifestation of ICEP was similar to COP and cryptogenic OP manifestation. We have found that chest pain; fine rales and pleurisy were unrepresentative for ICEP. However, blood eosinophilia was typical sign of ICEP and wheezing was a frequent observation. Usually ICEP patients had relative mild clinical symptoms and moderate increased C reactive protein (CRP) level even in cases of multiple pulmonary infiltrates. In conclusion, in cases of not typical pneumonia course, i.e. non-resolving or recurrent pulmonary infiltrates; relative mild clinical symptoms and moderate increased CRP level with multiple pulmonary infiltrates; blood eosinophilia and/or signs of airway obstruction eosinophilic pneumonia should be suspected and bronchoalveolar lavage and/or bronchoscopic lung biopsy performed.

4

Study of Kazakhstan inpatient childhood asthma: assessment of prevalence and factors influencing treatment adherence

70%

Kosherbekov Y., Davletgildeyeva Z., Zholdybaeva A., Duisenbayeva A., Davletgildeyev E., Ispayeva Z., Assemov A., Bekmagambetova R., Fakhradiyev I., Tanabayeva S.

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vol. 27

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issue 2-3

94-103

EN

Background: Up to date, the assessment of adherence to the treatment of children with asthma in Kazakhstan has not been carried out yet. Objective: The study aimed to evaluate the level of therapeutic adherence of paediatric patients with asthma in urban and rural areas of Kazakhstan. In addition, the validity and reliability of a structured scale for assessing adherence in patients with asthma was also scrutinized. Methods: A prospective study of verified cases of bronchial asthma of 518 children in the dispensary control in the Children’s City Clinical Hospital N2 (Almaty, Kazakhstan) was conducted in the period from 2018 to 2020. Children with asthma were sub-divided into 2 groups: urban and rural residents. The demographic and clinical characteristics, external and social factors of the patients were analysed. Patient adherence to treatment was assessed using the Lebanese Medication Adherence Scale-14(LMAS-14). The reliability was tested using the measure of internal consistency (Cronbach’s alpha). Data were collected after the discharge from the hospital (T1) and after 6 months (T2). Results: Urban and rural patients made up 81.3% vs. 18.7% respectively. Children aged 5-12 years accounted for 70.6%. Male gender was predominant in all groups (p=0.73). Better financial situation, education were noted by 90.5% and 95.5% of urban parents (p=0.001). The influence of external factors (dampness, coal heating and possession of pets) was higher in rural areas (p=0.001).The results of study based on the LMAS-14 questionnaire (T1 period) showed no significant differences. However, in the T2 period, the adherence of urban children was higher than rural ones (p=0.001). The Cronbach’s α was 0.606 for the total score. According to the results of a survey after 18 months, a significant relationship was found between the levels of adherence and the frequency of asthma attacks (p=0.001). Conclusion: In 2018-2020, a low therapeutic adherence of children with asthma, especially in a rural area, was detected in the territory of the Republic of Kazakhstan. Our findings indicate the necessity to develop effective measures to regulate and increase adherence to treatment of patients, especially those living in rural areas.

5

Radon-enriched hot spring water therapy for upper and lower respiratory tract inflammation

70%

Passali D., Gabelli G., Passali G. C., Mösges R., Bellussi L. M.

Polish Journal of Otolaryngology

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2017

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vol. 71

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issue 4

8-13

EN

Background Radon-222-enriched hot spring therapy, which is characterized by a safe level of radioactivity, is used for the treatment of rheumatic disorders, and its efficacy has already been studied in several clinical trials. Radon-water inhalation therapy for the treatment of upper and lower airway inflammatory diseases is used in many hot springs centers. However, its application has not been reviewed to date. Methods We systematically searched the PubMed and Scopus databases for clinical trials published in the last 20 years in which objective parameters of upper and lower airway function had been tested before and after radon-enriched inhalation treatment. Results Four prospective studies were found: 1 asthma trial, 1 placebo-controlled chronic rhinosinusitis trial, 1 upper respiratory tract inflammation with nasal obstruction trial, and 1 case-control allergic rhinitis trial. Patients were treated with nasal inhalations of radon-enriched water for 12 to 28 days and were assessed at baseline and after therapy. After 2 weeks of treatment, nasal resistance decreased, flow increased, mucociliary clearance was enhanced, ciliated-to-muciparous cell ratio increased, and %FEV1 increased in asthmatic patients. Conclusion Radon-enriched inhalation therapy improves objective indicators of nasal function in allergic rhinitis and chronic rhinosinusitis, and causes relief of pulmonary obstruction in asthma.

