Bronchopulmonary System Research Articles

The importance of individual indicators of bronchial mucosa cellular composition for diagnosing infectious diseases of the bronchopulmonary system

The importance of individual indicators of bronchial mucosa cellular composition for diagnosing infectious diseases of the bronchopulmonary system

Non-specific factors of immunity in the pathogenesis of bronchial asthma in children

The role of nonspecific immunity factors in the pathogenesis of bronchial asthma in children with different clinical forms and degrees of severity of its course has been investigated in the work. A total of 228 children with BA who were aged from 5 to 14 years were examined. We determined the complement titer (C0) in the serum, components of complement C2 and C3a, the protein component of blood serum of properdin, and the level of total serum IgE. The data were statistically processed using Student's t-test. In patients with non-allergic form of BA, the greatest increase in deviation from the norm was noted in relation to the circulating immune complexes (CIC)(t = 16.74). The second ranking place occupies an increased content of C3a (t = 8.21), then in descending order from IgE (t = 4.55) to C0 (t = 1.89). Rating of the degree of deviation from the norm of indices of nonspecific immunity in patients with atopic BA has shown that, in contrast to patients with non-allergic form of BA, the main pathogenetic role belongs to reactive hypersensitivity (IgE; t = 17,39). The value of immunocomplex hypersensitivity in atopic form of BA is in the second ranked place. In children with mixed BA, an intermediate pathogenetic variant was identified, which consisted in approximately equal activity of both immunocomplex and reactive reactions with a certain dominant of the first: from CIC (t = 13.66) to IgE (t = 11.19). Thus, the obtained data confirm that in the pathogenesis of bronchial asthma in children is involved immunocomplex immunological mechanism (type III according to Gell-Coombs), which enhances immunospecific reactions, aggravating the severity of the course of the disease. In the blood serum of children with bronchial asthma, there is a decrease in the protein component properdin, which is consumed to activate the alternative (properdin) complement pathway through C3a, nonspecific immunological mechanisms are able to stimulate and maintain chronic allergic inflammation in the bronchopulmonary system in children with bronchial asthma.

Paresthesias of the upper respiratory tract in the patients of the elder age group

The present study was designed to carry out the comprehensive clinical examination of 120 patients presenting with paresthesia of the upper respiratory tract (42 men (35%) and 78 women (65%P) aged 56 to 90 years). The most frequent complaints included cough (72%), globus sensation (46%), itching (43%), dry throat (38%), and difficulty of swallowing (28%). The duration of the clinical symptoms ranged from 1 month to 3 years (m±M: 1+to 1.46). The etiological factors behind paresthesias in the patients of the older age groups in comparison with the patients below 55 years of age included gastroenterological and cardiovascular diseases, pathology of the broncho-pulmonary system, and neurological pathology. ENT pathology was diagnosed equally often in the patients of both groups. Endocrine pathology and stress-associated conditions occurred more frequently in the patients below the age of 55 years. The intolerance of drugs was more commonly encountered in the patients of the older age group (amounting up to 35%). It is concluded that the ultimate etiological factor of paresthesia of the upper respiratory tract can be deduced based on the detection of a particular disease and the analysis of the dynamics of the patients' complaints after the completion of the adequate treatment.

ГАСТРОЭЗОФАГЕАЛЬНАЯ РЕФЛЮКСНАЯ БОЛЕЗНЬ, АССОЦИИРОВАННАЯ С ЗАБОЛЕВАНИЯМИ РЕСПИРАТОРНОГО ТРАКТА

The European community of gastroenterologists in 1997 recognized GERB as "illness of the 21st century". Diseases of a respiratory tract take the leading place among all extra esophageal implications of a gastroesophageal reflux disease. Among them bronchial asthma and a chronic obstructive pulmonary disease are the most widespread. The study of the features of the current and modern methods of diagnosing bronchial asthma, obstructive sleep apnea syndrome and chronic obstructive pulmonary disease associated with gastroesophageal reflux disease is of great importance for identifying potential obstacles to effective treatment and preventing an increase in the risk of hospitalizations of patients with this co-morbid pathology. The morbidity of the pathology of the respiratory tract, combined with gastroesophageal reflux disease, is steadily growing. There is a large number of publications concerning the relationship between gastroesophageal reflux disease and diseases of the bronchopulmonary system, but the etiopathogenesis and the cause-and-effect relationship of these diseases remain in question. 1t is interesting to note that the syndrome of obstructive sleep apnea is not included in the list of extra-oesophageal manifestations, both probably and reliably associated with gastroesophageal reflux disease (according to the Montreal Consensus, 2006), but is of great interest to researchers in recent years.

