[Bronchiolitis: classification, clinical picture, and anatomical pathology].
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Bronchi↗
Biomedical subjects
A G Chuchalin
Publications and source records attributed to A G Chuchalin.
Suppression of programmed cell death by intracellular cAMP is not mediated by expression of genes encoding an inhibitor of apoptosis.
The elevation of intracellular cAMP content is accompanied by expression of genes whose promoter contains a Ca(2+)-cAMP responsive element. In vascular smooth muscle cells (VSMC), activation of cAMP signaling blocks apoptosis triggered by serum deprivation. In the present study we investigated the role of gene expression in the inhibition of apoptosis by cAMP. In VSMC transfected with E1A adenovirus, incubation in the absence of serum for 6 h led to 20-fold elevation of chromatin fragmentation and 10-fold activation of caspase-3 activity, these being employed as markers of apoptosis. Forskolin-induced activation of cAMP signaling was accompanied by 50% elevation of RNA synthesis and completely abolished the development of apoptosis during the initial 6 h incubation in growth factor-free medium. In 12 h apoptosis in forskolin-treated VSMC was slowly developed and after 24 h the content of chromatin fragments was 2-fold less than in control cells. Addition of actinomycin D and cycloheximide completely blocked RNA synthesis and decreased protein synthesis by 80%, respectively. Neither compound affected baseline apoptosis or its inhibition by forskolin. More than 70 newly phosphorylated proteins were observed by 2D-electrophoresis of VSMC after incubation with forskolin for 3 h; in 24 h the number of phosphoproteins triggered by forskolin was decreased by 2-3-fold. These results show that suppression of VSMC apoptosis under activation of cAMP signaling is mediated via posttranslational modification of pre-existing intermediates of the apoptotic machinery rather than by de novo synthesis of inhibitors of programmed cell death.
Adenoviridae↗
Diagnostic value of tumor markers Cyfra 21-1 and neuron-specific enolase in analysis of pleural fluid.
The diagnostic value of tumor markers Cyfra 21-1 and neuron-specific enolase in blood serum and pleural fluid in differential diagnosis of pleural exudation in cancer patients and patients with nontumor pleurisy was evaluated. The most pronounced changes were characteristic of Cyfra 21-1. In patients with pleurisy caused by malignant tumors the degree and incidence of increased Cyfra 21-1 concentrations in the serum and pleural fluid were higher than in patients with pleural exudation of nontumor origin. These data attest to high diagnostic sensitivity and specificity of Cyfra 21-1. Complex measurements of the marker in the serum and pleural fluid will improve diagnosis of pleural exudation of tumorous etiology.
Adult↗
A health-related quality-of-life comparison of formoterol (Oxis) Turbuhaler plus budesonide (Pulmicort) Turbuhaler with budesonide Turbuhaler alone and noncorticosteroid treatment in asthma: a randomized clinical study in Russia.
BACKGROUND: In Russia, current therapy for the long-term management of asthma is mainly nonsteroidal. This situation provides the opportunity to evaluate new asthma treatments in a patient cohort with little previous exposure to inhaled corticosteroids. OBJECTIVES: To compare the effect of formoterol (Oxis) Turbuhaler plus budesonide (Pulmicort) Turbuhaler with budesonide Turbuhaler alone, on the health-related quality of life (HRQL) of patients with mild to moderate asthma. METHODS: A double-blind, parallel-group, randomized, 12-week study compared formoterol Turbuhaler plus budesonide Turbuhaler and budesonide Turbuhaler alone with an open control group of the investigator's choice of noncorticosteroid therapy. Patients completed the Short Form 36 (SF-36) and the Asthma Quality of Life Questionnaire (AQLQ). RESULTS: The improvement in HRQL scores for patients treated with noncorticosteroids was significantly less (p < 0.05) than those treated with formoterol plus budesonide and budesonide alone in all domains of the SF-36 and AQLQ with one marginal exception (budesonide versus investigator's choice, SF-36, Mental Component Scale, p = 0.053). Improvements in HRQL scores of formoterol plus budesonide, compared with budesonide alone, although generally higher, were not significantly different. Formoterol plus budesonide was more effective in improving lung function and reducing both symptoms and the need for relief terbutaline inhalation. CONCLUSION: Formoterol Turbuhaler plus budesonide Turbuhaler and budesonide Turbuhaler alone significantly improved the HRQL of patients with mild to moderate asthma compared with noncorticosteroid treatment.