6

Radon-enriched hot spring water therapy for upper and lower respiratory tract inflammation

70%

Passali D., Gabelli G., Passali G. C., Mösges R., Bellussi L. M.

Otolaryngologia Polska

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2017

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vol. 71(4)

8-13

EN

Background Radon-222-enriched hot spring therapy, which is characterized by a safe level of radioactivity, is used for the treatment of rheumatic disorders, and its efficacy has already been studied in several clinical trials. Radon-water inhalation therapy for the treatment of upper and lower airway inflammatory diseases is used in many hot springs centers. However, its application has not been reviewed to date. Methods We systematically searched the PubMed and Scopus databases for clinical trials published in the last 20 years in which objective parameters of upper and lower airway function had been tested before and after radon-enriched inhalation treatment. Results Four prospective studies were found: 1 asthma trial, 1 placebo-controlled chronic rhinosinusitis trial, 1 upper respiratory tract inflammation with nasal obstruction trial, and 1 case-control allergic rhinitis trial. Patients were treated with nasal inhalations of radon-enriched water for 12 to 28 days and were assessed at baseline and after therapy. After 2 weeks of treatment, nasal resistance decreased, flow increased, mucociliary clearance was enhanced, ciliated-to-muciparous cell ratio increased, and %FEV1 increased in asthmatic patients. Conclusion Radon-enriched inhalation therapy improves objective indicators of nasal function in allergic rhinitis and chronic rhinosinusitis, and causes relief of pulmonary obstruction in asthma.

7

Spontaneous pneumomediastinum: ten years of our experience in diagnosis and outcome

70%

Hromis S., Zvezdin B., Kopitovic I., Milutinov S., Kolarov V., Vukoja M., Zaric B.

Open Medicine

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2014

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vol. 9

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issue 5

642-647

EN

Spontaneous pneumomediastinum (SPM) is a rare clinical condition that may be mild but also dramatic with sudden onset of chest pain and dyspnea accompanied by swelling and subcutaneous crepitations. The objective of this study was to analyze the clinical presentation and outcome of SPM in a specialized pulmonary tertiary care centre over a 10 years year period. In subsequent followup, we received information related to recurrence episodes of SPM by patients or their GPs physicians. Eighteen patients, 15 (83%) men, mean age 24 years (SD ±7.86) were diagnosed with SPM. Predominant symptoms were chest pain and cough (n=11) then dyspnea (n=9). Asthma was the most common predisposing condition (n=12). Pneumomediastinum was present on chest radiograph in 17 cases (94%), and in one case it was detected only by computed tomography. The mean length of hospital stay was 7 days (SD ±4.4 days). All our patients recovered and there were no complications. Recurrent event occurred in one asthma patient, 2 years after the first episode. Although, SPM is usually a self-limiting and benign condition, close monitoring is necessary. Recurrence is rare, but possible, with no evidence that routine monitoring of those patients is needed.

Refine search results

Analysis of the SMAD4 gene in asthma

Occam’s razor reveals a hidden Churg-Strauss syndrome

Manifestation peculiarities of idiopathic chronic eosinophilic pneumonia

Study of Kazakhstan inpatient childhood asthma: assessment of prevalence and factors influencing treatment adherence

Radon-enriched hot spring water therapy for upper and lower respiratory tract inflammation

Radon-enriched hot spring water therapy for upper and lower respiratory tract inflammation

Spontaneous pneumomediastinum: ten years of our experience in diagnosis and outcome