Advances in Respiratory Medicine

174 KiB

Open AccessReview

Nowo?ci z Kongresu ERS w Barcelonie, 18–22 wrze?nia 2010 (Cz??? II)

by Michał Bednarek, Elżbieta Puścińska and Jan Zieliński

Adv. Respir. Med. 2011, 79(3), 253-258; https://doi.org/10.5603/ARM.27662 - 21 Apr 2011

Viewed by 401

Tematyce zaburze? oddychania w czasie snu po?wi?cono jak zwykle wiele uwagi, przygotowano im 14 sesji, w tym 2 sympozja, 2 praktyczne seminaria warsztatowe, 2 sesje wyst?pie? ustnych, 2 sesje komunikacji elektronicznych, 5 sesji plakatowych oraz jeden kurs podyplomowy [...] Full article

192 KiB

Open AccessReview

Rola Nieinwazyjnej Wentylacji w Leczeniu Przewlek?ej Obturacyjnej Choroby P?uc

by Jacek Nasiłowski

Adv. Respir. Med. 2011, 79(3), 246-252; https://doi.org/10.5603/ARM.27666 - 21 Apr 2011

Viewed by 517

Abstract

Nieinwazyjna wentylacja (NIW) jest jednym z najwa?niejszych osi?gni?? w leczeniu chorób p?uc w ostatnich kilkunastu latach. Stosuj?c j?, uzyskuje si? podobny efekt fizjologiczny jak w przypadku wentylacji inwazyjnej, polegaj?cy na zmniejszeniu pracy mi??ni oddechowych i poprawie wymiany gazowej, przy jednoczesnym unikni?ciu gro?nych powik?a? [...] Read more.

Nieinwazyjna wentylacja (NIW) jest jednym z najwa?niejszych osi?gni?? w leczeniu chorób p?uc w ostatnich kilkunastu latach. Stosuj?c j?, uzyskuje si? podobny efekt fizjologiczny jak w przypadku wentylacji inwazyjnej, polegaj?cy na zmniejszeniu pracy mi??ni oddechowych i poprawie wymiany gazowej, przy jednoczesnym unikni?ciu gro?nych powik?a? intubacji. Podstawowym wskazaniem do NIW jest ci??kie zaostrzenie przewlek?ej obturacyjnej choroby p?uc (POChP), charakteryzuj?ce si? kwasic? oddechow?. Kontrolowane badania wykaza?y zmniejszenie ?miertelno?ci, konieczno?ci intubacji, liczby powik?a? zwi?zanych z leczeniem oraz skrócenie czasu pobytu na OIOM i w szpitalu u chorych leczonych NIW. Rola NIW w przewlek?ym leczeniu chorych z ci??k?, hiperkapniczn? postaci? POChP nie jest ustalona. Chocia? zarówno przes?anki teoretyczne, jak i wyniki bada? klinicznych sugeruj? korzy?ci z tego leczenia, to nadal nie jest jasne, którzy chorzy odnios? z niego korzy??. Obecnie uwa?a si?, ?e prób? NIW w warunkach domowych nale?y podj?? u chorych ze znaczn? hiperkapni?, powoduj?c? objawy hipowentylacji, w przypadku cz?stych zaostrze?, zw?aszcza wymagaj?cych stosowania wspomagania wentylacji oraz przy nieskuteczno?ci domowego leczenia tlenem w utrzymaniu prawid?owego utlenowania krwi. Stosowanie NIW, dzi?ki zmniejszeniu liczby powik?a? i czasu hospitalizacji, szczególnie w warunkach intensywnego nadzoru, jest post?powaniem przynosz?cym oszcz?dno?ci zarówno szpitalowi, jak i systemowi opieki zdrowotnej.
Full article

190 KiB

Open AccessReview

Profilaktyka Przewlek?ej Obturacyjnej Choroby P?uc

by Dorota Górecka and Elżbieta Puścińska

Adv. Respir. Med. 2011, 79(3), 239-245; https://doi.org/10.5603/ARM.27665 - 21 Apr 2011

Viewed by 880

Abstract

Przewlek?a obturacyjna choroba p?uc (POChP) jest jednym z najwa?niejszych schorze? spo?ecznych. Jest przyczyn? znacznej ?miertelno?ci (znajduje si? na czwartym miejscu najwa?niejszych przyczyn zgonów na ?wiecie), odpowiada za znaczn? chorobowo?? oraz przyczynia si? do pogorszenia jako?ci ?ycia chorych i ich najbli?szych. Dzi?ki profilaktyce mo?na [...] Read more.