The mathematical pathogenetic factors analysis of acute inflammatory diseases development of bronchopulmonary system among infants

The purpose . To study structure and to establish associative interaction of pathogenetic links of acute diseases development of bronchopulmonary system in infants. Materials and methods . The examination group consisted of 59 infants (average age 13.8 ± 1.4 months) sick with acute inflammatory bronchopulmonary diseases. Also we tested level of 25-hydroxyvitamin D (25(ОН)D), vitamin D-binding protein, hBPI, cathelicidin LL-37, s1-defensins, lactoferrin in blood serum with help of immunoenzymometric analysis. Selection of prognostically important pathogenetic factors of acute bronchopulmonary disease among infants was conducted using ROC-analysis. The procedure for classifying objects was carried out using Hierarchical Cluster Analysis by method of Centroid-based clustering. Results . Based on results of ROC-analysis were selected 15 potential predictors of development of acute inflammatory diseases of bronchopulmonary system among infants. The analysis made it possible to determine 6 main components . The biggest influence in development of disease was made by the anemia factor, the of inflammation, the maternal factor, the vitamin D supply factor, the immune factor and the phosphorus-calcium exchange factor” with a load of more than 0.6. The performed procedure of hierarchical cluster analysis confirmed initial role of immuno-inflammatory components. The conclusions . The highlighted factors allowed to define a group of parameters, that must be influenced to achieve a maximum effect in carrying out preventive and therapeutic measures. First of all, it is necessary to influence the anemia factor and the calcium exchange factor, as well as the vitamin D supply factor. In other words, to correct vitamin D deficiency and carry out measures aimed at preventing development of anemia. The prevention and treatment of pathological course of pregnancy will help stabilize the maternal factor in future.

Influence of Glucosaminilemuramylpentapeptide on the Functional Peculiarities of the Respiratory System and the Dynamics of IL-6 in Patients with Infiltrative Tuberculosis Combined with Chronic Bronchitis

The aim of our study was to evaluate the functional peculiarities of the respiratory system and the dynamics of IL-6 in patients with infiltrative tuberculosis combined with chronic bronchitis.Materials and methods. There were examined 40 patients with infiltrative tuberculosis combined with chronic bronchitis: 18 patients receiving basic therapy according to the category and 22 patients who were added glucosaminilemuramylpentapeptide to basic therapy. Determination of IL-6 in bronchoalveolar content was performed by ELISA analysis.Results. The additional inclusion of glucosaminilemuramylpentapeptide into the complex therapy of patients with infiltrative tuberculosis combined with chronic bronchitis in acute phase manifests itself with positively aimed dynamic changes of the bronchial mucous membrane according to the data of endoscopy. The standard scheme of treatment combined with immune modulator affects the recovery of lung function in comorbidity of pathologies explaining it as the action of the means aimed at enhancing of sanogenetic mechanisms of liquidation of combination of specific and nonspecific inflammation in the broncho-pulmonary system, and thus – the reduction of the basis for secondary bronchial obstruction. The results of this study indicate the advisability of administration of immune modulator of muramylpeptide series.

