bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of nebulized budesonide suspension in acute severe asthma: a controlled trial
Authors: Sereda V. P. , Svistov A. S.
Published: June 2021

A goal of the study was to evaluate efficacy of inhaled budesonide suspension via nebulizer compared with systemic steroids in acute severe bronchial asthma. We examined 68 patients admitted for acute severe asthma (FEV1 < 40 %pred., PEF < 150 L / min). A first step therapy included inhaled salbutamol 5 to10 mg, oxygen, prednisolone IV for 1.5 to 2 h. Then the patients were divided into 2 groups: good respondents (n = 32) with increase in FEV 1 up to 50 %pred. at least and patients with insufficient response (n = 36) and co existing COPD which still had FEV1 < 40 %pred. The group 1 patients were randomized in 2 subgroups: experimental (budesonide 4 mg / day) and control (prednisolone 120 mg / day IV). All of the group 2 patients received oral prednisolone 30 mg / day and were also randomized in experimental (prednisolone + budesonide 4 mg / day) and control (prednisolone + placebo) subgroups. The clinical course and pulmonary function were assessed after 5 days of the treatment. As a result, the efficacy of budesonide in the group 1 was similar to that of IV steroids. The group 2 patients receiving budesonide demonstrated faster clinical improvement and better FEV1 and PEF dynamics as compared to the controls (p < 0.05). Administration of budesonide allowed reducing the duration of the steroid therapy. So, inhaled budesonide can replace systemic steroids in patients with acute severe asthma and good response to the first step therapy. Early addition of budesonide to prednisolone in patients with more severe asthma and COPD allows to reach the asthma control faster and to reduce doses of steroids.
Analysis of efficiency of outpatient antibiotic therapy of respiratory diseases
Authors: Rubanik T. V. , Kroshkina I. Yu. , Shaporova N. L. , Trophimov V. I. , Sergeeva G. R. , Krasnoshekova O. I. , Aleshina O. A.
Published: June 2021

The aim of this study was to analyze the rationality of antibiotics administration and choice in patients with different respiratory diseases referred from outpatient departments to the city diagnostic center № 1 at Saint Petersburg. Two hundred and thirty five outpatient medical histories were analyzed. We revealed cases of unreasonable (in patients with bronchial asthma and exogenous allergic alveolitis) and irrational antibiotic administration (rare administration of inhibitor protected aminopenicillins, cefuroxime axetil, respiratory quinolones; use of aminoglycozides, co trimoxazolе and tetracyclines in therapeutic patients). Elderly and senile age, smoking and post tuberculotic lung pathology provided lingering pneumonia course. Eighteen patients with uncomplicated pneumonia (including lingering variants), exacerbation of chronic bronchitis and bronchiectasis were successfully treated by sparfloxacin.
Analysis of causes of late diagnosis of lung tuberculosis
Authors: Sukhova E. V. , Sukhov V. M.
Published: June 2021

A pilot study was designed to analyze causes of late diagnosis of lung tuberculosis and late start of the specific therapy. Thirty-eight inpatients with proven infiltrative lung tuberculosis were randomly involved in the study; they were city and rural dwellers of different age. A special questionnaire was developed to determine reasons of late diagnosis. An analysis of results obtained has shown that 8 patients, or 21 % were diagnosed at a scheduled large frame photofluorography, 30 % of the late diagnosed patients were not aware of their disease, 25 % of the females and 64 % of the maleswere self-treated. Primary care therapeutists were blamed for the late diagnosis in 33 % of the patients while failed to perform necessary investigations; the delay was 2 to 11 months.
Dyspnea Mechanisms, Assessment and Management: A Consensus Statement
Authors: Editorial Article
Published: June 2021

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System of pro-inflammatory cytokines in patients with chronic obstructive pulmonary disease
Authors: Tsevtkova O. A. , Voronkova O. O.
Published: June 2021

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Future research directions for development of antiasthmatic drugs
Authors: Shilova E. V. , Korolchenko L. V. , Sernov L. N. , Skachilova S. Ya. , Chuchalin A. G.
Published: June 2021

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New approaches to prognosing the course of community-acquired pneumonia in young people
Authors: Lebedeva M. N. , Gavrilov O. V.
Published: June 2021

The article presents an analysis of course of community-acquired pneumonia and features of the vegetative status in 147 young military servicemen. Modern clinical investigation recommended by an academician A.M.Vein was used in the study. A grading of vegetative disorders in various severity of pneumonia has been proposed. A relationship between vegetative reactions and a severity of pneumonia has been demonstrated. Recommendations for practitioners how to predict the course of community-acquired pneumonia and to develop individual therapeutic and reha-bilitation programs for admitted and discharged patients are given regarding to a type of the vegetative reactions.
Efficiency of adaptation to smoking of the respiratory system in medical students under the nicotine-associated risk of chronic obstructive lung disease
Authors: Gnoevykh V. V.
Published: June 2021

Two hundred and twenty-seven healthy medical students were divided into the main (112 smokers) and the control (115 non-smokers) groups. Depending on the risk of COPD occurrence (smoking index > 140) the smokers were divided into the risk-positive (34.5 % of the smokers) and the risk-negative (65.5 %) subgroups. Smoking duration, smoking psychological dependence, need in smoking under an emotional exertion and a habit of nicotine were higher in the risk-positive smokers. The vital capacity, the inspiratory and expiratory reserve volumes, and the peak expiratory flow rate were higher in smokers as a result of adaptation of the respiratory system to smoking, in particular to the negative influence of carbon monoxide. This adaptation is aimed to the SpO2 restoration. But this parameter was lower in smokers, especially in the risk-positive subgroup. Thus, the functional adaptation of the respiratory system to the severe smoking in students with the risk of COPD is failed.
Molecular mechanisms of gas exchange disorders in the lung at the Extreme North
Authors: Velichkovsky B. T.
Published: June 2021

