Effectiveness of pulmonary rehabilitation in patients with chronic obstructive lung diseases, cystic fibrosis, and interstitial lung disease is well documented but little is known about the results of pulmonary rehabilitation in patients referred for lung transplantation. The purpose of this study is to prospectively examine the efficacy of Nordic walking, a low cost, accessible, and proven beneficial form of physical exercise, as a form of pulmonary rehabilitation in patients referred for lung transplantation. Twenty-two male patients referred for lung transplantation at the Department of Lung Diseases and Tuberculosis in Zabrze, Poland, were invited to take part in the study. The rehabilitation program, which was conducted for 12 weeks, was based on Nordic walking exercise training with ski poles. Lung function tests (FVC, FEV1), mobility (6 min walking test (6MWT)), rating of dyspnea (Oxygen Cost Index, MRC and Baseline Dyspnea Index), and quality of life assessments (SF-36) were performed before and after the completion of the exercise program. No adverse events were observed after completing the pulmonary rehabilitation program in patients referred for lung transplantation. After 12 weeks of pulmonary rehabilitation with Nordic walking we observed a significant increase in the mean distance walked in the 6MWT (310.2 m vs. 372.1 m, p < 0.05). The results of lung function tests also showed improvement in FVC. There were no significant differences in the perception of dyspnea before and after completing the rehabilitation program. General health and quality of life questionnaire (SF-36) showed improvement in the domain of social functioning (p < 0.05). In conclusion, pulmonary rehabilitation with a Nordic walking program is a safe and feasible physical activity in end-stage lung disease patients referred for lung transplantation and results in improvements in patients' mobility and quality of life.

INTRODUCTION : This report introduces two cases presenting absorption of considerable radiological changes in the course of the coronavirus pneumonia in patients treated with prolonged oral steroids. CASES : The first case concerns a male receiving steroids only during hospitalisation in the Infectious Disease Hospital. After discharge, the patient experienced increasing dyspnoea resulting in hospitalisation in our Department of Lung Diseases. HRCT revealed progression of a bilateral, middle, and basal ground-glass opacity when compared to the examination performed at the early stage of the disease. The supplementary oxygen therapy and steroids were administered, followed by extended prednisone consumption up to 2 months after discharge. Follow-up HRCT revealed an almost complete absorption of the ground-glass opacity. The second case concerns a male treated with steroids only during hospitalisation in the Infectious Disease Hospital. Chest CT revealed widespread bilateral ground-glass opacities with consolidations. After discharge with no treatment, he suffered from severe dyspnoea and exercise intolerance, resulting in hospitalisation on the 7 th day of home stay. Since then, a continued steroid treatment was administered resulting in a clinical, spirometric, and radiological improvement. CONCLUSIONS : Based on these observations, patients after the COVID-pneumonia may derive benefits from a prolonged steroid treatment. Therefore, this class of medications should be considered in SARS-CoV-2 patients, especially in patients with persistent radiological changes and dyspnoea requiring the supplementary oxygen therapy. However, randomised controlled trials are required to establish guidelines for the steroid treatment in this group of patients.

Introduction: It is known from clinical practice that data concerning plasma sodium concentration and its influence on patient prognosis are underestimated. The aim of this study was the evaluation of the prevalence and influence of hyponatraemia on prognosis in patients with lung diseases, particularly with lung cancer. Material and methods: Retrospective analysis of data obtained from a single Pulmonary Department was performed. A total of 449 patients divided in two groups, were analysed. The first group consisted of all lung cancer patients (n = 290) hospitalized in the analysed period. The second group included patients with hyponatraemia but without diagnosed lung cancer (n = 159). The prevalence of hyponatraemia, including severity (mild, moderate or severe), was evaluated. Histological types of lung cancer as well as comorbidities were taken into account. Results: Hyponatraemia was found in 46.9% of patients with lung cancer, including mild (serum sodium 135-130 mEq/L), moderate (129-125 mEq/L) and severe hyponatraemia (< 125 mEq/L) in 66.9%, 25% and 8.1, respectively. In patients without lung cancer and with recognized hyponatraemia, mild, moderate and severe hyponatraemia were found in 81.8%, 13.2% and 5%, respectively (mainly in obstructive and interstitial lung diseases). Hyponatraemia was observed in 52.6% of patients with non-small cell lung cancer (NSCLC) and in 45.2% of patients with small cell lung cancer (SCLC). There was no statistical significance in prevalence of hyponatraemia between histological types of lung cancer. In patients with lung cancer and hyponatraemia compared to patients with lung cancer but without hyponatraemia, a significant increase of in-hospital mortality was found (28.7% vs. 7.8%, respectively) p < 0.001. Conclusions: Hyponatraemia was a common abnormality found in approximately 50% of lung cancer patients. Hyponatraemia was a significant prognostic factor associated with poor prognosis.

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.

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.