Biomedical subjects

Piotr Rudziński

Publications and source records attributed to Piotr Rudziński.

7 recordsLinked to original sources

PubMed2005

[Caplan's syndrome: case report].

A case of a 56-years old male with rheumatoid arthritis and unclear tumoral radiological changes in the lungs was described. Since noninvasive diagnostic procedures failed to explain nature of the pulmonary changes, an open pulmonary biopsy was performed. Pathological examination revealed presence of rheumatoid nodules and pneumoconiosis, typical for Caplan's syndrome. In the past, the patient had been working in foundry industry for 16 years and he had been exposed to silica and iron dust. Articular symptoms were revealed prior to finding the lung changes even dust exposure had occurred many years earlier. In spite of the fact that rheumatoid arthritis is a relatively common disease and pneumoconiosis is also not rare entity, the coexistence of both conditions i.e. Caplan's syndrome has been rarely diagnosed and described.

Arthritis, Rheumatoid↗

PubMed2004

[Hypersensitivity pneumonitis recognised by open lung biopsy in patients at the Institute of Tuberculosis and Lung Diseases].

UNLABELLED: Diagnosis of hypersensitivity pneumonitis (HP) is made on the basis of a combination of clinical features connected with the exposition to organic dusts, radiographic abnormalities, lung function tests and immunological tests. Open lung biopsy (OLB) and histological examination is not necessary and is indicated mainly in chronic and subacute form of HP. In the chronic form of HP symptoms often do not show a temporal relationship with antigen exposure and errors occur especially if specific questions are not asked about exposure to antigen if HP. The aim of this paper was to analyse whether OLB was necessary in all patients in whom HP was recognised just after this procedure. Material included 21 patients in whom microscopic examination suggested HP among 258 pts in whom OLB was performed in the period of 1998-2003. There were 13 men and 8 women at the age of 18 to 65 years, mediana 42 years. RESULTS: We found 3 groups of pts. Group "+" included 9 exposed pts. They were asked and confirmed contact with birds, hay and 7 of them observed correlation between exposition and symptoms. The second Group "-" included 7 pts who were asked about exposition and who answered in the negative. In all of them HRCT scans suggested HP. Restriction was below 70% of VC in 3 pts. The third Group "0" included 5 pts who were not asked about exposition and correlation with symptoms. Two from them lived in the rural area. CONCLUSIONS: Open lung biopsy was not necessary for 6 patients in Group "+", because then had enough symptoms to recognise HP. In 3 patients of Group "+" and in 5 of Group "0" OLB could be not necessary because specific anamnesis and additional examinations were not collected. OLB was necessary method for 7 patients in Group "-".

Adult↗

PubMed2004

[Organizing pneumonia--analysis of 18 own cases].

Organizing pneumonia (OP) is a rarely diagnosed disease, however the incidence ratio was estimated as 6-7/100000. Disease can occur in cryptogenic form or as a secondary reaction to various noxious agents, drugs, and ionising radiation, as a concomitant disease to infections, lympho- and myeloproliferative disorders, and connective tissue diseases. Symptoms of OP are non-specific therefore lung biopsy and histological examination are necessary for diagnosis. Eighteen cases of OP, 15 women and 3 men, aged 40 to 76 years, are presented with analysis of clinicopathological characteristic and therapeutic problems. In all cases diagnosis was confirmed by open lung biopsy. In one case radiotherapy and in one trastuzumab treatment was the cause of OP. In further 3 women antibodies against Chlamydia pneumoniae and in one--against Mycoplasma pneumoniae were found in serum. Probably Hashimoto disease was the cause of one case. In 12 patients the OP was idiopathic. Majority of patients were treated by prednisone (0.5 mg/kg). In one patient regression without any treatment was noticed and in other one--after cessation of trastuzumab. Five women were treated by clarithromycin. In 3 of them regression was observed but in other 2 corticotherapy was necessary. The observation period ranged from 1 month to 9 years, mean 34 months.

Adult↗

PubMed2004

[Organizing pneumonia--own experiences with clarithromycin treatment].

