Original papers

Respiratory features of Aspergillus infection in eight years of pulmonology practice

Abstract

Aim: To evaluate clinical manifestations of Aspergillus infections in our pulmonology practice.

Methods: Between 2002-2009, we assessed retrospectively and prospectively, Aspergillus related diseases in patients admitted in Clinical Hospital of Pneumology from Cluj-Napoca, Romania. Positive diagnosis was based on identification of Aspergillus speciae (A spp) on Sabouraud

medium, pathological, or immunological proves.

Results: 83 patients were included. A spp was isolated in 73 patients from: sputum 46, bronchial lavages (BL) 17, both sputum and BL 4, sputum and nasal secretion 1, or from surgical samples 5 cases. In those 10 cases without A spp positive cultures, diagnosis was confirmed by pathologic examination on surgical or bronchoscopical samples in 6 and 2 cases respectively. 76 patients had previous chronic respiratory diseases and 7 had nonrespiratory chronic diseases. We identified the following clinical forms: chronic cavitary aspergillosis 46 cases, aspergillus tracheobronchitis 19 cases, allergic aspergillosis 15 cases, invasive aspergillosis 3 cases. We observed a poor definition on nosological forms, diagnosis like „pulmonary aspergillosis" or „aspergilloma" were the most common. In 12 cases no clinical significance was attributed for detection A spp in bronchial smears. 60 patients supported specific management: antifungal therapy in 38 cases, surgical procedures in 14 cases and both methods in 8 cases, with many differences in treatment and follow-up.

Conclusions: Chronic cavitary aspergillosis was the most frequent clinical form observed in our pulmonology practice. Using the clinical guidelines for fungal respiratory infections we can avoid the wrong diagnosis and then include a correct antifungal treatment in the complex management of our chronic pulmonary patients.

Key words: Aspergillus, aspergillosis, pulmonology.

Article

Smoking and autoimmune thyroid diseases

Abstract:

Introduction: The chronic autoimmune thyroiditis are heterogeneous entities by the functional, lesional and evolutive point of view. Ethiopathogenic factors involved in chronic autoimmune thyroiditis are genetical factors, combines with environmental factors, hormonal factors, infectious factors, etc. The exact role of smoking on the autoimmune mechanism is unclear, but smoking is known to have an antithyroid effect.

Aim: Our study tries to estimate the influence of smoking on serum levels of antithyroid peroxidase antibodies and antithyroglobulin antibodies, in a group of patients with various clinical forms of chronic autoimmune thyroiditis.

Materials and methods: We studied a group consists of 310 patients with chronic autoimmune thyroiditis, hospitalised in the Endocrinology Department of Constanta County Hospital, between january 2006 - december 2009. We detected serum values of antithyroidperoxidase antibodies and antithyroglobulin antibodies of our patients. We also followed the age, sex and presence of smoking in our study group. For statistical processing of the data we use Student′s t- test.

Results and discussions: In our study group 24,28% of patients were smokers. Serum levels of antithyroid peroxidase antibodies were significantly increased (p < 0.001) in the smokers patients, compared with the nonsmokers patients. Serum levels of antithyroglobulin antibodies were significantly increased (p < 0.01) in smokers patients, compared with those who were nonsmokers.

Conclusions: Smoking increased the serum levels of antithyroid antibodies at patients with chronic autoimmune thyroiditis.

Key words: smoking, chronic autoimmune thyroiditis, antithyroid antibodies.

Article