bluuebunny/crossref_metadata_2025 huggingface dataset:
MODELING OF URBAN FLOODING AND WATERFALL EFFECT ON STEPPED STREETS IN ISTANBUL, TURKEY
Authors: HALAT Oğuzhan Murat , CİRİTCİ İlke , YÜCEL Gül
Published: June 2021

Flood is one of the most common and deadly natural disasters. Most of the cities are under the threat of flash floods due to precipitation regime changes with global climate change. The existing infrastructure and the stepped streets that were not previously risky in the city create a waterfall effect in heavy rain and reduce street safety. Today, there are more than a hundred stepped streets in the settlement as by topography conditions such as Beyoglu, Sisli and Uskudar, with different type of stepped streets that form a short path in the transportation network. Many researchers studied to calculate discharges through spillways or dam break flows using numerical models. In the study, different step streets related vertically with Meclis-i Mebusan Street in Istanbul are examined in terms of flooding after heavy rains. The data was obtained through on-site observation. Physical properties such as stair length, width, slope, stair shape and railing were taken into consideration during the on-site examination. The step street as staircase models was analyzed with FLOW 3D software according to the selected flood height. In the numerical models examined by CFD method, the maximum speed zones occurring on the staircase during the flood were determined and the critical zones were specified. In this way, it is possible to comment on the impact assessment of stairs by considering water heights and speeds in critical areas. Some precautions are suggested to be taken in line with the data against the flash floods.
Social Mechanisms of Musical Stylistic Change: A Case Study from Early 20th-Century France
Authors: Harrison Jane
Published: June 2021

This study examined notated meter changes in scores by French composers to probe the role of sociological mechanisms in musical stylistic change. The stylistic feature of notated meter changes, which indexed metrical complexity, was conducive to empirical observation and functioned as a salient innovation in France around 1900. The principal sociological variable was membership in the Apaches artistic club, known for its avant-garde identity. A hypothesis that the Apaches would use significantly more meter changes than their peers was supported. Additional explanatory variables were derived from previous historical research on French composers and from theories about stylistic change. A complex relationship between the stylistic feature and social mechanisms emerged, involving multiple, overlapping social structures. The Labovian sociolinguistic approach was especially resonant in this data, as a composer's proximity to certain individuals, groups, and institutions in the social space related to their degree of enthusiasm for metric innovation. In addition, sociolinguistic theories about stylistic variation in human languages were consistent with patterns in this data set. Finally, a descriptive title was also a significant explanatory variable, which implicates the Labovian notion of register and the importance that Meyer gave to aesthetic goals in musical stylistic change.
Empirical Musicology: An Interview with David Huron Part II
Authors: Shanahan Daniel
Published: June 2021

On the occasion of David Huron's retirement, EMR Editor, Daniel Shanahan, recently interviewed him regarding research methodology, public musicology, music and emotion, formal theory, the place of biology in music studies, and other topics. The second of two interviews.
Commentary on Harrison: "Social Mechanisms of Stylistic Change"
Authors: Burgess Samantha
Published: June 2021

This is a review of Harrison's (2021) paper "Social Mechanisms of Stylistic Change: A Case Study from Early 20th-Century France." In this study, Harrison found that the Apaches, a group of composers known for pushing stylistic boundaries in 20th-century France, employed slightly more instances of notated meter change in their music than a control group of their peers, but that the use of notated meter change also depended on other factors such as composers' generational membership. This commentary primarily explores Harrison's methodologies: while the stringent definitions Harrison defines for each variable in her studies allow for specificity in the statistical analyses, they leave out a large portion of perceptually relevant data that would lend greater musicological generalizability to the results presented.
Graphic analysis of FEV1 informative value when evaluating bronchodilating response in bronchial asthma patients
Authors: Yartsev S. S.
Published: June 2021

This work was aimed to graphic analysis of informative reliability of FEV1 in the bronchodilation test assessed as the ratio to baseline or predictive values and to determine the optimal FEV1 cut-off in bronchial asthma (BA) patients. The study analyzed 529 bronchodilation test results in 365 BA patients. A control group included 48 persons. The FEV1 changes were calculated twice in each test: as ratios to the baseline and predictive values. A high diagnostic reliability of FEV1 in the bronchodilation test as a percentage of baseline and predictive values was found in BA patients with baseline ventilation disorders using the ROC method. The informative reliability of the FEV1%pred. was worse. Graphic analysis of cut-off for FEV1 improvement made to distinguish positive or negative bronchodilation test results showed 10 % increase independently on the method. We propose the differentiated assessment of the bronchodilation test results using 10 % to 12 % cut-off depending on severity of ventilation disorders.
Beclason ECO Easy Breathe: new possibilities of known drug in treatment of asthma
Authors: Sinopalnikov A. I. , Klyachkina I. L. , Mironov M. B.
Published: June 2021

An open comparative trial was designed to compare clinical efficacy of beclomethasone dipropionate (BDP) via non-freon metered dose inhaler (MDI) Easy Breathe or freon-containing MDI. The trial involved 30 patients not younger than 18 yrs with stable moderate to severe bronchial asthma (BA). The length of the disease exceeded 12 months and duration of previous therapy with inhaled steroids (freon-containing BDP) 1 000 to 1 500 mcg daily was at least 4 months. The trial duration was 6 months. The patients were randomised into 2 groups, 15 patients in each. Clinical signs, peak expiratory flow rate, need in short-acting β2-agonists were monitored. The study group patients were given non-freon BDP (Easy Breathe) instead of freon-containing BDP in the ratio 1 : 1. The control group patients continued treatment with freon-containing BDP. Then BDP daily doses were gradually reduced in both the groups while BA was controlled adequately. The daily dose was reduced by 500 mcg in average in 11 of 15 (73.3 %) non-freon BDP patients and in 6 (40 %) freon-containing BPD patients. So, BDP via MDI ECO Easy Breathe allows moderate to severe BA to be controlled with lower doses of the drug. This reduces a cost of the therapy, rate of potential adverse effects and results in improvement of quality of life of the patients.
Clinical and functional features of bronchial asthma in pregnancy
Authors: Prikhodko O. B. , Landyshev Yu. S. , Romantsova E. B.
Published: June 2021