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Inappropriate inhaler use: assessment of use and patient preference of seven inhalation devices
Authors: Lenney J. , Innes J. A. , Crompton G. K.
Published: June 2021

Inefficient inhaler technique is a common problem resulting in decreased disease control and increased inhaler use. The aim of this study was to assess patients' use of different inhaler devices and to ascertain whether patient preference is indicative of ease of use and whether current inhaler use has any influence on either technique or preference. We also wished to define the most appropriate method of selecting an inhaler for a patient, taking into account observed technique and device cost. One hundred patients received instruction, in randomized order, in the use of seven different inhaler devices. After instruction they were graded (using predetermined criteria) in their inhaler technique. After assessment patients were asked which three inhalers they most preferred and which, if any, they currently used. Technique was best using the breath-actuated inhalers; the Easi-Breathe and Autohaler, with 91 % seen to have good technique. The pressurized metered dose inhaler (pMDI) fared poorly, in last position with only 79 % of patients showing good technique, despite being the most commonly prescribed. The Easi-Breathe was by far the most popular device with the patients. The Autohaler came in second position closely followed by the Clickhaler and Accuhaler. The majority of patients (55 %) currently used the pMDI but the pMDI did not score highly for preference or achieve better grades than the other devices. Only 79 % of patients tested could use the pMDI effectively even after expert instruction yet it continues to be commonly prescribed. This has important repercussions for drug delivery and hence disease control. Prescribing a patient's preferred device increases cost but can improve efficiency and therefore be cost effective in the long term. Using an inexpensive device (pMDI) when technique is good and the patient's preferred inhaler device when not is one way to optimize delivery and may even reduce cost.
Efficacy of 6-month therapy with Seretid of chronic obstructive lung disease
Authors: Chernyak B. A. , Trofimenko I. N.
Published: June 2021

The efficacy of salmeterol/fluticasone propionate (S / FP) (Seretid, GlaxoSmithKline) was studied in a randomized open comparative trial in parallel groups. The study involved 36 patients with severe COPD (GOLD, 2003). The 1st group patients (n = 18) received S / FP f 50 / 500 mcg daily using dose-metered aerosol inhaler 25 / 250 mcg and salbutamol (Ventolin, GlaxoSmithKline) if needed for 6 months. The 2nd group patients (n = 18) kept receiving short-acting beta-2-agonists alone (salbutamol, Berotec, Berodual, or Atrovent) in the mode as before the study. The efficacy of the treatment was evaluated with regards to severity of dyspnea and cough, sputum production, FEV1, physical tolerability (6-minute walk test — 6MWT), quality of life (QoL). The QoL was assessed using a Russian version of the St. George's Respiratory Questionnaire (SGRQ). The study showed a high efficacy of S / FP for treatment in severe COPD resulted in significant reduction in the COPD signs and symptoms, bronchial obstruction, exacerbation rate, improvement of the physical tolerability and the QoL when compared both to the baseline parameters and to the control group.
Long-term combined inhaled therapy with ipratropium bromide and ambroxol of heavy smoking patients with chronic obstructive lung disease
Authors: Tatarsky A. R. , Sukhanova E. V. , Bobkov E. V. , Kiryukhin A. B.
Published: June 2021

The study was aimed to investigate the efficiency of long-term combined inhaled therapy with ipratropium bromide and ambroxol via compressor pneumatic nebulizer in 86 COPD patients. Significant improvement in clinical status, physical tolerance and cell content (macrophages, neutrophils) of induced sputum was revealed in all the patients in comparison with a control group. Mild to moderate COPD patients had considerable improvement in FEV1. The authors concluded that the proposed treatment had resulted in the positive effects.
New approach to drug therapy of asthma patients at Samara region
Authors: Mishchenko O. V. , Pavlov V. V. , Kupaev V. I.
Published: June 2021

The aim of the study was to analyze granted drug provision for asthma (BA) patients at Samara region to spend healthcare resources more rationally and to improve asthma patients' quality of life. This population-based study of drug therapy involved 19,697 BA patients surveyed at Samara region in 2003–2004. The analysis was performed using a personified database of the granted drug provision and integral parameters of health. We used multi-factorial statistical analysis with mathematical modelling. The results demonstrated that the healthcare quality for BA patients depends on a structure of the drug therapy. A model of basic anti-asthmatic therapy for Samara region was created using the study results.
Administration of 2 types of inhaled freon-free beclomethasone dipropionate in asthmatic patients
Authors: Belevsky A. S. , Avdeev S. N. , Assadulina R. R. , Denisova T. V. , Korneva L. I. , Peshkova O. A. , Popova Yu. N.
Published: June 2021