DETECTION OF RS9939609 POLYMORPHISM OF FTO GENE AND RS324011 POLYMORPHISM OF STAT6 GENE AND SEVERITY DEGREE OF BRONCHIAL ASTHMA ASSOCIATED WITH OBESITY

The aim of this research was to analyze the distribution of FTO and STAT6 genes polymorphism in patients with bronchial asthma (BA), associated with obesity (Ob) depending on the main disease severity degree. Materials and methods. The study included 117 patients 18–48 years old, divided in 3 groups. The main group (bronchial asthma, associated with obesity) included 57 patients, two groups of comparison – 30 patients with the diagnosis BA and a normal body weight, and 30 patients with obesity, but without the pathology of the bronchopulmonary system. The general genomic DNA was extracted from blood according to the standard protocol. The genetic typing was realized by the method of allele-specific amplification with the detection of results in the real time regime using TaqMan-probes, complementary to polymorphic parts of DNA. The detection of deletions in FTO and STAT 6 genes was realized by the method of polymerase chain reaction (PCR) using specific primers. Results. In the main group, among patients with BA and Ob, carriers of Т/Т genotype were 36,84 %, Т/А – 45,61 %, А/А – 17,55 % against 40 %, 60 % and 0 % respectively in PHP group by FTO gene. Carriers of С/С genotype in the main group were 38,6 %, С/Т – 35,09 %, Т/Т – 26,31 % against 40 %, 55 % and 5 % respectively in PHP group by STAT6 gene. In the main group the light persisting BA was diagnosed in 20,0 % of cases, middle severity – in 60,0 % and severe – in 20,0 % of patients. In the group of comparison this disease severity was observed in 17,7 %, 66,5 % and 15,8 % of observations, respectively. Conclusions. So, among patients with BA, associated with Ob with the middle and severe course of asthma the percent of heterozygous (Т/А) and mutant carriers (А/А) rs9939609 polymorphism of FTO gene is higher than at the light course. The analogous situation is observed at the study of rs324011 polymorphism of STAT6 (C2892T) gene among this category of patients. So, the determination of FTO and STAT6 genes polymorphism in patients with BA, associated with Ob, can be considered as a marker of the more severe course of asthma.

Реакції імунокомпетентних клітин у бронхолегеневій системі хворих на хронічне обструктивне захворювання легень

Реакції імунокомпетентних клітин у бронхолегеневій системі хворих на хронічне обструктивне захворювання легень

A Carcinoid Tumor in the Urinary Bladder With Uncommon Clinicopathological Presentation

Carcinoid tumors usually originate from the enterochromaffin cells located in gastrointestinal tract and bronchopulmonary system. They may rarely arise in the urinary bladder, where this can be eventually miscued as any other commoner bladder neoplasms. The current study was conducted to connote an uncommon clinicopathological presentation by a carcinoid tumor in the urinary bladder. A 52-year-old male, who initially experienced obstructive urinary symptoms, underwent cystourethroscopy to remove a tumor in the urinary bladder. The tumor exhibited insular, trabecular, and organoid architecture on histology without any necrosis or mitosis, stained positively with chromogranin A, and thereby, confirmed the diagnosis of a pure carcinoid tumor. Carcinoid tumors rarely arise in the urinary bladder and other genitourinary organs. But, several other and relatively more common bladder neoplasms may often deceptively simulate it. This dilemma could be resolved easily with the application of proper immunohistochemistry (IHC) in neuroendocrine tumors.

A Method for Noninvasive Diagnosis of Bronchial Asthma Based on Microwave Technology

A means for the noninvasive diagnosis of bronchial asthma (BA) and identifying the location of pathological changes in the bronchopulmonary system based on the characteristics of the propagation of microwave electro-magnetic radiation through the human thoracic cavity is discussed. The method proposed here provides for the diagnosis of respiratory system diseases, particularly bronchial asthma, in patients of all age groups, including young children; the method also provides for monitoring patient status and the dynamics of illnesses throughout treatment.

Emerging use of everolimus in the treatment of neuroendocrine tumors.

