Bronchopulmonary Diseases Research Articles

Osteoporosis – a Silent Epidemic of XXI Century: Secondary Forms

The objective of the study was to determine the main causes of osteoporosis in chronic kidney disease, chronic obstructive pulmonary disease, pulmonary sarcoidosis and understand how the disease develops in these conditions.
 Materials and Methods. To study the mechanisms of developing secondary osteoporosis, a literature review was conducted.
 Results. Secondary forms of osteoporosis account for approximately 15-20% of reported cases and result mainly from concomitant diseases or from using drugs that have a negative effect on bone tissue. Despite its inert and stable appearance, bone tissue is a metabolically active, continuously renewing system. Throughout life, it continuously undergoes remodeling cycles involving the two main processes: the first one is called bone resorption and involves the breakdown of old bone followed by the destruction and removal of both the mineral substance and the organic matrix from resorption sites; the second one is called new bone formation and involves bone matrix synthesis and its subsequent mineralization. The imbalance between these two processes, the predominance of bone resorption over bone formation, is the key link in the pathogenesis of osteoporosis. Such an imbalance reflects the impairment of the major mechanisms of systemic hormonal and local (cytokine) regulation of cellular activity and occurs in secondary osteoporosis.
 Conclusions. To date, at the stage of providing medical care to patients with chronic bronchopulmonary diseases and chronic kidney disease, inadequate attention is paid to timely diagnosis and treatment of concomitant osteoporosis. The latter often develops as a secondary condition due to systemic inflammation, severe hypoxia, low physical activity, taking inhaled and systemic glucocorticoids. Its signs are not clinically apparent; hence, it is referred to as the ‘silent epidemic. Since osteoporosis has no pathognomonic symptoms and its clinical presentation is rather vague, in patients with chronic bronchopulmonary diseases and chronic kidney disease, its early diagnosis by determining mineral bone density is recommended to prevent the development of severe complications, including low-energy fractures.

Risk factors for the development of bronchopulmonary pathology in workers producing synthetic polyacrylonitrile fiber

Aim of the study was to assess the risk of bronchopulmonary pathology in workers of the production of synthetic polyacrylonitrile fiber as a result of exposure to harmful chemicals and smoking tobacco products . Material and methods . During the periodic medical examination , the function of external respiration and adherence to smoking in 137 employees were studied , medical records were analyzed (025/u accounting form ). Hygienic assessment of working conditions was carried out on the basis of the results of in-situ sanitary and hygienic studies . Results and discussions . As a result of a hygienic assessment of working conditions , it was found that workers engaged in the production of polyacrylonitrile fiber are subject to the combined intermittent effects of harmful chemicals of hazard classes 1–3 ( acrylonitrile , methyl acrylate , hydrocyanide , ammonia , sodium rhodanide , sulfuric acid , methanol , isopropyl alcohol , ethylene glycol ), the content of which in the working area exceeded the maximum permissible concentrations in 1.6% of samples . The occupational risk of developing bronchopulmonary diseases in groups of workers who smoke is assessed as unacceptably high , while in people exposed to harmful chemicals , its level is 28.46 times higher than in people who are not exposed to these effects . The risk of the formation of ventilation disorders in groups of smoking workers is unacceptably high , while its level is 2.46 times higher in workers exposed to harmful chemicals than in non-workers in such conditions . In groups of workers exposed to harmful chemicals , the occupational risk of obstructive disorders is unacceptably high , in the group of smokers the risk is 2.32 times higher . Conclusions . Among the employees of the enterprise producing synthetic polyacrylonitrile fiber , the influence of tobacco smoking on the development of bronchopulmonary pathology is higher than the influence of harmful working conditions , and the use of smoking tobacco products significantly increases the negative effect of chemical pollutants .

