This work investigated etiology of communityacquired pneumonia in children at SanktPetersburg from 1998 to 2001 using microbiological and immunological methods. S.pneumoniae was found to be a cause of pneumonia in 74.5 % of the patients and it was the leading pathogen out of proportion with the children's age. C. pneumoniae was detected in 67.3 % of the patients, prevalently in children 1 to 7 years old. The acute Мycoplasma рneumoniae respiratory infection was diagnosed in 40.4 % of the children. Non typing strains of H. influenzae were yielded in 10.2 % of the patients. Most patients had microbial associations that demonstrates multiple etiology of the current community-acquired pneumonia in children. Epidemiological rise in spread of acute respiratory C. pneumoniae infection was noted during last 4 years at Sankt-Petersburg which was thought to be a cause of a sharp increase in frequency of childhood community-acquired pneumonia.

The article presents an analysis of course of community-acquired pneumonia and features of the vegetative status in 147 young military servicemen. Modern clinical investigation recommended by an academician A.M.Vein was used in the study. A grading of vegetative disorders in various severity of pneumonia has been proposed. A relationship between vegetative reactions and a severity of pneumonia has been demonstrated. Recommendations for practitioners how to predict the course of community-acquired pneumonia and to develop individual therapeutic and reha-bilitation programs for admitted and discharged patients are given regarding to a type of the vegetative reactions.

We examined 50 patients with caseating pneumonias of various types and size. We selected CT types of caseating pneumonia (acinous, lobar, lobular, peribronchial), their structure and extension. Computed tomography is found to be the optimal radiological method to detect caseating pneumonic TB forms. Chemotherapy modes for caseating pneumonia patients are presented regarding to its CT types.

The reported practical work shows a significance of detection the exhaled fraction of nitric oxide (FENO) compared with bronchial challenge tests to diagnose the allergic inflammation and to determine the inflammatory activity in the airways.
Methods: 30 bronchial challenge tests were performed in 24 children aged 5 to 16 yrs with different degrees of sensitization detected by the prick-test. The challenge tests were performed with various allergens, the lung function was examined by spirometry or pneumotachometry, the airway resistance was studied by impulse oscillometry. The FENO was measured using a chemiluminescent gas analyzer. The FENO levels obtained after the challenge tests allowed to divide the patients with positive test results in 2 groups and those with negative test results in 3 groups. Two negative and the positive groups had the similar FENO levels and only the third negative group had different FENO level.
Therefore, the FENO allows detecting the allergy imflammation including its latent form even if the challenge test is negative.

Structural reconstruction of branches of the pulmonary artery was not seen in severe atopic asthma. Precapillary pulmonary hypertension with marked structural wall changes of small branches of the pulmonary artery, such as hypertrophy of intima and muscles, sclerosis of adventitia, as well as bronchiolitis and lung emphysema, were shown morphometrically and immunohistochemically in smokers with severe chronic obstructive lung disease. The thickening of the muscle layout was due to the increase in myofibroblast number.

Severe cough associated with COPD can induce dynamic instability of trachea. It is important to investigate large airways in COPD patients and to create diagnostic program for evaluation of this dynamic changes.
Aim: to investigate sensitivity and specificity of different methods for detection of dynamic tracheal instability in COPD patients.
Of fifty five patients involved in this study 30 ones were selected according to inclusion criteria. They were divided into 2 groups: 20 COPD stage 2 patients with dynamic tracheal instability detected by fiberoptic bronchoscopy (the 1-st group; 14 females, 6 males; the mean age, 60.9 ± 7.9 yrs; BMI, 28.2 ± 4.3 kg / m²; the smoking history, 35.4 ± 5.2 pack-year) and 10 COPD stage 2 patients without dynamic tracheal instability according to fiberoptic bronchoscopy findings (the 2nd group; 2 females and 8 males; the mean age, 55.2 ± 4.8 yrs; BMI, 26.8 ± 2.6 kg/m²; the smoking history, 28.2 ± 3.4 pack-year). Clinical examination, flow-volume curve, body plethysmography, impulse oscillometry, X-ray examination of trachea, fiberoptic bronchoscopy, and electron-beam tomography were used in our work.
As a result, the most sensitive functional method was impulse oscillometry (Se = 85 %). Electron-beam tomography is more sensitive (Se = 90 %) than X-ray examination of trachea (Se = 65 %) while diagnosing dynamic tracheal instability in the COPD patients.

Two hundred and twenty-seven healthy medical students were divided into the main (112 smokers) and the control (115 non-smokers) groups. Depending on the risk of COPD occurrence (smoking index > 140) the smokers were divided into the risk-positive (34.5 % of the smokers) and the risk-negative (65.5 %) subgroups. Smoking duration, smoking psychological dependence, need in smoking under an emotional exertion and a habit of nicotine were higher in the risk-positive smokers. The vital capacity, the inspiratory and expiratory reserve volumes, and the peak expiratory flow rate were higher in smokers as a result of adaptation of the respiratory system to smoking, in particular to the negative influence of carbon monoxide. This adaptation is aimed to the SpO2 restoration. But this parameter was lower in smokers, especially in the risk-positive subgroup. Thus, the functional adaptation of the respiratory system to the severe smoking in students with the risk of COPD is failed.

The study was aimed to investigate efficacy, safety, and ability of correction some metabolic disturbances in patients with chronic obstructive pulmonary diseases (COPD) at the North during therapy with Russian anticholinergic drug Troventol. Thirty-nine moderate COPD patients and 11 mild non-atopic asthma patients were observed. Good clinical efficiency was noted in 72.3 % and satisfactory effect was in 20.8 % of the patients after the Troventol alone therapy. The treatment resulted in normalization of reduced blood antioxidant potential due to increase in intercellular superoxiddysmutase erythrocyte level, ceruloplasmin and transferrin plasma levels. Troventol provided normalization of increased fluidity of the erythrocyte membrane lipid bilayer. Therapeutic doses of Troventol were well-tolerated and did not cause severe adverse effects.

Relations between perception of breathing and work of the respiratory center (RC) in healthy persons (n = 20) and COPD patients (n = 64) were studied using the electric stimulation of the diaphragm (ESD) and subsequent inhalations of the bronchodilator Berodual. Descriptive, comparative, correlative, multifactorial, regressive and informative analyses of the results were performed. The ESD and Berodual were found to have adaptive effects on sensory parts of the central nervous system and work of the RC. Structural models of breathing patterns have been described which create basic functional biomechanical links of the respiratory systems adjustable by the RC.

The article is devoted to the improvement in therapy of bronchial asthma, namely to achievement and maintenance of the control of the disease using combined drugs containing inhaled steroids and long-acting β₂-agonists. We used data of multi-center, randomised, double-blind, double-masking 1-year trial CONCEPT. We demonstrated advantages of therapy with fixed-dosed Seretid (fluticasone propionate / salmeterol) compared to flexible dosed Simbicort (budesonide / formoterol). As a result of this trial, the fixed-dosed Seretid was shown to provide more symptom-free days (medians, 73.8 % and 64.9 %, respectively, p = 0.03); days without emergency drug needed (94.5 % and 90.7 %, respectively, p = 0.008); better morning peak expiratory flow rate (the corrected mean, 9.5 L / min; 95%CI, 2.7–16.3, p = 0.006), approximately two-fold decrease in moderate to severe acute exacerbation rate compared to the flexible dosing of Simbicort (the corrected exacerbation rate per year, 0.18 and 0.33, p = 0.008). The total length of therapy with systemic steroids at the Seretid group was 46 % less than that at the Simbicort group (301 and 559 days, respectively, р = 0.026).