The article presents results of investigation of element homeostasis in 62 patients (males and females) with community-acquired pneumonia living in Karelia. Atomic-emission and atomic-absorption spectroscopy methods were used. Statistically significant decrease in mass concentrations of Zn, Fe and Mn and increase in mass concentrations of Cd and Cu were found in the whole blood of men at the onset of the disease; decrease in mass concentration of Mn and increase in mass concentration of Cd were found in women. The authors offered differentiated techniques for the dietary and medication correction of these disturbances.

Clinical, laboratory, functional, and radiological examination of 82 patients with slowly resolving pneumonia was performed. The average age of the patients was 42.0 ± 2.4 yrs, 34 (41.5 %) were males and 48 (58.5 %) were females. The patients were randomly divided into 3 comparative groups: the 1st and the 2^nd groups received pelotherapy and naftalan, respectively, in combination with medications for relief of symptoms and physiotherapy. The 3^rd group (control) patients received medications for relief of symptoms and physiotherapy. Implementation of these methods in treatment of patients with slowly resolving pneumonia could promote regress of residual inflammation, considerably shorten length of the disease, reduce medication load and need in healthcare resources that, in turn, could reduce healthcare expenditures for treatment of such patients. Clinical results were confirmed by short- and long- term results of morphologic and blood biochemical investigations, microscopic examination of sputum, lung function testing, immunological, bronchoscopic and radiological data, investigations of physical capacity and quality of life.

A retrospective comparative trial was performed to analyze management of adult patients with community-acquired pneumonia (CAP) hospitalized to a large clinical hospital of Moscow from January, 2006, to December, 2006. The study involved 42 in-patients with CAP (21 of them were discharged and 21 died). Time period from the onset of the disease to the hospital admission was 9.5 (95 % CI 6.4–12.6) days without a significant difference between the groups. Death occurred in 6.7 (95 % CI 2.7–10.7) days in average after presentation. Factors influencing the course of CAP in inpatient adults were inadequate and / or delayed antibacterial treatment before the admission, underestimation of severity of the disease in presentation to the hospital, uncommon use of computed tomography of the lungs to diagnose complications of CAP, poor adherence to current guidelines for management of patients with CAP

Investigation of informative value of NO metabolite measurement in the exhaled breath condensate (EBC) has been performed. NO metabolites were considered as a biochemical marker for detection and monitoring of course of the acute respiratory distress syndrome (ARDS) in newborns. Measurement of NO metabolites in EBC was performed using spectrophotometry with Grace`s reagent in 80 newborns with different stages of ARDS. Two-fold increase in NO metabolite concentration was found in early stage ARDS (the acute lung injury syndrome) and 3- to 4-fold increase was found in advanced ARDS. In the terminal stage of ARDS, NO synthesis decreased to the level measured in controls. Multifactoral nitroxide changes in the lungs depending on activity of pulmonary proteolysis and fibrinolysis and functional activity of blood neutrophils were describes. Measurement of NO metabolites in EBC is a sensitive and informative test to diagnose ARDS in newborns and could be used for diagnosis of parenchymal type respiratory failure and evaluation of its clinical course in newborns.

There are numerous problems regarding lung function assessment in infants and preschool children despite the great interest to this field worldwide. Therefore, investigations of the interrupter technique in infants and preschool children are of great importance. This article contains results of measurement of airway resistance in children with asthma, atopic dermatitis, acute bronchitis and croup and in healthy children using the interrupter technique. Results of mathematic modeling have also been discussed in the article.

