Quality of outpatient management of patients with chronic obstructive pulmonary disease (COPD) and ways to improve it have been studied in this trial. The study included analysis of 560 medical recorders of outpatients followed up in one and the same outpatient clinic by one and the same physician for 5 to 10 yrs and who were currently newly diagnosed for COPD, epidemiological investigation using questionnaire and spirometry in all patients attending the outpatient clinic, and organization of educational COPD center for physicians, nurses and patients. We assessed concordance of the patients' management according to medical records to national guidelines. Most frequent discrepancies were inaccurate recording of the patient's symptoms and history, incomplete and inadequate examination, incorrect diagnosis, inadequate therapy. Functional disorders were not estimated in 95.9 % of the patients, COPD stage was not determined in 100 % of the cases, severity was not assessed in 83.9 %, and 70.7 % of the patients were not diagnosed for complications and exacerbations of the disease. Inhaled bronchodilators were not administered in 41.9 % of the patients, 90 % of the patients were inadequately treated with antibiotics, 100 % of the patients were not vaccinated. The main reasons for this mismatching were thought to be poor awareness of COPD by physicians, lack of pneumologists in outpatient clinics, and insufficient technical provision of the outpatients clinics with spirographs, oxymeters, etc. The epidemiological examination involved 8 672 patients, among them 38 % reported respiratory symptoms and 24 % had ventilatory disorders. COPD was firstly diagnosed in 768 patients. Implementation of educational programmes have led to necessary functional investigations to be used twice more frequent.

The paper introduces correlations between clinical, functional, laboratory, and self reported parameters of quality of life of COPD patients using the St. George's Respiratory Questionnaire. Close correlations were found between some objective and subjective parameters.

Objective: to study the clinical and antibacterial efficacy and safety of gemifloxacin in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AE COPD) hospitalized into pulmonology departments. Study design: open non-comparative prospective study. Settings: 25 different pulmonology centres in Russia. A total of 222 patients with AE COPD (156 males and 66 females, mean age 56,4 ± 11,9 years) were included in the study. The majority of patients (70.3 %) were classified as I type Anthonisen of AE COPD. All patients received oral gemifloxacin (Factive^® , Veropharm, Russia) 320 mg once daily for 7 days. Clinical and bacteriological outcomes and treatment safety were assessed at the end of therapy (7–8 days of study) and at follow up (14–16 days of study). At the end of therapy (7–8 days) statistically significant improvements were noted in all symptoms of AE COPD (improvement of cough, dyspnea, sputum volume and purulence). No clinical improvement was seen in 5.6 % of patients, so the clinical success rate of gemifloxacin therapy was 94.4 %. Sputum cultures were performed in 73.0 % of patients and in 60.4 % of them respiratory pathogens were isolated. The leading pathogens were Streptococus pneumoniae (37.7 %) and Haemophilus influenzae (27.8 %). Eradication and presumed eradication of all pathogens were 69.4 % and 26.9 %, respectively. The bacteriological success rate of gemifloxacin therapy was 96.3 %. A total of 15 patients reported adverse events (AEs), most frequent AEs was diarrhea (4.7 %). All AEs were no severe and transitory, and did not require the withdrawal of antibiotic therapy. Oral gemifloxacin had high clinical and bacteriological efficacy in hospitalized patients with AE COPD. The treatment with gemifloxacin was generally well tolerated and was convenient to patients.

The aim of this study was to investigate morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease (COPD). We measured erythrocyte parameters (RBC, HGB, HCT, MCV, MCH, MCHC, RDW-SD) using the automatic hematological analyzer Sysmex XT-2000i. Sixty-nine patients participated in the study. The patients were divided into 3 groups: 34 patients with COPD (mean age 63 yrs, median smoking history 36 packyrs); 15 smokers without bronchial obstruction (mean age 56 yrs, median smoking history 28 packyrs) and 20 nonsmokers of the sane age without bronchial obstruction. Smokers with COPD and smokers without bronchial obstruction had significantly higher erythrocyte parameters compared to those of nonsmokers. Smokers demonstrated higher HGB level that could be as a compensatory reaction to nicotine-related preclinical hypoxia. Marked increase in RBC number and anisocytosis (RDW-SD) reflected the erythron activation in smokers with COPD. These results suggest that measurement of erythrocyte parameters could be useful to assess symptomatic erythrocytosis in COPD patients.