КОНЦЕПЦИЯ МЕДИЦИНСКОЙ ИНФОРМАЦИОННОЙ СИСТЕМЫ ДЛЯ РЕШЕНИЯ ЗАДАЧ ДИАГНОСТИКИ ЗАБОЛЕВАНИЙ НА ОСНОВЕ ВЕРИФИКАЦИИ ФРАГМЕНТОВ МЕДИЦИНСКИХ БИОЛОГИЧЕСКИХ ОБЪЕКТОВ

This article offers one of the variants of the concept of developing and implementing the synthesisof MIS from the perspective of a systematic approach, which is designed to solve the problems of diagnosingdiseases through the application and development of a methodology for verifying the state offragments of biological objects using computed tomographic images and using statistical parameters forthis (expectation, variance, histogram, coefficient of variation, autocorrelation matrix, correlation coefficient) for quantitative assessment of the conditions of the frontal or maxillary sinus inotolaryngological diseases, chest organs in bronchopulmonary diseases, bone tissues and their identificationin accordance with the class of pathologies in the diagnosis of the patient in automatic mode byradiographic (tomographic) images. A variant of the implementation of MIS for the diagnosis and evaluationof the results of medical research is proposed, built on a modular principle based on the technologiesof Intranet and Internet networks using standard data transmission protocols, audio-video information,graphic information of a medical nature and including a subsystem of technical support, a subsystemof mathematical support, a subsystem of software, a subsystem of information support, a subsystemof organizational support, information security subsystem, subsystem of methodological supportand support. It is pointed out the current state of development of medical diagnostic equipment, theequipment of which medical institutions of the country and its non-operational accessibility to the populationcontributed to and led to the emergence and active development of new directions in the field ofradiation diagnostics, which include: digital and film radiography, computed tomography, magneticresonance imaging. A brief analysis of the implementation of mathematical models of diagnostic methodsimplemented by software for the functioning of the decision support subsystem of the medicalautomated information system is given. Examples of practical implementation of software and informationsupport for verification methods of medical objects in the form of screen forms for workingwith fragments of the object under study and the results of the analysis of radiographic images areshown. This makes it possible to increase the efficiency, accuracy of verification of the state of medicalbiological objects, the reliability of the disease diagnosis process. The scientific novelty, the resultsof the approbation of the material presented in the article at international, All-Russian conferences,scientific journals are shown.

Hypoxic Conditioning in Rehabilitation and Secondary Prevention Programs in Cardiac Patients with Multimorbidity: a Review

INTORDUCTION. Patients with multiple chronic diseases are at higher risk of premature death, hospitalization, longer hospital stays, and reduced health-related quality of life compared to patients with a single disease. On the other hand, the presence of comorbid conditions limits the enrolment of traditional exercise-based cardiac rehabilitation programs. It is predicted that as life expectancy increases, the level of multimorbidity will increase, making it even more important to find new additional methods and technologies for the rehabilitation of cardiac patients with comorbidities. AIM. To analyze the data from the current publications or to define the validity and effectiveness of using different hypoxic conditioning regimens in cardiac patients with concomitant chronic pathology (arterial hypertension, obesity, diabetes mellitus, and chronic bronchopulmonary diseases) as well as in multimorbid elderly patients. MATERIAL AND METHODS. The search for relevant papers was carried out using the Medline, e-library, and Web of Science Core Collection databases, as well as the following keywords: “hypoxic conditioning”, “hypoxic training”, “hypoxic therapy”, “interval hypoxic therapy”, “intermittent hypoxia”, “hypoxic conditioning”, “interval hypoxia training”, and “hypoxic exposure”. The analysis included publications regarding the use of the hypoxic conditioning method in cardiac and elderly patients with multimorbid pathology, as well as publications on the use of the method in the rehabilitation of patients with certain nosologies to identify potential mechanisms in correcting bronchopulmonary violations and lipid and carbohydrate metabolism disorders. The last search date was April 05, 2022. RESULTS. Most of the analyzed studies proved that the hypoxic conditioning technology in passive interval exposure regimes is an effective method for non-pharmacological correction of cardiometabolic risks in cardiac patients with multimorbid pathology and can increase exercise tolerance, optimize hemodynamic parameters (HR, SBP and DBP), reduce the manifestations of bronchial obstruction and respiratory failure, and improve cognitive function and metabolic indicators. Personalized physical activity doses in oxygen-depleted ambient air appear to be promising, but require additional studies to establish optimal application protocols. CONCLUSION. The data presented may recommend hypoxic conditioning technologies for wider implementation in cardiac rehabilitation programs for patients with multimorbid pathologies.