The aim of this study was to compare clinical efficiency of Freon-free ultra-fine metered dose aerosol of beclomethasone dipropionate (BDP) (Beclason ECO) and Easy-Breath system (Beclason ECO EB), or an inhaler with larger BDP particles (Beclojet). Methods. The study involved 120 moderate to severe asthma (BA) patients (the average age, 50 yrs; the mean length of the disease, 12 to 13 yrs). More than 75 % of the Beclason and Beclojet group patients have received inhaled steroids when starting the study (the mean doses, 542 ± 308 and 641 ± 379 mcg daily, respectively). The patients have been treated with Beclason ECO 500 mcg daily or Beclojet 1 000 mcg daily (moderate BA), Beclason ECO EB 750 mcg daily or Beclojet 1 500 mcg daily (severe BA) for 12 wks. Results. FEV1 increased by 18 and 20 % in Beclason ECO / Beclason ECO EB group and Beclojet group, correspondingly; FVC increased by the 11 and 21 %, and FEF25–75 grew by 26 and 24 % correspondingly by the end of the study. Daytime symptoms improved by 1.6 and 1.3 scores in the Beclason ECO / Beclason ECO EB patients and Beclojet patients correspondingly and nighttime symptoms improved by 1.0 score in both the groups. The need in beta-2-agonists reduced during the study by 3.1 and 3.4 doses daily correspondingly in the groups. Quality of life improved in both the groups, the difference between the groups was not significant. The inhaled drugs were well-tolerated, rate of unwanted events was low and quite similar in both the groups. Therefore, the freon-free ultra-fine aerosols of BDP (Beclason ECO and Beclason ECO EB) have the comparable clinical efficiency with freon-free non-ultra-fine aerosol (Beclojet) in the dose ratio 2 : 1.
Efficacy of fenspirid (Erespal) in chronic obstructive lung disease
Authors: Shmelev E. I. , Ovcharenko S. I. , Tsoy A. N. , Bezlepko A. V. , Aisanov Z. R. , Shmeleva N. M. , Fedorova T. A. , Chuchalin A. G.
Published: June 2021

The aim of this study was to assess efficacy of the antiinflammatory drug fenspirid (Erespal) in patients with stable COPD. The study was opened, comparative, randomized, multicentre and involved 84 patients with 2 stage stable COPD from 7 Russian medical centres. The patients were randomly divided in 2 groups: the study group (42 patients) received Erespal during 6 months additionally to the standard therapy, the comparative group (42 patients) received the standard therapy only which included ipratropium bromide (Atrovent) 2 doses twice daily and salbutamol as needed. Significant improvement in cough severity (p = 0.004), need in salbutamol (p = 0.023). and FEV1 (p = 0.012) was noted in the Erespal group by the end of the study period. These parameters also improved in the comparative group but with no statistical significance. The exacerbation rate was lower in the Erespal group but the difference was not significant. Quality of life improved in all the parameters in the Erespal group and only in psychical health in the comparative group. Therefore, Erespal allows improving cough severity, need in salbutamol, and quality of life, slowing FEV1 decline. The rate of side effects while using Erespal is similar to the standard therapy. The results show reasonability of basic administration of Erespal in stable 2 stage COPD patients.
Pulmonary vascular thrombosis masked by pneumonia with pleural effusion. Diagnostic problems
Authors: Ovcharenko S. I. , Litvinova I. V. , Zavrazhina I. N. , Koroleva I. M. , Fominykh E. V.
Published: June 2021

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Cytological markers of non-progredient course of respiratory oxalosis
Authors: Pospekhova G. P. , Aleshina L. A. , Voronina O. V. , Vakharlovsky V. G. , Razorenova T. S.
Published: June 2021

Respiratory oxalosis (RO), a special hereditary form of obstructive lung disease accompanied by hyperoxaluria, non-progredient course, absence of allergy and several cytology markers was studied in this comparative prospective study. We have observed 2 groups of non-smoking women (71 patients with RO and 64 patients with asthma accompanied by allergy with progredient course during 5 years). We evaluated the locomotor function of the mononuclear and polynuclear blood phagocytes using the inhibition of lymphocyte migration test as an immunological marker, and the hepatocyte function using AST / ALT ratio as a cytological marker. Their prevalence was the greatest in the 1-st group and constituted 100 % for the immunological marker and 98 % for the cytological one. We assume that function of the mononuclear phagocytes in RO probably results in the non progredient course of the disease. It relates to congenital high threshold of the immunocompetent cell sensitivity to polyclonal mitogens.
Effect of long-term treatment with fenspiride (Erespal) on clinical and functional status of patients with chronic obstructive lung disease
Authors: Visel A. A. , Pronina E. Yu. , Visel I. Yu. , Yunusova M. A.
Published: June 2021

This open comparative randomized study has shown that fenspiride is an effective and well-tolerated drug while being administered in combined therapy of COPD for 3 to 12 months. The anti-inflammatory action of fenspiride 80 mg t. i. d. significantly reduced cough in COPD patients and enhanced the effect of bronchodilators. Fenspiride (Erespal) can be included in standards of combined treatment of patients with mild, moderate and severe COPD.
Antibacterial therapy in patients with bronchial asthma and latent Mycoplasma pneumoniae infection
Authors: Khamitov R. F. , Palmova L. Yu. , Novozhenov V. G.
Published: June 2021

Influence of Mycoplasma pneumoniae (Мр) infection on asthma course and quality of life (QoL) of asthmatic patients was studied. Mp infection was diagnosed using specific immunoglobulins and PCR. The 6-week course of antibacterial therapy with azithromycin (Zitrolidum) was administered followed by analysis of clinical features and QoL. The latter was done using the AQLQ questionnaire with consideration of gender, asthma severity, contamination with and Мp eradication. Negative influence of Мp on clinical course of asthma and QoL was found. Therapy with Zitrolidum led to Мp eradication in 43 % of the cases, clinical improvement and increasing QoL in successfully treated patients. The results allow recommendation of azithromycin as a possible addition to the basic therapy of patients with severe asthma and laboratory signs of Mp infection.
Antiinflammatory drug fenspirid
Authors: Visel A. A. , Visel I. Yu. , Pronina I. Yu.
Published: June 2021

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Systematic mediastinal lymph dissection (SMLD) as a standard of surgical treatment of patients with the I, II and IIIA stage nonsmall cell lung cancer (NSSLC)
Authors: Davydov M. I. , Polotsky B. E. , Allakhverdiev A. K.
Published: June 2021

