Mariya Marushchak, Khrystyna Maksiv and Inna Krynytska
Cardiovascular diseases (CVDs) are common in people with chronic obstructive pulmonary disease (COPD), and their presence is associated with an increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality. We assessed the role of angiotensin-converting enzyme (ACE) gene polymorphism in the occurrence of arterial hypertension (AH) in patients with COPD.
The study group consisted of 96 patients. Group 1 had 25 individuals with COPD, Group 2 had 23 individuals with AH and Group 3 had 28 individuals with COPD and AH. The control group consisted of 20 healthy subjects. I/D genotypes of ACE were determined by polymerase chain reaction amplification.
The frequency distribution of polymorphic genotypes of the gene encoding ACE and assessment of compliance with the Hardy-Weinberg population equilibrium were carried out in groups of patients with COPD, AH and COPD + AH combination. The frequencies of the genotype responsible for I/D polymorphism of the ACE gene in the control and experimental groups were not found to deviate significantly from the Hardy–Weinberg equilibrium. The results of the study have not demonstrated any significant impact of alleles of ACE genes or ACE genes on occurrence of diseases such as COPD, AH and combinations thereof. However, analysis of odds ratio has demonstrated that the presence of the D allele of the ACE gene may increase the risk for occurrence of the COPD + AH (OR = 1.26).
The data obtained in the study allow suggesting that the presence of D allele of the ACE gene may increase the risk for AH in patients with COPD.
The main objective of this study was to determine the relationship between the pro- and anti-inflammatory response based on the interleukin 1α and interleukin 10 levels in the serum of patients with acquired bronchiectasis and healthy controls. This study was conducted on 77 subjects, divided into two lots: one lot comprising 57 patients with the aforementioned bronchiectasis and the second one comprising 20 healthy control subjects. The enzyme-linked immunosorbent assay method was used to perform the spectrophotometry test for the serum to detect and measure interleukin 1α and interleukin 10 levels. The results were significant from a statistical point on view but only in terms of the mean value of interleukin 10 that was much higher in the anti-inflammatory cytokine. Therefore, we can assume that there is a systemic anti-inflammatory reaction to the inflammation caused by bronchiectasis. Interleukin 1α is unspecific, and the values were similar in both groups; therefore, this interleukin should not be researched further in this direction. Future research is open in this field for the analysis of interleukin levels in bronchoalveolar lavage compared to serum levels.
Lilia Todoriko, Ihor Semianiv, Radu Criṣan-Dabija and Olʼha S. Shevchenko
The aim of this paper was to evaluate the oxidative modification of proteins and limited proteolysis in the hepatocytes of patients with resistant forms of pulmonary tuberculosis (TB).
Material and method:
This is a prospective pathomorphological study of 60 patients with confirmed pulmonary TB (clinically and anatomopathologically) deaths from various causes. To evaluate the intensity of free radical processes in hepatocytes, we used a methodology developed by Davydenko IS, 2003. Histological sections were stained with bromphenol blue by Michel-Calvo.
When comparing the digital data indicated in our study, it is evident that changes in proteins properties in average tendencies run virtually identically in the hepatocytes of different zones of the comparison group. Thus, the difference is unlikely (p > 0.05) when comparing red/blue ratio (specific staining of acid and basic proteins by Michel-Calvo) in the hepatocytes of zones I, II and III of the comparison group. A similar trend is observed in the analysis of average values of the optical density of a specific colouration on the free amino group of proteins by A. Yasuma and T. Ichikava.
The analysis of all parameters showed a linear increase in the intensity of oxidative protein modification and limited proteolysis from zone I to III (from the periportal to the centrolobular parts of the acinus) in all subgroups of the main group according to the acinus zone (by Rappoport).
Pulmonary TB leads to increased processes of free radical oxidation of proteins with characteristic effects – increased proteolysis and oxidation of amino groups of proteins – in the hepatocytes of the liver.
Oxana Munteanu, Dumitru Chesov, Doina Rusu, Irina Volosciuc and Victor Botnaru
Pulmonary sequelae related to tuberculosis (TB) are among the major causes of bronchiectasis in Eastern Europe. The role of bacterial colonisation in the pathogenesis of bronchiectasis has been continuously studied over the last decades, less understood remains the impact of fungal infection, alone or in association with bacterial. Although the data on the development of chronic pulmonary aspergillosis (CPA) secondary to TB are scarce, recent evidence suggests a higher prevalence of CPA in patients with a past history of pulmonary TB than it was previously estimated. We present a case of natural evolution of CPA, with a radiological follow-up, in a patient with post-tuberculous bronchiectasis.
Bogdan I. Popovici, Dana Matei, Anca Daniela Farcas, Milena Man, Cornelia Popovici, Romeo Chira and Cornel Iancu
The need to identify the risk factors (RFs) predictive of mortality after pulmonary lobectomy has fuelled several single- or multi-institution studies, without establishing a prediction model of the generally accepted risk. Each single-institution study offers its own RFs, which corroborated with the RFs published in other multicentric studies may allow a better prediction of postoperative mortality for specific categories of patients. The aim of our study was to identify the 30-day mortality RFs in our lobectomy patients and to compare our results with those published in literature. We therefore analysed the influence of 49 perioperative parameters on postoperative mortality of consecutive lobectomy patients. The 192 lobectomy patients enrolled had malignant (81.25%) and infectious conditions (12.5%) and a 2.6% mortality rate. The results of our study support the following perioperative RF associated with a high mortality rate: thrombocytosis, chronic obstructive bronchopulmonary disease (COPD), digestive and hepatic comorbidities, neoadjuvant chemotherapy, tuberculosis, the American Society of Anesthesiologists rating and the characteristics of postoperative drainage. In conclusion, these RFs may serve as the factors to consider when calculating the mortality rate after lobectomy, in preoperative selection as well as in instruments for the assessment of postoperative results.
Asthma is a common disorder, sometimes with nonspecific presenting features, which can lead to misdiagnosis. To obtain a definitive diagnosis of difficult-to-treat asthma, it should be ruled out non-adherence to prescribed therapy, other diagnosis or even psychiatric problems. The authors present two cases in which patients had symptoms that mimic asthma or complicated asthma management: foreign body aspiration mistaken as asthma and difficult-to-control asthma due to tracheal stenosis. Through this article, we recall the importance of anamnesis and differential diagnosis as key steps to the patient’s best approach.
Tuberculosis (TB) is still a leading cause of morbidity and mortality worldwide. The impact on patient’s life is significant, leading to physical, mental and social deconditioning, not only in active TB but also in post TB sequela. Although with specific antituberculous treatment sputum negativity can be achieved, TB extrapulmonary symptoms such as cachexia, muscle weakness and depression may persist for a long time.
The pulmonary rehabilitation (PR) may be a useful tool in this patient’s therapy in active and also in sequela phase. The benefits of PR are: reducing symptomatology, improving the degree of functional independence and quality of life, and increasing the ability to perform daily activities. This article discusses the components of a PR programme in active TB and TB sequela, and the results obtained by studies so far.