[Estimation of volume of pleural fluid and its impact on spirometrical parameters]. / Ocena objetosci plynu w jamie oplucnej i jego wplyw na parametry spirometryczne.

UNLABELLED: In the course of various diseases, there is an accumulation of fluid in the pleural cavities. Pleural fluid accumulation causes thoracic volume expansion and reduction of volume lungs, leading to formation of restrictive disorders. The aim of the study was to estimate the volume of pleural fluid by ultrasonography and to search for the relationship between pleural fluid volume and spirometrical parameters. MATERIAL AND METHODS: The study involved 46 patients (26 men, 20 women) aged 65.7 +/- 14 years with pleural effusions who underwent thoracentesis. Thoracentesis was preceded by ultrasonography of the pleura, spirometry test and plethysmography. The volume of the pleural fluid was calculated with the Goecke' and Schwerk' (GS) or Padykula (P) equations. RESULTS: The obtained values were compared with the actual evacuated volume. The median volume of the removed pleural fluid was 950 ml. Both underestimated the evacuated volume (the median volume 539 ml for GS and 648 ml for P, respectively). Pleural fluid removal resulted in a statistically significant improvement in VC (increase 0.20 +/- 0.35 ; p < 0.05), FEV1 (increase 0.16 +/- 0.32 l; p < 0.05), TLC (increase 0.30 +/- 0.58 l; p < 0.05) and PEF (0.37 +/- 1 l/s; p < 0.05) CONCLUSIONS: Pleural fluid removal causes a significant improvement in lung function parameters. The analyzed equations for fluid volume calculation do not correlate with the actual volume.

Short communication: subtyping of Mycobacterium kansasii by PCR-restriction enzyme analysis of the hsp65 gene.

Mycobacterium kansasii is one of the most common causes of pulmonary disease resulting from nontuberculous mycobacteria (NTM). It is also the most frequently isolated NTM species from clinical specimens in Poland. The aim of this study was to investigate the distribution of M. kansasii subtypes among patients suspected of having pulmonary NTM disease. Fifty clinical isolates of M. kansasii recovered from as many patients with suspected mycobacterial lung disease between 2000 and 2010 in Poland were genotyped by PCR-restriction enzyme analysis (PCR-REA) of partial hsp65 gene. Mycobacterium kansasii subtype I was the only genotype to be identified among the isolates, both disease-associated and non-disease-associated. Isolation of M. kansasii subtype I from clinical specimens may be indicative of infection but may also merely represent colonization.

[Pulmonary mycobacteriosis--the diagnostic challenge. The authors' experience]. / Mikobakteriozy pluc--trudnosci diagnostyczne doswiadczenia wlasne.

UNLABELLED: The diagnosis of NTM-related pulmonary disease is based on clinical symptoms, radiological features and several positive cultures of one and the same NTM species from samples obtained from the respiratory tract. Short hospitalization usually does not enable sufficient diagnostic procedures to meet the diagnostic criteria, and this may lead to the reduction of diagnostic sensitivity. The aim of the study was to draw attention to NTM-related pulmonary disease, to share the authors' experience in the diagnosing of pulmonary mycobacteriosis and to indicate the possibilities of improving the diagnostic accuracy in this disease. A group of 31 patients with sputum, bronchial washing and/or bronchoalveolar lavage fluid (BALF) NTM-positive cultures was selected from a cohort of 245 patients evaluated for tuberculous and nontuberculous mycobacterial diseases (total number of 1277 specimens were invastigated). In two of them NTM related pulmonary disease was diagnosed (caused by M. kansasii and M. avium) at the course of initial evaluation. In the remaining 29 patients the microbiological data did not allow to establish the diagnosis of mycobacterial lung disease mainly due to a small number of samples from the respiratory tract. From this group 13 patients were reevaluated within 3 - 6 months from the initial investigation. This allowed to identify two new cases of mycobacteriosis (M. kansasii and M. avium). Thus among 31 patients with NTM positive cultures from respiratory tract specimens 4 patients (4/31, 12,9%) met the diagnostic criteria for mycobacterial disaease. CONCLUSION: Microbiological analysis of an adequate number of samples in symptomatic patients with radiological features suggestive for NTM-related pulmonary disease increses the diagnostic sensitivity in pulmonary mycobacteriosis. Identification of the species in positive cultures is of great importance.