The reasonability of SMLD in lung carcinoma when compared with resection of enlarged lymph nodes only has been widely discussing in literature. This study was aimed to define the tumour extent and to improve results of surgical treatment of NSSLC applying the "extended" surgical interven tion (with SMLD) as a standard. The study analyzed short term and long term outcomes in 1109 NSSCL patients of 18 to 80 yrs old who were oper ated at the Russian Oncology Scientific Centre in 1980 to 1999. Of the total number of surgical interventions, 417 (37.6 %) were "extended" and 692 (62.4 %) were typical. In the "extended" surgery group, 86 (44.6 %) of the patients had NSSLC stage I, 144 (35.5 %) had the stage II and 87 (20.9 %) had the stage IIIA; in the "typical" group, there were 429 (62 %), 146 (21.1 %) and 117 (16.9 %) patients, respectively. The total survival was significantly higher in the SMLD group (p = 0.03). The 3 year survival and the 5 year survival was 65 % and 55 % after the extended surgery and 54 % and 43 % after the typical surgery, respectively.The tumour relapse in the bronchial stump in 6.2 %, metastases at the mediastinal lymph nodes in 8.7 % and at the supraclavicular lymph nodes in 1.7 % were found in the typical surgery group. These parameters in the extended surgery group were 1.9 %, 3.6 % and 0.9 %, respectively (p < 0.05). Thus, the SMLD technique improves long term results of surgical treatment of NSSLC stages I, II and IIIa. It decreases the rate of local relapses of the tumour and does not increase the rate of post surgery complications and mortality. This type of surgical intervention is thought to be the standard surgical treatment of lung carcinoma and has to be performed in all the patients despite of the tumour size, hystological, clinical and anatomical type and of its location in the lung.
Mortality and morbidity of chronic lung disease and its morphological features in population of Semipalatinsk region
Authors: Sagindikova G. E. , Kogan E. A. , Shakhanov T. E.
Published: June 2021

This work was aimed to study prevalence, morbidity, mortality and morphological features of chronic respiratory pathology (CRP) in population living for a long time at Semipalatinsk region contaminated with radioactive products. We analyzed healthcare reports on prevalence, mortality and morbidity of CRP in population of Semipalatinsk region from 1969 to 2003 and questioned 7 274 residents of Semipalatinsk region using a special ly developed screening questionnaire. The latter considered the radiation related route and clinical status of the person. We have also analysed 631 autopsy reports of died patients with CRP and archive autopsy, biopsy and resected samples from 300 patients with CRP living near the experimental range from their childhood to 2003. The resected and autopsy samples of 22 patients with CRP living at the territories with normal radiation level was the control group. The results showed a tendency to increase in morbidity and mortality of CRP in proportion of the radiation dose and neighbourhood of the living place to the experimental range. The morbidity and mortality of CPR tended to decrease in 1992–2003 when nuclear experiments were stopped. Besides of well known morphological features of CRP we found severe sclerosis of the bronchial walls and interstitial tissue, vascular injuries and haemosiderosis, neuroendocrine cell hyperplasia, dysplasia of bronchial, bronchiolar and alveolar epithelium. These facts suppose the role of radiation as etiological and pathogenic factor of CRP.
Reduction of exacerbations of COPD under long-term administration of N-acetylcysteine
Authors: Avdeev S. N.
Published: June 2021

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Efficacy of α-tocopherol administration in community-acquired pneumonia
Authors: Farkhutdinov F. R.
Published: June 2021

We studied effect of α tocopherol on clinical course and production of reactive oxygen species (ROS) in the whole blood in patients with community acquired pneumonia (CAP). The trial involved 70 patients with CAP. Generation of ROS was studied using the luminol dependent chemilumines cence (LDCL) method. Conventional treatment was given to all the patients. Besides this, 35 patients received α tocopherol. LDCL intensity of the blood was enhanced in all the patients. Treatment with α-tocopherol decreased ROS blood concentration and resulted in positive dynamics of clini cal and laboratory parameters. By contrast, patients on the conventional treatment maintained high LDCL intensity and there was slowly resolved course of inflammation in many cases. So, α tocopherol improved redox status in patients with CAP and increased efficiency of the treatment.
Organizational experience of rehabilitation of asthma children in a modern specialized sanatorium
Authors: Gheppae N. A. , Mokina N. A. , Bityutskaya T. M.
Published: June 2021

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Molecular and genetic mechanisms of eosinophil apoptosis in childhood asthma
Authors: Deev I. A. , Sazonov A. E. , Ogorodova L. M.
Published: June 2021

Expression of mRNA apoptosis effectors, antagonists (bcl-2), prodeath protein (bax) and matrix activity of IL-5 in peripheral blood eosinophils were evaluated in children with asthma before and after therapy. Expression of bcl-2 was not revealed in peripheral blood eosinophils of healthy children, however increased expression of IL-5 gene mRNA and increased bcl-2 activity were found in children with asthma. After the course of basis therapy in asthma children, activity of antiapoptotic effectors of bcl-2 family decreased and mRNA expression of proapoptotic factors increased. These modifications were associated with improvement in asthma symptoms and functional parameters.
Immune and metabolic characteristics of children with recurrent respiratory diseases and efficacy of complex differentiated improving using seleksen and ascorbic acid
Authors: Mizernitsky Yu. L. , Melnikova I. M. , Dorovskaya N. L. , Marushkov V. I.
Published: June 2021