Clinical course of bronchial asthma (BA) was followed-up during pregnancy (in I, II, and III trimesters). We observed 62.3 % of patients with mild BA, 29.8 % with moderate and 7.9 % with severe BA. Acute bronchial asthma was diagnosed in 68.4 % of the patients, of them 40.5 % were in the I trimester, 55.7 % were in the II trimester and 54.4 % were in the III trimester. During the follow-up period BA was stable in 43 % of the cases, improved in 14 % and worsened in 43 %. Complicated pregnancy course was diagnosed in 94.7 % of the patients. High frequency of perinatal complications was found. A complex assessment of lung function using spirography and zonal reography of the lungs allows early detection of the respiratory failure and timely diagnosis of BA impairment.
Prevalence of allergic diseases in adolescents
Authors: Minkailov E. K. , Minkailov K.-M. O. , Abueva R. M. , Strok A. B.
Published: June 2021

A screening search of 495 adolescents found bronchial asthma in 7.45 % and allergic diseases (AD) in general in 44.8 %. Most frequent AD were allergic rhinitis (16.6 %) and skin lesions (15.1 %). AD patients considerably more often nave respiratory signs (cough, breathlessness, sputum, wheezing), bronchial obstruction (22.7 % vs. 6.6 %, P < 0.05) and bronchial hyperresponsiveness (34.3 % vs. 5.7 %, P < 0.05) as compared to controls.
Delayed results of lung volume reduction surgery in heterogeneous lung emphysema
Authors: Wex P. , Haas V. , Utta E.
Published: June 2021

The aim of the study was to search delayed results and to characterize patients with heterogeneous emphysema which do not improve their quality of life after lung volume reduction surgery. Retrospective analysis was done based on medical history reports from July, 1994, to January, 1998. The surgical lung volume reduction was performed in 81 patients (45 males and 13 females, the average age was 61.9 yrs). Postoperative mortality was 6.9 % (4 patients). Twenty-three patients died within 5 yrs after the intervention; their mean follow-up period was 33.3 months. The average follow-up period was 54.3 months. Functional parameters for patients survived 3 to 5 yrs were: FEV1 50 ± 23.8 %, RV 35.6 ± 29.1 %, RV / TLC 12.3 ± 12 %, the 6-min walk distance was 96.7 ± 62 m. The total 5-year survival was 63.8 %, the survival for the patients having FEV1> 30 % was 83.8 % and that for the patients with FEV1 < 30 % was 50 %. Age and lung function parameters did not differ in survivors and died patients. On the contrary, differences in the blood gas parameters, oxygen therapy time and 6-min walk distance were significant between these groups. Some negative factors were revealed: predominant injury of the lower lung fields, FEV1 < 30 % pred., respiratory failure (PaCO2 ≥ 48 mm Hg), oxygen therapy longer than 6 months, the 6-min walk distance shorter than 80 m.
Idiopathic interstitial pneumonia in adults and children (review)
Authors: Tereshchenko Yu. A. , Tereshchenko S. Yu. , Vlasova M. V.
Published: June 2021

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A comparative efficacy of Russian bronchodilating drugs in therapy of asthma with regards to pathological agents
Authors: Skorlyakov A. V. , Shapovalova T. G. , Kirillov M. M. , Arzhnikov V. V.
Published: June 2021

We examined 364 asthma patients while treated in the Saratov pulmonary centre from 1989 to 2002. The aim of the work was to improve medication course programs including Russian oral bronchodilating drugs. The coefficient of harmony of changes which indicates a rate and synchrony of dynamics of clinical and laboratory parameters under a therapy was calculated using the method of regressive and graphic ratio. Severity of acute asthma exacerbation and, at less extent, severity of asthma course were proven to exert decisive influence upon results of the therapy
Diffuse and focal pulmonary fibrosis after narcotic inhalations: а case report
Authors: Karabinenko A. A. , Storozhakov G. I. , Eremina I. I. , Novikov Yu. K. , Chernyaev A. L.
Published: June 2021

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A role of Streptococcus pneumoniae, Мycoplasma рneumoniae and Сhlamydia pneumoniae in community-acquired pneumonia in children
Authors: Vishnyakova L. A. , Nikitina M. A. , Petrova S. I. , Papayan A. V. , Vydumkina S. P. , Smolianinova T. V.
Published: June 2021

This work investigated etiology of communityacquired pneumonia in children at SanktPetersburg from 1998 to 2001 using microbiological and immunological methods. S.pneumoniae was found to be a cause of pneumonia in 74.5 % of the patients and it was the leading pathogen out of proportion with the children's age. C. pneumoniae was detected in 67.3 % of the patients, prevalently in children 1 to 7 years old. The acute Мycoplasma рneumoniae respiratory infection was diagnosed in 40.4 % of the children. Non typing strains of H. influenzae were yielded in 10.2 % of the patients. Most patients had microbial associations that demonstrates multiple etiology of the current community-acquired pneumonia in children. Epidemiological rise in spread of acute respiratory C. pneumoniae infection was noted during last 4 years at Sankt-Petersburg which was thought to be a cause of a sharp increase in frequency of childhood community-acquired pneumonia.
Caseating pneumonia: computed tomography, differentiated therapy
Authors: Lazareva Ya. V. , Sokolova G. B. , Solovieva I. P.
Published: June 2021