Pathophysiological and pharmacological concepts in the treatment of bronchopulmonary diseases

Bronchopulmonary diseases are an urgent problem for practical health care, as they are a frequent complication of acute respiratory viral infections (ARVI), which have a very high incidence in all age groups of the population, and especially among children. The novel coronavirus infection (COVID-19) pandemic, which the world faced in 2019, convincingly confirmed these facts. Therefore, effective pathophysiological treatment of patients with bronchopulmonary diseases is the most important task of modern pharmacotherapy. The 2 most important highly effective mechanisms for protecting the respiratory tract from pathogenic agents that provide the drainage function of the respiratory tract are described: mucociliary transport and cough. When pathological processes occur in the tracheobronchial tree (various bronchopulmonary diseases), the rheological properties of the bronchial secretion, structural and functional characteristics of the mucous membrane and submucosal layer of the airways change. This leads to mucostasis, a violation in the system of mucociliary transport – a key mechanism for protecting the respiratory tract from pathogenic agents, which significantly complicates the course and treatment of bronchopulmonary diseases, because mucostasis contributes to the violation of bronchial patency and the occurrence of atelectasis. Multfactorial is a distinctive feature of changes in mucociliary transport in bronchopulmonary diseases and requires a complex pharmacological action aimed at its normalization. Therefore, pathogenetic therapy aimed at restoring all the key factors of mucociliary transport is targeted in the treatment of various bronchopulmonary diseases. Mucoactive drugs that belong to different pharmacological groups, the use of which is aimed at restoring mucociliary transport, are considered. The necessity of using combined mucoactive drugs for the treatment of patients with bronchopulmonary diseases has been substantiated.

Some features of the coronavirus infection course in bronchial asthma patients

The outbreak of a new coronavirus infection was officially recognized by the World Health Organization as a global pandemic since March 11, 2020. The pandemic is currently gradually receding, the number of patients is also steadily decreasing. However, these circumstances are not grounds to believe that the virus has been definitively and irrevocably defeated. For this reason, the world medical community is still concerned about the coronavirus impact on the course and outcome of various chronic bronchopulmonary diseases. Bronchial asthma has been recognized as one of the leading forms of human somatic pathology throughout the history of mankind and medicine. It is quite natural that the focus of the researchers' attention turned out to be questions about the SARS-CoV-2 virus impact on patients suffering from bronchial asthma, starting with the peculiarities of the course of combined pathology and ending with the peculiarities of therapy and subsequent rehabilitation. The issues of coronavirus infection and bronchial asthma pathogenesis were considered. The research data on some features of the development and course of a new coronavirus infection in patients with this profile were analyzed and summarized. The low coronavirus infection prevalence among patients with an allergic bronchial asthma form compared with other phenotypes is shown among such features, data on the effect of eosinophilia on the course of infection are presented, and the basic therapys positive effect using inhaled glucocorticosteroids and/or monoclonal antibodies (biological therapy) in severe asthma, is shown in the form of a protective effect that provides a lighter coronavirus infection course. The main features of patient management suffering from bronchial asthma in the conditions of a pandemic are the organization of stable medical control in online telemedicine once monthly, regular examinations in accordance with the severity of the course of the disease and the correction of basic therapy to achieve complete control over the course of asthma.

Terrencure as a highly effective method of treatment and rehabilitation of patients with diseases of the cardiovascular system

This review is devoted to a modern and highly effective complex method of treatment and rehabilitation of patients with cardiovascular diseases — terrencure, which, according to A. D. Fesyun (2022), is a combination of climate therapy and physical exercises in the open air in a natural environment, significantly increasing the effectiveness of each of these methods. Physical activity is important for preventing and limiting morbidity and mortality from chronic diseases and thereby reducing health care costs and reducing economic productivity. Terrenkur is a method of training therapy that helps to improve endurance and functioning of the cardiovascular, respiratory and nervous systems, metabolism, as well as the muscles of the limbs and trunk. The method represents metered physical activity in the form of hiking over rough terrain, climbing in mountainous terrain along certain marked routes under the supervision of a doctor. dosed physical activity by distance, time and angle of inclination of hiking is a method of training and treatment of various forms of cardiovascular, bronchopulmonary and other diseases. World and domestic scientific and practical experience testifies to its high efficiency and an increase in the adaptive and compensatory potential of the patient’s body as a result of the use of terrencure, the safety of its use in medical and rehabilitation programs. Wide availability, low cost-effectiveness and additional therapeutic effects in contact with the terrain, it seems appropriate to expand the use of the terrencure for spa treatment and rehabilitation.

