[Prognostic criteria of efficacy of inhalation glucocorticosteroids in non-severe bronchial asthma]. / Prognosticheskie kriterii éffektivnosti ingaliatsionnykh gliukokortikosteroidov pri netiazheloi bronkhial'noi astme.

The aim of the study was to evaluate efficacy of inhalation glucocorticosteroid (GCS) drugs in patients with persisting bronchial asthma (BA) previously steroid untreated and identify factors influencing the results of GCS therapy. 67 patients with non-severe BA given long-term theophilline with inadequate effect received inhalation GCS drug budesonid which produced a complete clinical effect (group 1), a delayed effect (group 2) or no effect (group 3). The above groups were compared by clinico-anamnestic data, functional respiration parameters, chemiluminescence of mononuclear cells of the peripheral blood measured before therapy with budesonide. The discriminant analysis estimated the minimal set of the initial parameters by which the groups differ. The regression model was used to calculate an individual prognostic index of probable treatment efficacy for each patient. The results of the study agree with the view on BA as a multistage disease in which chronic persisting inflammation provokes progressive remodeling of the respiratory tracts and formation of pathophysiological disorders resistant to glucocorticoids. It is necessary to use inhalation GCS drugs early in persistent BA. They are strictly indicated if BA patients need regular daily intake of short-term beta 2-agonists.

[Evaluation of the efficacy of inhaled glucocorticosteroids in mild bronchial asthma]. / Otsenka éffektivnosti ingaliatsionnykh gliukokortikosteroidov pri netiazheloi bronkhial'noi astme.

AIM: To develop a procedure for evaluating the efficacy of antiinflammatory agents in mild persistent bronchial asthma. MATERIALS AND METHODS: 76 patients with mild bronchial asthma were given long acting theophylline. If a complete clinical and functional effect was absent, the inhaled glucocorticosteroid budesonide was added to the therapy. Before and after therapy, the forced expiratory volume per second and forced vital capacity (FVC) were measured many times within 24 hours, by using two procedures: 1) that involving morning and diurnal tests using short acting beta 2-agonists and 2) that without a bronchodilator. The time of onset of the plateau of values of different functional indices obtained during monitoring and their dispersion in the stable state were automatically calculated. The reliability of indices for evaluating the efficiency of antiinflammatory therapy was compared. RESULTS: There were great differences in the patients' response to therapy: a complete clinical and functional effect of therapy with long acting theophylline alone (n = 9) and in combination with budesonide (n = 56). Moreover, therapy-resistant patients (n = 11) were identified. When a complete therapeutic effect was achieved, the clinical symptoms of the disease disappeared before the onset of the plateau of values of the most reliable functional indices. A comparative analysis of the indices has indicated that the ratio of the morning value of FVC measured just after awakening to its best personal value throughout the study was most convenient for the patients and reliable. CONCLUSION: The authors propose to use the index "ratio of the morning value of FVC measured just after awakening to its best personal value the percentage", by calculating the dispersion of this index, which characterizes the steady state of the expiratory respiratory system in order to evaluate the efficiency of antiinflammatory therapy for bronchial asthma and to solve other problems that require functional monitoring.

[Individual patient sensitivity to glucocorticoids and hormone resistance in bronchial asthma]. / Individual'naia chuvstvitel'nost' bol'nykh k gliukokortikoidam i gormonorezistentnost' pri bronkhial'noi astme.

The paper reports glucocorticoid actions in bronchial asthma, covers problems of individual sensitivity to glucocorticoids and resistance to hormones, illustrates the dependence of beclometasone dipropionate efficacy on condition of glucocorticoid receptors in alveolar macrophages and clinical appearance of the disease, describes physiological features of patients with hormone-resistant bronchial asthma and its new treatment (extracorporeal photohemotherapy) allowing reduction of prednisolone dose in 14 of 15 patients from 29.6 to 11.4 mg/day, on the average.

[The Pulma-01 automated microprocessor system for testing external respiratory function]. / Avtomatizirovannaia mikropressornaia sistema dlia issledovaniia funktsii vneshnego dykhaniia "Pulma-01".

The automated system consisting of a pneumotachographic transducer, a differential pressure gauge, a precision amplifier and a microcomputer with a built-in printer is designed for the analysis of 20 main indices of external respiration functioning during forced expiration. It evaluates the measured data, compares them with the normal values and automatically diagnoses the pulmonary disease type.