We examined 50 patients with caseating pneumonias of various types and size. We selected CT types of caseating pneumonia (acinous, lobar, lobular, peribronchial), their structure and extension. Computed tomography is found to be the optimal radiological method to detect caseating pneumonic TB forms. Chemotherapy modes for caseating pneumonia patients are presented regarding to its CT types.
Functional evaluation of trachea in patients with COPD
Authors: Marchenkov Ya. V. , Pashkova T. L. , Chuchalin A. G. , Sinitsin V. E.
Published: June 2021

Severe cough associated with COPD can induce dynamic instability of trachea. It is important to investigate large airways in COPD patients and to create diagnostic program for evaluation of this dynamic changes. Aim: to investigate sensitivity and specificity of different methods for detection of dynamic tracheal instability in COPD patients. Of fifty five patients involved in this study 30 ones were selected according to inclusion criteria. They were divided into 2 groups: 20 COPD stage 2 patients with dynamic tracheal instability detected by fiberoptic bronchoscopy (the 1-st group; 14 females, 6 males; the mean age, 60.9 ± 7.9 yrs; BMI, 28.2 ± 4.3 kg / m2; the smoking history, 35.4 ± 5.2 pack-year) and 10 COPD stage 2 patients without dynamic tracheal instability according to fiberoptic bronchoscopy findings (the 2nd group; 2 females and 8 males; the mean age, 55.2 ± 4.8 yrs; BMI, 26.8 ± 2.6 kg/m2; the smoking history, 28.2 ± 3.4 pack-year). Clinical examination, flow-volume curve, body plethysmography, impulse oscillometry, X-ray examination of trachea, fiberoptic bronchoscopy, and electron-beam tomography were used in our work. As a result, the most sensitive functional method was impulse oscillometry (Se = 85 %). Electron-beam tomography is more sensitive (Se = 90 %) than X-ray examination of trachea (Se = 65 %) while diagnosing dynamic tracheal instability in the COPD patients.
Pulmonary oedema: physiology of lung circulation, pathophysiology of pulmonary oedema
Authors: Chuchalin A. G.
Published: June 2021

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Managing passengers with respiratory disease planning air travel: British Thoracic Society recommendations
Authors: Editorial Article
Published: June 2021

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Occupational asthma: clinical types and diagnosis
Authors: Vasilieva O. S.
Published: June 2021

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Otorhinolaryngology as a basis of preventive medicine
Authors: Piskunov G. Z.
Published: June 2021

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Non-invasive ventilation in acute respiratory failure
Authors: Avdeev S. N.
Published: June 2021

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Objective assessment of quality of work and material stimulation of medical staff in a hospital
Authors: Dukhanina I. V. , Malyavin A. G. , Alexandrova O. Yu. , Dukhanina M. V.
Published: June 2021

We propose and substantiate criteria of objective assessment of quality of work of medical staff in a hospital facility in order to restrict a length of inpatient treatment, to improve work of a doctor and a whole department and to achieve adequate material stimulation and appropriate wages. The criteria consider economic, medical and social aspects, allow computerized analysis of a doctor's and a department work, systematic analysis on clinical conferences and disclosure of factors worsening the quality of inpatients treatment.
Clinical efficacy and tolerability of new non-freon aerosol of troventol in asthma
Authors: Pashkova T. L. , Chikina S. Yu. , Chernyak A. V. , Naumenko Zh. K. , Nekludova G. V. , Shvarts G. Ya. , Chuchalin A. G.
Published: June 2021

The study was designed to assess clinical efficacy and tolerability of new non-freon aerosol of troventol. The study involved 20 patients (4 males and 16 females) with intermittent or mild persistent stable asthma aged 22 to 67 yrs, the average age, 44.3 ± 11.1 (М ± SD). Anticholinergic effect of troventol was assessed under a single inhalation of the drug (the acute test) which was the 1-st stage of the study, and after long-term (4 wks) treatment which was the 2-nd stage. Clinical efficacy was evaluated by Borg's scoring of cough and dyspnoea, lung and heart auscultation, need in short-acting beta-2-agonists. The acute test included the metacholine challenge test before and 3 hrs after inhalation of 80 mcg of troventol or placebo. The long-term treatment stage included the metacholine challenge test before and in 4 weeks of daily inhalations of 160 mcg of troventol. As a result, the new non-freon aerosol of troventol demonstrated distinct brochodilating and anticholinergic effects which significantly differed from placebo in patients with intermittent or mild persistent stable asthma. Being administered for a long period (4 wks) the drug improved cough and dyspnoea and reduced the need in short-acting beta-agonists while bronchial airflow parameters did not change considerably. There were no adverse events of the therapy during the study.
Изменения перикисного окисления липидов
при бронхиальной обструкции
Authors: Вострикова Е.А. , Кузнецова О.В. , Ветлугаева И.Т. , Тихонова А.В. , Вавин Г.В. , Разумов П.С. , Разумов А.С. , Стрелис А.К.
Published: June 2021

Хроническая обструктивная болезнь легких (ХОБЛ) - это экологически детерминированное заболевание, патофизиологической
основой которого является хронический воспалительный процесс в легких, когда в ответ на действие повреждающих факторов внешней
среды нарушается баланс между активностью про! и антиоксидантных систем организма. Цель работы - выявить общие закономерности изменений липопероксидационного статуса при формировании бронхообструктивной патологии. Обследовано 252 человека
(201 мужчина и 51 женщина) в возрасте от 20 до 70 лет. Установлено, что клинико!инструментальные признаки бронхиальной
обструкции сопряжены с увеличением содержания продуктов липопероксидации, снижением активности супероксиддисмутазы и
увеличением интенсивности хемилюминесценции. Пациенты с бронхообструктивными заболеваниями имеют выраженные нарушения
липопероксидационного статуса, характеризующиеся увеличением содержания диеновых конъюгатов и снижением антиоксидантного
потенциала крови.
Изучение приверженности больных бронхиальной астмой
к противоастматической терапии одним комбинированным
ингаляционным препаратом
Authors: Овчаренко С.И. , Акулова М.Н. , Ищенко Э.Н.
Published: June 2021

