[Clinico-immunological and bronchological characteristics of the late onset asthma]. / Kliniko-immunologicheskaia i bronkhologicheskaia kharacteristika pozdnei astmy.

Clinicoimmunological and bronchological examination was performed in 452 patients with bronchial asthma (BA) which were divided into two groups: 286 patients with late BA (onset at the age of 40 and older) and 166 patients with BA onset at the age under 40. Late BA develops because of non-allergic factors, especially persistent bronchopulmonary infection. Bad pulmonary background contributes to development of rapidly progressing respiratory obstruction with irreversible component. Cytological tests of the bronchoalveolar lavage revealed subnormal cytosis and viability of the cells, high counts of eosinophils and neutrophils, cells of bronchial epithelium with signs of dystrophy, low count of alveolar macrophages. Immunological tests in late BA patients evidence for suppression of local bronchopulmonary defense, low levels of both T-helper and T-suppressor cells, deficiency of C3 and C4, high serum IgG. The above changes are determined for the most part by immunosuppression induced by concomitant and past respiratory diseases.

[Use of a nebulizer as a new method of drug administration in treating dyspnea attacks in patients with bronchial asthma]. / Ispol'zovanie nebulaizera kak novogo metoda dostavki lekarstvennykh preparatov dlia kupirovaniia pristupov udush'ia u bol'nykh bronkhial'noi astmoi.

AIM: To try nebulizer for delivery of berodual solution to cope with asphyxia attacks in bronchial asthma (BA) patients. MATERIALS AND METHODS: Nebulizer was used in 86 patients suffering from bronchial asthma (BA) of different severity treated with standard therapy. Berodual inhalations (1 ml solution) were performed by means of nebulizer Pari Boy. Heart rate, respiratory movements rate, peak flowmetry were evaluated before and after the inhalations. RESULTS: One inhalation was enough for arrest of asphyxia in 70 patients (81.4%), two inhalations relieved the attack in 9 patients (10.46%), 7 patients (8.14%) needed intravenous infusion of euphylline solution for a complete attack arrest. Side effects were not registered. CONCLUSION: Berodual solution inhalations via nebulizer proved clinically and cost effective.

[Prognosis of nosocomial pneumonia outcome]. / Prognozirovanie iskhoda nozokomial'noi pnevmonii.

AIM: To assess frequency of occurrence of factors registered before or in the course of nosocomial pneumonia (NP) and implications of these factors for the risk of NP lethal outcome. MATERIALS AND METHODS: 70 NP patients entered the study. They were admitted to hospital with diagnosis of chronic nonspecific pulmonary disease, severe trauma, hemoblastosis, other tumors, etc. 26 of them recovered and were discharged from hospital, 44 patients died. RESULTS: The risk of lethal outcome in NP was higher in hepatic disturbances, high levels of urea in the blood, hemorrhagic syndrome, antibiotic treatment prior to NP, administration of glucocorticosteroids. St. aureus as the etiologic agent of nosocomial pneumonia was registered more frequently in patients with a lethal outcome. CONCLUSION: Further studies are needed for more precise evaluation of pathophysiological links between NP and lesions of other organs.

[Central hemodynamic function and the correction of heart rhythm disorders at the rehabilitation stage in IHD patients]. / Sostoianie tsentral'noi gemodinamiki i korrektsiia narushenii ritma serdtsa na étape reabilitatsii bol'nykh IBS.

Life expectancy and quality of sanatorium rehabilitation for patients with macrofocal myocardial lesions vary in line with severity of cardiac arrhythmia and left ventricular dysfunction. 24-h monitoring revealed defects in cardiac rhythm and conduction in 44.2% of cases. 42% and 36% of patients had ventricular extrasystole and high-grade Lown-Wolf ectopy, respectively. Supraventricular extrasystole occurred in 7.7%, combined extrasystole in 40% of cases. As to hemodynamics type, hypokinetic, hyperkinetic and eukinetic central hemodynamics were recorded in 63.0%, 5.2%, 31.8% of cases, respectively. Combinations of antiarrhythmic drugs (kilintin + obsidan, cordaron + disopiramide, cordaron + kinilentin, kinilentin + verapamil) were selected with consideration of the baseline type of central hemodynamics. Combined chemotherapy was more effective against different kinds of arrhythmia.

[The cholesterol esterase activity of the blood monocytes and alveolar macrophages in patients with chronic bronchitis]. / Aktivnost kholesterinésterazy monotsitov krovi i al'veoliarnykh makrofagovu bol'nykh khronicheskim bronkhitom.