Przewlek?a obturacyjna choroba p?uc (POChP) jest jednym z najwa?niejszych schorze? spo?ecznych. Jest przyczyn? znacznej ?miertelno?ci (znajduje si? na czwartym miejscu najwa?niejszych przyczyn zgonów na ?wiecie), odpowiada za znaczn? chorobowo?? oraz przyczynia si? do pogorszenia jako?ci ?ycia chorych i ich najbli?szych. Dzi?ki profilaktyce mo?na zapobiec powstaniu choroby (profilaktyka pierwotna), nie dopu?ci? do jej post?pu (profilaktyka drugorz?dowa) oraz zapobiec wyst?pieniu powik?a? (profilaktyka trzeciorz?dowa). Profilaktyka w POChP obejmuje dzia?ania skierowane na ograniczenie na?ogu palenia tytoniu, zmniejszenie szkodliwych wp?ywów ?rodowiska oraz stosowanie szczepie? ochronnych.
Full article

192 KiB

Open AccessReview

Nowe Leki w Przewlek?ej Obturacyjnej Chorobie P?uc

by Ryszarda Chazan

Adv. Respir. Med. 2011, 79(3), 232-238; https://doi.org/10.5603/ARM.27664 - 21 Apr 2011

Viewed by 454

Abstract

Zastosowanie u chorych na przewlek?? obturacyjn? chorob? p?uc (POChP) wziewnych leków rozkurczowych z grupy ??-mimetyków i cholinolityków zapewnia lepsz? kontrol? objawów choroby, zmniejsza liczb? zaostrze? oraz ich nasilenie, zwi?ksza tolerancj? wysi?ku i zapewnia lepsz? jako?? ?ycia. Leki te maj? akceptowalny profil bezpiecze?stwa. [...] Read more.

Zastosowanie u chorych na przewlek?? obturacyjn? chorob? p?uc (POChP) wziewnych leków rozkurczowych z grupy ??-mimetyków i cholinolityków zapewnia lepsz? kontrol? objawów choroby, zmniejsza liczb? zaostrze? oraz ich nasilenie, zwi?ksza tolerancj? wysi?ku i zapewnia lepsz? jako?? ?ycia. Leki te maj? akceptowalny profil bezpiecze?stwa. U chorych w umiarkowanym i ci??kim stadium choroby rekomendowane jest zastosowanie skojarzone leków rozkurczowych d?ugodzia?aj?cych z dwóch grup: beta?-mimetyków i leków muskarynowych (LABA/LAMA). Pierwszym lekiem z grupy LABA, który dzia?a 24 godziny, a jednocze?nie ma bardzo szybki pocz?tek dzia?ania i który mo?na stosowa? raz na dob? jest indakaterol. Korzy?ci z zastosowania indakaterolu zarówno w monoterapii, jak i w skojarzeniu z LAMA wi??? si? z uproszczeniem sposobu leczenia. U osób, u których choroba nadal post?puje, i które maj? cz?ste zaostrzenia, rekomendowana jest terapia trójlekowa: dwa leki rozkurczowe w po??czeniu z wziewnym glikokortykosteroidem (LABA/LAMA/wGKS). W ci??kiej postaci POChP dodanie inhibitora PDE4 - roflumilastu do leku rozkurczowego z grupy LABA lub LAMA poprawia czynno?? p?uc i zmniejsza cz?sto?? zaostrze?. Wp?yw dodania roflumilastu na zmniejszenie cz?sto?ci zaostrze? jest porównywalny z wynikami, jakie uzyskuje si? za pomoc? leczenia skojarzonego z wGKS. Wykazano korzystne dzia?anie inhibitorów PDE4, zw?aszcza w po??czeniu z innymi lekami. Terapia skojarzona stanowi kolejny krok w optymalizacji leczenia chorych na POChP.
Full article

188 KiB

Open AccessReview

Mega Trials in COPD—Clinical Data Analysis and Design Issues

by Samy Suissa and Pierre Ernst

Adv. Respir. Med. 2011, 79(3), 227-231; https://doi.org/10.5603/ARM.27663 - 21 Apr 2011

Cited by 1 | Viewed by 466

Abstract

The TORCH and UPLIFT randomised controlled trials have provided important data on the benefits of COPD treatments, but also some lessons in study design and data analysis that we will here review. Firstly, it is fundamental that the study question be answerable by [...] Read more.