Было проведено изучение изменения приверженности больных бронхиальной астмой (БА) к противоастматической терапии с учетом
показателей кооперативности (КП) на фоне терапии одним ингаляционным препаратом, содержащим иГКС и β2-агонист длительного
действия (Симбикорт турбухалер) в режиме гибкого дозирования. Показатели КП оценивались по вопроснику ИкБА-50, состоящему
из 50 пунктов (102 вопроса). Данный вопросник позволяет оценить КП по 8 основным критериям. КП оценивалась исходно, через
6 мес. наблюдения за пациентами на фоне терапии 2 препаратами и на фоне применения 1 ингаляционного комбинированного
препарата (Симбикорт турбухалер 160 / 4,5 мкг / доза) в течение 6 мес. В исследовании принял участие 31 пациент (22 женщины и 9
мужчин), длительно получавшие терапию 2 ингаляционными препаратами (иГКС и бронхорасширяющий препарат) в режиме
многократного применения фиксированной суточной дозы, средний возраст - 54,48 ± 11,94 лет, и средняя длительность БА - 14,26 ±
9,84 лет. Эта группа пациентов наблюдалась в клинике в течение 6 месяцев. В последующем 26 из 31 пациента (17 женщин и 9 мужчин,
средний возраст - 52,54 ± 13,28 лет, длительность БА в среднем 10,69 ± 7,41 лет) смогли перейти на терапию одним комбинированным
препаратом. Было установлено, что использование в качестве базисной терапии одного комбинированного препарата в режиме гибкого
дозирования и контролируемое ведение больных привело к повышению приверженности больных к противоастматической терапии,
что, в свою очередь, способствует стабилизации клинического состояния, уменьшению количества и выраженности обострений.
Полученные данные могут помочь в повышении эффективности лечения больных БА.
Evaluation of asthma control in primary care practice
Authors: Ovsyannikov N. V. , Bagisheva N. V. , Serdyuk L. V. , Suvorova S. G. , Sabakar T. M.
Published: June 2021

Asthma control in clinical trials achieves 25 to 68 %; it is significantly lower in real-life clinical practice. This study was designed as a prospective open study for evaluating asthma control in 104 asthmatic adults in primary care settings of Omsk city. The efficacy of treatment has being assessed during 6 months using the validated Russian version of ACT questionnaire; score < 20 was considered as uncontrolled asthma, 20–24 as a good control, and 25 as the full control. The patients received budesonide (Benacort), beclomethasone dipropionate (Beclasone ECO Ease Breathe), budesonide/formoterol (Symbicort), or fluticasone (Flixotide) as the basic therapy; 4 patients were treated with symptomatic therapy alone. Asthma control improved by 3 to 8 points in average while using inhaled steroids and by 1.25 points under the symptomatic treatment. Severe asthma patients failed to reach the control. Improvement in asthma control was similar for all basic medications. Abilities to further improvement in asthma control are thought to improve quality of management of asthma patients in primary care settings.
Clinical equivalency of Beclasone Eco Easi Breathe and Flixotide via MDI in asthma patients
Authors: Visel A. A. , Seliverstov V. N. , Visel I. Yu. , Sergeev V. A. , Rakhmatullina N. M.
Published: June 2021

It is well known that efficacy of asthma treatment depends on a choice of a basic medication as well as on a delivery system. The aim of this study was a comparison of clinical efficacy of equal doses of beclomethasone dipropionate (Beclasone Eco Easi Breathe) and fluticasone propionate (Flixotide) via MDI. The study was designed as a randomized open prospective comparative trial. Findings of 26 patients with moderate and severe asthma of > 18 yrs old were analyzed, such as medical history, physical findings, spirometric and bronchodilating test results, heart beat rate and blood pressure, quality of life (QoL) using Russian version of AQLQ questionnaire. After the run-in period the patients randomly received Beclasone Eco Easi Breathe 500 to 1000 μg daily or Flixotide at the same doses for 4 weeks followed the cross-over change of the drugs for the next 4 weeks. After 1 month of the treatment, significant improvements in airflow parameters, need in short-acting β2 -agonists and QoL have been reported. After changing the drugs these effects have been maintained with no further reliable improvement. Thus, the study demonstrated similar efficacy and safety of these inhaled steroids that could be considered as being clinically equal in treatment of moderate and severe asthma.
Molecular and epidemiological characterization of rpoB mutations in rifampicin-resistant Mycobacterium tuberculosis in Kyrgyz Republic
Authors: Isakova G. T. , Pak O. A. , Yusupova A. U. , Goncharova Z. A. , Tumashova A. F. , Kozhomkulov M. D. , Kozhomkulov D. K. , Сhubakov T. Ch. , Alisherov A. Sh. , Friedland J. , Aldashev A. A.
Published: June 2021