This comparative clinical and immunological trial investigated clinical efficacy of Seleksen combined with ascorbic acid as a part of complex rehabilitation of children with recurrent respiratory diseases in sanatorium pre-school child care settings. We assessed serum levels of IgA, IgG, IgM, IgE, and interleukin-8, leucocyte luminol-induced chemiluminescence, secretory IgA level in saliva, erythrocyte glutathione peroxidase activity, serum superoxide dismutase activity, serum concentrations of malone dialdehyde and diene conjugates. The follow-up period was 12 months. The complex rehabilitation with Seleksen and ascorbic acid led to clear improvement in clinical, immunological, and metabolic parameters. It allows significant reduction in rate of upper and particularly lower respiratory infections in children attending pre-school child care facilities. This therapy was the most effective in children with allergic respiratory diseases and recurrent tracheobronchitis.
Association between polymorphism at the promotor region of NO-synthase gene and bronchial asthma development
Authors: Petrova I. V. , Kozyritskaya D. V. , Kamaltynova E. M. , Ogorodova L. M.
Published: June 2021

The purpose of this work was to study NO-synthase gene polymorphic variants in term of asthma occurrence. Clinical and functional characteristics of asthma with regards to different NO-synthase gene polymorphic variants were analyzed in 250 asthmatic children aged 7 to 14 years under the 12-wk standard basic therapy for asthma. We used the typical spectrum of tests for children with asthma and molecular genetic methods. Polymorphism at the promotor region of the NO-synthase gene was found to be associated with phenotype of pathogenic features of asthma and was an important part of inherited predisposition to asthma.
Impulse oscillometry as a method of diagnosis of early respiratory dysfunction in asthmatic children
Authors: Chernaya N. L. , Fomina O. V. , Ivanova I. V.
Published: June 2021

We have assessed diagnostic value of impulse oscillometry for recognition of early respiratory dysfunction in asthmatic adolescents. There were 242 adolescents aged 10 to 17 under the supervision. Of them, 223 had mild stable asthma and 19 were as controls without respiratory dysfunction. According to clinical features, asthma control level and treatment all the asthmatic adolescents were subdivided into 5 groups. Lung ventilation was examined with MasterScreenBody (Erich Jaeger, Gmbh) MasterIOS including impulse oscillometry and spirometry. The impulse oscillometry can be very helpful in assessment of severity and location of respiratory obstruction in asthmatic adolescent with normal spirometric parameters.
Nitric oxide as a biomarker of allergic inflammation in children
Authors: Tsyplenkova S. E. , Mizernitsky Yu. L.
Published: June 2021

The aim of this study was to analyze clinical importance of exhaled nitric oxide (NOex) measurement for early detection, differential diagnosis and control of treatment of chronic respiratory pathology in children. The study involved 412 children of 5 to 18 years old with different chronic bronchopulmonary diseases. Apart from a typical clinical, laboratory, and instrumental diagnostic methods, NOex was measured in all the children using the chemiluminescent gas analyzer 280i (Sievers, USA). The control group included 30 healthy children aged 5 to 18 with mean NOex 14.8 ± 1.4 ррb (9.2 ÷ 21.4 ррb). The majority of asthmatic children had high NOex (> 20 ppb in 284 (90 %) asthmatic children), р < 0.01, both in stable asthma and exacerbation. The NOex level was directly correlated to the severity and period of the disease (frequency of asthma attacks, time from the last asthma attack, lung function parameters), and blood levels of allergic markers (eosinophils, total IgE, circulating immune complexes, IL-4). Therefore, NOex monitoring was useful in evaluating the efficacy of different treatment modes. In other chronic respiratory diseases, NOex level was also elevated but to lesser degree. In children with primary ciliary dyskinesia, NOex was significantly below the normal level that could be used as a preliminary screening tool. In conclusion, NOex measurement is a reliable and objective method to control allergic inflammation in the airways. It is of great clinical importance and is helpful in differential diagnosis of chronic respiratory diseases and confirmation of the diagnosis. It allows individual choice of therapy, control of the patient's adherence to treatment and prognosis of future exacerbations.
Efficacy of budesonide for prevention of bronchopulmonary dysplasia in premature newborns with different gestation age
Authors: Grebennikov V. A. , Garkusha V. E. , Gheppae N. A.
Published: June 2021

Prematurely born children with severe respiratory distress-syndrome are at risk of bronchopulmonary dysplasia (BPD) development. Treatment of BPD is extremely difficult and sometimes non-effective; therefore, prevention of this disease is an actual problem. Efficacy of budesonide for BPD prevention in comparison to children not treated with this drug has been proven in recent studies but its action differed according to the gestation age and body weight. The present study was aimed to compare efficacy of inhaled budesonide in newborns with various gestation ages. To evaluate the efficacy of the therapy, all the children involved in the study were divided into 2 groups: 18 children with the body weight >1500 g and gestation age of > 31 weeks (the 1st group) and 21 children with the body weight < 1500 g and the gestation age of > 30 weeks (the 2nd group). Budesonide was given via a nebulizer 400 μg b.i.d. for 15 days. We assessed FiO 2 in the gas mixture, maximal pressure within mechanical ventilation, the mean pressure in the airways, index of the lung injury, dynamical extension of the chest — lung system. The systemic haemodynamics, carbohydrate metabolism, length of mechanical ventilation and of oxygen therapy, and number of complications were also evaluated. The study demonstrated that inhaled budesonide as a preventive measure against BPD was the most effective in premature newborns with gestation age of < 30 weeks. This drug has not affected the systemic haemodynamics nor carbohydrate metabolism. As a result, number of pulmonary complications and time of treatment in the ICU were reduced.
Primary ciliary dyskinesia as a genetic pathology
Authors: Bogorad A. E. , Rozinova N. N.
Published: June 2021

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A role of tiotropium bromide in different methods of physical rehabilitation in patients with COPD
Authors: Meshcheryakova N. N. , Belevsky A. S.
Published: June 2021