The TORCH and UPLIFT randomised controlled trials have provided important data on the benefits of COPD treatments, but also some lessons in study design and data analysis that we will here review. Firstly, it is fundamental that the study question be answerable by the study design. The question in the TORCH study was aimed at a comparison with ‘usual care’, but the placebo group was not ‘usual care’. Secondly, TORCH and UPLIFT were among the first trials to follow the intent-to-treat principle, fundamental to avoid bias in randomised trials. However, this principle was followed for the mortality outcome, but not for lung function, so that the findings related to lung function decline are subject to bias from regression to the mean. Finally, a re-analysis of the TORCH study (performed to fully exploit the data as a 2 × 2 factorial trial) shows that a mortality benefit is entirely accounted for by the effect of the long-acting ?-agonist salmeterol, with no effect attributable to the inhaled corticosteroid fluticasone component of the combination therapy. Together, these data suggest that long-acting bronchodilators, including anticholinergics such as tiotropium and beta-agonists, are associated with lower mortality of patients with COPD, but not inhaled corticosteroids. With COPD one of the major causes of morbidity and mortality worldwide, mega trials such as TORCH and UPLIFT are much needed, but must achieve the utmost scientific rigour in their design and analysis. Full article

228 KiB

Open AccessCase Report

Chemotherapy in the Management of Disseminated Thymoma: A Case Report and the Authors’ Own Experience

by Izolda Mrochen-Domin, Ewa Chmielik, Danuta Starzyczny-Słota, Elżbieta Nowara and Marlena Sikora

Adv. Respir. Med. 2011, 79(3), 222-226; https://doi.org/10.5603/ARM.27660 - 21 Apr 2011

Viewed by 470

Abstract

Thymomas are tumours originating from the epithelial tissue of the thymus. While surgery is the mainstay of therapy in thymoma, chemotherapy may significantly improve the prognosis. Effective chemotherapy may be administered in the neoadjuvant setting (prior to surgery), in the adjuvant setting (following [...] Read more.

Thymomas are tumours originating from the epithelial tissue of the thymus. While surgery is the mainstay of therapy in thymoma, chemotherapy may significantly improve the prognosis. Effective chemotherapy may be administered in the neoadjuvant setting (prior to surgery), in the adjuvant setting (following surgery), may be combined with radiotherapy or be used for palliation in disseminated disease. We report a case of a 66-year-old male with advanced thymoma who received second-line treatment with a good outcome. Full article

137 KiB

Open AccessCase Report

Recurrent Exudative Pericarditis in the Course of Adult-Onset Still’s Disease—Two Case Reports

by Anna Bilska, Ewelina Wilińska, Monika Szturmowicz, Liliana Wawrzyńska, Anna Fijałkowska, Karina Oniszh, Andrzej Światowiec, Agnieszka Wsół and Adam Torbicki

Adv. Respir. Med. 2011, 79(3), 215-221; https://doi.org/10.5603/ARM.27659 - 21 Apr 2011

Cited by 1 | Viewed by 458

Abstract

Exudative pericarditis is a disease of varied aetiology requiring inclusion of both infectious and non-infectious causes in its differential diagnosis. The possible diagnoses include adult-onset Still’s disease (AOSD), a rare systemic inflammatory disease of unknown aetiology. AOSD typically develops in patients between 16 [...] Read more.

Exudative pericarditis is a disease of varied aetiology requiring inclusion of both infectious and non-infectious causes in its differential diagnosis. The possible diagnoses include adult-onset Still’s disease (AOSD), a rare systemic inflammatory disease of unknown aetiology. AOSD typically develops in patients between 16 and 35 years of age and is characterised by fever, arthralgia, transient salmon-coloured rash and other abnormalities including pharyngitis, serositis (particularly pleuritis and pericarditis) and laboratory abnormalities, such as elevated white blood cell count and elevated markers of inflammation. We report two cases of AOSD with recurrent exudative pericarditis. Full article

207 KiB

Open AccessReview

Równowaga Proteazowo-Antyproteazowa a Palenie Tytoniu

by Joanna Kołodziejczyk, Milena Wojciechowska, Zbigniew Bartuzi and Andrzej Dziedziczko

Adv. Respir. Med. 2011, 79(3), 207-214; https://doi.org/10.5603/ARM.27661 - 21 Apr 2011

Viewed by 546

Abstract

Smoking tobacco can induce formation of inflammable state in respiratory tract and cause lungs damage. Experimental investigations affirm, that the exposure to tobacco smoke causes growth of penetrability of blood-vessels, which favors the enlarged migration of inflammable cells. The growth of exposure to [...] Read more.