The nature and frequency of mutations in the rpoB gene of M. tuberculosis (MBT) vary considerably in various geographical locations. There is no information on the prevalence of specific mutations in the rpoB gene of MBT isolated from patients in Kyrgyz Republic. In this work, we analyzed a distribution of the rpoB gene mutations in Kyrgyz Republic. A total of 380 rifampicin-sensitive and 225 rifampicin-resistant MBT cultures were analyzed to identify and to characterize mutations in the rpoB gene using a biological microchip assay. The biochip test determined 18 different mutation types in 8 codons of the rifampicin-resistant samples. The majority of mutations (180 of 225, or 80 %) were in the codons 531 and 526, mainly in the codon 531 (137 of 225, 60.8 %). The Ser531>Leu mutation (134 of 225, 59.4 %) was by far the most common. Another group of mutations were in the codon 526 (43 of 225, 19.1 %). Five different types of mutations were found in the codon 526 which were: His526®Tyr (4.9 %), His 526®Asp (4.9 %), His526®Arg (4.0 %), His526®Leu (3.5 %), and His526®Pro (1.8 %). The third group of common mutations were Leu511®Pro (6.3 %) and Asp516®Tyr (4.4 %). Other mutations found in the codons 533, 522, 513, and 512 were less frequent and had a very low rate comprising about 1.8 % of the total mutation number among 225 rifampicinresistant samples.
Factors reducing adherence to therapy and abilities to enhance motivation for treatment
Authors: Sukhova E. V. , Barsukov V. N. , Sukhov V. M. , Zainullin N. R.
Published: June 2021

The problem of lowering adherence to therapy in lung tuberculosis patients and abilities to enhance motivation to for treatment has not been highlighted in literature. The aim of this study was to investigate factors influencing the adherence to treatment in tuberculosis patients and abilities to enhance their motivation for treatment. A total sample of 72 inpatients with infiltrative and firbocavernous lung tuberculosis were involved. They were residents of Samara region aged 22 to 56 yrs. To investigate factors reducing adherence to therapy a special questionnaire consisting of 34 points has been created proposed by Samara military medical university. Statistic analysis was performed using SPSS programme, version 12.0. As a result, the most common factors reducing adherence to therapy in lung tuberculosis patients were adverse effects of antituberculosis drugs, financial problems, complications of the disease and fear of their appearance, painfulness of treatment procedures, tiredness of long treatment period and of hospital environment. To overcome the fear education of the patients is necessary. To reduce the emotional component and painfulness of some treatment procedures, manual and audiomethods could be helpful. Effective therapy, confidence in the attendant physician and full information of the disease could enhance motivation to treatment.
Expression of P-glycoprotein on blood lymphocytes and its role in development of steroid resistance in severe asthma
Authors: Demko I. V. , Salmina A. B. , Morgun A. V. , Malinovskaya N. A.
Published: June 2021

P-glycoprotein (Pgp) is a membrane transporter of hydrophobic molecules providing efflux of xenobiotics from the cytosole outside the cell. In epithelial cells, Pgp is thought to be responsible for resistance to steroids. Severe bronchial asthma (SBA) is a heterogenous disease characterized by resistance to and dependence on steroids. The goal of this study was to assess expression of Pgp on peripheral blood lymphocytes in severe bronchial asthma and to evaluate the role of Pgp in developing the resistance to glucocorticoid therapy (GC). Assessment of Pgp expression revealed difference in response to GC treatment. All the patients were susceptible to GC, however, the time of therapeutic effect appearance and the number of Pgp-immunopositive cells differed significantly. Thus, more prolonged application of GC for reducing clinical manifestations was required in patients with aspirin induced or fatal bronchial asthma. The number of Pgp-immunopositive lymphocytes per one patients was significantly higher in patients with fatal bronchial asthma and in patients with steroid dependent bronchial asthma (6.8 ± 0.1 and 7.2 ± 0.2, respectively) comparing with patients with non stable bronchial asthma being therapeutically resistant (3.2±0.2 and 3.5±0.1, respectively). Thus, our findings suggest possible pathogenic role of Pgp in development of resistance to GC therapy in patients with bronchial asthma. Detection of Pgp expression on peripheral blood lymphocytes would allow optimizing the volume and duration of intensive anti inflammatory therapy and predicting the doses of basic drugs.
Preventive and therapeutic use of pneumococcal vaccine in industrial workers with chronic pulmonary diseases
Authors: Ignatova G. L. , Fedosova N. S. , Stepanishcheva L. A.
Published: June 2021

The efficacy of immunization against various pathogens has been proved in a long term practice worldwide. A delayed effect of vaccination with pneumococcal vaccine Pneumo 23 in 243 workers in a large industrial enterprise in Chelyabinsk has been analyzed in the article. One year after the vaccination a second examination was carried out in 102 persons (38 with chronic simple bronchitis (CSB) and 64 with COPD) and 1.5 years after vaccination it was done in 92 persons (59 persons with CSB and 33 with COPD) The efficacy of the vaccination was assessed by the rate, length and severity of exacerbations of chronic respiratory diseases, as well as by clinical symptoms, results of physical examination, lung function parameters, and quality of life. The 1st control group included 33 patients with COPD, the 2nd control group included 57 patients with chronic bronchitis working in the same enterprise. The groups were compatible for age, length of work, duration of the disease and FEV1 . After immunization the exacer bation rate in the vaccinated patients with CSB decreased by 3.6 and 2.5 times within 1 and 1.5 years correspondingly (р < 0.01). The vaccinated patients with COPD demonstrated a 2.4 fold and a 2.2 fold reduction respectively (р < 0.01). The duration of exacerbations in patients with CSB decreased by 1.6 and 1.1 respectively (р < 0.01) and by 1.78 and 1.2 in patients with COPD respectively (р < 0.01). Of vaccinated patients with COPD 39.4 % did not experience any exacerbations during the follow up period compared to 0 % in the control group. The quality of life of the vaccinated patients improved in terms of physical activity, general and psychological health, vitality, reduction of discomfort. The results allow us to recom mend pneumococcal vaccination for wide implementation in high risk industrial workers.
Efficacy of short course asythromycin in non-severe community-acquired pneumonia
Authors: Chuchalin A. G. , Avdeev S. N. , Tsareva N. A.
Published: June 2021