COPD is characterized not only by pulmonary pathology but also by systemic disorders leading to abrupt reduction in physical tolerance causing a significant decrease in the patients' quality of life (QoL). Training of upper and lower limb muscles along with breathing training, training of respiratory muscles using respiratory training devices and adequate drug therapy can improve physical tolerance of COPD patients. The aim of this work was to compare different methods of physical rehabilitation under the therapy with tiotropium bromide (TB). The study involved 45 patients with severe and very severe COPD (the mean age, 64.5 ±11.0 yrs) randomized into 3 groups: the 1st group patients took inhaled corticosteroids (ICS), short-acting b-agonists and TB, the 2nd group patients were treated with the same medications plus respiratory muscle training with Threshold IMT, PEP, and the 3rd group received the same medications plus skeletal muscle training. The study continued for 3 months and included 3 active visits with testing of lung function (LF) and respiratory muscle strength (Pi, Pe), 6-minute walking test (6-MWT), evaluation of QoL using the SF-36 questionnaire and of dyspnea using MRC scale. As a result, all groups have improved QoL, LF, respiratory muscle strength, and 6-minute walk distance after 3-month treatment. The best values of QoL and 6-MWT were seen in the 3rd group. The greatest improvement for the 2nd group patients was noted in LF and respiratory muscle strength. The 1st group also improved all the parameters. Therefore, we can not exclude the effect of TB on physical tolerance in COPD patients. We conclude that combined application of respiratory and skeletal muscle training and drug therapy including TB is the optimal treatment for COPD patients.
About the possible role of endogenous modulators of β-adrenoreactivity and M-cholinoreactivity in the pathogenesis of asthma
Authors: Tsirkin V. I. , Kononova T. N. , Sizova E. N. , Popova I. V. , Vakhrusheva A. S.
Published: June 2021

Ability of blood sera from 19 asthmatic children and 56 asthmatic adults to modify reactivity of β-adrenoreceptors and M-cholinoreceptors in isolated smooth muscles of the uterus horns from nonpregnant rats (n = 234) and cow trachea (n = 36) have shown that asthma presence did not change serum myocyte-stimulating activity but reduced the sensitizing activity of β-adrenoreceptors and the blocking activity of M-cholinoreceptors and enhanced the blocking activity of β-adrenoreceptors. The similar changes were also seen in child urine and indicated the decreased level of the endogenous sensitizer of β-adrenoreceptors and the growing level of the endogenous blocker of β-adrenoreceptors in asthma patients and the decreased level of endogenous blocker of M-cholinoreceptors in certain asthmatics. These events could provide asthma occurrence.
New abilities of therapy of asthma in outpatient children
Authors: Yakovleva M. G. , Seroklinov V. N. , Suvorova A. V. , Chursin A. A. , Tokareva T. A. , Logvinova T. V. , Ulchenko N. V.
Published: June 2021

Effective, safe and convenient inhalation therapy of asthma is of particular importance in pediatric practice. We performed open randomized comparative trial to evaluate efficacy of ultra-fine Beclazone ECO Ease Breathe (BEEB) vs fluticasone in equal doses in children with asthma. The study involved 40 children (26 males, 14 females) of 6-17 years of age with moderate asthma. They were treated with fluticasone followed by BEEB 250 μg b.i.d. We analyzed clinical findings, frequency and severity of asthma symptoms, peak expiratory flow rate (PEFR), medications used for asthma, lung function parameters. After 2 months of treatment with BEEB, the full control of asthma has been achieved in 11 patients (27.5 %) vs 9 patients treated with fluticasone (22.5 %). The good control was achieved in 27 (67.5 %) and 28 (70 %) patients, respectively. The asthma control was poor in 2 patients with BEEB (5 %) and 3 patients with fluticasone (7.5 %). Moderate improvement in mean FEV 1 and PEFR and reduction of their postbronchodilator growth were noted. All the children easily acquired the proper inhalation technique for BEEB. After 2 months of treatment, 39 of 40 patients have wished to continue therapy with this inhaler. There were no adverse events of the drug. There were no additional expenses for asthma and need of hospitalization or other medical care during the study. Therefore, BEEB as the basic therapy of childhood moderate asthma improves asthma control and compliance of the patient and the physician, and significantly decreases the cost of treatment.
Particularities of lung tumour angiogenesis and stroma formation in inhabitants from radionuclide-contaminated territories at Semipalatinsk region, Kazakhstan
Authors: Sagindikova G. E. , Kogan E. A. , Satbaeva E. B.
Published: June 2021

The aim of this study was to investigate particularities of angiogenesis and stroma formation in various histological types of lung carcinoma in inhabitants from radionuclide-contaminated territories at Semipalatinsk region, Kazakhstan. We used operational and biopsy material from 87 lung carcinoma patients. Of them, 33 patients (the 1st group) lived in the neighbourhood of Semipalatinsk testing area from their childhood to 2002 and were exposed to radiation for a long time (the mean year radiation dose exceeded 0.1 rem). Operational and biopsy material from 54 patients living at Kazakhstan territories with normal radiation level (14 patients) or in Moscow (40 patients) were as controls (the 2nd group). Immunohistochemical methods were used to detect ММР-1, ММР-2, ММР-9, TIMP-1, VEGF, CD34, chromogranin, and CD68. Expression of ММР-1, ММР-2, ММР-9 in tumour cells was enhanced in the 1st group compared to the controls. Angiogenesis in tumour stroma of Semipalatinsk patients was more significant compared to the controls with regard to VEGF expression and density of newly formed vessels. We proposed that the mentioned above factors could provide poor prognosis of lung carcinoma in inhabitants of radionuclide-contaminated territories.
Substantiation and approaches to rehabilitation of patients with chronic respiratory diseases
Authors: Ayrapetova N. S. , Rassulova M. A. , Razumov A. N.
Published: June 2021

