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Article ; Online: Myocarditis after COVID-19 pneumonia: incidence and risk factors.

Martusewicz-Boros, Magdalena M / Boros, Piotr W / Piotrowska-Kownacka, Dorota / Paciorek, Marcin

2023 Volume 133, Issue 6

MeSH term(s)	Humans ; COVID-19/complications ; Myocarditis/epidemiology ; Myocarditis/etiology ; Incidence ; SARS-CoV-2 ; Risk Factors
Language	English
Publishing date	2023-05-25
Publishing country	Poland
Document type	Journal Article
ZDB-ID	123500-x
ISSN	1897-9483 ; 0032-3772
ISSN (online)	1897-9483
ISSN	0032-3772
DOI	10.20452/pamw.16510
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Article: Hospital Admission Factors Independently Affecting the Risk of Mortality of COVID-19 Patients.

Paciorek, Marcin / Bieńkowski, Carlo / Kowalska, Justyna Dominika / Skrzat-Klapaczyńska, Agata / Bednarska, Agnieszka / Krogulec, Dominika / Cholewińska, Grażyna / Kowalski, Jacek / Podlasin, Regina / Ropelewska-Łącka, Katarzyna / Wasilewski, Piotr / Boros, Piotr W / Martusiewicz-Boros, Magdalena M / Pulik, Piotr / Pihowicz, Andrzej / Horban, Andrzej

Journal of clinical medicine

2023 Volume 12, Issue 19

Abstract: Introduction: COVID-19 is a disease characterized by high in-hospital mortality, which seems to be dependent on many predisposing factors.: Objectives: The aim of this study was to analyze the clinical symptoms, abnormalities in the results of ... ...

Abstract	Introduction: COVID-19 is a disease characterized by high in-hospital mortality, which seems to be dependent on many predisposing factors. Objectives: The aim of this study was to analyze the clinical symptoms, abnormalities in the results of laboratory tests, and coexisting chronic diseases that independently affected the risk of in-hospital mortality in patients with COVID-19. Patients and methods: We analyzed the records of patients with COVID-19 who were hospitalized from 6 March 2020 to 30 November 2021. Results: Out of the entire group of 2138 patients who were analyzed, 12.82% died during hospitalization. In-hospital mortality was independently associated with older age (OR 1.53, 95% CI 1.20-1.97); lower arterial blood oxygen saturation (OR 0.95, 95% CI 0.92-0.99); the presence of a neoplasm (OR 4.45, 95% CI 2.01-9.62), a stomach ulcer (OR 3.35, 95% CI 0.94-11.31), and dementia (OR 3.40, 95% CI 1.36-8.26); a higher score on the SOFA scale (OR 1.73, 95% CI 1.52-1.99); higher lactate dehydrogenase (LDH) (OR 1.08, 95% CI 1.05-1.12); higher N-terminal pro-brain natriuretic peptide (NT pro BNP) (OR 1.06, 95% CI 1.01-1.11); and lower total bilirubin in blood concentration (OR 0.94, 95% CI 0.90-0.99). Conclusions: We found that low oxygen saturation, old age, and the coexistence of cancer, gastric ulcers, and dementia syndrome were variables that independently increased mortality during hospitalization due to COVID-19. Moreover, we found that decreased platelet count and bilirubin concentration and increased levels of LDH and NT-proBNP were laboratory test results that independently indicated a higher risk of mortality. We also confirmed the usefulness of the SOFA scale in predicting treatment results. The ability to identify mortality risk factors on admission to hospital will facilitate both adjusting the intensity of treatment and the monitoring of patients infected with SARS-CoV-2.
Language	English
Publishing date	2023-09-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12196264
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Article: New 6-Minute-Walking Test Parameter-Distance/Desaturation Index (DDI) Correctly Diagnoses Short-Term Response to Immunomodulatory Therapy in Hypersensitivity Pneumonitis.