Pathogens of fatal community-acquired pneumonia have been studied in 63 adult patients from Smolensk city and Yartsevo town of Smolensk region using autopsy material. Pneumonia was confirmed during histological exanimation in 57 (90.5 %) of the patients. Bacterial pathogens were identified in 91.2 % of the confirmed pneumonias, among them one type of pathogens was yielded in 75% and bacterial associations were identified in 25 % of the cases. The most prevalent pathogens were K. pneumoniae, S. aureus, S. pneumoniae and H. influenzae (31.4, 28.6, 12.9 and 11.4 % of all the identified strains, respectively). Comorbidity (alcohol abuse, chronic heart disease, chronic respiratory disease) was an important factor predetermining pathogen spectrum and poor outcome of the disease.

The aim of the study was to investigate airway conditioning function and cold hyperresponsiveness in patients with bronchial asthma (BA) and nasal polyps. One hundred and eleven asthma patients with or without chronic polypous rhinosinusitis (CPR) were examined. Respiratory heat exchange and cold airway hyperresponsiveness were assessed using thermometry of expired air during quiet breathing and isocapnic hyperventilation with cold air in comparison with a group of healthy persons. The conditioning nasal function was worsened in BA patients with CPRS. Disorders of nasal heat exchange led to decreased temperature of the exhaled air during quiet breathing and cold hyperventilation. These disorders were closely related to increased frequency and severity of cold airway hyperresponsiveness.

Ultrasound investigation was done in 96 patients with bronchial asthma to define changes in endothelium-dependent and endothelium-independent reactivity of brachial artery and their relations to central and pulmonary hemodynamics as well as to the airway reactivity. Tests with reactive hyperemia and nitroglycerine revealed disorders of vascular reactivity (decrease in endothelium-dependent and endothelium-independent brachial artery dilation) which progressively worsened while severity of the disease increased. Dilation disorders in the systemic circulation closely related to the left ventricle diastolic dysfunction, increased total pulmonary vascular resistance and the airway reactivity.

Karyological analysis of buccal epithelial cells obtained from 70 children with atopic asthma and 90 non-asthmatic children living in Tula was performed. Asthma children had higher rate of cytogenetic lesions (portions of cells with micronuclei and protrusions were 2.22 ‰ vs 1.66 ‰ in controls; p < 0.05) and apoptosis (14.3 ‰ and 11.0 ‰, respectively; p < 0.001) in buccal epithelial cells. The lesions were more prominent in exacerbation and in severe asthma. Alterations of buccal epithelial cells corresponded to those in other tissues, in particular bronchial epithelial cells; this fact confirms similar lesions in these cell populations in asthmatic patients.

Has studied influence of social and medical factors on tuberculosis morbidity in children and adolescents at Udmurt Republic. The study involved children and adolescents receiving preventive antituberculosis medications in 1990. Tuberculin testing was Irregular in 73.2 % of children with tuberculosis. Preventive treatment was irregular or untimely in 76.1 % of children needed this therapy in spite of annual increase in number of children and adolescents treated preventively. In a half of cases, administration of preventive antibiotics did not consider local resistance of Micobacterium tuberculosis. Persons infected with tuberculosis generally had low educational level, poor living conditions and hazardous habits influencing on the local epidemiological situation. One third of persons infected with had low income.

Combined implication of optical, transmissive and scanning electron microscopy allowed detection of early response to dust exposure: slowing of blood flow and dilation of pulmonary capillaries, oedema and initial stage of fibrillogenesis in aerohaematic barrier.

Study was performed using a rat model of thermal burn of upper respiratory tract (URT). The URT burn in rats was induced by intratracheal instillation of 70 °C water vapor using a micro-vapor generator. In a week after the intervention about 50 % of the ciliated epithelium was destructed. In 2 weeks after the intervention the inflammatory response enhanced and tissue edema increased. In 4 weeks after the intervention partial irregular restoration of tracheal epithelium cells was observed. Both IL-1 and IL-4 expression did not change significantly during restoration of tracheal epithelium, but IL-8 and IL-10 expression increased and was high even 1 month after the burn. Simultaneously, dramatic increase in expression of peroxyredoxine 6, which is the main antioxidant protein in trachea, was observed during regeneration of trachea epithelium. Iimmunohistochemical investigations showed that the increase in peroxyredoxine 6 in trachea during the regeneration of trachea epithelium after the burn could be related to increased peroxyredoxine expression in goblet cells. Therefore, activation of peroxyredoxine 6 synthesis by goblet cells appears to be the key step in activation of epithelium defense systems after thermal burn.