Ukrainian Pulmonology Journal最新文献

{"title":"ASTHMA-COPD OVERLAP: MUCH IS ALREADY KNOWN, BUT PART OF THE QUESTIONS STILL REMAIN UNANSWERED","authors":"S. Zaikov, A. Bogomolov, N. A. Gritsova, L. Veselovsky","doi":"10.31215/2306-4927-2022-30-4-58-66","DOIUrl":"https://doi.org/10.31215/2306-4927-2022-30-4-58-66","url":null,"abstract":"The review is devoted to topical issues of terminology, diagnostic criteria and principles of therapy for a pathological condition known as “Asthma-COPD overlap”. Specialists in the field of pulmonology have got used to such term as “Astma- COPD overlap” (ACO), but till now the nuances of diagnostics and treatment of such patients are not developed. The prevalence of ACO in the population varies within 2–55 %. This discrepancy is due, first of all, to the absence of clearly defined criteria of the ACO. Nowadays, the prevailing view is that the ACO is a state characterized by persistent air flow limitation with several signs usually associated with asthma or COPD. This is not a definition of a single disease, but a description term for clinical use, which includes several different clinical phenotypes. The risk of ACO is that the patients have frequent exacerbations, higher mortality, fast lung function decline and worse quality of life. For the purpose of diagnosis of ACO, it is recommended to use the large criteria (persistent airflow limitation (post-bronchodilation FEV1/FVC < 0.7 or the lower limit of normal) in patients aged 40 years and older, with at least 10 pack-years of tobacco smoking or equivalent exposure to indoor or outdoor air pollution, documented history of asthma under 40 years or post-bronchodilation Δ FEV1 > 400 ml) and small criteria (documented history of atopy or allergic rhinitis, post-bronchodilation ΔFEV1 > 200 ml and 12% of baseline values during 2 or more visits, the number of eosinophils in the peripheral blood ≥ 300 cells per μl). Patients with ACO should use therapy containing inhaled corticosteroids (ICS), as this reduces the risk of their hospitalization and death compared to long-term treatment only with bronchodilators. Availability of ACO requires review of planned therapy for patients who previously had asthma or COPD diagnosis only. If COPD is accompanied by asthma, patients should be prescribed ICS as soon as possible. When asthma is accompanied by COPD and at the same time the patient is already taking ICS and long-acting beta-agonists, then long-acting M-cholinolytics should also be considered. Research in the field of the diagnosis and treatment of ACO continues, as some questions are still to be answered. Key words: asthma, chronic obstructive pulmonary disease, asthmaCOPD overlap, diagnosis, treatment.","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134545390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RECOMMENDATIONS ON COPD AND FAMILY PRACTITIONERS: WHAT IS THE LEVEL OF ADHERENCE?","authors":"Y. M. Y. M. Mostovoy, T. V. Konstantinovych, O. R. Lindiuk, O. V. Bugaichuk","doi":"10.31215/2306-4927-2021-29-4-15-18","DOIUrl":"https://doi.org/10.31215/2306-4927-2021-29-4-15-18","url":null,"abstract":"Y. M. Mostovoy, T. V. Konstantinovych, O. R. Lindiuk, O. V. Bugaichuk Abstract Majority of COPD patients should receive medical care provided by family practitioners. Only the cases of severe, uncontrolled diseases must be managed by pulmonologists. That is why family practitioners must be well informed on actual requirements on diagnosis and treatment of COPD in order to give effective care to this population of patients. Following the aim to study quality of medical care, provided to COPD patients by family practitioners, we analyzed 220 out-patient records (95 men (43,2 %), 125 women (56,8 %); mean age 69 years). Analyzing medical records the attention was mainly focused at two issues — accuracy of diagnosis formulation and correctness of treatment prescription. It was revealed that the clinical group of disease was not mentioned in 107 (48,6 %) patients. This made impossible to prescribe maintenance treatment correctly. Long-acting anticholinergic drugs and it combinations were prescribed unreasonably rarely (11 (5 %) vs needed 97 (44,1 %) cases). On the contrary, short-acting bronchodilators (salbutamol, berodual monotherapy) and inhaled corticosteroid/long-acting beta 2 agonist combination were used in 51 (23,2 %) and 50 (22,7 %) cases, respectively. Among them 48 (48,9 %) patients required hospitalization, use of antibiotics and systemic corticosteroids. This is mainly explained by incorrect use of maintenance therapy for COPD. The authors conclude about low adherence of family practitioners to state and