Lewandowska, Katarzyna B / Sobiecka, Małgorzata / Boros, Piotr W / Dybowska, Małgorzata / Barańska, Inga / Jędrych, Małgorzata E / Gładzka, Agata / Tomkowski, Witold Z / Szturmowicz, Monika

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 6

Abstract: The six-minute-walking test (6MWT) is an easy-to-perform, cheap and valuable tool to assess the physical performance of patients. It has been used as one of the endpoints in many clinical trials investigating treatment efficacy in pulmonary arterial ... ...

Abstract	The six-minute-walking test (6MWT) is an easy-to-perform, cheap and valuable tool to assess the physical performance of patients. It has been used as one of the endpoints in many clinical trials investigating treatment efficacy in pulmonary arterial hypertension and idiopathic pulmonary fibrosis. However, the utility of 6MWT in patients diagnosed with hypersensitivity pneumonitis (HP) is still under investigation. The aim of the present retrospective study was to assess the value of different 6MWT parameters, including the newly developed distance-desaturation index (DDI), to evaluate immunomodulatory treatment outcomes in HP patients. Methods: 6MWT parameters (distance, initial saturation, final saturation, desaturation, distance-saturation product (DSP), and DDI) were analyzed at baseline and after 3 to 6 months of treatment with corticosteroids alone or in combination with azathioprine. Results: 91 consecutive HP patients diagnosed and treated in a single pulmonary unit from 2005 to 2017 entered the study. There were 44 (48%) males and 52 (57%) patients with fibrotic HP (fHP). Sixty-three patients (69%) responded to treatment (responders) and 28 (31%) did not respond (non-responders). In the responders group, all parameters assessed during 6MWT significantly improved, whereas in non-responders, they worsened. Medians (95% CI) of best indices were post-treatment DDI/baseline DDI-1.67 (1.85-3.63) in responders versus 0.88 (0.7-1.73) in non-responders ( Conclusions: 6MWT may be used as a tool to assess and monitor the response to immunomodulatory therapy in HP patients, especially if indices incorporating both distance and desaturation are used. Based on the present study results, we recommend 6MWD and DDI use, in addition to FVC and TL,co, to monitor treatment efficacy in patients with interstitial lung diseases.
Language	English
Publishing date	2023-03-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13061109
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Article ; Online: New 6-Minute-Walking Test Parameter—Distance/Desaturation Index (DDI) Correctly Diagnoses Short-Term Response to Immunomodulatory Therapy in Hypersensitivity Pneumonitis

Katarzyna B. Lewandowska / Małgorzata Sobiecka / Piotr W. Boros / Małgorzata Dybowska / Inga Barańska / Małgorzata E. Jędrych / Agata Gładzka / Witold Z. Tomkowski / Monika Szturmowicz

Diagnostics, Vol 13, Iss 1109, p

2023 Volume 1109

Abstract	The six-minute-walking test (6MWT) is an easy-to-perform, cheap and valuable tool to assess the physical performance of patients. It has been used as one of the endpoints in many clinical trials investigating treatment efficacy in pulmonary arterial hypertension and idiopathic pulmonary fibrosis. However, the utility of 6MWT in patients diagnosed with hypersensitivity pneumonitis (HP) is still under investigation. The aim of the present retrospective study was to assess the value of different 6MWT parameters, including the newly developed distance-desaturation index (DDI), to evaluate immunomodulatory treatment outcomes in HP patients. Methods: 6MWT parameters (distance, initial saturation, final saturation, desaturation, distance-saturation product (DSP), and DDI) were analyzed at baseline and after 3 to 6 months of treatment with corticosteroids alone or in combination with azathioprine. Results: 91 consecutive HP patients diagnosed and treated in a single pulmonary unit from 2005 to 2017 entered the study. There were 44 (48%) males and 52 (57%) patients with fibrotic HP (fHP). Sixty-three patients (69%) responded to treatment (responders) and 28 (31%) did not respond (non-responders). In the responders group, all parameters assessed during 6MWT significantly improved, whereas in non-responders, they worsened. Medians (95% CI) of best indices were post-treatment DDI/baseline DDI—1.67 (1.85–3.63) in responders versus 0.88 (0.7–1.73) in non-responders ( p = 0.0001) and change in walking distance–51 m (36–72 m) in responders, versus 10.5 m (−61.2–27.9) in non-responders ( p = 0.0056). The area under the curve (AUC) of receiver operating characteristics (ROC) for post-treatment DDI/baseline DDI was 0.74 and the optimal cut-off was 1.075, with 71% of specificity and 71% of sensitivity. Conclusions: 6MWT may be used as a tool to assess and monitor the response to immunomodulatory therapy in HP patients, especially if indices incorporating both distance and desaturation are used. Based on the present study results, ...
Keywords	hypersensitivity pneumonitis ; 6-minute walk test ; 6-minute walk distance ; desaturation ; distance-saturation product ; distance/desaturation index ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article: Respiratory system involvement in chronic liver diseases.

