There are as yet no markers known to predict the course of sarcoidosis. High resolution computed tomography (HRCT) is a tool that enables to visualize subtle parenchymal opacities in the lungs. Therefore, the aim of this study was to assess the prognostic role of HRCT at Stage I sarcoidosis. Fifty one patients (28 males and 23 females, aged 23-58) were studied. Based on HRCT examinations, two groups were distinguished: HRCT-positive (28 patients with pathologic changes in pulmonary parenchyma - mainly nodular opacities) and HRCT-negative (23 patients without parenchymal opacities). We found no significant differences between HRCT-negative and HRCT-positive groups in the mean values of pulmonary function tests (FEV1, FVC, FEV1/FVC, DLCO, and d(A-a)O2) between the starting and ending measurements of a 2-year long observation (check-up every 3 months). Likewise, there were no differences in the X-ray follow-up between the HRCT-positive and HRCT-negative groups. Nor were there significant differences in the percentage of patients showing stabilization, progression, or improvement between both groups (18 vs. 39 %, 21 vs. 4 %, and 61 vs. 57 %, respectively). We conclude that HRCT examination in stage I sarcoidosis has no significant prognostic role during a 2-year follow-up.
Background In the years 2007-2010 in the Department of Lung Diseases and Tuberculosis, Medical University of Silesia, 86 patients fulfilling ISHLT criteria qualified for lung transplantation. Objectives The aim of the study was to assess the correlation between dyspnea and quality of life, and how it is related to clinical data in the examined group. Material and methods MRC, OCD, BDI and Borg scale were used for dyspnea evaluation, whereas quality of life was evaluated with SF-36 and SGRQ. A reference group consisted of 18 females and 68 males of the mean age 52 ± 10 years and BMI 24 ± 6. Thirty patients were diagnosed with IPF, 22 with COPD, and 34 with IIP. Results In the reference group, there was a significant correlation between dyspnea and quality of life: between MRC and Pf (SF-36 domain) r = -0.53; OCD and activity (SGRQ) r = 0.56; OCD and Pf r = -0.55; BDI and impact (SGRQ) r = 0.51; Borg scale and impact r = 0.47. In patients after lung transplantation, correlation between MRC and SF was r = -0.92; OCD and Pf, Bp, MH, PCS r = -0.97; OCD and RE r = -0.89; BDI and Pf r = -0.89; BDI and activity r = 0.9; BDI and PCS r = -0.84. Depending on the diagnosis, the strongest correlation in IIP patients was found between OCD and activity (r = 0.62), in COPD patients - between BDI and impact (r = 0.79), and in IPF patients r = - 0.62 for OCD and Pf. Summing up the results, we can state that there is a significant correlation between dyspnea and quality of life. This correlation seems the strongest in patients after lung transplantation. Conclusions The correlation found between the level of dyspnea and quality of life domains in lung transplant patients suggests that it would be worthwhile to add questions regarding dyspnea to assess the severity of the disease, clinical symptoms, and functional impairment during referring the patients for lung transplantation.
The proper care of cystic fibrosis patients extends over their lifetime. More than half of the children with the disease die before adulthood. An important element in the patient's care is a time of transition from a paediatric to the care of an internist and the patient's acceptance of this necessity. Transition from paediatric care to an internist should be adequately prepared. It is not only a question of transfer of medical records, but also careful preparation of patients for such transition. The patients expect not only continuity of care but also the introduction to the management with the disease. The creation of a base for specialist hospital treatment for exacerbation of the disease at the adulthood is an important element in the care of these patients. The problem has been solved in the children group, but is still waiting for solution in adults with cystic fibrosis. It has been proven that care in the centres carried out by a specialized team ensures longer life and better quality of life of these patients. The paper is an overview of these two important elements of care of adults with cystic fibrosis.
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