Genetic analysis of pandemic influenza A / H1N1 virus during epidemia.

По материалам: Freixinet Gilart J., Herna′ndez Rodrl′guez H., Martl′nez Vallina P. et al. Guidelines for the diagnosis and treatment of thoracic traumatism. Arch. Bronconeumol. 2011; 47 (1): 41–49.

Summary. Recently, growing attention has been paid to the genetic predisposition to respiratory diseases. A major direction is searching candidate genes responsible for occurrence and course of the disease. This study investigated the involvement of epoxide hydrolase gene group in development of occupational respiratory diseases and nonoccupational chronic bronchitis.

Summary. The aim of the study was to investigate risk factors of high respiratory morbidity in preschool children with frequent respiratory infection episodes. Medical records of 95 children with frequent respiratory infections and of 30 healthy children and questioning of their parents were retrospectively analyzed. The results demonstrated that most significant risk factors of frequent respiratory infection episodes were obstetric and gynecological morbidity of the child's mother, metabolic and dystrophic disorders in children, presence of smokers in the family. Investigation of local and systemic defensive mechanisms revealed decreased serum immunoglobulin A and INF-γ levels and elevated concentrations of IL-4 and TNF-α. Increased concentration of nitrates / nitrites in exhaled breath condensate was also found. A direct correlation was found between concentration of nitric oxide metabolites in exhaled breath condensate and IL-4 level in the serum; an inverse relationship was found between the former parameter and INF-γ level in the blood serum.

Summary. This was an open comparative trial of efficacy and safety of combined bronchodilating nebulized therapy in children with moderate to severe bronchial asthma (BA). As a result, combination of ipratropium bromide and short-acting β2-agonists was found to have additive effect on lung function in BA exacerbation.

Summary. We observed 150 patients aged 18 to 34 yrs with pulmonary TB exacerbation. For patients 18–24 years old, the rate of exacerbations was equal in men and women. For patients 25–34 years old, TB exacerbations in men were 4.4 times more often. Infiltrative and fibrocavitating TB were more prevalent characterized by intoxication, productive cough, shortness of breath and rales in the lungs. Unilateral lesions of one or two lobes were more frequent; 88.7 % of patients had cavities of 2–4 cm in diameter and sputum-positive TB. The highest rate of drug resistant mycobacteria was registered in patients with caseosus pneumonia (77.0 %), disseminated pulmonary TB (75.0 %), infiltrative and fibrocavitating TB (55.6 % for each).

Summary. Bronchiscopic examination was performed in 103 patients, of them, 44 patients had chronic obstructive pulmonary disease (COPD) and 59 patients had atrophic bronchitis. Mild pulmonary hemorrhage was diagnosed in 24 patients with COPD and in 39 patients with atrophic bronchitis. Laser Doppler flowmetry was performed using a laser analyzer of capillary circulation LAKK-01 (Lazma, Moscow). After revision of bronchi, the optical guide with laser wavelength of 0.63 μm was run through biopsy channel of the bronchoscope and was located on the bronchial mucosa 1 cm higher the bronchial spur of the right upper lobe bronchus under visual control. The examination was done during 2 min. All patients with hemorrhage in bronchial mucosa had microcirculatory disorders of different character and severity. Character parameters of tissue perfusion significantly decreased. Mostly, the mean square deviation has been decreasing that indicated unsuccessful tissue perfusion. The amplitude of variations in VLF, LF and HF ranges increased indicating the increased capacity of venules and increased tone of precapillary vessels that also prevented adequate capillary circulation. Amplitudes of variables at CF range was noted that characterized arteriolar dilation.

Summary. The aim of this study was to investigate quality of life (QoL) in patients with COPD and relationships of QoL with bronchial obstruction, pulmonary hypertension (PH), myocardial remodeling, and systemic inflammation. The study involved 56 patients with chronic obstructive pulmonary disease (COPD) and 25 healthy controls. We assessed QoL by SF-36 questionnaire. PH, sizes of right and left ventricles and atria (RV, LV, RA, LA) and their dynamics during 2-year follow-up were assessed using echocardiography. Also, TNF-α and IL-6 concentrations were measured and spirometry was performed. Correlation analysis was performed. Patients were categorized as having "poor QoL" (n = 12) or "better QoL" (n = 44) and compared. All parameters of QoL were lower in COPD patients compared with controls (p < 0.001), especially in the Role-Physical Functioning domain (by 58.9 %, р < 0.0001). Poor QoL was associated with rapid and significant dilatation of LV, RA, and LA, diastolic LV dysfunction, elevated levels of serum TNF-α, IL-6, and creatinine; polycithaemia and lower FEV1 (p < 0.05) but not with PH. Therefore, all the QoL parameters were impaired in patients with COPD, especially physical health component. Heart remodeling, systemic inflammation, bronchial obstruction, polycythaemia and renal dysfunction appear to contribute to the QoL worsening. The impact of PH on QoL was less significant.