Martusewicz-Boros, Magdalena M / Boros, Piotr W / Wiatr, Elżbieta

Polskie Archiwum Medycyny Wewnetrznej

2013 Volume 123, Issue 11, Page(s) 635–642

Abstract: Liver diseases are often associated with respiratory complications. They may manifest as pleural effusion, interstitial lung disease, as well as various combinations of symptoms affecting the pulmonary vasculature. The duration and severity of liver ... ...

Abstract	Liver diseases are often associated with respiratory complications. They may manifest as pleural effusion, interstitial lung disease, as well as various combinations of symptoms affecting the pulmonary vasculature. The duration and severity of liver disease is not always reflected by the degree of lung function impairment. On the other hand, progressive damage to the lungs significantly worsens prognosis in the course of severe liver disease. The diagnosis is difficult and often requires multidisciplinary cooperation. The effects of pharmacological treatment are not always satisfactory. In numerous cases, liver transplantation proves to be the best option.
MeSH term(s)	Comorbidity ; Diagnosis, Differential ; Hepatitis, Autoimmune/diagnosis ; Hepatopulmonary Syndrome/diagnosis ; Hepatopulmonary Syndrome/epidemiology ; Hepatopulmonary Syndrome/therapy ; Humans ; Liver Cirrhosis, Biliary/diagnosis ; Liver Transplantation ; Prognosis ; Smoking/epidemiology ; alpha 1-Antitrypsin Deficiency/diagnosis ; alpha 1-Antitrypsin Deficiency/epidemiology
Language	English
Publishing date	2013-11-15
Publishing country	Poland
Document type	Journal Article ; Review
ZDB-ID	123500-x
ISSN	1897-9483 ; 0032-3772
ISSN (online)	1897-9483
ISSN	0032-3772
DOI	10.20452/pamw.1980
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Article ; Online: Systemic treatment for sarcoidosis was needed for 16% of 1810 Caucasian patients.

Martusewicz-Boros, Magdalena M / Boros, Piotr W / Wiatr, Elżbieta / Fijołek, Justyna / Roszkowski-Śliż, Kazimierz

The clinical respiratory journal

2017 Volume 12, Issue 4, Page(s) 1367–1371

Abstract: Introduction and objective: Sarcoidosis is a systemic granulomatous disease predominantly affecting the lungs, although granulomas can also involve all other organs. Fortunately, it is often a self-limiting disease and aggressive treatment is not ... ...

