[Non - tuberculous mycobacteriosis of the lungs - diagnostic possibilities in the practice of the pulmonologist].

AIM OF THE STUDY: Show the possibilities of diagnosing non - tuberculous mycobacteriosis of the lungs (NTML) in the practice of the pulmonologist. MATERIALS AND METHODS: A survey of 90 patients with a confirmed diagnosis of non - tuberculous mycobacteriosis of the lungs (NTML) was presented. The diagnosis of pulmonary mycobacteriosis was established in accordance with the criteria proposed in 2007 by the American Thoracic Society and the American Society of Infectious Diseases (ATS/IDRS). Among the patients, 55 (61.1%) women prevailed, the average age was 51.2±15.3 years. Patients were evaluated complaints, the presence of concomitant diseases of the lungs, was carried out computed tomography of the chest high - resolution (HRCT), a culture study of sputum, in the absence of sputum or a single determination of the NTM culture in it, a study was conducted on materials of bronchoalveolar washout (ALS/BAL), or lung biopsies. Statistical processing of the research results was performed using descriptive statistics using Microsoft® Excel for Windows xp® on a personal computer. RESULTS AND CONCLUSION: As a result of the study, it was revealed that before the diagnosis of NTML was established, 66.7% of patients were long observed for chronic lung diseases (chronic obstructive pulmonary disease, chronic bronchitis), and in 55.6% of cases (50 people) were registered with a phthisiologist about pulmonary tuberculosis. According to the CT scan of OGK, dissemination was determined in 66.7% of cases, in 48.9% - bronchiectasis, single or multiple destruction cavities - 46.7% of cases. In 72.2% of cases, non - tuberculous mycobacteria (NTM) were found in sputum, in 33.3% - in ALS and in 22.2% of NTMs were found in the surgical material. In 14.4% of cases, only surgery allowed to establish the diagnosis of mycobacteriosis.

[Mucoactive therapy in pulmonological practice: current aspects].

The paper describes the causes of mucostasis and the mechanisms of its development. It presents classifications of mucolytic drugs. A group of combination mucolytic drugs is identified by indicating the standard of their design and usage. The characteristics of the drugs including the combination agent ascoril are described in detail and information on the successful results of its use is given.

[Use of the mucoregulator ascoril for respiratory diseases].

The paper deals with the use of the combined mucoregulatory drug ascoril in pulmonological care. Due to its multicomponent composition, the drug has mucoregulatory properties that combine a bronchodilator effect and an ability to dilute sputum and to synthesize the surfactant. The mechanism of action of each ascoril component is analyzed; the results of basic experimental and clinical studies on the use of the drug are given. A wide range of indications, such as respiratory system diseases, for ascoril use is demonstrated.

[Current anti-inflammatory therapy in patients with chronic obstructive pulmonary disease].

The lecture analyses current tools of anti-inflammatory treatment of patients with chronic obstructive pulmonary disease (COPD). Anti-inflammatory treatment is aimed at a key element of COPD pathogenesis. The results of treatment with main anti-inflammatory drugs and methods in COPD management are reviewed as well as efficacy of a new anti-inflammatory drug roflumilast in COPD patients.

[Errors in outpatient pulmonology].

The diagnosis and treatment of patients with bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) by local physicians of one of the large administrative districts of Moscow were examined. Nine hundred and sixty outpatient's cards at 22 polyclinics were randomly checked up. There was a high percentage of diagnostic and therapeutic errors, the main reason for which was therapists' inadequate training in pulmonology. After implementing the intensive educational programs on BA and COPD for a year, a reexamination showed a considerable reduction in the number of medical errors.

[Possibilities of improving the diagnosis and treatment of obstructive pulmonary diseases in the Northern Administrative District of Moscow].

The quality of the diagnosis and treatment of lung diseases was assessed in the polyclinics of the Northern Administrative District of Moscow by 2 methods: (1) selective examination of 960 case histories of bronchial asthma and chronic obstructive pulmonary diseases and (2) questionnaire survey and spirometry of 2132 patients aged 35 to 75 years who have visited a polyclinic for no respiratory diseases. Random check of the case histories revealed a large number of diagnostic and medical errors suggesting the undertraining of therapists in pulmonology. The performed cycles of educational programs could considerably reduce the number of the errors found on recheck. Questionnaire survey and spirometry could increase the number of diagnosed cases of chronic lung diseases by 10 times.

[Clarythromycin in the treatment of exacerbations of chronic obstructive lung disease].

Clarythromycin (Clerimed) is an antibiotic that has a high antibacterial potential, is successfully used in the treatment of moderate and severe exacerbations of Stage II chronic obstructive lung disease (COLD). Comparison of the clinical efficacy of Clerimed with beta-lactams and respiratory fluoroquinolones has indicated the equal clinical efficacy of the compared groups of drugs. A functional and laboratory monitoring of patients with an exacerbation of COLD treated with Clerimed has established that the most pronounced changes (improvement) occur within the first week of antibiotic therapy, which is typical of control patients. The side effects of Clerimed have been found to occur not more frequently than those of other antibiotics and they are considered to be slight. Clarythromycin may be recommended for the starting therapy of exacerbations of COLD in everyday practice.