Smoking tobacco can induce formation of inflammable state in respiratory tract and cause lungs damage. Experimental investigations affirm, that the exposure to tobacco smoke causes growth of penetrability of blood-vessels, which favors the enlarged migration of inflammable cells. The growth of exposure to reactive forms of oxygen and concentration changes of cellular antioxidants enzymes, leads to disorders in balance of proteinases and antiproteinases and oxidative stress. As the years go, the disorders mentioned above can lead to deterioration of ventilating efficiency of lungs, and consequently to pronouncement chronic obstructive pulmonary disease (COPD), which becomes serious problem on a world scale. Full article

614 KiB

Open AccessArticle

Transcervical Extended Mediastinal Lymphadenectomy (TEMLA) for Staging of Non-Small-Cell Lung Cancer (NSCLC)

by Marcin Zieliński, Łukasz Hauer, Jolanta Hauer, Juliusz Pankowski, Artur Szlubowski and Tomasz Nabiałek

Adv. Respir. Med. 2011, 79(3), 196-206; https://doi.org/10.5603/ARM.27658 - 21 Apr 2011

Cited by 5 | Viewed by 630

Abstract

Introduction: The aim of the study is to analyze diagnostic yield of the new surgical technique — the Transcervical Extended Mediastinal Lymphadenectomy (TEMLA) in preoperative staging of Non-Small-Cell Lung Cancer (NSCLC). Material and methods: Operative technique included 5–8 cm collar incision in the [...] Read more.

Introduction: The aim of the study is to analyze diagnostic yield of the new surgical technique — the Transcervical Extended Mediastinal Lymphadenectomy (TEMLA) in preoperative staging of Non-Small-Cell Lung Cancer (NSCLC). Material and methods: Operative technique included 5–8 cm collar incision in the neck, elevation of the sternal manubrium with a special retractor, bilateral visualization of the laryngeal recurrent and vagus nerves and dissection of all mediastinal nodal stations except of the pulmonary ligament nodes (station 9). Results: 698 patients (577 men, 121 women), of mean age 62.8 (41–79) were operated on from 1.1.2004 to 31.1.2010, including 501 squamous-cell carcinomas, 144 adenocarcinomas, 25 large cell carcinomas and 28 others. Mean operative time was 128 min. (45 to 330 min.) and 106.5 min. in the last 100 patients. 30-day mortality was 0.7% (unrelated causes) and morbidity 6.6%. The mean number of dissected nodes during TEMLA was 37.9 (15 to 85). Metastatic N2 and N3 nodes were found in 152/698 (21.8%) and 26/698 patients (3.7%), respectively. Subsequent thoracotomy was performed in 445/ 513 patients (86.7%) after negative result of TEMLA. During thoracotomy, omitted N2 was found in 7/445 (1.6%) patients. Sensitivity of TEMLA in discovery of N2–3 nodes was 96.2%, specificity was 100%, accuracy was 99,0%, Negative Predictive Value (NPV) was 98.7% and Positive Predictive Value (PPV) was 100%. Conclusions: TEMLA is a new minimally invasive surgical procedure providing unique possibility to perform very extensive, bilateral mediastinal lymphadenectomy with very high diagnostic yield in staging of NSCLC. Full article

110 KiB

Open AccessArticle

Variability in the Clinical Profile of Children with Asthma Referred to Allergy Clinic: A 10-Year Observation

by Ewa Bąk-Walczak, Joanna Jerzyńska, Iwona Stelmach, Jan Krakowiak and Włodzimierz Stelmach

Adv. Respir. Med. 2011, 79(3), 189-195; https://doi.org/10.5603/ARM.27657 - 21 Apr 2011

Viewed by 578

Abstract

Background: Asthma is the most common chronic respiratory disease in the paediatric population. Underdiagnosis is a frequent phenomenon and is associated with undertreatment, which results in increased morbidity and mortality. The delay in the diagnosis of asthma reflects problems with the correct implementation [...] Read more.