The activity of cholesterol esterase (CE) in blood monocytes and alveolar macrophages (AMF) of bronchoalveolar fluid (BAF) according to Brecher et al., cell composition of endobronchial cytogram were investigated in 32 patients with chronic bronchitis (CB) and control subjects. In CB sufferers CE activity in AMF was inhibited, while in monocytes it was elevated reaching maximal values in purulent bronchopulmonary CB. Determination of CE activity in AMF and peripheral blood monocytes in CB may serve an additional diagnostic indicator of impaired lipid metabolism and suggests new approaches to investigation of CB pathogenesis.

[Lymphogenic introduction into lesser circulation of orally administered rifampicin in standard and liposomal forms]. / Limfogennoe postuplenie v malyi krug krovoobrashcheniia peroral'no vvodimogo v obychnoi i liposomal'noi formakh rifampitsina.

Pharmacokinetics of water and liposomal suspensions of lipophilic antibiotic rifampicin introduced intragastrically through a tube was studied in experiments on Wistar rats. After administration of water suspension rifampicin concentration reached its peak in all the tissues in 3 hours, lung concentration being 1.6 and 1.9 times higher than blood one. After liposomal suspension administration lymphatic rifampicin concentrations were maximal in 3 hours, while in the lungs and blood they were the highest in 6 hours. It is concluded that oral liposoluble drug enter primarily chyle vessels and via thoracic lymphatic duct directly lesser circulation. Liposomal inclusion of the drug warrants its high concentration in lymphatic system and lung tissue.

[The clinical and structural-metabolic characteristics of atrophic forms of chronic bronchitis]. / Klinicheskie i strukturno-metabolicheskie osobennosti atroficheskikh form khronicheskogo bronkhita.

A clinical-morphological study of bronchobiopsies from 78 patients with endoscopic picture of atrophic endobronchitis was carried out. Two forms of morphogenesis of chronic atrophic process in the bronchial mucosa are distinguished: primary dystrophic and primary inflammatory. Primary dystrophic bronchopathy is a clinical manifestations of the first form which presents structurally and functionally as primary dystrophy and atrophy of the bronchial mucosa in combination with sclerosis of the lamina propria in a sharp decrease of synthetic processes in bronchial epitheliocytes as indicated by the data of autoradiography. The primary inflammatory form of atrophic process has clinical symptoms typical for inflammatory process and is characterized by gradual reorganization in the bronchial wall and by maintaining sufficiently high level of metabolic reactions in bronchial epitheliocytes.

[The interferon status in diabetes mellitus]. / Interferonovyi status pri sakharnom diabete.

The investigation of interferon status in 54 diabetes mellitus patients gave evidence for high levels of blood serum interferon, leukocyte inhibition of alpha-interferon production against moderate synthesis of gamma interferon. More marked alterations in the interferon status were registered in severe insulin-dependent diabetes mellitus complicated by angiopathies and running more than 5 years. Compensation of metabolic processes was not relevant to interferon status. Variations in the levels of alpha- and gamma-interferons in the course ob observation occurred in 30% of the patients.

[Platelet aggregation inhibitors in the comprehensive treatment of bronchial asthma]. / Primenenie dezagregantov v kompleksnoi terapii bronkhial'noi astmy.

Platelet aggregation in infectious bronchial asthma patients was examined in vitro and in vivo upon administration of disaggregation agents trental, curantyl, sermion. A significant disaggregation related to trental and sermion action was recorded in vitro and in vivo as shown by hemolysate-aggregation test, ADP-induces aggregation, plasma levels of the platelet factor IV. Introduction of disaggregation agents in to combined therapy of infectious bronchial asthma contributes to more rapid arrest of bronchoconstriction in relevant patients.

[The immediate results of using plasmapheresis in patients with chronic glomerulonephritis]. / Blizhaishie rezul'taty primeneniia plazmafereza u bol'nykh khronicheskim glomerulonefritom.

A study was made of the effect produced by a short-term course of plasmapheresis (PA) combined with cytostatic, glucocorticoid and deaggregation therapy on the clinico-laboratory characteristics in 45 patients suffering from chronic glomerulonephritis (CGN). It has been established that PA rapidly normalizes the characteristics such as the level of circulating immune complexes and fibrinogen in the blood, ESR. Exerting no effect on renal function, PA led to a significant lowering of proteinuria and erythrocyturia, with its beneficial effects being preserved after discontinuation of the sessions. The best results were attained in associated CGN and nephrotic syndrome, in mesangioproliferative and mesangiocapillary CGN. The effectiveness of the short-term course of PA in patients with membranous and diffuse fibroplastic CGN turned out questionable.

