EDITORIAL COLUMN
EDITORIAL
Prevalence of chronic obstructive pulmonary disease in a large industrial city (Nizhny Novgorod)
CLINICAL GUIDELINES
Источник: Reddel H.K., Taylor D.R., Bateman E.D. et al. An Official American Thoracic Society / European Respiratory Society Statement: Asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice. Am. J. Respir. Crit. Care Med. 2009; 180: 59–99.
REVIEW
ACQ questionnaire as a new tool for assessing control of asthma
Opportunity to control asthma: a role of small airways
ORIGINAL STUDIES
Summary. Clinical features, drug resistance of Mycobacterium tuberculosis, a course of the disease and treatment efficacy in 210 patients with fibrocavernou tuberculosis of the lung have been presented in this article. The patients were treated in specialized penitentiary settings in Kirov region.Particula attention was paid for the course of complicated fibrocavernous tuberculosis. The later was characterized by severe clinical manifestation, significan drug resistance of M. tuberculosis, lower effectiveness of the therapy and high mortality.
Patients with swear-positive fibrocavernous tuberculosis including those with drug-resistant M. tuberculosis were found to be a persistent source of infection led to worse epidemiologic situation requiring strict isolation of the patients in specialized facilities and a regular control.
Summary. We analyzed concentration of matrix metalloproteinase MMP9 and complex MMP9/TIMP1 in blood serum in patients with chronic obstructive pulmonary disease (COPD) and in patients with co-existing COPD and ischemic heart disease (IHD).
Serum concentration of complex MMP9/TIMP1 in patients with COPD was significantly higher than in controls. Patients with COPD stage III had higher concentration of the complex than those with COPD stage II. It is important that MMP9/TIMP1 concentration increased more significantly in patients with combined pathology than in patients with COPD. Difference between MMP9 level in patients with COPD and in patients with co-existing COPD and IHD was estimated. Highest levels of MMP9 were found in patients with combined disease.
Therefore, concentrations of MMP9 and MMP9/TIMP1 positively correlated with COPD severity both in patients with COPD and with combination of COPD and IHD.
Summary. COPD affects not only the respiratory system but has systemic effects including peripheral muscle dysfunction, synovial and vascular pathology and depression partly caused by the direct influence of inflammatory mediators. Pulmonary rehabilitation is recognized as a crucial component of management of patients with COPD. This study was performed in Research Institute of Pulmonology of Federal Medical and Biological Agency and evaluated one of rehabilitation methods, namely physical training, in term of its influence on systemic inflammation markers and level of testosterone in COPD patients. The study involved 31 patients with COPD stage III–IV treated with standard drug therapy according to the disease severity. Of them, 16 patients were involved in pulmonary rehabilitation programs. As a result, pulmonary rehabilitation group patients improved 6-min distance by 80 m, FEV1 by 13 % and decreased FRV by 14 % and RV by 30 % from baseline. These parameters did not change or changed non-significantly in patients treated with medications alone. Systemic inflammation and testosterone level were also improved in pulmonary rehabilitation group.
Summary.The study investigated duration of treatment effect of monoclonal anti-IgE-antibodies (omalizumab) after discontinuation of the therapy in asthma patients. The study involved 23 patients treated with monoclonal anti-IgE-antibodies. Daytime and nighttime asthma symptoms, need in rescue medications, daily dose of inhaled steroids (ICS) in beclomethasone equivalents, FEV1, allergy skin tests, quality of life according to AQLQ questionnaire, and asthma control level according to GINA, 2006, were analyzed. Patient-reported control of asthma was evaluated using the Asthma Control test (ACTФ). In 2 months after discontinuation of therapy with monoclonal anti-IgE-antibodies, increase in daytime and nighttime asthma symptoms, need in rescue medications and daily doses of ICS, worsening in asthma control, increase in skin hyperreactivity to domestic and epidermal allergens, and decrease in quality of life were found (all statistically significant). Therefore, the results have shown that monoclonal anti-IgE-antibodies could be administered in discrete regimen; this would allow reduction in frequency of the patient's visits to clinic and in cost of treatment.
Summary. The study was aimed at investigating the intracranial and cerebral perfusion pressures during lung ventilation in 58 patients with brain insult. The study demonstrated that non-invasive ventilation did not affect the intracranial pressure and cardiovascular activity significantly and therefore did not deteriorate the cerebral perfusion pressure. This confirms a benefit of non-invasive lung ventilation and a rationale for its use for respiratory support incorporated in intensive therapy of acute cerebral vascular failure. A role of monitoring gas content and arteriovenous oxygen difference in the venous blood flow from the cranial cavity was also defined during respiratory support in patients with acute cerebral vascular failure.
PRACTICAL NOTES
An experience of administration of inhaled tobramycin in severe nosocomial pneumonia
HEALTHCARE MANAGEMENT
Issues of respiratory diseases and possible ways of their resolution in municipal healthcare service
EDUCATION
The first experience of simulation-based education of emergency care physicians on cardiac and pulmonary resuscitation
ERS NEWS
ANNIVERSARIES
Gabrielle Pauli. To the 70th birthday
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