Neuroendocrine tumors (NETs) consist of a diverse family of malignancies, which are derived from neuroendocrine cells, most commonly originating from the gastroenteropancreatic (GEP) tract or the bronchopulmonary system. In general, NETs are more indolent than epithelial tumors, with median survival rates of longer than 30 months. The upregulation of mTOR pathway has been shown to play a pivotal role in NET pathogenesis. Inhibition of mTOR protein with everolimus represents a progress in the treatment of advanced NETs. Everolimus has shown a significant improvement in progression-free survival (PFS) among patients with pancreatic NETs (pNETs) and nonfunctional GEP and lung NETs in the Phase III RAD001 in Advanced Neuroendocrine Tumors (RADIANT)-3 and RADIANT-4 studies, respectively. In addition, the combination of everolimus with octreotide showed a clinically significant improvement versus octreotide alone in functional NETs in the RADIANT-2 trial. These studies led to the US Food and Drug Administration (FDA) and European Medical Agency (EMA) approval of everolimus. Safety profile of everolimus is generally acceptable. The most common adverse events are stomatitis, diarrhea, rash and fatigue. There is a growing range of novel treatment options in the setting of NETs, but there are no data comparing the activity of different treatment strategies. Thus, treatment decisions are based on different aspects, such as clinical course, patient symptomatology, primary tumor site, tumor functionality, rate of progression and burden of disease. Further research is required to clarify the treatment sequencing to achieve the maximum prolongation in survival and maintenance of quality of life. Future research should concentrate on identification of predictive biomarkers for benefit from different therapies, and studies should also include quality of life as an important measurement in this disease.

Relationship between smoking and indicators of systemic inflammation in patients with coronary heart disease

To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1β, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1β, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.

Pulmonary embolism in combination with a reversible and irreversible airflow obstruction

Pulmonary thromboembolism, combined with bronchial obstruction is the most difficult in the diagnosis, because it can be presented as a combination of unventilated and not perfused areas and this disorders can occur in the acute phase of embolism, and also in long-term period after the onset. Aim: To evaluate influence of different disorders of blood circulation in the lungs on the development of bronchial obstruction in patients with different forms of PE. Material and Methods: We analyzed of the results of radiological methods: perfusion scintigraphy, single photon emission computed tomography using the combined technology (SPECT-CT) and multislice computed tomography - high-resolution computed tomography (VRKT), functional tests, multislice computed tomography angiography (MSCTA) in 250 patients (without concomitant pathology of bronchopulmonary system) suspicious of pulmonary embolism. Results and conclusions: Bronchoconstriction in patients with pulmonary embolism of small branches pulmonary artery increases severity of the disease. Analyzing the patients data we founded out that distinct clinical effect was achieved only with additional treatment with bronchodilators. In chronic course of the pulmonary embolism development of emphysema was detected, at first local - in ischemic segments, then involving the adjacent lung regions. In this case, the severity of the disease is caused not by embolism itself, but also because of development of persistent bronchial obstruction. These changes are considered as «postembolic pulmonary disease», and determine severity of perfusion and ventilation dysfunction.

CLINICAL-EPIDEMIOLOGICAL FEATURES OF TOXOCAROSIS IN CHILDREN

Aim. The aim of the study was to study the clinical and epidemiological features of visceral forms of toxocariasis in children. Materials and methods. The study involved 34 children (17 boys and 17 girls from 1 to 17 years old) with a diagnosis of toxocariasis. The diagnosis was confirmed by the method of immunoenzymatic analysis (ELISA) of blood, which allows to determine the level of specific antibodies of JgG to antigens of toxocar in children. In all patients, antibodies to toxocaram were found in a titer of 1: 800 and above, which was considered a diagnostic criterion. To exclude mixed infections, antibodies to lamblia antigens, ascarids, trichinelles and opistarchs were determined using the ELISA method of blood. Feces were studied for eggs of helminths threefold in all children. Results. Toxocarosis in children is characterized by a polymorphism of clinical manifestations. In 85.3% of patients the gastrobiliary system was damaged, dyspepsia, unstable stool, hepatosplenomegaly, which was confirmed by instrumental research methods (ultrasound examination of the abdominal cavity organs, esophagogastroduodenoscopy). In addition to lesions of the gastrointestinal tract, 44.1% of patients showed lung damage, and 63.3% of patients had skin manifestations. Eye damage was noted in 10.2% of sick children, a kind of strabismus and reduced vision. Conclusion. Analysis of clinical and epidemiological data of children with toxocarosis showed that all observed had signs of impairment from the gastrointestinal tract, bronchopulmonary system and skin. In the epidemic process, preschool children are primarily involved. The decisive role in the prevention of toxocarias is played by public health education and early education of children with health skills.