Abstract	Introduction and objective: Sarcoidosis is a systemic granulomatous disease predominantly affecting the lungs, although granulomas can also involve all other organs. Fortunately, it is often a self-limiting disease and aggressive treatment is not indicated in majority of cases. However, treatment is recommended when critical organs are affected or the disease is progressive. So far, there is lack of reliable information regarding the frequency of treatment in Caucasian population or data are discordant. The aim of this study was to evaluate the prevalence of systemic immune-modulating treatment in a large cohort of sarcoidosis patients. Methods: We performed a retrospective analysis of patients discharged from our institution with the final diagnosis 'sarcoidosis' (ICD-10: D86) from January 2010 to December 2013. Results: 1810 sarcoidosis patients were hospitalized during these four years, 47.6% were females, mean age was 43.5 ± 12.2 years. The majority (80.6%) were discharged as pulmonary and/or lymph node sarcoidosis (D86.0, D86.1, D86.2). Only 281 (15.5%) patients were discharged with systemic treatment, 60.1% of them were men (OR 1.5; 95% CI: 1.1-1.9, P = .0047). The 44.8% of patients who had sarcoidosis also involving an organ other than the lungs (D86.8) were much more likely to be treated: OR 5.6; 95% CI: 4.2-7.4, P < .0001). Older age (>50) was also identified as a risk factor for treatment (odds ratio: 1.8; 95% CI: 1.5-2.4). Conclusions: Less than 16% sarcoidosis patients required systemic treatment. Older men with multiorgan sarcoidosis were more likely to be treated.
MeSH term(s)	Adult ; Biological Factors/therapeutic use ; Female ; Follow-Up Studies ; Glucocorticoids/therapeutic use ; Humans ; Immunotherapy/methods ; Male ; Middle Aged ; Odds Ratio ; Patient Discharge/trends ; Poland/epidemiology ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors ; Sarcoidosis/diagnosis ; Sarcoidosis/epidemiology ; Sarcoidosis/therapy
Chemical Substances	Biological Factors ; Glucocorticoids
Language	English
Publishing date	2017-08-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2442214-9
ISSN	1752-699X ; 1752-6981
ISSN (online)	1752-699X
ISSN	1752-6981
DOI	10.1111/crj.12664
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Article: Health state and the quality of life in patients with chronic obstructive pulmonary disease in Poland: a study using the EuroQoL-5D questionnaire.

Boros, Piotr W / Lubiński, Wojciech

Polskie Archiwum Medycyny Wewnetrznej

2012 Volume 122, Issue 3, Page(s) 73–81

Abstract: Introduction: Chronic obstructive pulmonary disease (COPD) is a severe condition that leads to respiratory disability, considerably reduces the comfort of living, and affects all aspects of patient activity.: Objectives: The aim of our study was to ... ...

Abstract	Introduction: Chronic obstructive pulmonary disease (COPD) is a severe condition that leads to respiratory disability, considerably reduces the comfort of living, and affects all aspects of patient activity. Objectives: The aim of our study was to assess the quality of life (QoL) in patients with diagnosed COPD using the health‑related QoL questionnaire, EQ‑5D, as a research tool. Patients and methods: A cross‑sectional survey was conducted in a large group of patients with COPD (n = 9310). The data were obtained using a specially designed questionnaire. Results: The majority of the study population were patients with mild and moderate COPD (stage 1 and 2 according to the Global Initiative for Chronic Obstructive Lung Disease, 16% and 54%, respectively). Lower QoL, reported by patients, was shown for each stage of the disease, including patients with mild‑to‑moderate COPD. Significant differences were observed between the groups of patients stratified by spirometry results in the perceived health state assessed using the questionnaire and the visual analogue scale (VAS), and the results of the EQ‑5D correlated with those of the VAS. We observed a statistically significant effect of comorbidities (especially heart failure) and severe (or very severe) COPD on the health status reported by patients (linear regression model, P < 0.001). Patients with history of exacerbations had higher VAS scores (P < 0.001). Conclusions: The EQ‑5D along with VAS seems to be a useful tool in assessing the health status of patients with COPD. Of note, significant limitations affecting the various aspects of patients' lives were reported also in milder stages of COPD.
MeSH term(s)	Aged ; Cross-Sectional Studies ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Poland/epidemiology ; Population Surveillance ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/psychology ; Quality of Life ; Surveys and Questionnaires
Language	English
Publishing date	2012-02-14
Publishing country	Poland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	123500-x
ISSN	1897-9483 ; 0032-3772
ISSN (online)	1897-9483
ISSN	0032-3772
DOI	10.20452/pamw.1177
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Article ; Online: Reversibility of airway obstruction vs bronchodilatation: do we speak the same language?

