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PULMONOLOGIYA

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No 4 (2004)
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https://doi.org/10.18093/0869-0189-2004-0-4

EDITORIAL

ORIGINAL STUDIES

10-15 151
Abstract

An attempt was made to discover pathogenic links between gene polymorphism of interleukin-4 which is "the critical inflammatory cytokine", atopic features, respiratory function and bronchial hyperresponsiveness (BHR) in 70 families of atopic asthma patients. Spirometry, methacholine challenge test ("MasterLab pro"), serum total IgE level, serum IL-4 level (by the ELISA method), skin prick tests ("Immuno Tek"), IL-4 (-589C /T, G /C З'-utr) and IL-4RA (lleSOVal, Glu551Arg) genes polymorphism were investigated in 70 probands (11.6 ± 1.2 yrs) and 247 relatives (36.7 ± 1.2 yrs) from Tomsk region (Siberia). Significant associations of certain variants of polymorphous IL-4 and IL-4RA genes with bronchial airflow param eters (FEVt), atopic features (increased IgE level), and bronchial asthma severity were found. Patients with persistent mild, moderate, and severe asthma had their proper variations of polymorphism. The methacholine challenge test was an objective marker of BHR in this study but any associations between BHR and IL-4 and IL-4RA polymorphous variants were not found.

16-21 364
Abstract

One hundred patients (36 males, 64 fem ales, the average age 44.6 ± 1.2 yrs) were divided into 3 groups depending on their co-existing somatic or psychical pathology. The 1-st group consisted of 40 patients with hyperventilation syndrome (HVS) and bronchial asthma (15 males, 25 fem ales, the average age 44.3 ± 1.2 yrs). The 2-nd group included 39 patients with HVS and arterial hypertension (8 males, 31 fem ales, the average age 49.4 ± 2.1 yrs). The 3-rd group included 21 patients (7 males, 14 fem ales, the average age 36.6 ± 2.3 yrs) with HVS and panic disorders. Differences were found between the groups regarding clinical manifestations of HVS due to different lung functional status. HVS was characterized as "brittle breath" in the '1 -s t group patients with bronchial obstruction, as "heavy breath" in the 2-nd group patients with restrictive disorders, and as "empty breath" in the 3-rd group patients with high airflow values. We discuss a role of mesenchym al dysplasia in the occurrence of such breathing patterns.

21-24 708
Abstract

We examined 36 asthma patients having the ileocecal valve failure diagnosed during the irrigoscopy. Some clinical features of this co -morbidity were noted. Examination of the proximal gastrointestinal parts with endoscopy, probe duodenography and manometry revealed predominance of chronic duodenal obstruction and gasrtoesophageal reflux. High prevalence of small and large intestine dysbacteriosis and endogenous intoxication due to this was found. These changes allow to consider the ileocecal valve failure as a factor of asthma pathogenesis.

24-27 196
Abstract

A course of neuroregulatory therapy constituting artificial stable functional links (ASFS-II) was held in 29 patients with bronchial asthma. It was shown that the optimal photostimulation frequencies lay in a range of 45 to 50 Hz. Greater efficiency of a matrix with doxepin versus mianserin was established. Positive clinical dynamics during the neuroregulatory therapy was accompanied by significant changes in psychological and neuroendocrine status and also in pulmonary function parameters.

28-32 225
Abstract

The aim of the study was to establish peculiarities of regulatory effects of exogenous cyclic AMP (ex-cAMP) on membrane-receptor erythrocyte com plex in bronchial asthma (BA). Healthy controls, patients with atopic and non-atopic BA were examined. BA patients taking oral glucocorticoides were included in a separate group. The intercellular cooperation (erythrocyte aggregation influenced by the ex-cAMP, the patent № 2058551) was used as a model. An effect of the ex-cAMP in atopic BA — inhibition of the erythrocyte aggregation — was analogous to those in healthy. The non-atopic BA patients showed the inverse effect which was acceleration of the erythrocyte aggregation. The data are discussed in term of membrane-receptor disturbances in BA, in particular of the regulatory effect of ex-cAMP on the membrane-receptor erythrocyte com plex bypassing the β adrenoreceptors in atopic BA.

33-37 196
Abstract

The mean pulmonary artery pressure using Doppler echocardiography and lung function were studied in 131 bronchial asthma patients. Nifedipine, phenoterol and ipratropium bromide in acute tests effectively decreased the pulmonary artery pressure. Two-week treatment with nebulized ipratropium bromide and phenoterol also decreased the pulmonary artery pressure and improved the lung function parameters. The influence of the drugs on the mean pulmonary artery pressure in the asthma patients depended on a portion of the residual volume in the total lung capacity and the peak expiratory flow rate.

37-43 250
Abstract

The aim of this pharmacoepidemiological study was to assess direct medical expenditure in bronchial asthma patients of Tomsk region. This study involved 394 patients with different severity of asthma. The main marker of efficacy was asthma control levels according to E.Bateman’s criteria. Results dem onstrated that majority of the patients (86.1 %) had not achieved the asthma control with E. Bateman's criteria. Structures of direct medical expenses w ere different in patients with controlled and uncontrolled asthma. Personal expenditure for basic therapy predominated in patients with controlled asthma and state expenditure for expensive medical care (emergency, hospitalization) prevailed in patients with uncontrolled asthma. The most effective asthma treatment program was a com bination of adéquate basic therapy and regular specialized consultations.