1% Versus 2% Lignocaine for Airway Anaesthesia in Flexible Bronchoscopy

Introduction: Flexible bronchoscopy is one of the most widely performed procedures for diagnosis of various bronchopulmonary diseases. Most patients tolerate the procedure well although cough is often reported as a distressing symptom. Objectives: The main objective of the study is to find the comparison of 1% versus 2% lignocaine for airway anaesthesia in flexible bronchoscopy. Material and methods: This randomized control trial was conducted in pulmonology department of DHQ Hospital Faisalabad and the duration of this study was from July 2018 to December 2018. The data was collected with the permission of ethical committee of hospital. Data was collected with the permission of ethical committee of hospital. The data was collected through random sampling technique. Demographic and baseline values of all the selected patients were collected. Before the start of the bronchoscopy procedure, blood pressure, heart rate, respiratory rate, and pulse oximetric saturation were recorded and monitoring continued during the procedure. Results: The data was collected from 100 patients with mean age 44.56±2.45 years in group I and 46.78±2.34 years in group II. The demographic and baseline values were similar in both groups. Table 01 explains all the basic parameters of both groups. Fifty subjects each were randomized to 1% and 2% groups, and all randomized subjects completed the study protocol. The cumulative dose of lignocaine administered in 2% lignocaine group was significantly greater than in 1%. The doses of midazolam in 1% and 2% lignocaine groups administered were similar Practical implications: After this trial we may apply this procedure for airway anaesthesia in flexible bronchoscopy Conclusion: It is concluded that there was no significant difference in operator-rated overall procedure satisfaction or cough in between the two groups. Keywords: Lignocaine, Patients, Significant, Efficacy, Satisfaction, Anaesthesia

ABOUT MODERN METHODS OF TREATMENT OF ACUTE STENOSING LARYNGOTRACHEITIS IN CHILDREN

Acute infectious and inflammatory processes in the upper respiratory tract still form the main list of diseases in childhood, which maintains the constant interest in this pathology of specialists in various fields, such as pediatricians, infectious disease specialists, otorhinolaryngologists, allergists, and immunologists. Particular attention of researchers and clinicians is attracted by the study of the etiopathogenetic mechanisms of the occurrence of laryngotracheitis, which is caused, first of all, by the development of a life-threatening condition of acute stenosis of the respiratory tract in children. According to our observations and according to the literature, there has recently been a clear trend towards an increase in the frequency of repeated episodes of acute stenosing laryngotracheitis (ASLT) in children, which makes it obvious that further study of the underlying mechanisms of not only the occurrence, but also the recurrence of ASLT is necessary. Recurrence of laryngotracheitis contributes to the formation of chronic inflammatory processes and hyperreactivity of the upper respiratory tract, negatively affects the maturation of the child's immune system, which leads to the development of secondary immunosuppression. Each new respiratory infection provokes more and more serious disorders of the immune system, contributing to the formation of both chronic inflammatory diseases of the pharynx and respiratory allergies. The modern concept of the etiopathogenesis of laryngotracheitis takes into account the action of multiple infectious and allergic trigger factors, the most significant in immunocompromised children. Currently, the primary tasks awaiting solution are timely prevention and diagnosis, the provision of highly qualified medical care, including bronchopulmonary diseases in children by expanding the use of modern methods of diagnosis and treatment, which will improve the quality of life of children.

Approach to Software Integration of Heterogeneous Sources of Medical Data Based on Microservice Architecture