The aim of our study was to evaluate HRCT abnormalities in adult CF patients and to determine correlations between these findings and clinical, exercise, lung function measurements and BMI, if any. 33 patients participated in the study. All patients had documented clinical and genotypic features of CF as well as abnormal sweat test results. CT scans were scored using Bhalla scoring system. Body plethysmography, lung diffusion capacity, oxygen saturation (SpO₂), 6-MWT, dyspnea (by Borgand MRC scale) and BMI were also evaluated. Bronchiectasis were observed in all the patients (30 % mild, 46 % moderate, 24 % severe affecting 1–5 segments in 37 %, 6–9 segments in 37 %, and > 9 segments in 26 %) as well as peribronchial wall thickening (mild in 88 %, moderate in 12 %), with bronchial involvement (up to the 4^th generation in 40 %, up to the 5^th in 37 %, up to the 6^th and more distal in 23 %) and mucus plugging were found in 54 % of patients. Less common abnormalities included sacculations or abscesses, bullae, emphysema and collapse (36, 18, 15 and 15 %, respectively). The overall HRCT score showed significant correlations to lung function, BMI and SpO₂, more closely to bronchiectasis and bronchial involvement. 6-minute distance, though correlating significantly with BMI and lung function, had no correlation with HRCT findings. HRCT is a sensitive tool to evaluate morphologic pulmonary changes in CF patients. Bronchiectasis and peribronchial wall thickening are the most common finding in CF adults. Extent of bronchiectasis and generations of bronchial divisions involved correlated best with clinical, BMI and lung function measurements.

Functioning of mucociliary system (MCS) including integral rate of tracheobronchial mucociliary clearance (MCC) using dynamic perfusion-lung scanning, ciliary activity in bronchial biopsy specimens and viscous and elastic properties of bronchial mucus was studied in 128 patients with chronic obstructive pulmonary disease (COPD). Of them, 90 % had mucociliary insufficiency (MCI), the intensity of which was in direct proportion to the disease severity. Development of MCI was caused by decrease in ciliary beat frequency, increased viscosity of bronchial mucus and active inflammation identified during bronchoscopy. While considered correlations between these parameters and integral rate of MCC, a method for detection of MCI has been proposed based on the solution of a discriminant equation; this method allows diagnosing MCI with 81 % of probability. Changes of MCC rate were investigated in a 6-wk prospective comparative randomized controlled trial in 69 patients with stage II COPD under different therapies according to GOLD recommendations. As a result, functional MCI was improved in 14 of 29 patients (48 %) receiving standard therapy during exacerbation and in stable condition, whereas similar improvement was reached in 28 of 40 patients (70 %) who additionally took long-acting anticholinergic drug tiotropium bromide 18 μg daily. Other 12 patients (30 %) had a weak response of MCC to tiotropium bromide due to low baseline MCC rate. A method predicting effect of tiotropium bromide on MCI in patients with stage II COPD using baseline MCC rate and a discriminant equation has been proposed.

The aim of this study was to evaluate efficacy of mucolytic drug ambroxol (Lasolvan) as a part of combined treatment of patients with chronic obstructive pulmonary disease (COPD). Fifty-two patients with exacerbation of COPD participated in the study. Bronchoalveolar lavage fluid (BALF) obtained during bronchofiberoscopy was examined for cell differential and immunoglobulin concentration. The latter was found to be reduced. The patients were divided into 2 groups: the main group included 25 patients treated with standard therapy (antibiotics, bronchodilators, glucocorticosteroids) and inhaled ambroxol through a nebulizer; the comparator group included 27 patients with COPD who received standard therapy and placebo (inhaled saline solution). Administration of ambroxol has led to improvement in clinical symptoms and local immunity. In the comparator group, the duration of exacerbation was longer and improvement in the local immunity was insignificant. Therefore, the use of ambroxol as a part of combined therapy of COPD exacerbation could improve the local immunity and contribute to the result of treatment.

The study was performed in 120 Wistar male rats. Animals were exposed to nitrogen dioxide for 15, 30, 60 or 90 days. Ten intact rats were as controls for each exposed group. Histological examination was performed using immunohistochemistry and morphometry. Pathological changes developed simultaneously in all lung structures. After 15-day exposition with nitrogen dioxide, acute changes have been observed, such as oedema, mucosal thickening and inflammation, enhanced bronchial secretion. In 30 days, morphological features reflected a subacute stage. In 60 days of exposition, inflammation became chronic with sclerosis of bronchial wall followed by worsening of the pathology and occurrence of panacinar emphysema if exposition was prolonged to 90 days.