international COPD guidelines. Further work is needed to increase the knowledge of physician regarding COPD diagnosis and treatment along with active consultancy of out-patient facilities by the pulmonologists.","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128088583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POSSIBILITIES OF NEW GENERATION SEQUENCING TECHNOLOGY FOR THE DETERMINATION OF RESISTANCE OF M. TUBERCULOSIS STRAINS TO ANTIMYCOBACTERIAL DRUGS","authors":"Yu. A. Cherednik, O. A. Zhurilo, A. Barbova, O. Pavlova","doi":"10.31215/2306-4927-2022-30-1-57-61","DOIUrl":"https://doi.org/10.31215/2306-4927-2022-30-1-57-61","url":null,"abstract":"POSSIBILITIES OF NEW GENERATION SEQUENCING TECHNOLOGY FOR THE DETERMINATION OF RESISTANCE OF M. TUBERCULOSIS STRAINS TO ANTIMYCOBACTERIAL DRUGS Y. A. Cherednik, O. A. Zhurilo, A. I. Barbova, O. V. Pavlova Abstract The aim of the study was to analyze the possibilities and informativeness of the new generation sequencing technology in the variant of targeted sequencing of the panel of genes responsible for drug resistance to a wide range of antimycobacterial drugs with Deeplex Myc-TB analytical solution for use in clinical practice. Materials and methods. M. tuberculosis DNA was isolated from 22 cultures obtained on Levenstein-Jensen medium using the QIAamp® DNA Mini Kit. The Deeplex Myc-TB kit was used to amplify the target panel. Sequencing was performed on the Illumina platform (MiSeq, NextSeq 500, Nextera XT library kit). 15 Ukrainian isolates from patients with pulmonary tuberculosis were also characterized by ETR-VNTR PCR typing methods by ETR loci (Exact Tandem Repeats) A, B, C, D and E. Results. According to the sequence data, out of 15 Ukrainian isolates (from Kyiv city population) M. tuberculosis 9 (60.0%) isolates were multidrug resistant and 4 (27.0%) isolates were characterized by broad drug resistance. All MDR and BDR strains had identical mutations, determining resistance to rifampicin (rpoB1 S450L) and isoniazid (katG S315T). Three strains additionally had common mutations that caused resistance to ethionamide (fabG C-15T), ethambutol (embB Y334H) and streptomycin (rpsL K88R). Another group of strains had common mutations in the genes, responcible for resistance to ethambutol (embB M306V) and streptomycin (rpsL K43R). This may indicate the existence of clusters of strains that are already resistant to these 5 or 4 drugs and prevalent in the population. New mutations with unknown effect on resistance have been found in genes and regions responsible for resistance to rifampicin, pyrazinamide, ethambutol, streptomycin, fluoroquinolones, kanamycin, amikacin, capreomycin, ethionamide. Conclusions. The Deeplex Myc-TB analytical solution provides a wealth of relevant information on antimycobacterial drug resistance markers and speeds up the data analysis process. To address epidemiological issues, it will be important to use additional typing methods and search for new phylogenetic markers of the most common in the population of clusters of M. tuberculosis strains. Key words: tuberculosis, mycobacteria tuberculosis, drug resistance, polymerase chain reaction, sequencing.","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133643917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE RISK FACTORS FOR THROMBOSIS IN PATIENTS RECOVERED AFTER COMMUNITY ACQUIRED PNEUMONIA ASSOCIATED WITH COVID-19","authors":"T. Pertseva, N. O. Gabshidze","doi":"10.31215/2306-4927-2023-31-2-24-28","DOIUrl":"https://doi.org/10.31215/2306-4927-2023-31-2-24-28","url":null,"abstract":"The aim of the study was to identify the risk factors for thrombotic events in individuals who have experienced community acquired pneumonia associated with COVID-19 and did not have thrombotic events during the acute period of COVID-19. Materials and methods. 45 individuals were examined in postCOVID-19 period (age - 61.0 (54.0; 68.0) years, males - 22 (48,9 %), females - 23 (51,1 %)). All patients were examined twice: at visit 1 — 45,0 (40,0; 60,0) days from the onset of COVID-19, and at visit 2 — 150,0 (117,5; 160,0) days from the onset of COVID-19. Depending on whether the patients received anticoagulant therapy during post-COVID-19 period, the main group was divided into two subgroups: subgroup 1 included 25 (55,6 %) individuals who received anticoagulants during post-COVID-19 period (the course of acute COVID-19 was moderate in 7 (28,0 %) individuals, and severe or critical in 18 (72.0 %) individuals); subgroup 2 included 20 (44,4 %) individuals who did not receive anticoagulants during post-COVID-19 period (the course of acute COVID-19 was moderate in 12 (60,0 %) individuals and severe in 8 (40,0 %) individuals). Clinical methods, pulse oximetry, laboratory and instrumental methods as well as assessment of the probability of thrombosis according to the Wells and Padua scales were used. Results. There was not any thrombotic event occurred in subgroup 1 during post-COVID-19 period. The duration of anticoagulant use in patients from subgroup 1 was 63,0 (60,0; 90,0) days from the onset of COVID-19 symptoms. In subgroup 2, thrombosis was detected in 5 (25,0%) patients during post-COVID-19 period (4 patients had pulmonary embolism and 1 patient had a combination of pulmonary embolism and acute ischemic stroke). Thrombotic events had occurred before visit 1, at 40,0 (33,0; 45,0) days from the onset of COVID-19, which corresponded to 16,0 (15,0; 18,0) days after the end of anticoagulant therapy. Age, gender, body mass index, and comorbidities (hypertension, obesity, diabetes) were not associated with the occurrence of thrombotic events. Risk factors included severe COVID-19 (p=0,04) and the presence of hereditary thrombophilia. Conclusion. The risk of thrombosis in post-acute COVID-19 period is higher in patients after severe course of the acute period of COVID-19, in the absence of anticoagulant therapy during the post-COVID-19 period. On the other hand, the administration of anticoagulants during at least two months from the onset of COVID-19 symptoms, decreased the risk of thrombosis in the post-COVID-19 period not only in patients with severe course but in patients with critical course of the acute period of COVID-19 as well. Key words: COVID-19, post-COVID-19 period, thrombosis, pulmonary embolism, anticoagulants.","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125127016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEATURES OF RESISTANCE TO HYPOXIA IN ELDERLY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE","authors":"E. Asanov, Y. Golubova, I. Dyba, S. Asanova","doi":"10.31215/2306-4927-2021-29-3-36-40","DOIUrl":"https://doi.org/10.31215/2306-4927-2021-29-3-36-40","url":null,"abstract":"FEATURES OF RESISTANCE TO HYPOXIA IN ELDERLY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE E. O. Asanov, Yu. I. Golubova, I. A. Dyba, S. O. Asanova Abstract Aim: to study the features of resistance to hypoxia in elderly patients with COPD. Material and methods. We examined 46 elderly patients with COPD and 18 apparently healthy elderly people. Hypoxia resistance was determined by performing a hypoxic test with inhalation of 12 % O2 for 20 minutes. The state of ventilation and blood saturation were assessed. Results. Hypoxia caused the reduction of SpO2 and the development of arterial hypoxemia in elderly patients with COPD, which were more significant than in healthy elderly people. It was found that among elderly patients with COPD and healthy elderly subjects there were people with preserved and reduced resistance to hypoxia. However, reduced resistance to hypoxia was much more common in elderly patients with COPD. Decreased resistance to hypoxia in elderly patients with COPD was associated with the degree of bronchial obstruction: deterioration of bronchial passability led to reduced resistance to hypoxia. Elderly patients with COPD with reduced resistance to hypoxia had a decrease in the ΔVE/ ΔSpO2 ratio and a slow ventilation response to hypoxic exposure. Conclusions. Among healthy elderly people and elderly patients with COPD there were subjects with reduced and preserved resistance to hypoxia. Decreased resistance to hypoxia was much more common in elderly patients with COPD. Decreased resistance to hypoxia was more common in patients with moderate than mild bronchial obstruction. Elderly patients with COPD with reduced resistance to hypoxia had reduced ventilation response to hypoxia and chemoreflex sensitivity. Key words: COPD, older age, resistance to hypoxia, ventilation, saturation. Ukr. Pulmonol. J. 2021;29(3):36–40:","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130294661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OPTIMAL DURATION OF INDIVIDUALIZED REGIMENS OF ANTIMYCOBACTERIAL THERAPY, CONTAINING BEDAQUILINE AND REPURPOSED MEDICINES, FOR PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS INCLUDING","authors":"Y. Feschenko, N. Lytvynenko, N. Grankina, M. Pogrebna, Y. Senko, L. Protsyk","doi":"10.31215/2306-4927-2022-30-2-5-11","DOIUrl":"https://doi.org/10.31215/2306-4927-2022-30-2-5-11","url":null,"abstract":"OPTIMAL DURATION OF INDIVIDUALIZED REGIMENS OF ANTIMYCOBACTERIAL THERAPY, CONTAINING BEDAQUILINE AND REPURPOSED MEDICINES, FOR PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS INCLUDING