The study was aimed to evaluate clinical efficacy, safety, and tolerability of 3 day course of azythromycin (Zitrolid forte) in comparison with a stan dard 7 to 10 day therapy with amoxicillin (Flemoxin solutab) in patients with mild community acquired pneumonia (CAP). Included patients were randomized in 2 groups: 1) 20 patients taking Zitrolid 500 mg daily for 3 days (15 males, 5 females, mean age, 40.7 ± 18.4 yrs); 2) 20 patients taking amoxicillin 500 mg t.i.d. for 7 to 10 days (13 males, 7 females, mean age, 39.8 ± 12.5 yrs). Pneumonia was confirmed by chest X ray in all the patients. Severity of pneumonia was assessed with PSI score. In the 1st group, 12 (60 %) of patients had PSI class I and 8 (40 %) had PSI class II. In the 2nd group, there were 13 (65 %) and 7 (35 %), respectively. In the 1st group patients, improvement in clinical signs and laboratory parame ters was noted at the 3rd day of therapy and complete recovery was detected at the 7th day. The 2nd group patients demonstrated similar dynamics at the 7th and the 14th days, respectively. Microbiological efficacy of the drugs was equal (100 %). The drugs did not differ in rate of adverse events. Therefore, 3 day course of azythromycin in patients with mild CAP were as effective as standard (7 to 10 days) therapy with amoxicillin. Azythromycin (Zitrolid forte) was well tolerated with no serious adverse events requiring interruption the treatment.
Bronchial asthma and respiratory infections in children
Authors: Zaitseva O. V.
Published: June 2021

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Peculiarities of asthma diagnosis and treatment in draftees
Authors: Luntsov A. V. , Skorokhodkina O. V.
Published: June 2021

Sometimes timely detection of asthma is difficult so as mild asthma is often underestimated. This point is of particular importance in adolescents due to medical expertise for future military service. Three hundred and sixty one young men aged 15 to 18 were referred to the Republic clinical immunology centre of Kazan from military registration offices to confirm the diagnosis of asthma. Asthma was diagnosed according to the algorithm included analysis of medical records, clinical examination, special allergologic tests, and challenge tests with inhaled allergen, histamine, hypertonic solution or physical exercise if necessary. The results of the combined examination have confirmed the diagnosis in 344 patients (95.3 %); 77.3 % of the asthmatic patients had mild asthma.
Features of pulmonary haemodynamics and endothelium function in children with asthma
Authors: Starovoytova E. A. , Ivanov S. N. , Ogorodova L. M.
Published: June 2021

Asthma patients (n = 79, 7 to 17 years of age) were divided into 3 groups according to asthma severity: mild (n = 23), moderate (n = 24), and severe asthma (n = 32). Asthma was diagnosed according to GINA (2002). Echocardiography, ultrasound evaluation of endothelium vasomotor function and measurement of nitrite anion concentration in exhaled breathe condensate (EBC) were performed in the all patients. Right ventricle dilatation and increase in the total pulmonary vascular resistance were revealed only in patients with severe asthma compared to the control group. Increase in pulmonary artery systolic pressure was significantly higher in the severe asthma patients compared both to the control group and mild asthma patients. Increased right ventricle pressure was accompanied by endothelium dysfunction in 48.1 % (38 patients). High EBC nitrite anion concentration (12.11 ± 1.72 μmol/L) was revealed in asthmatic children compared to control group (3,34 ± 1,58 μmol/L). The results suggest that childhood asthma is associated with morphological and functional abnormalities of pulmonary hemodynamics and endothelium function depending on severity of the disease.
Management of asthma patients in primary care settings: effect of a physician's training
Authors: Brimkulov N. N. , Vinnikov D. V. , Ryzhkova E. V.
Published: June 2021

A cross-sectional analysis of management of asthma patients before and after short-term training of 78 physicians in Bishkek was performed. At baseline, diagnosis of asthma was made in 37 patients (4.1 % of all respiratory diseases). Just after training, in 1 year and in 2 years, asthma was diagnosed in 26, 45 and 26 patients, respectively. At baseline, peak flow measurement and spirometry were not used at all and treatment was mainly symptomatic. The training resulted in improvement of theoretical knowledge score from 84.6 % to 73.3 %; p < 0.001. Use of peak flow measurements increased to 38.5 %, 51.1 % and 38.5 % just after the training, in 1 and 2 years, respectively. Use of spirometry grew to 11.5 %, 17.8 % and 26.9 %, respectively. Inhaled corticosteroids (ICS) were administered to 42.3 %, 53.3 %, and 46.2 %, respectively, vs. 5.4 % at baseline with simultaneous reduction in inadequate administrations of vitamins, antibiotics and expectorants. So, the short-term training was effective. However, application of peak flow measurement in 100 % of the patients should be achieved; the majority of patients need ICS. Ways to increase the training efficiency are necessary.
Improvement of outpatient rehabilitation in patients with bronchial asthma
Authors: Masuev K. A. , Kazanbekov D. G. , Alieva K. M.
Published: June 2021

