[Possibility of achieving and maintaining asthma control in patients with bronchial cold hyperreactivity].

AIM: To evaluate the clinical efficiency of tactics to widen the scope of monotherapy with inhaled glucocorticosteroids (IGCS) in asthmatic patients with bronchial cold hyperreactivity (BCHR) during winter to achieve control of the disease in real clinical practice. SUBJECTS AND METHODS: An open-label longitudinal study was conducted in a cold period in 106 asthmatics divided into 2 groups: 1) those with BCHR and 2) those with unchanged bronchial reactivity to a cold stimulus. The study involved monitoring the symptoms by the asthma control test, peak expiratory flow rate (PEFR), and spirometry results before and after cold bronchoprovocation testing; assessment of the pattern of bronchial inflammation from the ratios of induced sputum (IS) cell populations; and estimation of the number of asthma exacerbations and emergency care recourses. Group 1 used a stepwise increase of the scope of basic therapy with beclomethasone dipropionate 1000 microg/day until asthma control was achieved, which was followed by the therapy with the stable dose. Group 2 received monotherapy with beclomethasone dipropionate as the stable dosage of < or = 500 microg/day. RESULTS: After the first 12 weeks of a follow-up, Group 1 showed the most marked positive changes in the intensity of clinical symptoms, forced expiratory volume in one second, and PEFR that remained within the following 12 weeks during the continued therapy with the stable dose of the drug. A preponderance of the eosinophilic and neutrophilic pattern of inflammation was seen in the patients of this group. By the end of the study, there was a decline in the number of IS inflammatory cells. A discriminant model was developed as a tool to predict asthma control achievement in patients with BCHR. CONCLUSION: A stepwise increase in the scope of IGCS monotherapy in asthmatic patients with BCHR during winter can yield the results of disease control and the incidence of exacerbations, which are similar to those seen in asthmatics with no signs of BCHR (53 and 49%, respectively).

[Correlation of brain electrical activity and motivation in healthy people].

Motivation dominates in the structure of the personality and is one of the basic notions which explains the dynamics of the behavior. The literature has little data about neurophysiology of motivation. The aim of the research was to study the correlation between the motivational sphere and electrical activity of the brain at the influence of different provocations. 24 healthy people at the age of 26-36 years were examined. The results of motivation tests turned out to be uniform (the motivation to success was of a moderate or high level, there were mean values of readiness to risk and low motivation to achievement and approval). Multiple correlations between different types of motivation and electrical activity of the brain at rest, at hyperventilation with room temperature air and at isocapnic cold air hyperventilation were revealed.

[Electrical activity of the brain in different ventilation mode and its relationship with pattern of quite breathing and forced expiratory indices].

The influence of hyperventilation on electric activity of the brain has traditionally been the subject of study of physiologists. The role of the brain in the processes of adaptation to cold air inhalation is still studied not enough. The aim of the work is to define the peculiarities of brain reaction to isocapnic hyperventilation with cold air and identify correlation between its electric activity against different modes of ventilation and the pattern of breathing and parameters of the forced expiration. 21 healthy volunteers went through complex functional examination. Qualitative differences of relative power of theta rhythm at isocapnic hyperventilation with cold air were found out. The peculiarities of correlation between brain electric activity during cold provocation and breathing pattern and bronchomotor tone were revealed.

[Ergospirometry in the diagnosis of disorders of the oxygen transport system in patients with chronic bronchitis]. / Ergospirometriia v diagnostike narushenii sistemy transporta kisloroda u bol'nykh khronicheskim bronkhitom.

Ergospirometry was used to carry out a study with the increasing exercise in 56 patients with chronic bronchitis and 46 healthy subjects. The limit physical potentialities, qualitative and quantitative characteristics of ventilation, hemodynamics, gas exchange at the height of the exercise were compared. It has been established that in the early disease stages, there was a tendency to hyperventilation during exercise in response to the deterioration of bronchial patency, which was accompanied by significant deterioration of the efficacy of ventilation with respect to the level of gas exchange attained. A close relationship has been discovered between the magnitude of energy activity and bronchial patency. The authors give practical recommendations for determining work fitness prognosis on the basis of the linear regression equation with the use of the parameters of external respiratory function.

[Regional characteristics of pulmonary ventilation and hemodynamics in pregnant women suffering from chronic bronchitis]. / Regional'nye osobennosti ventiliatsii i gemodinamiki v legkikh u beremennykh zhenshchin, stradaiushchikh khronicheskim bronkhitom.

Altogether 96 normal women and 82 women with chronic nonobstructive bronchitis were examined during pregnancy using zonal rheography of the lungs. It was established that in pregnant women afflicted with chronic nonobstructive bronchitis, the regional ventilation and hemodynamics of the pulmonary circulation underwent rearrangement. It was discovered that in the second half of pregnancy there develop the signs of latent respiratory insufficiency manifesting themselves in an increase of the rheographic parameters of the ventilation perfusion relations. The regression equation is offered to calculate the proper values of the ventilation/blood flow ratio depending on the time of pregnancy.