Y. I. Feschenko, N. A. Lytvynenko, N. V.Grankina, M. V. Pogrebna, Y. O. Senko, L. M. Protsyk Abstract The world is on the verge of a new era of antibiotic therapy due to the emergence of new drugs that can significantly reduce the overall duration of treatment for patients with tuberculosis. Aim of the study: to develop an algorithm for selecting the optimal duration of individualized regimens of antimycobacterial therapy, containin bedaquiline and repurposed drugs for patients with drugresistant tuberculosis. Materials and methods. A prospective observational study was conducted in 425 patients treated during 2017–2021. Patients were prescribed individualized therapy regimen (ITR) which included bedaquiline and repurposed drugs (without delamanid) according to the same WHO step-by-step principle, but of different duration. Patients with successful outcome were divided into 3 groups: 1st group (176 patients) with ITR duration of 12 months (less than or equal to 400 days); 2nd group (170 patients) – 13-16 months; 3rd group (79 patients) – 16-20 months. Results and discussion. Among patients treated for more than 12 months, there were significantly more pre-treatment patients with common destructive lesions in the lungs (cavities preserved after 6 month of treatment) and fluoroquinolone resistance, treated with second line antimycobacterial medications. There was a clear relationship between patients in the comparison groups: in groups 1 and 2 a cessation of bacterial excretion was significantly more often registered at the 1st-2nd month of treatment (p <0.05). The average term of culture negativity in groups 1 and 2 was — (50.3 ± 2.9), (44.4 ± 2.2) days, respectively, vs group 3 — (61.1 + 5.0) days, (p <0.05). Conclusion. The decision on the optimal duration of ITR should be made at 6 months from the beginning of treatment, based on the main (early period of negative culture) and additional criteria (no destructive changes in the lungs at 6 months, no resistance to fluoroquinolones and history of past second line antimycobacterial treatment). Key words: tuberculosis, individualized treatment regimens","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117353784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IDIOPATHIC PULMONARY FIBROSIS AND PROGRESSIVE PULMONARY FIBROSIS IN ADULTS: ADAPTED EVIDENCE-BASED CLINICAL GUIDELINE (DRAFT)","authors":"Y. Feshchenko, V. Gavrysyuk, N. Gorovenko, O. Dziublyk, T. Pertseva, M. Ostrovsky, A. Basanets, O. Bychenko, Y. Dziublyk, L. Konopkina, T. V. Kireieva, I. Liskina, Y. O. Merenkova, N. Rudnytska, O. V. Strafun, O. Tolokh","doi":"10.31215/2306-4927-2023-31-1-5-33","DOIUrl":"https://doi.org/10.31215/2306-4927-2023-31-1-5-33","url":null,"abstract":"In 2000 American Thoracic Society (ATS) and European Respiratory Society (ERS) published first international statement on diagnosis and treatment of idiopathic pulmonary fibrosis (IPF) — American Thoracic Society, European Respiratory Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. In 2011 there was published new statement on diagnosis and treatment of IPF, approved by ATS, ERS, Japan Respiratory Society (JRS) and Latin American Thoracic Society (ALAT) — An Official ATS/ERS/JRS/AL: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management, in 2015 — section «Treatment», and in 2018 — section «Diagnosis» an update. It is known, that in part of the patients with such an insterstitial lung disease (ILD) as idiopathic nonspecific interstitial pneumonia, systemic sclerosis, pneumoconiosis, chronic hypersensitivity pneumonitis, sarcoidosis, lung fibrosis may acquire a progressive uncontrolled character with combination of symptoms described as Progressive Pulmonary Fibrosis (PPF). Besides, in recent years there have been published data on successful use of antifibrotic therapy in several fibrosing ILD, other than IPF (INBUILD, SENSCIS studies). This has required the change of the treatment paradigm in favor for a unified approach to antifibrotic therapy. This was a rationale for an inclusion of other ILD manifested as PPF into the list of indications for use of antifibrotic therapy. To comply with this novelty the experts of ATS, ERS, JRS and ALAT in May 2022 published new statement An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults. In this document alongside with partial update of IPF diagnosis and treatment principles, there have been presented a definition, diagnosis criteria and recommendations for treatment of PPF in other ILD. In summary, «An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management» (2011) and its updated sections «An Official ATS/ERS/JRS / ALAT Clinical Practice Guideline: