Publications by authors named "Grabczak E"

Imaging methods are fundamental tools to detect and diagnose lung diseases, monitor their treatment and detect possible complications. Each modality, starting from classical chest radiographs and computed tomography, as well as the ever more popular and easily available thoracic ultrasound, magnetic resonance imaging and nuclear medicine methods, and new techniques such as photon counting computed tomography, radiomics and application of artificial intelligence, has its strong and weak points, which we should be familiar with to properly choose between the methods and interpret their results. In this review, we present the indications, strengths and main limitations of methods for chest imaging.

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Article Synopsis
  • - The study investigated the prevalence of refractory and unexplained chronic cough among patients at a cough center from 2018 to 2022, acknowledging the ambiguity around defining refractory chronic cough.
  • - Out of 201 patients, only 1.5% were found to have unexplained chronic cough, while nearly 30.7% were diagnosed with refractory chronic cough based on the standard definition after evaluating therapy response.
  • - The findings indicate that refractory chronic cough is frequently observed in cough clinic patients, but its prevalence varies slightly depending on the strictness of the diagnostic criteria applied.
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Interventional bronchoscopy has seen significant advancements in recent decades, particularly in the context of lung cancer. This method has expanded not only diagnostic capabilities but also therapeutic options. In this article, we will outline various therapeutic approaches employed through either a rigid or flexible bronchoscope in multimodal lung cancer treatment.

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The incidence of non-malignant pleural effusions far outweighs that of malignant pleural effusions and is estimated to be at least 3-fold higher. These so-called benign effusions do not follow a "benign course" in many cases, with mortality rates matching and sometimes exceeding those of malignant pleural effusions. In addition to the impact on patients, healthcare systems are also significantly affected, with recent US epidemiological data demonstrating that 75% of resource allocation for pleural effusion management is spent on non-malignant pleural effusions (excluding empyema).

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  • * Community-acquired pneumonia is the most common type, typically resulting from infections acquired outside of a hospital.
  • * Imaging, such as chest radiographs, lung ultrasound, and CT scans, is essential for diagnosis and management, each having specific advantages and limitations, while understanding radiological patterns can help in identifying the causative pathogens.
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The pleural space is a "potential" anatomical space which is formed of two layers: visceral and parietal. It normally contains a trace of fluid (∼10 mL in each hemithorax). Diseases of the pleura can manifest with thickening of the pleural membranes or by abnormal accumulation of air or liquid.

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Background: Chylothorax is an uncommon medical condition for which limited data are available regarding the contemporary aetiology, management and outcomes. The goal of this study was to better define these poorly characterised features.

Methods: The medical records of adult patients diagnosed with chylothorax at 12 centres across Europe, America and South Africa from 2009-2021 were retrospectively reviewed.

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Background: Hiatal hernia may coexist with gastro-oesophageal reflux (GOR)-related chronic cough. This study aimed to evaluate whether the presence of hiatal hernia was related to chronic cough severity and the response to antireflux therapy.

Methods: This was a retrospective analysis of data on adults with GOR-related chronic cough managed in our cough centre between 2017 and 2021.

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Background: Chest radiograph (CXR) is a routine imaging test in adults with chronic cough (CC), while value of thoracic computed tomography (CT) in these patients is still a matter of discussion. The aims of the study were to assess the diagnostic yield of CXR and to evaluate the impact of thoracic CT on management of patients with difficult-to-treat CC referred to our cough clinic.

Methods: The retrospective analysis of paired CXR and CT results was performed in 189 consecutive adults treated due to CC between 2015-2019 in our cough clinic.

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Cough during therapeutic thoracentesis (TT) is considered an adverse effect. The study was aimed to evaluate the relationship between cough during TT and pleural pressure (Ppl) changes (∆P). Instantaneous Ppl was measured after withdrawal of predetermined volumes of pleural fluid.

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Background: Eosinophilic inflammatory phenotype was thought to be the most common phenotype of cough variant asthma (CVA), nevertheless other phenotypes were also reported.

Purpose: The study aimed to analyze the inflammatory phenotypes of CVA in relation to treatment response to the stepwise anti-asthmatic treatment.

Patients And Methods: The study included 45 patients with chronic cough (CC) and suspicion of CVA (normal chest X-ray, presence of bronchial hyperresponsiveness and no history of wheezing or dyspnea) in whom induced sputum was successfully collected.

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Introduction: Therapeutic thoracentesis is highly effective in providing symptomatic improvement in patients with large volume pleural effusion (PE). However, some physiological effects of pleural fluid (PF) withdrawal are still not fully elucidated.