Pathogenetic mechanisms of remodelling bronchi in the case of bronchial asthma of children

In children with asthma aged 6 to 14 years parameters of metabolic activity of lung analyzed. Exacerbation was accompanied by disorganization of the phospholipid layer of surfactant, electrolyte imbalance, variations in oxidant-antioxidant system. In remission sohranyalis changes, most pronounced in patients with severe and long-term course of the disease. The nature and orientation of metabolic changes in patients with severe asthma patients, their conjugation with reduced FEV1 and dysregulation of the internal environment of the organism, can be considered as criteria for uncontrolled cell death, leading to disruption of the structure and remodeling in bronchopulmonary system.

АНТИОКСИДАНТНАЯ ЗАЩИТА И ОСОБЕННОСТИ ПЕРЕКИСНОГО ОКИСЛЕНИЯ ЛИПИДОВ ПРИ БРОНХИАЛЬНОЙ АСТМЕ У ДЕТЕЙ

Objective: To research peculiarities of the lipid peroxidation and antioxidant system in children with bronchial asthma.Methods: It has taken the results of the research in 56 children aged from 5 to 14 years, who suffered with bronchial asthma (BA). Along with the general clinical examination, spirometry were used to identify respiratory function, and malondialdehyde (MDA) and superoxide dismutase contents in blood serum were analyzed. Results: Spirometry in all BA patients from attack of disease up to attack-free interval showed increasing of forced expiratory volume in 1 second (from 61.5±3.70% to 84.3±5.33%) and maximum voluntary ventilation (from 59.1±4.21% to 81.7±6.31%), and decreasing of residual volume (from 117.4±6.01% to 93.1±5.25%) . Biochemical studies revealed increase in the content of MDA (3.2±0.04), reduced activity of superoxide dismutase (10.7±0.2) and reduced content of ascorbic acid (57.6±0.28) in blood serum in children with BA. Conclusion: At the time of attacks in children lipid peroxidation processes are intensified and followed by increasing development of lipid peroxidation products (MDA), depletion of antioxidant system in blood serum, lower activity of superoxide dismutase, and increased sialic acid, which facilitates development of immune-inflammatory process in the bronchopulmonary system. Administration of Mexidol in children with BA led to earlier elimination of the key clinical and paraclinical implications such as: elimination of asthma attacks, disappearance of pulmonary rale, improved respiratory function parameters, and indicators of lipid peroxidation and antioxidant system in the blood serum. Keywords: Bronchial asthma, children, lipid peroxidation, antioxidants.

Border psychic disorders in the case of patients with a combined pathology of bronchopulmonary system

Border psychic disorders in the case of patients with a combined pathology of bronchopulmonary system

Clinical and morphological comparisons of the influence of tobacco smoke on the respiratory system of children and rats.

Background . Tobacco smoking is the most common bad habit on a global scale, which is one of the main risk factors of chronic bronchopulmonary pathology. Most sensitive to exposure to the components of tobacco smoke are children and teenagers, since their respiratory system is very vulnerable through age-related functional, anatomical and morphological features. Objective . To study the depth and dynamics of morphological changes in the bronchopulmonary system of adolescents under the influence of tobacco smoke based on the comparison of clinical data and experiment on rats. Methods . There was conducted a comparative study of the influence of tobacco smoke on the respiratory system of adolescents, who were divided into 3 groups: 1 group from the earliest age were exposed to passive exposure to tobacco smoke; group 2 consisted of teenagers, whose mother during pregnancy smoked, and after being born, they continued to be subjected to passive exposure to tobacco smoke from parents; 3 group – teenagers who were active smokers, however, had not been exposed to tobacco smoke at an early age. The examination included clinical, functional and instrumental methods. The experimental part of the work was to study the morphological changes in the respiratory system of Wistar rats that were in similar conditions, in terms of load and duration of the impact of the pathological factor. Results. It is established that the level of pathological load correlates with the depth of the morphological changes. Thus, the most evident changes in the functional parameters were shown by the second group of adolescents, which coincides with the depth of disorders of the morphological structure of lung tissue of rats that were in similar conditions. The comparison of the results of clinical and experimental studies also took place in other research groups, which allowed to confirm the damaging effect of tobacco smoke on respiratory system of children and adolescents. Conclusion . Studies have shown that tobacco smoke in children and adolescents leads to morphological changes in the bronchopulmonary system, the severity of which depends on age and the duration of its exposure.