Boros, Piotr W / Martusewicz-Boros, Magdalena M

COPD

2012 Volume 9, Issue 3, Page(s) 213–215

Abstract: Airway reversibility test (or bronchodilatation test) is performed routinely in the diagnosis of obstructive lung diseases. The results of this test may be helpful in the diagnosis and differential diagnosis of asthma and chronic obstructive pulmonary ... ...

Abstract	Airway reversibility test (or bronchodilatation test) is performed routinely in the diagnosis of obstructive lung diseases. The results of this test may be helpful in the diagnosis and differential diagnosis of asthma and chronic obstructive pulmonary disease (COPD), but sometimes bring confusion. Unfortunately, the nomenclature used for test result is not uniform, which also leads to confusion. Next the reader will find an attempt to order the state of affairs and the introduction of a uniform nomenclature, which would be consistent with the logic and allow for unambiguous classification of reversibility test results to facilitate future decisions based on the differential diagnosis.
MeSH term(s)	Airway Obstruction/diagnosis ; Asthma/diagnosis ; Bronchodilator Agents ; Diagnosis, Differential ; Humans ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Respiratory Function Tests ; Terminology as Topic
Chemical Substances	Bronchodilator Agents
Language	English
Publishing date	2012-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2171107-0
ISSN	1541-2563 ; 1541-2555
ISSN (online)	1541-2563
ISSN	1541-2555
DOI	10.3109/15412555.2012.669434
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Article ; Online: Guidelines of the Polish Respiratory Society on the Diagnosis and Treatment of Progressive Fibrosing Interstitial Lung Diseases Other than Idiopathic Pulmonary Fibrosis.

Piotrowski, Wojciech J / Martusewicz-Boros, Magdalena M / Białas, Adam J / Barczyk, Adam / Batko, Bogdan / Błasińska, Katarzyna / Boros, Piotr W / Górska, Katarzyna / Grzanka, Piotr / Jassem, Ewa / Jastrzębski, Dariusz / Kaczyńska, Janina / Kowal-Bielecka, Otylia / Kucharz, Eugeniusz / Kuś, Jan / Kuźnar-Kamińska, Barbara / Kwiatkowska, Brygida / Langfort, Renata / Lewandowska, Katarzyna /

Mackiewicz, Barbara / Majewski, Sebastian / Makowska, Joanna / Miłkowska-Dymanowska, Joanna / Puścińska, Elżbieta / Siemińska, Alicja / Sobiecka, Małgorzata / Soroka-Dąda, Renata Anna / Szołkowska, Małgorzata / Wiatr, Elżbieta / Ziora, Dariusz / Śliwiński, Paweł

Advances in respiratory medicine

2022 Volume 90, Issue 5, Page(s) 425–450

Abstract: The recommendations were developed as answers to previously formulated questions concerning everyday diagnostic and therapeutic challenges. They were developed based on a review of the current literature using the GRADE methodology. The experts suggest ... ...

