A comparative randomised trial of fenspirid (Erespal) had been administered for 3 months together with bronchodilating and mycolytic drugs involved 45 patients with chronic obstructive pulmonary disease (COPD). Clinical status, forced expiratory values and quality of life (QoL) were studied using World Organization of Health questionnaire (W H O Q O L -100). Thirty four patients completed the examination (24 males and 10 females, the average age was 52.7±1.9 yrs). The comparative group included 25 healthy non-smokers. The trial demonstrated that the therapy resulted in improvement of QoL in physical and psychical health scales. The patients becam e more active, their sleep becam e better. Their attention was transferred from their physical status to the surroundings. The application of fenspirid (Erespal) facilitated the improvement in the forced expiratory values and ESR. The drug was well tolerated and caused only mild adverse effects which rates were equal to those in patients not received fenspirid. The results permit fenspirid to be included to modern treatment protocols for patients with mild to moderate COPD when combined with bronchodilators.

The aim of this study was to evaluate a role of different demographic factors and asthma symptoms on quality of life In asthmatic patients. This wide-spread population-based study included 2100 adults aged 18 to 74 years from 22 regions of Russia (1050 patients with well-controlled asthma and 1050 patients with poorcontrolled asthma).

Influence of demographic factors (age and gender of a patient, occupation, education level, employment, family status, number of family members, personal Income, smoking history) and features of asthma course (duration and severity of the disease, need in bronchodilators, nighttime asthma symptoms, asthma control, current therapy) was estimated. A Russian analogue of general questionnaire MOS — SF36 and a Russian version of the specific Asthma Quality of Life Questionnaire (AQLQ) were used in this study.

The independent factors influencing on the quality of life in asthma patients were established. The most Important factors were the disease control and nighttime asthma symptoms. Current therapy of asthma Influenced on the quality of life controversially. Combined therapy with Inhaled corticosteroids and long-acting p-agonists provided the most improvement In the quality of life.

Combined administration of long-acting [32-agonists and inhaled glucocorticosteroids is a modern standard of long-term therapy for bronchial asthma (BA). From this point of view combined drugs such as Symbicort (budesonide+formoterol) appear to be the most perspective. The aim of this study was to assess clinical efficacy of Symbicort compared with usual therapy given to BA patients in Moscow policlinics.

Methods: this multi-center comparative trial with retrospective control involved 329 BA patients aged 10 to 75 years observed in 53 policlinics of Moscow and Moscow region. The patients received Symbicort 320/9 to 640/18 meg daily. The efficacy of the treatment was evaluated by peak expiratory flow rate (PEF), control for the disease signs (using the ACQ scale), seeking for medical care and quality of life.

Conclusion: Symbicort allows to reduce the symptom s intensity, better control the disease, to increase PEF values, to decrease the need of bronchodilators and to improve the quality of life in patients with stable BA of various severity compared with usual BA treatment. According to the results Symbicort is more effective than the usual therapy generally given to BA adults and children in Moscow.

The opened multi-center IV phase trial investigated clinical efficacy, tolerability and safety of levofloxacin in 1972 patients with com m unity-acquired respiratory infections (pneumonia, exacerbation of chronic bronchitis, acute and chronic sinusitis). The drug belongs to new "respiratory" quinolones having enhanced anti-pneumococcal activity. The trial involved 1011 males and 961 females aged 16 to 99 yrs (43.0±14.6 in average). Levofloxacin was given in the daily dose of 250 to 1000 mg (500 mg in 91% of the patients) and in most of them (in 93%) orally. The duration of the treatment was 5 to 12 days (7.0+1.8 days in average). Under the therapy with levofloxacin most of the patients demonstrated rapid improvement of main symptom s. The clinical efficacy was 94.2%; there was no effect in 107 (5.4% ) of the patients. The highest clinical efficacy of levofloxacin was noted in acute sinusitis (99% ), it was quite similar in other infectious diseases (92 to 93%). Adverse effects were found in 34 (1.7% ) of the patients but only 2 (0.1% ) cases required withdrawal of the drug. Digestive symptom s were the most frequent. Therefore, the results showed the high efficacy and safety of levofloxacin in com m unity-acquired respiratory infections at outpatient and inpatient facilities.

Efficacy of Zl-factor (azythromycln) ("Veropharm", Russia) was examined in 20 children with chronic bronchitis against the background of congenital lung malformations (13 patients), focal pneumosclerosis (6 patients), hypogammaglobulinemia (1 patient). The patients' age was 6 to 17 years. The drug was administered for exacerbations of the respiratory diseases. Sputum cultures yielded Haemophilus influenzae (66.7%), Streptococcus pneumoniae (25.6%) and Moraxella catarrhatis (7.7%). Zi-factor was given orally 500 mg once a day fo r the 1st day, then 250 mg once a day for the following 4 to 14 days depending on the character and severity of the disease. A positive clinical changes was obtained in all the patients and elimination of the microbial agents was found in 5 patients (from 5 ones examined over time). Adverse effects were not found.

A choice of therapy tactics and performing of specific allergy vaccination in atopic patients are greatly depended on a patient's motivation which is a conscious desire to keep preventing and therapeutic requirements. Thirty-year experience of the specific allergy vaccination in the Saratov allergological center demonstrates a significant activation of a patient’s role in the treatment and a transfer of medical practice from the paternalistic model, when a doctor has an exclusive right to decide a patient's future, to social-and-ethic partnership based on a patient's awareness of potential benefit and risk of treatment. Such decision for 98.4% of the patients is based on a positive motivation to reach future benefit of he treatment. Orientation to health without drugs and good results of the first therapy course predominate over social, occupational, emotional factors of the patients while being treated with specific allergy vaccination.

Genetic lesions of somatic cells (lymphocytes, erythrocytes, leukocytes, cheek epithelium cells) and biollquids (blood plasma) in patients with various severity of atopic bronchial asthma and healthy children were studied using methods of chromosom e aberration account in blood lymphocytes, analysis of micronuclei in blood erythrocytes and epithelial cells of the cheek internal surface, sedimentation velocity analysis of the leukocyte DNA integrity, chromosom e aberration account in seeds of Crepis ca pillaris. Levels of lymphocyte chromosom e aberrations and m icronuclei in the erythrocytes and the cheek epithelium cells were higher in the asthmatic children than in healthy ones. Amount of the leukocyte DNA breaks in bronchial asthma children was also more than in healthy.

Experiments with the blood plasma of the asthmatic and non-asthmatic children revealed a tendency to increase a clastogenic activity as the plasma concentrations grew (50 and 100%). The plasma clastogenic activity in 25% of both the groups was not found. So, the metabolic disorders in asthmatic children were accompanied by occurrence of clastogenic factors in the cells and intercellular environment, decreasing in influence of antimutagenic systems and in elimination of aberrant cells.

This work is devoted to population spectrum of lymphocytes and oxlgen-dependent metabolism of neutrophils in 140 moderate persisting asthma patients of young, middle and old ages. Markers of persisting inflammation such as increased levels of immunoglobulin E and circulating immune complexes, considerable activation of spontaneous and induced NST-test, increased in elderly, various shifts In lymphocyte populations and subpopulations were revealed in all the groups. These features require additional attention of a doctor and special therapeutic measures.