Prophylaxis Against Atrial Fibrillation After General Thoracic Surgery: Trial Sequential Analysis and Network Meta-Analysis

Postoperative atrial fibrillation/flutter (POAF) is associated with significant morbidity and mortality after general thoracic surgery, but the need for and the best agent for prophylaxis remains obscure. A systematic literature search was performed to identify randomized controlled trials that compared regimens for POAF prophylaxis after general thoracic surgery. Random-effects meta-analyses with trial sequential analyses were performed to compare the effects of medical prophylaxis vsplacebo/usual care. The risk of POAF among patients receiving various prophylactic regimens was subjected to Bayesian network meta-analysis. Twenty-two trials (2,891 patients and 11 regimens) were included. Overall, medical prophylaxis reduced the incidence of POAF (OR, 0.33; 95%CI, 0.22-0.49) but not short-term mortality (OR, 0.85; 95%CI, 0.41-1.73). There was no significant difference in patient withdrawal due to adverse events (OR, 1.67; 95%CI, 0.67-4.16). Trial sequential analysis showed that as of 2012, sufficient evidence had accrued in support of the effectiveness of medical prophylaxis in reducing POAF after general thoracic surgery. In network meta-analysis, β-blockers, angiotensin-converting enzyme inhibitors, amiodarone, magnesium, and calcium channel blockers significantly reduced the risk of POAF compared with placebo/usual care. β-Blockers had the highest probability of being the most effective agents (OR, 0.12; 95%credible interval [CrI], 0.05-0.27; probability of being best, 77.7%; number needed to treat, 5.2). The current literature supports the effectiveness and tolerability of medical prophylaxis and the superiority of β-blockers in preventing POAF after general thoracic surgery. β-Blockers are recommended, taking into consideration the status of the bronchopulmonary system.

Heart rate variability in patients with chronic heart failure and chronic obstructive pulmonary disease: clinical parallels

Diseases comorbidity issues are of concern of many researchers, in recent decades, there are attempts to understand the hierarchy of diseases cause-and-effect relationships. Integrative approach to the patient’s condition assessment, whose comorbidity index increases with aging, is of great practical importance, since it allows the practitioner to choose the best drug therapy strategy and to objectively assess the risk of adverse cardiovascular events. Cardiovascular diseases, including those associated with bronchopulmonary system diseases, occupy leading position in mortality rate. One of the most common combinations in clinical practice is a combination of heart failure and chronic obstructive pulmonary disease. Their pathogenetic relationship may be due to common for diseases neurohumoral imbalance. The review presents data on the prevalence and mortality of patients with congestive heart failure and chronic obstructive pulmonary disease, describes the importance of autonomic nervous system dysfunction assessment in cardiovascular and bronchopulmonary diseases combination. Data on the heart rate variability assessment informativeness from the perspective of the clinical characteristics determination relevance and prognosis in patients with congestive heart failure and chronic obstructive pulmonary disease are presented. The main assessed time-domain and spectral parameters are narrated. The results of the heart rate variability parameters study in multicenter clinical trials in patients groups with heart failure and bronchopulmonary obstruction, which define the clinical and prognostic predictors among the heart rate variability parameters, are presented. In general, information on heart rate variability in congestive heart failure in comorbidity with chronic obstructive pulmonary disease is scantily presented in the available literature.