Treatment of Idiopathic Pulmonary Fibrosis. An Update of the 2011 Clinical Practice Guideline» (2015), “Diagnosis of Idiopathic Pulmonary Fibrosis: An Official ATS/ERS/JRS/ ALAT Clinical Practice Guideline» (2018) and Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults were used a the prototype documents for creation of Adapted clinical guideline «Idiopathic pulmonary fibrosis and progressive pulmonary fibrosis in adults». Key words: idiopathic pulmonary fibrosis, progressive pulmonary fibrosis, definiition, diagnosis, treatment, antifibrotic therapy.","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115237269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LONG-TERM TREATMENT OUTCOMES IN COMMUNITY-ACQUIRED COVID-19 VIRAL PNEUMONIA ASSESSED BY COMPUTED TOMOGRAPHY DATA","authors":"O. K. Yakovenk, V. Ignatieva, G. Gumeniuk, O. Tarasenko, V. Svyatnenko, M. Lynnyk","doi":"10.31215/2306-4927-2022-30-2-37-41","DOIUrl":"https://doi.org/10.31215/2306-4927-2022-30-2-37-41","url":null,"abstract":"The aim was to study the evolution of changes in the structure of the lungs in patients with a complicated course of community-acquired COVID-19 viral pneumonia by software processing of CT scan data and to determine the features of changes to predict its outcome. Materials and methods. The analysis of CT scan series of 70 patients with community-acquired viral pneumonia (COVID-19) was performed. The diagnosis of COVID-19 was established in accordance with the current protocols for the treatment of coronavirus disease. CT scan was performed on the scanner Aquilion TSX-101A “Tochiba” (Japan) with the recording of the results on digital media and subsequent software processing of data. Results. Of the 70 study patients in 21 patients (30 % of all examined subjects, 15 men and 6 women) bullous-emphysematous lesions of lung parenchyma attributable to “vanishing lung syndrome” were revealed. There were no cases of massive post-inflammatory pulmonary fibrosis found. Conclusions. Considering high prevalence of “vanishing lung syndrome” caused by the autoimmune process in patients with complicated community-acquired COVID-19 viral pneumonia, it is necessary to develop the methods of its management. To reveal complications, prevent them and predict the course of severe forms of COVID-19pneumonia, it is necessary to perform repeated CT scans with densitometry of the pulmonary parenchyma. Key words: COVID-19, CT scan, vanishing lung syndrome, densitometry, post-inflammatory pulmonary fibrosis.","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130839088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POSSIBILITIES OF HALOAEROSOLTHERAPY AS RESPIRATORY REHABILITATION IN THE CORRECTION OF INSULIN RESISTANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE","authors":"O. Lemko, N. Vantiukh, D. Reshetar","doi":"10.31215/2306-4927-2023-31-1-66-71","DOIUrl":"https://doi.org/10.31215/2306-4927-2023-31-1-66-71","url":null,"abstract":"Comorbidity in chronic obstructive pulmonary disease (COPD) considerably determines both the prognosis and social-economic outcomes and requires thorough evaluation. The aim of the study was to investigate the possibilities of insulin resistance (IR) correction, as the basis for comorbidity, in COPD patients under the influence of renewal non-pharmacological treatment using haloaerosoltherapy (HAT). Materials and methods. Complex clinical, functional and laboratory examinations were carried out in 32 patients with COPD (GOLD II-III) beyond the acute period. The average age of patients was 60.3±1.71 years, and duration of the disease — (14.2 ± 0.89) years. The control group of apparently healthy subjects included 24 persons. Data of the COPD Assessment Test, results of the six-minute walk test, and lung function data were analysed. The severity of oxidant stress (OS), activity of systemic inflammatory process were evaluated. Carbohydrate metabolism was studied according to the data of glucose, insulin, C-peptide levels in the blood and the HOMA-IR index was calculated. The basis for renewal treatment was HAT with certain parameters of concentration and dispersion. Results. It was found that, regardless of the remission, certain clinical and functional changes were persistent, which indicated a tendency to the progression of disease, which is confirmed by the OS severity, endogenous intoxication presence and the inflammatory process activity. These changes were the pathogenetic basis for IR and the corresponding metabolic and clinical consequences. In particular, strong direct correlations were found between the content of Schiff bases and the level of insulin (r = 0.71), HOMA-IR index value (r = 0.76), the content of C-peptide (r = 0.67) and a correlation of medium strength between the level of tumor necrosis factor-α and insulin (r = 0.52). After renewal treatment with the use of HAT, positive change of the studied indices were observed, which was accompanied by a decrease in the manifestations of IR, but not reaching the level of the control group. Conclusions. 