A role of epidemiological studies in pulmonology.

The objective of this study was to analyze risk factors of death in patients with community-acquired pneumonia (CAP). This was a retrospective analysis of medical records of 62 patients dead from CAP within a year in hospitals at Kazan city. We described clinical course of CAP leading to a patient's death. Predictors of fatal outcome of CAP were social status, delayed admission to a hospital, smoking history, alcohol abuse, mental and nutritive disorders, bilateral lung injury, pleural effusion, respiratory failure and haemodynamic instability.

Chronic obstructive pulmonary disease (COPD) is frequently complicated by secondary pulmonary hypertension and development of chronic cor pulmonale. Serum concentrations of IL-17, IL-18 and TNF-a were investigated in patients with stable COPD of different stages. A statistically significant increase in serum cytokine concentrations was found in COPD patients in comparison to healthy individuals. Moreover, significant direct correlations were found between serum cytokine concentrations, on the one hand, and the mean pulmonary artery pressure and the right heart dimensions, on the other hand. The results of the study suggest a possible role of IL-17, IL-18 and TNF-a in the pathogenesis of COPD, pulmonary hypertension and chronic cor pulmonale.

We investigated effects of peptide therapy on the lung tissue remodeling in a rat model of chronic obstructive pulmonary disease (COPD) using histological, morphometric and immunohistochemical methods. The rats were exposed to nitrogen dioxide during 60 days. One-month course of peptide therapy has led to reduction in hyperplasia and muscle hypertrophy, recover of bronchial epithelium squamous metaplasia, and decrease in
T- and B-lymphocyte number. In treated rats, foci of alveolar hyperextension and irregular emphysema, that were typical for untreated animals with COPD, were small and found only in subpleural areas. There results suggest therapeutic influence of low molecular peptides on the lung disease related to toxic inhalation.

The aim of the study was to examine efficacy of atorvastatin plus amlodipine combination in patients with chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MS) as a comorbidity. The study involved 32 patients with COPD and MS and 20 patients without MS. We measured blood concentrations of lipids, C – reactive protein (CRP), leptin and tumor necrosis factor-a (TNF-a). In 6 months, patients with COPD and MS decreased body mass index, fat mass percentage, blood pressure, and blood concentrations of triglycerides, low density and very low density cholesterol, CRP, TNF-a, and leptin. Therefore, atorvastatin plus amlodipine combination improved lipid metabolism and the patients' physical tolerance and reduced inflammation.

The aim of study was to investigate incidence of chronic obstructive pulmonary disease (COPD) among young people. We examined 1,389 persons (683 men and 706 women, mean age was 30.97 ± 7.3 years and 29.11 ± 9.1 years, respectively) using a questionnaire (demographic data, smoking history, respiratory symptoms) and spirography. COPD was diagnosed in 0.5 % of the responders, of them, GOLD I was detected in 57.1 %, GOLD II in 42.9 %; 74.1 % of the participants were smokers.

Cytokine profile in bronchoalveolar lavage fluid (BALF) and blood serum was investigated in 80 patients with newly diagnosed sarcoidosis. Of them, 42 patients were treated with prednisolone and 38 patients were treated with fenspirid (Eurespal). BALF interleukin (IL) concentration was higher than serum IL concentration that could reflect a local immune response. To the 6th month of the therapy, significant blood levels of IL-2, IL-4 and IL-5 in prednisolone-treated patients were found compared to fenspirid-treated patients that could indicate an increased immune Tx-2 activity that, in turn, could facilitate development of prednisolone adverse effects. Treatment with fenspirid during 6 months has led to increased production of IL-10 that was 2.5-fold higher compared to IL-10 level in prednisolone-treated patients. The results suggest more effective inhibition of excessive immune inflammation in prednisolone-treated patients.

Genotypic and phenotypic features of patients over 18 years of age with late-onset unclassical cystic fibrosis have been analyzed in this article. The patients had relatively mild disease without significant exocrine pancreatic insufficiency.

This study was aimed at description of CF phenotypes in adult patients carrying 3849+10kbC>T mutation. This mutation was shown to cause "mild" phenotype leading to late diagnosis, absence or late development of pancreatic insufficiency, and digestive disorders. Patients with 3849+10kbC>T/F508del genotype had better survival compared to patients with F508del/F508del genotype. Some patients carrying 3849+10kbC>T mutation had negative or borderline sweat test results.

Analysis of gender difference in presentation of newly diagnosed infiltrative pulmonary tuberculosis included data of 252 males and 147 females and showed that females develop the disease more frequently in childbearing age (20 to 29 years) and have more frequent contacts with TB patients. The ways to diagnose the disease, clinical manifestations, irregular fluorographic examination, and delayed seeking the aid were not related to gender. Despite more localized lung injury in females the frequency of positive culture was similar in females and males but multidrug resistance of M. tuberculosis was registered 1.6-fold more often in females. This could indicate higher risk of TB transmission from a woman with pulmonary TB to children owing to their close contact.