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Nebulized therapy with suspension of budesonide in exacerbations of asthma and chronic obstructive pulmonary disease
Authors: Avdeev S. N.
Published: June 2021

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Current problems of lung tuberculosis detection
Authors: Pryimak A. A. , Butylchenko O. V.
Published: June 2021

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Effect of surfactant on clinical course of slowly resolving pneumonia
Authors: Provotorov V. M. , Velikaya O. V.
Published: June 2021

The aim of the study was to evaluate efficacy of surfactant treatment in patients with a slowly resolving pneumonia. Fifty patients with slowly resolving pneumonia were randomized into 2 groups. The studyt group patients (n = 10) received nebulised natural surfactant. The control group patients (n = 40) were treated without surfactant. Clinical and immunological methods were used in all patients at admission and in 2 weeks. There were no adverse effects of surfactant in our trial. In 14 days, lung function parameters improved significantly in the study group compared to the baseline and to the controls. The 6-min walk distance also increased greater in the study group. Significant increase in T-lymphocytes number, phagocyte number and phagocytic index was seen in the study group patients compared to the controls. Therefore, efficacy of this complex therapy of slowly resolving pneumonia was higher than in patients not receiving surfactant.
Epidemiology of COPD: state of the art of an actual problem
Authors: Sinopalnikov A. I. , Vorobiev A. V.
Published: June 2021

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Telemedicine in pulmonology
Authors: Tarasenko I. Yu.
Published: June 2021

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GINA 2006: asthma control as the main goal of treatment and criterion of efficacy of the therapy
Authors: Ogorodova L. M. , Deev I. A. , Selivanova P. A.
Published: June 2021

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Antioxidant therapy of chronic obstructive pulmonary disease at the Far North
Authors: Mironova G. E. , Vasiliev E. P. , Velichkovsky B. T.
Published: June 2021

The aim of this study was to investigate human antioxidant defense at various COPD stages and to substantiate administration of vitamins C and E as a part of complex treatment of COPD at the Far North. We followed-up 92 COPD patients aged 20 to 50 yrs (of them, 42 males). The control group consisted of 58 healthy persons of 20 to 45 yrs of age. A total blood antioxidant activity (TAA) was detected using G.I.Klebanov's method. Superoxide dismutase (SOD) and catalase levels in erythrocyte membrane were assessed with chemiluminescent methods. Lipid peroxide (LPO) activity was measured by malone dialdehyde (MDA) plasma concentration. We also investigated hepatic and renal functions, protein, lipoid, and carbohydrate metabolism. Patients with exacerbation of stage II COPD had increased LPO activity (2.97 ± 0.12 nmol/ml compared to 1.86 ± 0.09 nmol/ml in stable phase and 1.36 ± 0.06 nmol/ml in controls) with TAA increased by 40 %. The stage III COPD patients demonstrated more significant growth of LPO activity (2.04 ± 0.08 nmol/ml in stable phase and 3.44 ± 0.15 nmol/ml in exacerbation; p < 0.05) accompanied by less prominent increase in TAA. Early stages of COPD were characterized by increased levels of antioxidant enzymes (2.44 ± 0.06 μg/g of Hb for SOD and 8.30 ± 0.15 –g/g of Hb for catalase compared to 1.56 ± 0.02 and 7.36 ± 0.10 μg/g Hb in controls). At the later COPD stages, the SOD level was less high and catalase concentration even decreased. COPD patients had increased concentrations of oxyproline (1.76 ± 0.48 g/ml to 2.80 ± 0.50 μg/ml; р<0.05 for both when compared to the controls) and α1-antitripsin (for stage II COPD, 284 ± 47 μg/ml in stable phase and 240 ± 20 μg/ml in exacerbation, for stage III COPD, 245 ± 18 μg/ml and 223 ± 15 μg/ml, respectively). Administration of vitamins C and E 25 mg/kg and 5 mg/kg of body weight, respectively, as a part of a complex therapy of the disease exacerbation resulted in shortening of exacerbation, improvement in clinical status and lung function, TAA activation, and lowering of LPO activity. Therefore, COPD is accompanied by significant activation of oxidantive processes, which depend on the stage and phase of the disease. The results allow including antioxidant vitamins in programs of treatment of COPD to be recommended.
Chronic renal ischemia as a cause of pleural effusion
Authors: Akopov A. L. , Semenov D. V. , Karev A. V. , Philippov D. I. , Trubkin V. E.
Published: June 2021

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Comparative characterization of Doppler echocardiography for detection of diastolic function in asthma patients
Authors: Baranov V. L. , Kharitonov M. A. , Khrustaleva M. I.
Published: June 2021

Diastolic dysfunction of both right and left heart could not be diagnosed using usual Doppler echocardiography in early#stage bronchial asthma. Recently a new more sensitive method of tissue Doppler echocardiography is available which allows detection of right and left heart diastolic dysfunction in mild asthma patients whereas spectral Doppler echocardiography reveals these disorders in moderate and severe asthma.
Prevalence of adult asthma at Tomsk
Authors: Balaganskaya M. A. , Volkova L. I. , Polsha N. G. , Chigan A. V. , Tszin N. V. , Baranovskaya S. V.
Published: June 2021

The aim of this study was to estimate prevalence of asthma in adults at industrial city Tomsk. A total of 2000 responders aged 18 to 75 yrs participated in the study. Prevalence of asthma-like symptoms was estimated using the standardized questionnaire ECRHS. Two hundred patients with asthma-like symptoms underwent clinical, functional, and allergological examination. Asthma-like symptoms were revealed in 37.8 % of the studied population. Prevalence of asthma was 9.8 %. These findings significantly exceed official data. Asthma was newly diagnosed in 60 % of symptomatic adults that is evidence of late detection of the disease.
Clinical and functional cardiovascular disorders in patients with chronic obstructive pulmonary disease and chronic heart failure
Authors: Shoikhet Ya. N. , Klester E. B.
Published: June 2021