Investigation of efficacy of various rehabilitation methods in patients with asthma was performed. We observed 165 patients divided into 3 groups. All of them received the basic therapy for asthma. Each group included the study subgroup (40 patients) and the placebo subgroup (15 patients). The 1st study subgroup patients received 250 μg of nebulized ipratropium bromide and 500 μg of phenoterol hydrobromide followed by 22.5 mg of nebulized ambroxol; inhalations of 0.9 % saline solution were as placebo. The 2nd study subgroup patients were treated with acupuncture; and placebo patients received spontaneous pricks of the skin. The 3rd group was treated with willed limitation of deep breathing (WLDB) by K.Buteyko's method and placebo physiotherapy. We noted qualitative changes in clinical course of the disease, significant reduction of drug therapy and improvement in all lung function parameters in the 1st group patients. In the 2nd and the 3rd groups, some patients reported improvement in their health status, reduction in dyspnea and in need in bronchodilators. However, analysis of their peak expiratory flow rate (PEFR) and lung function parameters did not show statistically significant improvement compared to placebo.
Cell bronchopulmonary reactions in patients with pesticide accumulation and exacerbation of COPD
Authors: Аrifkhanova S. I. , Ubaydullaeva K. M.
Published: June 2021

Cell reactions of bronchopulmonary system in COPD exacerbation were investigated in BALF from 182 patients. Patients were divided into 2 groups: with or without pesticide accumulation. Smoking habit was also taken into consideration. We estimated biocide potential of AM using spontaneous and induced NST-test in 4 groups, calculated the stimulation index that revealed several patterns of cell reactions. Chronic excessive activation of AM by smoking, pesticides and/or other risk factors provided hyperresponsiveness of biocide systems of mononuclear monocytes.
Chronic obsrtuctive pulmonary disease and occupational factors
Authors: Vasilieva O. S.
Published: June 2021

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Prevalence of chronic obstructive pulmonary disease and its major risk factors among the inhabitants of high
Authors: Sooronbaev T. M. , Uchkempirova B. K. , Shabykeeva S. B. , Myrzaakhmatova A. K. , Кadyraliev J. K. , Мirrakchimov M. M.
Published: June 2021

Clinical and epidemiological examination of 2 264 residents of highaltitude regions (2 400 to 3 800 m*) and 1 498 inhabitants of lowaltitude regions (760 m*) ages 18 to 75 yrs was performed to estimate prevalence of COPD and its major risk factors. Higher prevalence of COPD among highlanders (7.6 %) was found compared to lowlanders (5.8 %; р < 0.05), especially in men older 40 yrs of age. The growth of COPD spread was observed in population of young persons including women. Leading risk factors for COPD in highlanders were smoking, air pollution inside houses from burn ing of pressed dung (kizyak) used as fuel and acute respiratory infections. Actually, the primary issues to decrease morbidity, mortality and preva lence of COPD in highlanders are preventive measures and early diagnosis of the disease.
Inflammatory marker levels and peripheral blood circulation in skin microvessels in patients with chronic obstructive pulmonary disease
Authors: Tikhonova I. V. , Tankanag A. V. , Kosyakova N. I. , Chemeris N. K.
Published: June 2021

Levels of inflammatory markers and skin microcirculation were studied in patients with chronic obstructive pulmonary disease. Proinflammatory cytokine concentrations and number of desquamated endothelial cells in blood flow were significant increased during exacerbation compared with controls. The increase in proinflammatory cytokine concentrations in exacerbation was accompanied by increased skin perfusion, increased oscil lation amplitudes in the frequency ranges of respiratory rhythm and higher endothelial activity compared with controls. In stable condition, the lev els of proinflammatory cytokines decreased compared with those in exacerbation. Myogenic activity was decreased twice in patients with stable con dition compared with healthy persons. The endothelialdependent vasodilation did not change and the endothelialindependent vasodilation increased in all patients compared with controls.
Safety and efficacy of different drug forms of amoxicillin / clavulanic acid in treatment of lower respiratory tract infections in adults: an open prospective randomized trial
Authors: Guchev I. A. , Kozlov R. S.
Published: June 2021

Amoxicillin/clavulanic acid (ACA) is one of the drugs of choice for treatment of lower respiratory tract infections (LRTI) in adults. One of the serious disadvantages of ACA is relatively high rate of gastrointestinal adverse events (AE). A new form of ACA, which is dispersable tablets Solutab, could potentially reduce the rate of AE because of more rapid and predictable absorption of clavulanic acid from intestine and improve clinical outcomes due to higher adherence to treatment. This trial was aimed to compare AE rate and clinical efficacy of the new dispersable ACA form Solutab with those of traditional ACA tabs in adult patients with non-severe LRTI. The treatment regimen comprised 500/125 mg t.i.d. during 5 to12 days. This was an open, prospective randomized trial performed at 4 clinical centres. Adults with clinically and radiologically detected non-severe community-acquired pneumonia or I or II types COPD exacerbations with purulent sputum received dispersable ACA tablets (the 1st group) or traditional coated tabs of ACA (the 2nd group) in a random proportion of 1 : 1. Clinical efficacy was evaluated with clinical signs, physical symptoms, additional laboratory and instrumental testing. The safety was assessed based on the patient's complaints and results of physical and laboratory examination in visits 2 (Day 3 or 4), 3 (Day 5 to 12), and 4 (Day 30 to 40 after taking the first dose of the drug). The trial involved 200 patients, the mean age, 32.7 ± 18.7 and 33.3 ± 18.6 yrs in the 1st and the 2nd groups, respectively. The groups were similar for history, severity, and clinical course of the disease. Clinical efficacy was 96.9 % in both groups in visit 3, 95.9 % and 96.9 % in the 1st and the 2nd group, respectively, in visit 4. The mean duration of antibacterial therapy was 7.1 ± 1.5 days in the 1st group and 7.2 ± 1.4 days in the 2nd group. AE were reported in 15 % and 31 % of the patients, respectively (p = 0.01). Gastrointestinal AE predominated in both the groups but the rate of diarrhea was lower in patients receiving dispersable ACA: 6 % vs. 17 % in the 2nd group (p = 0.027). Therefore, the new dispersable drug form of ACA has better safety profile in adult patients with non-severe LRTI compared to traditional ACA that was demonstrated by reduction in the AE, mainly diarrhea, rate. Both drug forms showed equally high clinical efficacy.
To the informative value of flow-volume curve in forced expiration
Authors: Lyubimov G. A. , Skobeleva I. M. , Sakharova G. M. , Suvorov A. V.
Published: June 2021