Objectives: The study aimed to evaluate alterations in the breathing pattern, pulmonary function, and arterial blood gases (ABG) in relation to both withdrawn PF volume and pleural pressure (Ppl) changes in patients undergoing therapeutic thoracentesis.

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There is lack of evidence on the role of blood eosinophil count (BEC) as a predictor of treatment response in patients with chronic cough. The study aimed to evaluate BEC as a predictor of treatment response in all non-smoking adults with chronic cough and normal chest radiograph referred to cough clinic and in a subgroup of patients with chronic cough due to asthma or non-asthmatic eosinophilic bronchitis (NAEB). This prospective cohort study included 142 consecutive, non-smoking patients referred to our cough centre due to chronic cough.

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Bronchial hyperresponsiveness is a typical, but non-specific feature of cough variant asthma (CVA). This study aimed to determine whether bronchial hyperresponsiveness may be considered as a predictor of CVA in non-smoking adults with chronic cough (CC). The study included 55 patients with CC and bronchial hyperresponsiveness confirmed in the methacholine provocation test, in whom an anti-asthmatic, gradually intensified treatment was introduced.

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Article Synopsis
  • The 2020 update to the lung ultrasound recommendations for internal medicine (POLLUS-IM) is based on a comprehensive review of new literature since 2018, incorporating 528 publications, including 253 new studies.
  • The recommendations were developed through a rigorous process that involved assessing data quality and expert evaluations using the modified Delphi method.
  • Key areas addressed in the updated recommendations include pneumonia, heart failure, hydration status monitoring in dialysis patients, pleural effusion assessment, pulmonary embolism, and diaphragm function testing—all aimed at assisting clinicians in their daily practice.
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Introduction: Due to a relatively high prevalence and negative impact on quality of life chronic cough (CC) is a challenge for both patients and clinicians. There is ongoing research to address the unmet need and develop more effective antitussive treatment options. This is the first part of a series of two reviews of new antitussive medications.

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  • Pleural manometry helps analyze lung mechanics issues linked to pleural effusion, revealing oscillations in pleural pressure termed pleural pressure pulse (PPP).
  • An observational study with 54 adult patients examined how these pressure oscillations relate to the amount of fluid withdrawn and various health parameters, showing that PPP aligns with the heart's diastole phase.
  • The findings suggest that PPP is more pronounced in patients with larger pleural effusions and certain respiratory patterns, hinting its importance in understanding lung compliance and potential atelectasis, though further research is needed to clarify its significance.
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  • Upper airway cough syndrome (UACS) is a key contributor to chronic cough, often linked to allergic rhinitis (AR), non-allergic rhinitis (NAR), or chronic rhinosinusitis (CRS).
  • A study of 143 UACS patients revealed similar clinical characteristics between those with AR and NAR, with notable symptoms including post-nasal drip and nasal congestion.
  • While no significant differences in cough duration or severity were found, AR was more common among asthma patients, and sinus CT abnormalities were more frequent in NAR cases.
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The cough reflex is an airway defensive process that can be modulated by afferent inputs from organs located also out of the respiratory system. A bidirectional relationship between cough and heart dysfunctions are presented in the article, with the special insights into an arrhythmia-triggered cough. Albeit rare, cough induced by cardiac pathologies (mainly arrhythmias) seems to be an interesting and underestimated phenomenon.

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Introduction: The efficacy of management of chronic cough in adults is limited. Speech therapy is one of the few therapeutic methods which seems to be useful in patients with persistent chronic cough. However, the method has not been available in Poland so far.

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: Local cytokine milieu (especially Th2 inflammatory type) secreted into the asthmatic airways affect the alternative activated macrophages polarization (M2). TSLP and IL-33 are important alarmins of allergic response associated with Th2 inflammation. The aim of the study was to investigate the expression of the receptors for epithelial derived cytokines: TSLP (TSLPR) and IL-33 (ST2) on induced sputum CD206 positive macrophages from asthma and healthy subjects and analyze the relationships between these receptors and clinical features of the disease.

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The aim of this study was to establish recommendations for the use of lung ultrasound in internal medicine, based on reliable data and expert opinions. Methods: The bibliography from the databases (Pubmed, Medline, OVID, Embase) has been fully reviewed up to August 2017. Members of the expert group assessed the credibility of the literature data.

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Introduction: Interleukin 25 is an epithelial-derived cytokine associated with allergic Th2 inflammation. However, little is known about the role of IL-25 in different asthma phenotypes and its relationship with disease severity.

Aim: To evaluate and compare the mRNA and protein expression of IL-25 in patients with mild-to moderate/severe asthma and cough variant asthma (CVA).

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