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PULMONOLOGIYA

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No 5 (2005)
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https://doi.org/10.18093/0869-0189-2005-0-5

EDITORIAL

CLINICAL GUIDELINES

LECTIONS

ORIGINAL STUDIES

75-79 719
Abstract

Investigation of inflammatory markers in the exhaled breath condensate (EBC) is a non-invasive method for evaluation and monitoring of bronchopulmonary inflammation. Endogenous oxidative processes in the airways can be evaluated by pH measurement in the EBC. We examined 153 healthy volunteers (of them, 51 smokers) and 615 patients with lung pathology (of them, 131 asthma (BA) patients, 205 COPD patients, 43 patients with bronchiectasis, 72 patients with idiopathic lung fibrosis (ILF), 142 pneumonia patients, and 42 cystic fibrosis patients). EBC was collected with ECoScreen equipment (Erich Jaeger, Germany) using a standardized method. The EBC pH was measured using the f32 PH-meter (Beckman, USA) with a glass microelectrode. The average ECB pH was 6.16 ± 0.52 in BA, 6.35 ± 0.56 in COPD, 6.13 ± 0.46 in bronchiectasis, 5.98 ± 0.30 in ILF, 5.96 ± 0.37 in pneumonia, and 6.35 ± 0.23 in cystic fibrosis. It was significantly lower than in the healthy volunteers (6.97 ± 0.31, р < 0.0001). In patients with exacerbation of BA and COPD ECB pH was considerably lower compared with those in stable condition. A reliable growth of pH was noted in pneumonia patients after treatment of the disease. There was a correlation between ECB pH and severity of fibrotic and inflammatory disorders of lung tissue according to HRCT (r = –0.62, p = 0.01), lung diffusing capacity (r = 0.51, p = 0.01), Tiffeneau index (r = 0.68, p = 0.004) in ILF. Therefore, the ECB pH is a distinct marker of the airway inflammatory severity in lung pathology. The ECB pH monitoring can assess the inflammatory activity and efficacy of anti-inflammatory therapy in lung diseases.

80-86 367
Abstract

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.

87-92 332
Abstract

The aim of the study was to assess efficacy and safety of 24-month treatment with Seretide (salmeterol / fluticasone propionate, 100 / 1 000 mcg daily) or Flixotide (fluticasone propionate, 1 000 mcg daily) in 105 steroid-dependent asthma patients aged 18 to 60 yrs who had received oral steroids for at least 6 months but not longer than 10 years.
Methods. The study was comparative, randomized, multicentre, open in parallel groups (15 visits with 2-week intervals). Reduction of oral steroid doses started at the 3-rd visit.
Results. In spite of the continual treatment with oral steroids patients did not reach asthma control. After 6-month therapy with fluticasone propionate or salmeterol / fluticasone propionate the maintaining dose of prednisolone was 6 times lower in comparison with baseline. Moreover, oral steroids were abolished in each second patient receiving Seretide and each third patient receiving Flixotide. The asthma control and quality of life significantly increased.
Conclusion. The therapy with fluticasone propionate or salmeterol / fluticasone propionate allows to reduce doses of oral steroids and to cease oral steroids in most causes. Moreover, the patients can maintain good asthma control.

93-101 279
Abstract

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.

102-106 443
Abstract

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.

108-113 210
Abstract

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.

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)