This report introduces a mathematical model of forced expiration to analyze pulmonary function. Results of 3-year lung function monitoring of an ex-smoker have been shown in the paper. Actual values of lung volumes and airway resistance were used for modeling. The computerized data were compared to the flow-volume curve parameters and lung volumes measured during the forced expiration. Weak correlation between the "flow-volume" curve parameters and the time after quitting smoking together with significant change in the lung volumes and the airway resistance seen in the study could be due to some processes which have not been followed in this study (lung compliance, airway resistance at forced expiration, and elastic properties of airway walls).The results demonstrated that mathematical models could increase informative value of pulmonary functional tests. In addition, the model could emphasize additional functional tests for better diagnostic usefulness of functional investigations.
Biological microchips for detection of multiple drug resistant M. tuberculosis strains isolated in Kyrgyz Republic
Authors: Isakova J. T. , Goncharova Z. K. , Aldashev A. A.
Published: June 2021

The aim of the study was to estimate spread of primary and secondary multiple drug resistant Mycobacterium tuberculosis (MBT) and to characterize rpoB, katG, inhA, and ahpC gene mutations of rifampicin (RIF) and isoniazid (INH) resistant MBT strains isolated from tuberculosis patients in Kyrgyz. We obtained 493 specimens from patients with pulmonary tuberculosis which were diagnosed based on clinical, X-ray, and bacteriological examination. Among them, newly diagnosed pulmonary tuberculosis was in 445 patients (90.2 %), and 48 of the patients (9.8 %) have already been treated for tuberculosis. Mutations of rpoB, KatG, inhA, and ahpC genes associated with RIF and INH resistance were detected by biological chip test. Sensitive MBT strains were detected in 47 % and resistant strains were in 53 % of the newly diagnosed patients. Single-drug resistance to RIF only was detected in 3 % of cases; resistance to INH was found in 20 %, resistance to both the drugs was detected in 30 % of the patients. In pre-treated patients single-drug resistance to RIF was defined in 4 % of cases, resistance to INH was in 8 %, resistance to both the drugs was estimated in 75 % of the patients. Therefore, we suppose that there is a high prevalence of multi-drug resistant MBT in Kyrgyz Republic: 30 % among newly diagnosed patients and 75 % among pre-treated patients. The main cause of RIF-resistance of MBT is Ser531→Leu mutation of rpoB gene, and the main cause of INHresistance is Ser315→Thr mutation of katG gene.
Control of asthma and its achievement
Authors: Nenasheva N. M.
Published: June 2021

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Is there the alternative for high-dose inhaled corticosteroids to achieve asthma control?
Authors: Lazareva N. B. , Karlov A. I. , Arkhipov V. V.
Published: June 2021

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Hypersensitive pneumonitis caused by exposure of metal allergens
Authors: Vasilieva O. S. , Chuchalin A. G. , Chernyaev A. L. , Samsonova M. V. , Kulemina E. A.
Published: June 2021

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Complex laboratory investigations in occupational respiratory diseases
Authors: Ivanova L. A. , Gorizontova M. N. , Statsenko Yu. V. , Babenko I. V. , Vologzhanina G. M. , Krupenina O. V.
Published: June 2021

Results of complex laboratory examination of 103 patients with dust related bronchitis caused by exposure of various industrial dusts, 22 patients with pneumoconiosis and 12 subjects not having respiratory pathology and not exposed to quartz dust or any other occupational hazards are presented in this article. Laboratory examination included morphological investigations of sputum and bronchial brush biopsy specimens, cytochemical characterization of bronchial ciliated epithelium and blood cells, and bacteriological and serological investigations of bronchial mucus. Our results demonstrated that morphological lesions of bronchial epithelium cells leading to their death followed cell dysfunction, disorders of enzyme activity, hypoxemia, predominance of Haemophilus influenzae in microflora, and significant inflammatory and allergic response in blood. These changes were found in different clinical stages of dust related bronchitis and pneumoconiosis. The findings obtained are of great importance for understanding pathogenic mechanisms of dust related lung diseases as well as from clinical point of view such as diagnosis and development of individual treatment strategies.
Efficacy and safety of dry extract of ivy leaves in therapy of respiratory diseases in children
Authors: Soroka N. D. , Gomozova S. P. , Ilyina I. V. , Krechmar E. A. , Antonova E. A. , Vlasova T. G. , Berdysheva S. M. , Kiseleva O. M.
Published: June 2021

Data of morbidity of respiratory diseases in children at Sankt-Petersburg are given in the article. The authors described significance and current features of respiratory diseases in children, showed a role of mucostasis in poor course and importance of mucoactive therapy in community-acquired and in-hospital respiratory pathologies. Results of post-marketing clinical trial of mucoactive efficacy of Prospan in 180 children of 6 months to 17 years of age with wide-spread respiratory diseases have been presented in the article. High mucolytic and bronchodilating activity and good safety profile of Prospan, which is dry extract of ivy leaves, have been demonstrated. No interaction was noted between Prospan and other medications used in the treatment of respiratory diseases in children. Therapy with dry extract of ivy leaves was safe in children with most prevalent co-existing pathology including early age children.
Work process in a radiological diagnostic department of the Ludwig Maximilian University Grosshadern clinic, Munich, Germany
Authors: Marchenkov Ya. V.
Published: June 2021

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