Administration, Inhalation↗
Clinical equivalence trial on budesonide delivered either by the Novolizer multidose dry powder inhaler or the Turbuhaler in asthmatic patients.
BACKGROUND AND OBJECTIVES: To investigate the therapeutic equivalence of the two formulations of the glucocorticosteroid budesonide delivered either by the budesonide Novolizer, i.e. a multidose dry powder inhaler, or by the Pulmicort Turbuhaler in asthmatic patients in terms of efficacy, safety and tolerability during a 12-week treatment. METHODS: A total of 315 patients were randomised in this open, multicentre study. Inclusion criteria comprised previously diagnosed bronchial asthma of mild to moderate persistent intensity (ranging from 60% to a maximum of 90% predicted FEV(1)), need for anti-inflammatory therapy, inhalation of beta(2)-sympathomimetics on an as needed to regular basis, reversibility of airway obstruction of >12% after inhalation of 2 actuations of 100 microg salbutamol. Primary variable was FEV(1), secondary were other pulmonary function test variables, PC(20)FEV(1) for histamine challenge, morning and evening PEFR, salbutamol usage, asthma symptoms, reactions after inhalation, standard safety variables. RESULTS: The comparison of the FEV(1) at study endpoint indicated that the Novolizer was at least as efficacious as the Turbuhaler (p < 0.001). All other variables of the pulmonary function tests as well as the asthma symptoms, nocturnal awakenings, PEFR measurements, or salbutamol usage indicated no relevant difference. Only 1 patient (Turbuhaler discontinued prematurely due to lack of efficacy. None of the other safety variables (adverse events, laboratory variables, vital signs, etc.) indicated any difference between the groups. CONCLUSIONS: The budesonide Novolizer is therapeutically equivalent to the Pulmicort Turbuhaler for the long-term treatment of patients with mild to moderate persistent asthma.
Adolescent↗
[Primary systemic and pulmonary vasculitis].
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Churg-Strauss Syndrome↗
[Cardiorespiratory system in adult patients with mucoviscidosis].
AIM: To study cardiorespiratory system in adult patients with mucoviscedosis. MATERIAL AND METHODS: External respiration function, echocardiographic and dopplercardiographic evidence were analysed for 22 patients with mucoviscedosis. RESULTS: 66.7% examinees had mixed pulmonary ventilation disorders, 46% were found to have low diffuse capacity of the lungs correlating in degree with ventilatory abnormalities. Dilated right heart and high systolic pressure in the pulmonary artery were registered in 14% patients with marked obstruction. Left ventricular systolic and diastolic defects occurred in 23%. CONCLUSION: Adult patients with mucoviscedosis have mixed disorders of pulmonary ventilation, high pressure in pulmonary circulation and developing pulmonary heart in patients with severe obstruction.
Adolescent↗
[N-Acetylcysteine: low and high doses in the treatment of chronic obstructive lung diseases in Chernobyl accident liquidators].
AIM: To study clinical effectiveness and antioxidant activity of N-acetylcisteine (NAC) in daily doses 600, 1200, 1800 and 2400 mg in Chernobyl wreckers suffering from chronic obstructive pulmonary diseases (COPD). MATERIAL AND METHODS: Cough intensity and expectoration, malonic dialdehyde (MD), plasma calcium ions concentrations were studied in patients taking NAC. RESULTS: Cough intensity diminished insignificantly. Expectoration improved significantly only after intake of 1200 mg/day NAC. In higher doses expectoration difficulties appeared again. Five patients received a maintenance dose 200 mg/day as a result of which their expectoration improved. MDA in the above patients was 3.3 times higher than normal level, free calcium ion concentration was 1.7 times higher. Only 1200 mg/day dose of NAC brought MDA level to normal, higher doses made it subnormal. Calcium ions concentration decreased but insignificantly. Maintenance dose 200 mg/day returned MDA and calcium to initial level. CONCLUSION: For patients with radiation-induced affection of the respiratory tracts NAC dose 1200 mg/day is optimal both clinically and in terms of antioxidant activity.