Abstract	The recommendations were developed as answers to previously formulated questions concerning everyday diagnostic and therapeutic challenges. They were developed based on a review of the current literature using the GRADE methodology. The experts suggest that PF-ILD be diagnosed based on a combination of different criteria, such as the aggravation of symptoms, progression of radiological lesions, and worsening of lung function test parameters. The experts recommend a precise diagnosis of an underlying disease, with serological testing for an autoimmune disease always being included. The final diagnosis should be worked out by a multidisciplinary team (MDT). Patients with an interstitial lung disease other than IPF who do not meet the criteria for the progressive fibrosis phenotype should be monitored for progression, and those with systemic autoimmune diseases should be regularly monitored for signs of interstitial lung disease. In managing patients with interstitial lung disease associated with autoimmune diseases, an opinion of an MDT should be considered. Nintedanib rather than pirfenidon should be introduced in the event of the ineffectiveness of the therapy recommended for the treatment of the underlying disease, but in some instances, it is possible to start antifibrotic treatment without earlier immunomodulatory therapy. It is also admissible to use immunomodulatory and antifibrotic drugs simultaneously. No recommendations were made for or against termination of anti-fibrotic therapy in the case of noted progression during treatment of a PF-ILD other than IPF. The experts recommend that the same principles of non-pharmacological and palliative treatment and eligibility for lung transplantation should be applied to patients with an interstitial lung disease other than IPF with progressive fibrosis as in patients with IPF.
MeSH term(s)	Humans ; Idiopathic Pulmonary Fibrosis/diagnosis ; Idiopathic Pulmonary Fibrosis/therapy ; Idiopathic Pulmonary Fibrosis/complications ; Poland ; Disease Progression ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/therapy ; Lung Diseases, Interstitial/complications ; Fibrosis
Language	English
Publishing date	2022-10-04
Publishing country	Switzerland
Document type	Review ; Guideline
ZDB-ID	2893877-X
ISSN	2543-6031 ; 2451-4934
ISSN (online)	2543-6031
ISSN	2451-4934
DOI	10.3390/arm90050052
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Article ; Online: Use the Lower Limit of Normal, Not 80% Predicted, in Judging Eligibility for Lung Resection.

Wesolowski, Stefan P / Boros, Piotr W / Orłowski, Tadeusz M / Quanjer, Philip H

Respiration; international review of thoracic diseases

2016 Volume 92, Issue 2, Page(s) 65–71

Abstract: Background: Impaired lung function (LF) is a well-known risk factor for perioperative complications in patients qualified for lung resection surgery. The recent European guidelines recommend using values below 80% predicted as indicating abnormal LF ... ...

Abstract	Background: Impaired lung function (LF) is a well-known risk factor for perioperative complications in patients qualified for lung resection surgery. The recent European guidelines recommend using values below 80% predicted as indicating abnormal LF rather than the lower limit of normal (LLN). Objectives: To assess how the choice of a cut-off point (80% predicted vs. LLN at -1.645 SD) affects the incidence of functional disorders and postoperative complications in lung cancer patients referred for lung resection. Methods: Preoperative spirometry and the transfer factor for carbon monoxide (TL,CO) were retrospectively analysed in 851 consecutive lung cancer patients after resectional surgery. Results: Airway obstruction was diagnosed in 369 (43.4%), and a restrictive pattern in 41 patients (4.8%). The forced expiratory volume in 1 s (FEV1) or TL,CO was below the LLN in 503 patients (59.1%), whereas the FEV1 or TL,CO was <80% predicted in 620 patients (72.9%; χ2 test: p < 0.0001). In all, 117 out of 851 patients had LF indices <80% predicted but not below the LLN. Odds ratios (ORs) for perioperative complications were higher in patients with impaired LF indices defined as below the LLN (1.59, p = 0.0005) with the exception of large resections (>5 segments). In patients with test results above the LLN and <80% predicted, the OR for perioperative complications was not different (1.14, p = 0.5) from that in patients with normal LF. Conclusions: LF impairments are common in candidates for lung resection. Using the LLN instead of 80% predicted diminishes the prevalence of respiratory impairment by 14% and allows for safe resectional surgery without additional function testing.
MeSH term(s)	Aged ; Female ; Humans ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Patient Selection ; Pneumonectomy ; Poland/epidemiology ; Postoperative Complications/epidemiology ; Prevalence ; Respiration Disorders/epidemiology ; Respiratory Function Tests ; Retrospective Studies
Language	English
Publishing date	2016
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	206674-9
ISSN	1423-0356 ; 0025-7931
ISSN (online)	1423-0356
ISSN	0025-7931
DOI	10.1159/000447974
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