Background: Asthma is the most common chronic respiratory disease in the paediatric population. Underdiagnosis is a frequent phenomenon and is associated with undertreatment, which results in increased morbidity and mortality. The delay in the diagnosis of asthma reflects problems with the correct implementation of diagnostic goals set by the Global Initiative for Asthma (GINA). The aim of our study was to describe the clinical profile of children referred to the Clinic of Allergic Diseases and subsequently diagnosed with asthma. We evaluated the reasons for referral, demographic data and social data. Material and methods: We analysed a group of 907 children up to 18 years of age diagnosed with asthma at allergy clinic between 2000 and 2009. This was a cross-sectional study to assess the patients’ demographic, social and clinical data. Results: Our study revealed a shift in the clinical profile of children referred to allergy clinics over a period of ten years, subsequently diagnosed with asthma. The profile is characterised by a younger age, a higher incidence of recurrent infections and a lower incidence of wheezing and atopy as the reasons for referral to allergologists. Conclusions: The new clinical profile of children referred to allergologists reveals the necessity of conducting the costly differential diagnosis of asthma at specialist facilities. These data should be taken into account while developing new healthcare strategies in Poland. Full article

104 KiB

Open AccessArticle

The Effect of Physiotherapy on Interleukin-8 Levels in Patients with Chronic Obstructive Pulmonary Disease

by Jan Szczegielniak, Katarzyna Bogacz, Jacek Łuniewski, Edyta Majorczyk, Andrzej Tukiendorf and Marcin Czerwiński

Adv. Respir. Med. 2011, 79(3), 184-188; https://doi.org/10.5603/ARM.27656 - 21 Apr 2011

Cited by 1 | Viewed by 487

Abstract

Introduction: Interleukin-8 (IL-8), a chemokine formed by macrophages and epithelial cells and a potent chemoattractant for neutrophils, plays the principal role in the activation of neutrophils and eosinophils in the airways of patients with chronic obstructive pulmonary disease (COPD) and may be used [...] Read more.

Introduction: Interleukin-8 (IL-8), a chemokine formed by macrophages and epithelial cells and a potent chemoattractant for neutrophils, plays the principal role in the activation of neutrophils and eosinophils in the airways of patients with chronic obstructive pulmonary disease (COPD) and may be used as a marker of inflammation. The inflammation in the course of COPD may be characterised by an increased neutrophil count in the sputum and elevated IL-8 levels. The aim of the study was to assess the effect of physiotherapy on IL-8 levels in induced sputum in patients with COPD. Material and methods: The study included 44 patients (21 men and 23 women, mean age 56.47 ± 9.52) managed at the Ministry of Internal Affairs and Administration Specialist Hospital in G?ucho?azy, Poland, and undergoing rehabilitation at the Therapeutic Rehabilitation Facility, with the diagnosis of COPD (FEV₁/VC < 65%), receiving stable drug treatment during physiotherapy. Before physiotherapy all the patients underwent treadmill exercise testing according to the Bruce protocol and had their dyspnoea assessed on the 20-point Borg scale as part of qualification for physiotherapy. All the patients participated a multidirectional three-week respiratory physiotherapy programme based on aerobic training performed on a cycloergometer. The training loads were selected on an individual basis depending on exercise tolerance. The standard physiotherapy programme also included respiratory muscle exercises with a particular emphasis on the abdominal muscles and the diaphragm, saline inhalations, postural drainage and percussion, relaxation and walks. Results: IL-8 levels were significantly lower after completion of the three-week physiotherapy. IL-8 levels in the sputum decreased from 18.91 ± 25.2 to 9.69 ± 14.06 ng/ml (p = 0.0215). The highest reduction of IL-8 levels was observed in patients with the highest baseline values. Conclusions: The decrease of IL-8 levels in induced sputum following comprehensive physiotherapy in patients with COPD suggests suppression of neutrophil activity, which may be one of the reasons for the improved clinical condition of the patients. Full article

114 KiB

Open AccessArticle

Three-Month Continuous Positive Airway Pressure (CPAP) Treatment Decreases Total and LDL-Cholesterol Levels but Does Not Affect Serum Homocysteine and Leptin Levels in Patients with Obstructive Sleep Apnoea Syndrome (OSAS) without Co-Existent Ischaemic Heart Disease (IHD)

by Marta Kumor, Piotr Bielicki, Tadeusz Przybyłowski, Renata Rubinsztajn, Jan Zieliński and Ryszarda Chazan

Adv. Respir. Med. 2011, 79(3), 173-183; https://doi.org/10.5603/ARM.27655 - 21 Apr 2011

Cited by 2 | Viewed by 510

Abstract

Introduction: Continuous positive airway pressure (CPAP) treatment reduces cardiovascular morbidity and mortality in patients with obstructive sleep apnoea syndrome (OSAS). Homocysteine and leptin may play a role in the development of ischaemic heart disease (IHD) in these patients. The aim of the study [...] Read more.