44-47 537
Abstract

The work presents results of examination of 60 bronchial asthma (BA) patients. The uric acid (UA) blood concentration and its daily excretion were defined using the Zeyfirt-Muller method; lung function was tested using the "Spiroscop" device (Hungary). The researches revealed a close correlation between blood concentrations of the urinary acid and bronchial airflow rate; while the bronchial size reducing the correlation increased. This dependence allows to suppose a metabolic mechanism of BA development. Advantages of modified (low -purine diet and herbal mixture "Bronchodil") therapy were also noted in comparison with the typical basic therapy of BA. So, based on these data the purine metabolism is thought to have a pathogenic role in BA occurrence.

47-52 202
Abstract

A comparative investigation of structural lipids in blood cells and low and high density lipoproteins was done in blood samples of 88 patients with different types of bronchial asthma and in 40 donors. Modifications of phospholipid spectrum were determined in the blood cells and the lipoproteins of asthma patients. The abnormality was expressed as a change in ratio between individual phospholipids which was connected with a significant deficiency of the main membrane phospholipid phosphathidylcholine and with increased level of its lysoform lysophosphathidylcholin. These modifications in the structural lipids allow to consider asthma as membrane pathology. We used different types of treatment such as glucocorticosteroids, diet, methylxanthines, adrenergic drugs. Positive effects on the lipoproteins were reached against the background of glucocorticosteroids and dietary therapy. The phospholipid modifications in the blood cells was conservative in all the used methods of treatment.

53-55 273
Abstract

We examined 791 children suffering from bronchial asthma. Dermatorespiratory syndrome was observed more often in children aged 1 to 3 years; it had earlier onset and more severe course of both bronchial asthma and atopic dermatitis. Dermatorespiratory syndrom e in children is considered as a systemic allergic disease.

56-59 156
Abstract

While organizing medical care for respiratory patients prevention, outpatient surveillance and rehabilitation measures are of prior importance. We analyzed outpatient medical histories of adolescents being surveyed for respiratory pathology. The expert analysis founds serious defects in records of medical history and physical data, quality of clinical, laboratory, and instrumental examinations, and patients' surveillance. When using a screening system 3 groups of the patients were selected: the 1-st group had risk factors for lung pathology development, the 2 -nd group consisted of adolescents with first diagnosed lung disease, and the 3 -rd group included chronic respiratory patients. Proper measures were determined for each group. Rehabilitation monitoring is necessary for early detection of chronic respiratory patients who need preventive measures and rehabilitation. A functional-and-organizing model for outpatient rehabilitation of adolescents and an automatic screening system for multifactorial assessment of health were created.

60-66 187
Abstract

This comparative study involved 540 community-acquired pneumonia patients treated in a multi-profile hospital. A retrospective comparative analysis of antibacterial therapy efficacy before (250 patients) and after (290 patients) implication of a technological card considering modern clinical guidelines was made. The results demonstrated improvement in quality and efficiency of treatment of the pneumonia patients when using the modern guidelines.

67-71 209
Abstract

Intermittent hypoxic training (IHT) has been used for prevention and treatment of some diseases and for training athletes. In this study, we examined the morphological changes in lungs after IHT using light and electron microscopy. 39 male Wistar rats were sustained intermittent hypoxic training (10 % 0 2) for 5 min three times a day with 5-m in rebreathing intervals or 15, 30, 60 min once a day for 21 consecutive days, respectively. Results showed that pulmonary dam age occurred at 3-rd day of IHT, but one week later the pulmonary dam age repaired in IHT animals with brief-time hypoxia (5 or 15 min), but 30-m in and 60-m in IHT groups showed pulmonary dam age until 21- st day. Ultrastructurely, lungs in 5-m in and 15-m in IHT groups were characterized by hyperplasia of alveolar type II cells, which may enable them more rapid repairing of hypoxic lesions and may represent a key mechanism of the IHT. Those findings dem onstrate that IHT could be justified as the impulse therapy for the cells and tissues.

71-80 196
Abstract

Patients with infected haemothorax had elevated thrombinemia, plasma antithrombin-lll deficiency and depression of the fibrinolysis. The pleural effusion displayed increased thrombin level and significant deficiency of active inhibitors. The coagulated haemothorax was characterized by low thrombin activity and noticeable enhancem ent in inhibitory balance both in the plasm a and in the pleural effusion. Differentiated laboratoryassisted corre ction of fibrinogenesis and fibrinolysis in the pleural cavity considering a type of the haemothorax improves the outcome.

81-86 205
Abstract

The article presents research results of opportunities, clinical features, diagnosis and treatment efficiency of combined heart and lung pathology in the early posttraumatic period at a pulmotherapeutic hospital. A leading role of the combined lung and heart pathology in a patient’s general status in the early posttraumatic period was proved in mild to moderate mechanical injuries not requiring surgical or intensive care. These conditions provide the priority of therapeutic care of such patients and substantiate their treatment at a therapeutic hospital. The combined pulmonary and cardiovascular pathology is based on organ lesions following the trauma and on previous chronic diseases. Typical phenomena are primary posttraumatic pneumonia combined with the heart contusion, posttraumatic exacerbation of angina or arterial hypertension.

86-91 158
Abstract

Efficacy of Benacort was studied in 124 patients with chronic obstructive pulmonary disease (COPD) in different stages. Benacort was used against the background of bronchodilating drug Salben in exacerbation of the disease and then for a year. Doses and duration of treatment depended on a stage of the disease. High effectiveness of Benacort was noted in the COPD patients proved by clinical and laboratory data.

REVIEW

НОВОСТИ ERS



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