Pulmonologiya最新文献

{"title":"Intralobar bronchopulmonary sequestration: an example of the late onset of this rare congenital pathology","authors":"M. А. Tretyakov, A. Yu. Tretyakov","doi":"10.18093/0869-0189-2023-33-5-697-702","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-697-702","url":null,"abstract":"Bronchopulmonary sequestration (BPS) refers to a rare congenital lung malformation with a nonventilated dysplastic fragment of parenchyma separated from the main bronchial tree. This segment has a systemic blood supply through aberrant arteries and venous outflow into the systemic venous bed or pulmonary veins and has a common with the rest of the lung (intralobar BPS) or an independent (extralobar BPS) visceral pleura. Purpose of the study is to describe an unusual late onset of right-sided intralobar BPS characterized by a pseudopneumonic course in a patient with concomitant anomalies of the thoracic spine and diaphragm; to discuss the issues of formation, manifestation, diagnosis, differential diagnosis, complications, and treatment of intralobar BPS, and to consider its combination with other developmental anomalies. Conclusion. BLS should be considered in patients with an unusual course of pulmonary anomalies, especially localized in the basal segments of the left (more common) or right (less common) lung and characterized by abnormal blood supply and other malformations.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135205764","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":"Impact of biologicals on chronic rhinosinusitis with nasal polyps in combination with severe asthma","authors":"D. O. Timoshenko, K. S. Pavlova, O. M. Kurbacheva, M. E. Dyneva, N. I. Ilina, I. P. Shilovskiy, A. S. Dvornikov, M. R. Khaitov","doi":"10.18093/0869-0189-2023-33-5-600-610","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-600-610","url":null,"abstract":"Chronic rhinosinusitis with nasal polyps (CRSwNP) is often associated with asthma. This combination aggravates the course of both conditions, including the frequency and severity of asthma and CRSwNP exacerbations. Currently, the main strategy in the treatment of severe asthma is the use of biologicals, which may also impact CRSwNP symptoms, considering the similarity of pathogenic mechanisms of these diseases. The aim of our study was to evaluate the impact of biological therapy on CRSwNP in combination with severe asthma. Methods. 49 patients with CRSwNP and severe asthma were included in a single-center prospective cohort study. Patients were divided into 4 groups: dupilumab ( n = 20), benralizumab ( n = 15), mepolizumab ( n = 7), and omalizumab ( n = 7). Patients received the biologicals for at least 12 months ( min – 12.0 months; max – 52.2 months). Asthma control (ACT, FEV 1 , the number of asthma exacerbations) and CRSwNP control (SNOT-22, the number of nasal and sinus surgeries) were evaluated at baseline and during treatment. The safety of therapy was assessed by the examination results and the reported adverse events. Results. We observed statistically significant improvements in asthma control, respiratory function, and a decrease in the number of asthma exacerbations with the use of biologicals in all groups. However, there were no statistically significant differences between the groups ( p > 0.05). As for CRSwNP, we found the statistically significant improvements in symptoms (ΔSNOT-22 – (–67,3) ± 23,7, p < 0,001; (–26,1) ± 24,6, p < 0,001; (–34,0) ± 23,5, p = 0,016; (–35,1) ± 25,1, p = 0,025) and a decrease in the number of surgeries after therapy (Δ number of surgeries – (–5,2) ± 8,6, p < 0,001; (–3,7) ± 3,3, p = 0,002; (–3,6) ± 2,4, p = 0,036; (–1,6) ± 1,4, p = 0,010). in all groups. At the same time, dupilumab showed a greater improvement of CRSwNP control according to the SNOT-22 questionnaire than benralizumab (p = 0.001) and mepolizumab (p = 0.034). Conclusion. Biologicals currently used to treat severe asthma have a beneficial effect on concomitant CRSwNP. However, not all biologicals are characterized by an effect on the processes of polyposis tissue remodeling and formation. Our study confirms the relevance of searching for other potential targets for the development of the new biologicals to address the identified clinical needs.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"330 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135205622","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":"Blood periostin/procalcitonin index in patients with asthma and asthma-COPD overlap","authors":"V. I. Trofimov, D. Z. Baranov, V. N. Mineev","doi":"10.18093/0869-0189-2023-33-5-657-662","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-657-662","url":null,"abstract":"The significant prevalence of asthma and asthma-COPD overlap (ACO) necessitates further rationalization of diagnostic and treatment approaches and emphasizes importance of studying the pathogenesis of bronchial obstructive diseases. Well-known markers of allergic and infectious inflammation such as periostin and procalcitonin, respectively, have shown their utility in pulmonology. The aim of this study is to analyze the diagnostic value of blood periostin/procalcitonin index as a complex parameter reflecting both allergic and non-allergic inflammation. Methods. First, we calculated blood periostin/procalcitonin index. Then we compared this index between two groups using the Mann – Whitney test. Results. Patients with non-allergic asthma had lower blood periostin/procalcitonin index compared to the patients with allergic asthma ( p = 0.003). Blood periostin/procalcitonin index correlated well with diagnosis in patients with asthma and ACO in our clinical cases. Conclusion. Blood periostin/ rocalcitonin index has demonstrated its clinical utility as a complex inflammatory parameter. Its high values indicate active allergic inflammation. This index can be used to correct glucocorticoid and antibacterial treatment.