The task of processing medical information is currently being solved in our country and abroad by means of heterogeneous medical information systems, mainly at the local and regional levels. The ever-increasing volume and complexity of the accumulated information, along with the need to ensure transparency and continuity in the processing of medical data (in particular, for bronchopulmonary diseases) in various organizations, requires the development of a new approach to integrating their heterogeneous sources. At the same time, an important requirement for solving the problem is the possibility of web-oriented implementation, which will make the corresponding applications available to a wide range of users without high requirements for their hardware and software capabilities. The paper considers an approach to the integration of heterogeneous sources of medical information, which is based on the principles of building microservice web architectures. Each data processing module can be used independently of other program modules, providing a universal entry point and the resulting data set in accordance with the accepted data schema. Sequential execution of processing steps implies the transfer of control to the corresponding program modules in the background according to the Cron principle. The schema declares two types of data schemas - local (from medical information systems) and global (for a single storage system), between which the corresponding display parameters are provided according to the principle of constructing XSLT tables. An important distinguishing feature of the proposed approach is the modernization of the medical information storage system, which consists in creating mirror copies of the main server with periodic replication of the relevant information. At the same time, the interaction between clients and data storage servers is carried out according to the type of content delivery systems with the creation of a connection session between end points based on the principle of the nearest distance between them, calculated using the haversine formula. The computational experiments carried out on test data on bronchopulmonary diseases showed the effectiveness of the proposed approach both for loading data and for obtaining them by individual users and software systems. Overall, the reactivity score of the corresponding web-based applications was improved by 40% on a stable connection.

Prospects for Treatment of Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a severe, progressive lung disease of unknown etiology with an average worldwide prevalence of 15 per 100,000. According to the etiology, IPF is classified into sporadic, syndromic, and familial cases. Sporadic cases refer to multifactorial diseases and are associated with age, viral infections, smoking and inhalation of dust, contact with chemicals and drugs, gastroesophageal reflux disease. There were revealed an association of sporadic IPF with allelic variants of the genes AKAP13, ATP11A, DPP9, DSP, IVD, IL1RN, FAM13A, MUC5B, SFTPC, SPPL2C, TERC, TERT, TOLLIP. Syndromal IPF develops in German-Pudlak syndrome. Familial cases of the disease are caused by mutations in the genes encoding surfactant (SFTPC), mucin (MUC5B), deadenylation nuclease (PARN), components of telomere functioning (RTEL1, TERC, TERT). In 2000, the American Thoracic Society recommended glucocorticoids and cytostatics for the treatment of ELISA in order to influence the inflammatory process due to the activation of fibroblasts and their accumulation in the extracellular matrix of the lungs. These recommendations are still used by many doctors, despite the publication of reliable data on the increased mortality and hospitalizations of IPF patients taking prednisolone and azathioprine. According to recent meta-analyzes, pirfenidone (an inhibitor of the synthesis of procollagen I and II growth factors) and nintenadib (a tyrosine kinase inhibitor) are the most effective treatments for IPF. Since genetic factors play an important role in the etiopathogenesis of the disease, it is promising to search for methods of targeted therapy for IPF using specific noncoding RNAs as targets, changes in the expression of which are not specific of other bronchopulmonary diseases. These RNAs include miR-9-5p, miR-27b, miR-153, miR-184, miR-326, miR-374, miR-489, miR-630, miR-1343 (decreased expression in IPF); miR-340, miR-424, miR-487b, miR-493, lncRNA AP003419.16, lncRNA AP003419.16 (increased expression in IPF).

Methods for diagnosing dysfunction of small airways and uniformity of lung ventilation: their use after a novel coronavirus infection

In this lecture, we discussed methods and approaches to the diagnosis of small airways dysfunction, such as multiple breath nitrogen washout test, impulse oscillometry, as well as the calculation of poorly communicating fraction (PCF) as the ratio of total lung capacity to alveolar volume. The detection of the small airways dysfunction with the help of the diagnostic tools listed above makes it possible to establish functional disorders of the respiratory system in the early stages of bronchopulmonary diseases, when the results of traditional pulmonary functional tests remain within normal values. Thus, a well-standardized and the most accessible method for detecting the peripheral airways dysfunction is body plethysmography, which is used to diagnose the presence of “air trappings”. However, in the early stages of bronchopulmonary diseases, the possibilities of this method are limited. The lecture focuses primarily on the results of our own researches which were performed on patients who have suffered from a novel coronavirus infection complicated by viral pneumonia. Spirometry, body plethysmography, diffusion test, impulse oscillometry, multiple breath nitrogen washout test were conducted, and PCF index was calculated in all patients included in this analysis. The description of the PCF index, the method of its calculation, the range of normal values, as well as the possibilities of application in clinical practice are given for the first time in the Russian literature. The approaches to assessing the dysfunction of the small airways described in the lecture are not widely used at present, however, we hope that the knowledge that is currently being applied in scientific laboratories will gradually be introduced into routine clinical practice.