The study was aimed to investigate clinical and functional particularities of cardiovascular system in patients with COPD and chronic heart failure (CHF). We examined 1737 patients, of them, 498 with COPD (the 1st group), 721 with COPD and concomitant class I to III stable angina (the 2nd group), and 519 with class I to III stable angina (the 3rd group). All the patients also had CHF. The study included clinical assessment using modified R. Cody's scale, ECG, Holter monitoring, lung function testing, Doppler echocardiography, 6-minute walk test (6MWT). Obstructive disorders were found in 424 of the 2nd group patients (58.8 %) and 268 of the 3rd group patients (51.7 %). Number of patients with class II to IV chronic cor pulmonale was similar in all groups. The class III was determined more often in the 2nd group (36.5 %; р < 0.05), the class I prevailed in the 1st group (17.8 %; р < 0.05). The stage I CHF predominated in the 1st group (31.9 %; р < 0.05), the stages IIА and IIБ were seen mainly in the 2nd group (51.6 % and 26.4 % respectively; р < 0.05). The majority of the 3rd group patients (57.3 %) had the stage IIA CHF. According to most clinical signs, CHF was more severe in the 2nd group. 6MWT was 308.08 ± 6.03 m in the 1st group, 156.4 ± 4.38 m in the 2nd group, and 212.8 ± 5.65 m in the 3rd group (р < 0.05). Low left ventricular (LV) ejection fraction was seen significantly more often in COPD patients with concomitant angina. This group as well as COPD patients had significantly higher mean pulmonary artery pressure (mPAP) (24.7 ± 0.41 mm Hg and 29.9 ± 0.27 mm Hg respectively) compared to 21.7 ± 0.07 mm Hg in the 3rd group patients. Right ventricular (RV) diastolic dysfunction was revealed in 154 patients of the 1st group (83.7 %), 194 patients of the 2nd group (91.9 %) and 72 patients of the 3rd group (43.1 %). In conclusion, all the patients had RV and LV remodeling signs. COPD patients had more prominent RV hypertrophy and dilation, angina patients had enlargement of left heart and moderate decrease in LV contractility. The patients with COPD and angina had the greatest increase in size and wall thickness of both LV and RV and low pump function of LV.
Occupational chronic bronchitis: the role of polymorphic variants of antioxidant enzyme genes for susceptibility to the disease
Authors: Akhmadishina L. Z. , Korytina G. F. , Kochetova O. V. , Mingazova S. R. , Bakirov A. B. , Viktorova T. V.
Published: June 2021

Distributions of alleles and genotypes of GSTP1Ile105Val and Ala114Val, CAT С(-262)T and C1167T, NQO1 C609T and C465T, GPX1Pro197Leu, GSTM1, GSTT1 polymorphic loci have been studied in patients with occupational chronic bronchitis and in healthy workers. No statistically significant difference was determined in distribution of alleles and genotypes of GSTP1 Ala114Val, CAT С(-262)T and C1167T, NQO1 C609T, GPX1Pro197Leu, GSTM1, GSTT1 polymorphisms between these groups. Polymorphic marker NQO1 C465T was associated with higher risk of occupational chronic bronchitis (OR = 3.68; CI 95 %: 1.68-8.31) suggesting involvement of this gene in development of this pathology.
Clinical features and therapeutic efficacy in patients with pulmonary multidrug-resistant cavitary tuberculosis at Russian penitentiary system
Authors: Kononets A. S. , Safonova S. G. , Sidorova S. V. , Khoroshilova N. E. , Golubeva L. I. , Mishin V. Yu.
Published: June 2021

The aim of this study was to analyze the course of the disease and efficacy of treatment of pulmonary multidrugresistant (MDR) cavitary tubercu losis in antituberculosis settings of Russian penitentiary system. Drug resistant was studied using the method of absolute concentrations. Among 190 males with MBTpositive cavitary pulmonary tuberculosis followedup in antituberculosis hospitals of Russian penitentiary system in Voronezh in 2003–2006, 79 patients (41.6 ± 3.4 %) were yielded MDR strains resistant to the firstline antimucobacterial drugs and 111 patients (58,4 ± 3,4 %) had strains resistant both to the firstline and the secondline drugs (isoniazid and rifampicin). Moreover, MBT strains resistant to cycloserine and quinolones were found in patients who have not been previously treated with these drugs. Both newly diagnosed patients with pulmonary tubercu losis and those with recurrent cavitary pulmonary tuberculosis had a high rate of primary and secondary MDR to the firstline and the secondline antimicobacterial drugs. Administration of I and IIA chemotherapeutic regimens in these patients resulted in occurrence of additional resistance to a wide spectrum of the firstline and the secondline antibiotics. Patients with chronic pulmonary tuberculosis are at high risk of MDR to combi nations of the firstline and the secondline drugs and need other treatment strategies including surgical interventions. Tuberculosis patients with MDR to combinations of the firstline and the secondline drugs were characterized by more severe chronic course of the disease with extended lesions and large cavities in the lungs. Adverse events to the secondline drugs were seen in 42.6 % of the patients with cavitary tuberculosis. Of them, serious adverse events requiring cancellation of the drug and change in chemotherapeutic regimen were noted in 17.9 % of cases.
Choice of pharmacotherapy in severe asthma
Authors: Petrovsky F. I. , Ogorodova L. M.
Published: June 2021

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