[Tobacco smoking and nonspecific lung diseases]. / Tabakokurenie i nespetsificheskie zabolevaniia legkikh.

The data obtained by the authors indicate that the relationship between chronic nonspecific pulmonary diseases (CNPD) was only found in men and was established to be particularly dependent on the age, onset and duration of tobacco smoking. In men, the relationship manifested itself in the fact that with age and increase of the period of tobacco smoking the risk for pulmonary diseases rose. In women, such relationship appeared immaterial, but they also demonstrated a tendency towards the growth of the CNPD incidence with the rise of the period of tobacco smoking.

[A clinico-pathogenetic approach to choosing the therapeutic procedure in chronic glomerulonephritis]. / Kliniko-patogeneticheskii podkhod k vyboru terapevticheskoi taktiki pri khronicheskom glomerulonefrite.

The results have been compared of the use of two schedules (continuous and cyclic) of multimodality therapy of chronic glomerulonephritis (CGN) including cytostatics, corticosteroids, anticoagulants and deaggregation agents. Continuous therapy was carried out for 12.9 +/- 0.41 months on the average, with the drug dosage being corrected depending on the clinico-laboratory and immunological findings as well as on the parameters of the hemostatic system. Cyclic therapy was conducted for 6 months according to a strictly unified program. It has been shown that continuous individualized treatment compares very favourably with the cyclic schedule, which is particularly marked in mesangiocapillary CGN and CGN with a tubulointerstitial component. It is concluded that continuous multimodality treatment chosen with regard to the clinico-pathogenetic disease characteristics allows CGN prognosis to be improved.

[The mechanisms of intravascular blood coagulation in patients with systemic scleroderma]. / Mekhanizmy vnutrisosudistogo svertyvaniia krovi u bol'nykh sistemnoi sklerodermiei.

Hemostasis was investigated in 2 groups of patients with systemic scleroderma (SSD) with minimal (12 patients) and moderate (9 patients) activity of the process. It has been shown that in SSD, the triggering factor of intravascular blood coagulation is the release of Willebrand's factor, an activator of platelets, from the impaired endothelium. Hyperaggregation and labilization of platelets characterizes the course of SSD irrespective of the disease activity. The main changes in coagulation hemostasis are related to the dramatically accelerated triggered thrombin formation and deficiency of the antithrombin potential. The status of fibrinolysis confirming the thrombogenic situation is marked by a number of features: depression of contact lysis is maximally pronounced in chronic SSD with minimal activity, accumulation of the soluble complexes of fibrin monomer only correlates with the disease activity, and no significant rise of the level of fibrin/fibrinogen degradation products has been discovered.

[Study of the blood coagulation and fibrinolysis systems in evaluating the activity of glomerulonephritis]. / Koaguliatsionnaia i fibrinoliticheskaia sistema krovi v otsenke aktivnosti glomerulonefrita.

Certain parameters of blood coagulation and fibrinolysis were studied in 84 patients suffering from different variants of chronic glomerulonephritis. The disease is characterized by various conditions of the coagulation system, and acceleration of the initial stages of coagulation; the most typical are disturbances of thrombin inactivation. Simultaneous accumulation in the blood of products of degradation of fibrin and monomeric fibrin complexes is observed. The degree of manifestation of changes in blood coagulation and fibrinolytic systems corresponds to disease activity. The tests used are more sensitive than the traditional clinicolaboratory tests and reveal not only manifested by also latent disease activity.

[Organization of detection of patients with nonspecific diseases of the lung and their ambulatory care]. / Organizatsiia vyiavleniia bol'nykh nespetsificheskimi zabolevaniiami legkikh i dinamicheskogo dispansernogo nabliudeniia za nimi.

The rate of nonspecific diseases of the lungs among urban and rural population of the Novosibirsk Region was studied by using two-stage screening. It was shown that the number of tuberculous patients per 100,000 adults in the Region as a whole was in 1985-1987 the following: 860.0-1497.0 persons with chronic bronchitis and 170.0-187.0 persons with bronchial asthma. An increase in the number of the persons with chronic bronchitis and bronchial asthma among the inhabitants of both Novosibirsk and the Region was stated. On the basis of these data a scheme for differential dispensary observation was developed. The scheme includes combined prophylactic and treatment programs. The developed organizational grounds for the prophylaxis, early detection and treatment promoted a decrease in primary invalidism due to nonspecific respiratory diseases among the inhabitants of Novosibirsk from 2.2 per 10,000 workers in 1985 to 1.6 in 1987. The respective figures for the inhabitants of the Region were 4.7 and 3.9.