Organising pneumonia (OP) is a rare syndrome that has been associated with a variety of underlying disorders, including infections, collagen vascular diseases, toxic fumes, cancer, drugs and radiotherapy. Cryptogenic form is also observed. Steroids are usually effective in the treatment of OP, but other treatment regimens have been used as well. We present 5 women with OP, age ranged 57-76 years (mean - 67 years). Two of them were smokers and three were non-smokers. One patient was treated because of hyperthyreosis, one of COPD, and four had a hypertension. Four of them were diagnosed by the open lung biopsy and one by transbronchial lung biopsy. Dyspnoea (100%), cough (100%), fever (80%), weight loss (40%), chest pain (20%), were the most frequently noticed symptoms. All patients had bilateral consolidations with areas of ground glass attenuations at chest x-ray and HRCT. Migratory pattern of them was observed in four patients. Significant elevation of antibodies titers against Chlamydia pneumoniae was revealed in two patients. In all patients clarithromycin in a dose 0.5 g b.d. was administrated. Complete clinical and radiological remission was obtained after 3 months of clarithromycin therapy in 3 patients (one had Chlamydia antibodies). Two patients had not obtained significant improvement during the first two weeks of therapy so prednisolone in a dose 0.5 mg/kg/d was introduced. Also complete remission was noticed in these patients. The observation period ranged from 8 months to 4 years (mean - 34 months). Our study confirms that OP can be treated by the use of clarithromycin. It may be the alternative treatment, particularly for patients in whom probability of adverse reactions in the course of steroid treatment is high.

Aged↗

PubMed2003

[Etiologic factors of pleural empyema as a potential source of nosocomial infections].

Pleural empyema still comprises an important therapeutic problem despite the availability of effective antibiotic therapy. This disorder is characterised by 20% mortality rate. Moreover, the involvement of multi-drug resistant bacterial strains may pose a risk of a nosocomial spread to other hospitalised patients. In the present study we have analysed 184 bacterial strains isolated from 63 patients with pleural empyema. A predominance of aerobic bacteria was detected, both Gram-positive cocci and Gram-negative bacilli. Staphylococci isolated from the clinical samples were characterised by a high percentage of strains resistant to gentamicin (86.3%) and methicillin (38.2%). The other important etiological agents were Pseudomonas aeruginosa and Gram-negative enteric rods of the Enterobacteriaceae family. Only 1 strain of anaerobic bacteria was detected. The enteric bacilli were characterised by a low percentage of isolates susceptible to most of the tested antibiotics (< 60%), with an exception of ciprofloxacin (68%) and imipenem (100%). These multi-drug resistant strains may spread nosocomially to other patients.

Bacteria, Aerobic↗

PubMed2003

[Invasive treatment of proteinosis].

The case of alveolar proteinosis successfully treated with whole lung lavage is described. In 40 years old, heavy smoker man disease started with recurrent respiratory tract infections. Disseminated lesions in chest x-ray were found. Patient was treated with antibiotics and corticosteroids without response-respiratory failure was developed. Diagnosis of alveolar proteinosis was confirmed after open lung biopsy. Bronchoalveolar lavage with small amount of 0.9% saline (200 ml) was repeated 7 times without improvement. PaO2 was 48 mmHg. Whole lung lavage with 10 L of 0.9% saline to each lung was repeated 2 times (total amount of liquid equal 40 L). PaO2 after treatment was 64 mmHg and 2 months later-84 mmHg. No complications were observed. Procedure was exactly described with parameters of respiratory system function.

Adult↗

PubMed2003

[Purulent lung diseases necessitating surgical treatment--case reports].

Majority of purulent lung diseases are treated with antibiotics. But sometimes this therapy is not successful and surgical treatment is necessary. Two patients are described in this paper. 68 years old woman in whom infiltration in left lung enlarged during antibiotics therapy. CT examination did not allow to differentiate between abscessus and tumor. Results of bacteriologic and cytologic examination of transthoracic biopsy were negative. During thoracothomy abscessus was resected and diagnosis was confirmed by patomorphologic examination. The second case: 16-years old girl was addmitted to hospital because of high temperature and abnormal chest X-ray picture (infiltration and liquid level in lower right lobe). During puncture the pus was evacuated but bacteria were not cultured. Antibiotics were not effective. Thoracothomy was done and large cysta bronchogenes was resected. In both cases surgical treatment was effective.

Adolescent↗