Acetylcysteine↗
[Comparison of linezolid and vancomycin in nosocomial pneumonia: results of the multicenter double-blind study].
The results of multicenter, randomized, double-blind comparative study of linezolid and vancomycin efficacy, safety and tolerability in the treatment of nosocomial pneumonia are presented. The trial was performed on 69 patients. Clinical efficacy of linezolid was 83 per cent, of vancomycin--79 per cent. Bacteriological effect (pathogen eradication) was 83 per cent for linezolid group and 86 per cent for vancomycin group. During the study good clinical tolerability of linezolid was demonstrated along with lower side effects incidence and shortened recovery period when compared to vancomycin.
Acetamides↗
[Placebo-controlled study of short-term hypotensive effect of intranasal ventilation with continuous positive pressure upper respiratory tract therapy in patients with stage I arterial hypertension].
AIM: To compare a short-term hypotensive effect of intranasal ventilation with continuous positive airway pressure (CPAP-therapy) in patients with arterial hypertension stage I and placebo-control patients. MATERIAL AND METHODS: The CPAP-therapy and placebo-control groups consisted of 12 young men with arterial hypertension (AH) stage I. They were matched by age, body mass index, smoking habits, arterial pressure 24-h monitoring (APM) and night cardiorespiratory monitoring. Patients of the treatment group received CPAP-therapy (REMstar Choice, Respironics, USA) followed by repeated APM. Patients of the placebo group used a nasal mask without turning on the apparatus. Then a repeated APM was performed. RESULTS: As shown by improved APM data, CPAP-therapy was effective in AH stage I. Positive response was the greatest for systolic and diastolic hypertensive load. CONCLUSION: The above results may serve as an argument in support of a positive relation between elevated resistance of the upper respiratory airways in sleep and systemic AH.
Adolescent↗
Low titre autoantibodies against recoverin in sera of patients with small cell lung cancer but without a loss of vision.
To date, many authors have described the presence of autoantibodies against various neuronal proteins, paraneoplastic antigens (PNA), in a serum of patients with different kinds of malignant tumors located outside the nervous system. These autoantibodies may cross-react with the corresponding PNA or their epitopes present in neurons and thus initiate the development of a variety of neurological disorders, paraneoplastic syndromes (PNS), even though the primary tumor and its metastases have not invaded the nervous system. Cancer-associated retinopathy (CAR) is a rare ocular PNS induced by autoantibodies against several retinal antigens, one of which is a photoreceptor calcium-binding protein, recoverin. Only several CAR patients with a few kinds of cancer (endothelial carcinoma, breast cancer, epithelial ovarian carcinoma) have so far been found to contain autoantibodies against recoverin in their sera. As for lung cancer, the majority of CAR cases mediated by anti-recoverin autoantibodies have been revealed in patients with the most malignant lung cancer, small cell lung carcinoma (SCLC), and only one similar case has been described for a patient with non-small lung carcinoma. The common feature of all these anti-recoverin-positive patients, irrespective of the type of cancer, is the presence of both the CAR syndrome and high titres (as a rule, more than 1:1000) of the underlying autoantibodies in their serum. In this study, we have used recombinant myristoylated recoverin to screen serum samples of 50 patients with SCLC by Western blot and revealed 5 individuals with low titres of anti-recoverin antibodies, who have no manifestation of a loss of vision. To our knowledge, this is the first report on the presence of low titre autoantibodies against recoverin in a serum of patients with cancer, but without visual dysfunction.
Autoantibodies↗
Therapeutic equivalence of the Sofotec Novolizer to established standard devices in COPD and asthma.
The Novolizer is a breath-actuated multidose dry powder inhaler that was developed as an alternative to the pressurized metered dose inhalers. The efficacy, safety and tolerability of the Novolizer has been compared with those of established inhalational devices for the delivery of salbutamol (Sultanol) in patients with chronic obstructive pulmonary disease and for the administration of budesonide (Pulmicort Turbuhaler) to patients with asthma. In both studies, improvement in forced expiratory volume in 1 s in patients who were randomly assigned to use the Novolizer was comparable with that in patients who used the established devices. Furthermore, no differences in tolerability or safety between the Novolizer and the control devices were observed. Finally, patient acceptance of the Novolizer was high, with the majority of patients who used it stating that they would use the device again.