1. Chronic bronchial obstruction and insulin resistance are mutually aggravating pathological processes, connected by a common pathogenetic link — the presence of OS, endogenous intoxication and systemic chronic inflammation of low intensity. This determines the necessity to develop complex long-term management programs for patients with COPD, taking into account both respiratory disorders, as well as probability of IR, type 2 diabetes development and its complications. 2. Under the influence of HAT as a non-pharmacological method of respiratory rehabilitation, in accordance with the improvement of clinical manifestations of COPD, ventilation function, reduction in OS intensity and systemic inflammation activity, there is a decrease in the IR manifestations, but a certain level of it remains even after the renewal treatment course, which indicates a significant pathogenetic role of these ","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126837590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PECULIARITIES OF THE COURSE OF COPD IN PATIENTS WITH DIFFERENT A46G (RS1042713) ALLELES OF ADRB2 GENE","authors":"K. Dmytriiev, Y. Mostovoy, N. Slepchenko, N. Sinchuk","doi":"10.31215/2306-4927-2021-29-4-30-34","DOIUrl":"https://doi.org/10.31215/2306-4927-2021-29-4-30-34","url":null,"abstract":"PECULIARITIES OF THE COURSE OF COPD IN PATIENTS WITH DIFFERENT A46G (RS1042713) ALLELES OF ADRB2 GENE K. D. Dmytriiev, Y. M. Mostovoy, N. S. Slepchenko, N. I. Sinchuk Abstract A significant number of genetic factors, modulating inflammation, fibrosis and bronchial responsiveness, plays an important role in development of chronic obstructive pulmonary disease. Particularly, polymorphism of ADRB2 gene is associated with the development and severity of COPD, as well as with a response to beta-2 agonists. Aim — to study the prevalence of ADRB2 gene polymorphism among COPD patients and to reveal its possible relationship with the development of COPD and its clinical course. Materials and methods. 100 patients with the diagnosis of COPD were included into the study. An mean age was 64.09 ± 1.94 years. There were 66 men (66 %) and 34 women (34 %). There were 68 smokers (68 %), an average smoking experience was 24,44 ± 4,84 pack-years. Mean COPD duration was — 9.35 ± 2.42 years. We collected data about the amount of exacerbations, use of antibiotics, glucocorticoids, methylxanthines, data of mMRC and CAT questionnaires in all patients. Questionnaire data were collected during three visits — visit of inclusion, visit 2 (5±1 weeks), visit 3 (1 year). Data about exacerbation and drugs use were collected for the year prior to the study and the year of participation. Results. Regarding the presence of ADRB2 gene polymorphism all patients were allocated to 3 groups: group 1 — 23 (23 %) A46A allele carriers; group 2 - 39 (39 %) A46G allele cariers and group 3 — 38 (38 %) G46G allele carriers. Duration of COPD was greater in group 3 compared to the group 1 (7,08±1,59 vs 10,5±0,98) (p < 0,05). Group 2 and group 3 had greater proportion of patients with COPD GOLD D (46,15±8,32 % and 44,73±8,28 % correspondingly), when compared to group 1 (17,39±8,38 %) (p < 0,05). Group 1 had less exacerbations (2,13 ± 0,22) when compared to group 2 (2,97 ± 0,28), and group 3 (2,86 ± 0,25) (p < 0,05). Duration of treatment with antibiotics was significantly shorter in A46A allele carriers (8,61 ± 1,60 days), when compared to two other groups (in group 2 - 13,64 ± 1,25 days, in group 3 - 13,00 ± 1,28 days) (p < 0,05). Duration of treatment with GCS in group 1 (2,95 ± 0,85 days), A46A allele carriers, was shorter when compared to group 2 (5,28 ± 0,94 days), A46G allele carriers (p < 0,05). Conclusions. Occurrence of polymorphic (A46G) and mutant (G46G) alleles of ADRB2 gene was associated with more severe course of COPD, greater amount of exacerbations and hospital admissions, greater need in antibiotics and GCS, indicating an important role of this gene in regulation of the airways responsiveness and response to treatment. Key words: COPD, ADRB2 gene polymorphism.","PeriodicalId":328937,"journal":{"name":"Ukrainian Pulmonology Journal","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114573277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}