ABSTRACT
The aim of this work was to study the prevalence and clinical features of affection of lungs and lower respiratory tract (LRT) in patients with rheumatoid arthritis (RA). A total of 104 non-smoking patients with RA and 100 ones without RA or chronic pulmonary diseases were examined. RA was associated with affection of all parts of the respiratory tract including proximal and distal bronchi, lung interstitium, and pleura. Bronchopulmonary disorders in RA patients had multilevel character suggesting continuous inflammation and sclerotization of anatomic respiratory structures. Lesions in lungs and LRT are shown to be of prognostic value (bronchiectasis, bronchiolitis, interstitial pneumonia), they frequently produce only weak clinical symptoms, and therefore need to be actively detected. Combination of functional tests and imaging techniques is of primary importance for diagnosis of respiratory problems in patients with RA.
Subject(s)
Arthritis, Rheumatoid/pathology , Lung/pathology , Adult , Arthritis, Rheumatoid/physiopathology , Bronchi/pathology , Bronchi/physiopathology , Female , Humans , Lung/physiopathology , Male , Middle Aged , Pleura/pathology , Pleura/physiopathologySubject(s)
Connective Tissue Diseases/diagnosis , Adolescent , Adult , Chromosomes, Human, Pair 15 , Connective Tissue Diseases/genetics , Ehlers-Danlos Syndrome/diagnosis , Ehlers-Danlos Syndrome/genetics , Female , Genetic Linkage , Heart Diseases/diagnosis , Heart Diseases/genetics , Humans , Male , Marfan Syndrome/diagnosis , Marfan Syndrome/genetics , Middle Aged , Pneumothorax/diagnosis , Proteinuria/diagnosis , Syndrome , Visceral Prolapse/diagnosisABSTRACT
Metoprolol succinate was given to 60 patients with class I-III heart failure and ejection fraction <45% after myocardial infarction. Forty seven patients (mean age 59.3+/-9.8 years) completed 6 months of therapy. Dynamics of ventricular arrhythmias was assessed by Holter ECG monitoring, registration of parameters of high resolution ECG and heart rate variability. and echocardiography. Functional class of heart failure decreased in 93%, that of angina - in 55% of patients. Antiarrhythmic effect was achieved in 72% of patients. This was associated with diminishment of left ventricular volumes and increased ejection fraction, shortening of TotQRSF, and improvement of autonomic regulation of cardiac action. No dynamics of myocardial contractility and electrophysiological remodeling occurred in patients without antiarrhythmic effect.
Subject(s)
Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/prevention & control , Heart Failure/drug therapy , Metoprolol/analogs & derivatives , Metoprolol/therapeutic use , Adult , Aged , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/physiopathology , Drug Therapy, Combination , Female , Heart Failure/etiology , Heart Failure/physiopathology , Humans , Male , Middle Aged , Myocardial Infarction/complications , Treatment Outcome , Ventricular Remodeling/drug effectsABSTRACT
AIM: Study of late outcomes of bronchial asthma (BA) and factors of risk of rapidly progressive BA course. MATERIALS AND METHODS: A 10-year retrospective trial. Examination of 118 patients with BA aged 17-74 years. RESULTS: A rapid progression of BA observed in 17(14%) patients led to an unfavorable outcome (death, life-threatening conditions, invalidism) as early as the first year of the observation. Relevant factors of risk were active eosinophil endobronchitis found at fibrobronchoscopy, concomitant active nonspecific infection in the bronchi, unjustified use of oral corticosteroids when inhalation steroids were possible, family problems. CONCLUSION: Active secondary prophylaxis is necessary in patients at high risk of rapidly progressive BA.
Subject(s)
Asthma/therapy , Adolescent , Adult , Aged , Asthma/diagnosis , Asthma/mortality , Chronic Disease , Disease Progression , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Statistics, Nonparametric , Surveys and Questionnaires , Time Factors , Treatment OutcomeABSTRACT
In a 10-year retrospective observational study the authors investigated the effects of antiinflammatory therapy with corticosteroids (CS), broncholytic therapy with theophylline drugs (TD) and of inhalations of short-action sympathomimetics (ISM) on the course and long-terms outcomes of bronchial asthma (BA). The data were processed using actuarial analysis. It was established that long-term CS therapy diminishes the risk of the unfavourable BA outcome (death, life-threatening conditions, invalidism). The protective CS action was maximal in patients with severe persistent BA. The best treatment results were achieved in long-term CS course in doses warranting effective control over respiratory symptoms. Long-term TD administration failed to demonstrate a significant influence on long-term BA outcomes. Overdoses of ISM occasionally observed in the course of relevant treatment placed the exposed patients at higher risk of unfavourable BA outcome. ISM overdoses were associated with severe and uncontrollable BA.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Asthma/drug therapy , Beclomethasone/therapeutic use , Bronchodilator Agents/therapeutic use , Theophylline/therapeutic use , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
Medical service to bronchial asthma (BA) outpatients and their education were assessed in a specially designed study of BA outcomes. Negative factors which contributed to unfavourable BA outcome were the following: formal approach of the physicians to the patients follow-up, the patients' noncompliance, their rejection to apply for medical aid in BA exacerbation, bad skills of self-care in grave BA attacks.