Summary. The present study was aimed at investigation of clinical course of co-existing chronic heart failure (CHF) and COPD and influence of a selective β1-blocker (BB) nebivolol on clinical course of COPD and respiratory function in patients with ischemic CHF. Results showed that a combined therapy of CHF including nebivolol significantly increased effectiveness of CHF treatment irrespective of presence of COPD and did not worsen bronchial obsrtuction. Administration of Nebivolol in patients with coexisting CHF and COPD under the standard therapy did not reduce airflow parameters.

Summary. Mucociliary clearance (MCC) and thoracic muscles are defensive mechanisms which provide effective functioning of respiratory system. Usually, respiratory failure is associated with disorders of MCC and respiratory muscles, primarily due to hyperinflation of the lungs. Medication therapy can not successfully improve these changes. Chest high-frequency oscillation could enhance the airway clearance and decrease lung hyperinflation. The aim of this study was to investigate effects of the chest high-frequency oscillation methods on functional status of patients with pulmonary diseases. This open comparative study involved 3 groups of patients: 10 patient with bronchiectasis (the 1st group; mean age, 55.5 ± 39.0 years), 11 patients with COPD (the 2nd group, 66.2 ± 7.0 years), and 12 patients with COPD as controls (the 3rd group, 60.4 ± 8.6 years). Apart from the standard medication therapy, the 1st and the 2nd groups were treated with chest high-frequency compression device VEST, the 3rd group was administered standard drug treatment only. Lung function using spirometry and body plethysmography, dyspnea, cough and sputum production using the modified MRC scale were measured during the first and the final visits. The treatment with VEST device led to significant improvement in lung function (FEV1 increased by 9.9 % and 5.7 % in the 1st and the 2nd groups, respectively, FVC increased by 7.7 % and 5 %, respectively, RV decreased by 4.6 % and 10 %, respectively). In the 3rd group patients, significant improvement was noted only for FVC by 3 %. Also, dyspnea, cough and sputum production improved more markedly in groups treated with VEST device. Therefore, vibration and compression applied on the chest could improve MCC and lung hyperinflation.

Summary. The purpose of the study was to investigate relationship between parameters of lung function and arterial stiffness in patients with bronchial asthma during the follow-up at a pulmonary and allergological center of Krasnoyarsk. This was a prospective open study. Lung function was assessed using spirometry and body plethysmography at admission and in 48 weeks, arterial stiffness was evaluated with indirect arteriography at the same time points. Statistically significant positive relationship was found between expiratory bronchial resistance and main parameters of arterial stiffness (pulse wave velocity in the aorta and augmentation index) and also between the ratio of expiratory and inspiratory bronchial resistances and augmentation index. Oxygen saturation inversely related to pulse wave velocity in the aorta; this fact, in our opinion, indicates an influence of hypoxia and bronchial obstruction caused by chronic persistent airway inflammation on increased stiffness of proximal arteries.

Summary. The study was conducted to evaluate therapeutic and preventive effect of chest cryomassage and sylvinite speleotherapy in addition to the standard drug therapy in patients with mild to moderate persistent partially controlled bronchial asthma. Effects of a comprehensive rehabilitation programme were confirmed by a distinct reduction in eosinophilic and neutrophilic inflammation, significant improvements in systemic immunity, lung function, cardiorespitatory hemodynamics, exercise tolerance, and psychological adaptation.

Summary. The aim of this study was to determine the prevalence of low bone mineral density (BMD), minimal trauma fractures and thoracic and lumbar vertebral deformities in cystic fibrosis (CF) adults and also to assess the correlation between BMD, minimal or no trauma fractures and vertebral deformities with other CF characteristics.

We studied 130 adults with CF (16–42 years old; 63 men, 67 women). Lumbar spine, and proximal femur (in patients of 19 and older) BMD were measured by dual-energy X-ray absorptiometry. Lumbar spine measurement was performed in 130 patients, proximal femur – in 89 patients. Spinal radiographs (lateral and anterior posterior views) were taken in 26 patients with low BMD for assessment of vertebral fractures. Chest radiographs were graded using Genant's semi-quantitative method to identify and assess vertebral deformities. A range of anthropometric, clinical, functional and genetic variables were evaluated as potential correlates. BMD Z-score lower than –2 SD was observed in 42.2 % patients, and in 36,2 % this value was between –1 and –2 SD.

Effects of alfa-1-antitripsin deficiency on lung disease.

Hyperventilation syndrome in practical work of a pneumologist: pathogenesis, clinical features, diagnosis.

Perspectives for treatment with dornase-alfa in paediatric respiratory medicine.

Pierre Marie-Bamberger's disease as a paraneoplastic manifestation of lung carcinoma.

Orphan type of lung injury in rheumatoid arthritis.

Informational appealing letter of experts of Russian Respiratory Society to primary care physicians and pneumologists.