Caryocar coriaceum Wittm. (Caryocaraceae): Botany, Ethnomedicinal Uses, Biological Activities, Phytochemistry, Extractivism and Conservation Needs.

Caryocar coriaceum is an endemic tree of Brazil, occurring mainly in the northeast region in the Cerrado environment. The species, popularly known as “pequi”, produces fruits that are used in the manufacture of oil for food and medicinal purposes. This work reviewed studies conducted with the species, highlighting its ethnomedicinal use, its pharmacological potential, including its chemical constituents, and its cultural and socioeconomic importance. Information was obtained through the main scientific research platforms. The keyword “Caryocar coriaceum” was used as the main index for searching the following platforms: PubMed®, PubMed Central®, SciElo, Scopus® and Web of ScienceTM. The compiled papers demonstrate that C. coriaceum has great medicinal, economic and cultural importance for northeastern Brazil. Popularly, the fruits of C. coriaceum are used to treat broncho-pulmonary diseases (bronchitis, colds and flu). The fixed oil is widely used to relieve pain from various causes in the treatment of inflammation, flu, eczema, burns, fever, rickets, indigestion, heart murmurs, fatigue and erectile dysfunction. Some of these uses are corroborated by pharmacological trials, which have demonstrated the antioxidant, healing, anti-inflammatory, gastroprotective, antinociceptive and antimicrobial properties of the species. Chemically, fatty acids and phenolic compounds are the main constituents recorded for the species. Due to its medicinal properties, the fruits and oil of C. coriaceum have a high commercial demand and are one of the main forms of subsistence activities for local populations. On the other hand, the extractive practice of the fruits, associated with anthropic factors and its physiological nature, makes the species threatened with extinction. Thus, public management policies are highly necessary in order to avoid its extinction.

Evaluation of amoxicillin efficacy in the pharmacotherapy of bronchopulmonary diseases in children

In recent years, the rational treatment of bronchopulmonary diseases in children has been developing in all directions and is of great importance in modern pediatrics. Medical statistics in different countries record a steady annual increase in the number of cases of respiratory infections, recurrent bronchitis, and bronchopneumonia. One of the main components of adequate etiopathogenetic treatment of bacterial infections, regardless of the severity and localization of the inflammatory process, is the rational choice of antibacterial agents. The urgent problem has been the safe pharmacotherapy of a growing organism, taking into account the etiology and pathogenesis of diseases, in accordance with the standard of treatment. The aim of this study was to evaluate the effectiveness of the drug Amoxicillin, depending on the severity of the course, complication and comorbidity in children receiving inpatient treatment at the Tashkent Pediatric Medical Institute Clinic.

Pathogenetic treatment of patients with COVID-19 at the outpatient stage

ABSTRACT. It has been over 2 years since the world run into coronavirus disease (COVID-19), but the pandemic is still going. Today we have a much better understanding of the pathogenesis of the disease and immune defense mechanisms, which opens up new possibilities for the pathogenetic treatment of coronavirus infection. It is known that COVID-19 often has a wavy course: the first wave, which is characterized by mild symptoms, after a temporary improvement passes into the second wave (so-called pulmonary phase), which is much more severe and often fatal. Therefore, it is important to prescribe effective treatment at the early stage of COVID-19, which will allow to change the trajectory of the first wave and prevent its transition to the fatal “ninth shaft”. This can be achieved by inhibiting the replication of SARS-CoV-2 virus with etiotropic therapy, and by using of complex pathogenetic therapy to suppress inflammation and prevent cytokine storm, to protect pneumocytes, to minimize the effects of oxidative stress, possible interruption of the coagulation system. This complex approach is especially important for elderly patients or those with chronic cardiovascular, bronchopulmonary and endocrine diseases. In this review, we present the evidence base for the effectiveness of COVID-19 pathogenetic therapy. We hope that the presented therapeutic strategy will help physicians to improve the effectiveness of outpatient management of patients with coronavirus infection.