Albuterol↗
[Chronic obstructive lung diseases in patients with ischemic heart disease: a 15-year study].
AIM: To characterize acquired chronic obstructive pulmonary diseases (COPD) in patients with ischemic heart disease (IHD). MATERIAL AND METHODS: Monitoring of external respiration function (ERF) was performed for 15 years in 1552 IHD patients on combined drug treatment. RESULTS: The 15-year follow-up has revealed that IHD patients treated with beta-blockers develop pathological changes in respiration pattern manifesting primarily with dyspnea, obstructive and mixed ventilatory disorders, syndrome of early expiratory obstruction in affected small airways due to subnormal lung elasticity, defective diffuse function, signs of terminal respiratory failure. CONCLUSION: IHD patients taking drugs need monitoring of ERF. Optimal treatment consists in early diagnosis of IHD and COPD, adequate combined therapy with beta-blockers and bronchodilating drugs.
Adrenergic beta-Antagonists↗
[Severe forms of bronchial asthma].
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Anti-Asthmatic Agents↗
[Obstructive sleep apnea in patients with stage I arterial hypertension].
AIM: To study sleep breathing in young men with arterial hypertension stage I. MATERIAL AND METHODS: Somnological history, night cardiorespiratory monitoring, 24-h monitoring of arterial pressure (AP) and ECG were analysed in 34 young men with arterial hypertension (AH) of the first degree and 12 normotensive young men. RESULTS: Hypertensive young men had a higher index apnea/hypopnea, mean duration of apnea/hypopnea (p < 0.05), maximal desaturation (p < 0.1), indirect parameters of inspiratory apnea, they snored more and woke up in sleep more frequently, their night hypertension was more than daytime. This was observed even in patients with overweight. CONCLUSION: All hypertensive young men examined had indirect signs of obstructive sleep apnea. The triggering role in it of the lungs and subclinical obstruction of upper airways in AH is suggested.
Adolescent↗
[State of the upper respiratory tract in patients with stage I arterial hypertension].
AIM: To study morphofunctional features of the upper airways (UAW) in wakeful patients (juveniles with arterial hypertension stage I) and genetic predisposition to UAW obstruction in sleeping patients. MATERIAL AND METHODS: The examination of 18 juveniles with arterial hypertension stage I and II normotensive juveniles included measurements of body mass index (BMI), circumference of the neck (CN), conduction of lateral cephalometry, MR imaging of UAW tissues, evaluation of nasal breathing, smoking habits and collection of family disease history. All the patients were examined by otorhinolaryngologist. RESULTS: Hypertensive juveniles appeared to have significantly higher values of BMI, CN, ANB, NAPg angles, distance between the hyoid bone and the mandible, anteroposterior tongue length in lateral projection, less values of SNPg angle (p < 0.05). Relatives of hypertensive juveniles had significantly greater prevalence of hypertension, snoring and their combination. CONCLUSION: In arterial hypertension there are some anatomofunctional grounds to UAW resistance in sleep. In addition to hereditary predisposition to hypertension, this may underlie development of wakeful systemic hypertension.
Adolescent↗
[Levels of mucin-antigen 3EG5 in the blood and bronchoalveolar swabs in patients with tuberculosis, sarcoidosis and fibrosing alveolitis].
The levels of the antigen mucin 3EG5, a marker of the activity of interstitial lung diseases, were studied in the sera and bronchoalveolar swabs of patients with active tuberculosis, sarcoidosis of the respiratory organs, and idiopathic and exogenous allergic alveolitis. Its higher blood levels were detectable in patients with alveolitis (exogenous allergic ones to a greater extent) and absent in active tuberculosis and sarcoidosis. There was a correlation of the levels of the antigen mucin 3EG5 in the blood and bronchoalveolar swabs with the degree of lymphocytosis in the endopulmonal cytogram. The fact that there is a high variability of the blood levels of the antigen mucin 3EG5 in the range of nosological entities calls the differential diagnostic informative value of this parameter to question.
Adult↗
[The current state of diagnosis in pulmonology].
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Clinical Laboratory Techniques↗