Introduction: Continuous positive airway pressure (CPAP) treatment reduces cardiovascular morbidity and mortality in patients with obstructive sleep apnoea syndrome (OSAS). Homocysteine and leptin may play a role in the development of ischaemic heart disease (IHD) in these patients. The aim of the study was to assess the effects of 3-month CPAP treatment on the risk factors of IHD in patients with OSAS without co-existing IHD (OSAS without IHD) and on OSAS with co-existing IHD (OSAS with IHD). Material and methods: CPAP treatment was commenced in 42 patients with OSAS without IHD and in 23 patients with OSAS with IHD. Baseline and end-of-treatment levels of homocysteine, leptin, C-reactive protein (CRP), fibrinogen, lipids parameters and visceral obesity related parameters were determined. Results: No significant changes in the levels of homocysteine, leptin, fibrinogen or CRP in either of the study groups were observed at the end of the treatment. No changes in lipid parameters or the degree of obesity were observed in the OSAS with IHD group. A significant reduction in total and LDL-cholesterol levels were observed in the OSAS without IHD group (202.5 ± 38.5 mg/dl v. 186.7 ± 33.5 mg/dl, p = 0.001 and 127.3 ± 32.9 mg/dl v. 116.4 ± 26.9 mg/dl, p = 0.02, respectively). There were no significant changes in body mass index (30.4 ± 3.8 kg/m² v. 30.6 ± 3.6 kg/m², p = 0.5) or the amount of visceral fat, as measured by waist circumference (108.5 ± 8.0 cm v. 107.0 ± 7.5 cm, p = 0.09) and waist-to-hip ratio (1.03 ± 0.04 v. 1.01 ± 0.03, p = 0.07). Conclusions: Three-month CPAP treatment did not affect the levels of homocysteine or leptin in patients with OSAS, although there was a significant reduction in lipid parameters in patients with OSAS without co-existent IHD, which confirms the beneficial effect of this method of treatment on the risk factors of IHD. Full article

67 KiB

Open AccessEditorial

Non-Invasive Ventilation in Poland—For Whom the Bell Tolls?

by Jacek Nasiłowski and Jan Zieliński

Adv. Respir. Med. 2011, 79(3), 170-172; https://doi.org/10.5603/ARM.27654 - 21 Apr 2011

Viewed by 452

Abstract

In the 17th century the ringing of a church bell at an unusual time always signified some extraordinary event, summoning the entire local community to take action [...] Full article

75 KiB

Open AccessEditorial

Recurrent Pericarditis—Diagnostic and Therapeutic Implications

by Monika Szturmowicz

Adv. Respir. Med. 2011, 79(3), 167-169; https://doi.org/10.5603/ARM.27653 - 21 Apr 2011

Viewed by 407

Abstract

Exudative pericarditis is the cause of 5% of admissions to accidents and emergency departments with chest pain being the presenting complaint in most of these cases [...] Full article

59 KiB

Open AccessEditorial

The Lungs Are Not a Lonely Island—A Current View on Respiratory Diseases

by Joanna Chorostowska-Wynimko

Adv. Respir. Med. 2011, 79(3), 165-166; https://doi.org/10.5603/ARM.27652 - 21 Apr 2011

Viewed by 461

Abstract

Studies investigating the mechanisms responsible for the development and progression of respiratory diseases conducted in recent years but also the state-of-the-art and increasingly sophisticated technologies that successfully allow us to gain an insight into the structure of the lungs and the microcosm of [...] Read more.

Studies investigating the mechanisms responsible for the development and progression of respiratory diseases conducted in recent years but also the state-of-the-art and increasingly sophisticated technologies that successfully allow us to gain an insight into the structure of the lungs and the microcosm of cells and tissues have become a driving force for the key changes in contemporary opinions on the processes which eventually shape the clinical picture and complaints that prompt the patient to seek a pulmonologist consultation [...] Full article

Journal Menu

Journal Browser

Adv. Respir. Med., Volume 79, Issue 3 (April 2011) – 15 articles , Pages 165-258

Further Information

Guidelines

MDPI Initiatives

Follow MDPI