The formation of mucociliary insufficiency in the bronches in respiratory viral infection

Viral infectious inflammatory processes of the respiratory organs account for half of the total morbidity of children and one third of the morbidity of adolescents. One of the most important protective mechanisms of the respiratory system is the mucociliary transport system. There are studies of the mucociliary system in children with various bronchopulmonary diseases. In case of respiratory viral infection, the study of mucociliary transport is presented in single studies.

A comparison of informative between 6-minute walking test and sit-to-stand test in patients with fibrosing interstitial lung diseases

Physical intolerance is an important sign of many chronic respiratory diseases. The most useful tool for clinical evaluation of physical status is six-minute walking test (6-MWT), but sometimes its technical requirements are not feasible. By this reason, a search for alternative field tests have being going on in the last years, but the diagnostic yield of the new exercise tests for most chronic bronchopulmonary diseases is not clear.The aim of this study was to compare results of 6-MWT and 30-seconds sit-to-stand (30-s-STS) test in patients with fibrosing interstitial lung diseases (ILDs) and restrictive abnormalities of lung function.Methods. This was a cross-sectional non-randomized open comparative study. Patients with ILDs were asked to perform 6-MWT and 30-s-STS test with 30 min interval. We also analyzed medical history, lung function, and dyspnea assessed with Medical Research Council (MRC).Results. The study included 25 ILD patients (11 males; 14 women); 75% of patients had restrictive lung function disorders. The mean distance walked in 6-MWT (6MD) was 380.4 ± 111.9 m (M ± SD), 14 (56%) patients desaturated during the test. The mean number of repetitions in 30-s-STS test was 12 (10 – 13) during 30 s; 5 (20%) patients desaturated during the test. 6MD showed moderate correlation with the number of repetitions in 30-s-STS test and to dyspnea on exertion. The number of repetitions in the 30-s-STS test was not associated with any clinical or functional parameters. To the end of exercise, the number of patients who desaturated increased, the desaturation was greater, and post-exercise SpO2 was lower in 6-MWT compared to 30-s-STS test.Conclusion. 30-s-STS test was less informative in terms of reduced physical tolerance and desaturation on exertion compared to 6-MWT in patients with fibrosing ILDs and restrictive abnormalities of lung function.

The use of phytopreparations in the treatment of bronchopulmonary diseases: evidence base and practical experience

Respiratory diseases take the lead in the infectious pathology pattern of various organs and systems and are the most common. Acute bronchitis is inflammation of the bronchi due to a viral infection and is characterized by a persistent cough that can be productive or dry. The authors consider the use of herbal preparations as an effective symptomatic product for the treatment of cough of various origins. Medicinal herbs are widely used in medicine due to many useful properties and do not have any serious side effects. Ivy leaf (Hedera helix) extract preparations are common cough medicines available over the counter that are approved by the European Medicines Agency (EMA). Ivy (Hedera helix) leaves contain various biologically active components, but saponins are the main substance. Saponins are natural compounds that have a variety of biological effects. According to literature data, the action of saponins is determined not only by their bronchodilator and mucolytic properties: among additional therapeutic options of saponins are high anti-inflammatory activity, as well as antimicrobial, antifungal and antiviral effects. The article shows the potential for use of ivy saponins as carriers of pharmaceutical substances, which can significantly reduce the effective doses of certain drugs. Preparations containing ivy leaf extract are safe and approved for use even in new-borns. Also, herbal preparations with antiviral, immunomodulatory and anti-inflammatory potential become the object of study as a new strategy for treating COVID-19.

Cardiovascular changes in chronic bronchopulmonary diseases in children

The article evaluates echocardiographic indicators of secondary PAH in 37 children with chronic bronchopulmonary disease. The study group included: 22 children with CF and 15 children with other chronic bronchopulmonary diseases. Echocardiographic monitoring in children with CF revealed an increase in PSAP values compared to children with chronic bronchopulmonary disease. TVI was detected in both groups, denoting a secondary impairment of the right heart in bronchopulmonary diseases. Varicose and cylindrical bronchiectasis were more common in children with CF presented as chronic bronchopulmonary disease with severe disability.

The effect of bronchography on the gas composition of blood

Despite the widespread use of bronchography in bronchopulmonary diseases, the question of the possibility of hypoxia during bronchial tree contrast has not been sufficiently studied.