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135205624","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":"Course of sarcoidosis in patients treated with systemic corticosteroids","authors":"A. A. Vizel, S. N. Avdeev, I. Yu. Vizel, G. R. Shakirova, A. E. Vlasenko","doi":"10.18093/0869-0189-2023-33-5-634-644","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-634-644","url":null,"abstract":"The treatment of sarcoidosis remains uncertain despite 70 years of studies. The conventional approach is to initiate corticosteroids in individuals who require treatment. However, to date, there are no strict dosing regimens for systemic corticosteroids (SСS), and patients who were treated with SСS develop relapses more frequently than those who have not received these drugs. The aim of this work was to evaluate the course and outcomes of pulmonary sarcoidosis in patients who were prescribed systemic corticosteroids. Methods. The study was retrospective and noninterventional. 493 (32.5%) of 1,518 patients with sarcoidosis were prescribed corticosteroids during follow-up. Only 333 cases were selected because they had histologic confirmation and follow-up of 1 year or more. The data at the time of diagnosis and at the time of analysis were compared (patients remained under the supervision of the same physicians thereafter). Results. After at least one year of follow-up, the positive effect of SCS (resolution or stabilization of the process) was achieved only in half of the cases, while the rest of the patients required more courses of SCS or the use of alternative drugs. Worsening was more common when multiple organs were involved, when SCS were administered immediately after diagnosis without a follow-up period, and when the duration of the first course of hormone therapy was less than 7 months. 33.6% of patients treated with SCS had clinically significant adverse events (AEs), and 13.2% had to discontinue or replace one hormonal drug with another. Older age and repeated courses of SCS were associated with the development of fibrosis, whereas transition to second-line drugs was not. Conclusion. SCS remain the first-line drugs in the treatment of sarcoidosis. The analysis performed allows us to recommend them after an observation period (if the patient’s condition allows it) and for at least 6 months. In case of exacerbation or recurrence of sarcoidosis after treatment with SCS, subsequent therapy with second-line drugs is more effective that a repeated course of SCS.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135205758","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":"Fungal infections in patients with progressing COVID-19: pathomorphology and description of clinical cases","authors":"M. V. Mnichovich, A. A. Soldatova, S. I. Usmanov, I. A. Shiripenko, O. A. Sidorova, M. V. Lozina, S. V. Snegur, Ju. G. Pavlova, P. P. Baklanov, V. M. Kozeev","doi":"10.18093/0869-0189-2023-33-5-703-712","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-703-712","url":null,"abstract":"Invasive pulmonary mycoses are a common complication of severe COVID-19 ( COronaVIrus Disease 2019) and are characterized by rapid spread and high mortality. It is especially important to study the epidemiology and pathomorphology of fungal superinfection in order to understand the main vector of the diagnosis and treatment of this complication. The aim of this paper is to consider aspects of the epidemiology, pathomorphologic picture, and clinical manifestations of invasive pulmonary mycoses associated with COVID-19. Clinical cases of fungal superinfections (candidiasis, aspergillosis) associated with COVID-19 in patients receiving appropriate therapy were presented. Results of autopsy examination and light microscopy with routine staining were analyzed. Macroscopic assessment of lesions and histological examination revealed morphological multiorgan changes typical of the combination of fungal (candidiasis, aspergillosis) and viral infection (COVID-19). Conclusion. The presented data of post-mortem examination are important for both science and clinical practice as they form the basis for finding new ways of treating patients with comorbid pathology and developing a prognostic algorithm.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135205761","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":"Composition of bacterial microbiome in sputum of patients with localized forms of pulmonary tuberculosis","authors":"V. G. Druzhinin, E. D. Baranova, P. S. Demenkov, Ju. V. Zakharova, M. B. Lavryashina, A. V. Larionov, L. V. Matskova, A. V. Shabaldin, T. V. Pyanzova","doi":"10.18093/0869-0189-2023-33-5-645-656","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-645-656","url":null,"abstract":"Recent studies have shown that the respiratory bacterial microbiome has an impact on the development of pulmonary tuberculosis. Changes in the composition of the microbiome have been associated with the pathogenesis of Mycobacterium tuberculosis infection, response to therapy, and clinical outcomes of the disease. To date, the composition of the respiratory microbiome has not been studied in patients with localized forms of pulmonary tuberculosis. Methods. In the present study, the taxonomic composition of the sputum microbiome of 14 patients with localized forms of pulmonary tuberculosis (tuberculomas) and 14 healthy donors in the comparison group was analyzed by sequencing (NGS) of the V3 – V4 region of the bacterial gene encoding 16S rRNA . Results. The sputum microbiomes of the patients and the control group did not have significant differences in the species richness index (Shannon). However, the patients showed a decrease in the uniformity index, another parameter of alpha diversity. Bacterial community structures (beta diversity) did not differ significantly between patients with localized forms of tuberculosis and healthy subjects. In patients with limited forms of tuberculosis, contrary to the decrease in the content of representatives of the phyla Fusobacteria , TM7 , Tenericutes , Spirochaetes , and SR1 , and of the genera Dialister , Mycoplasma , and Filifactor in the sputum, no clear dominance of any bacterial taxon was observed. Conclusion. Certain alpha and beta diversity parameters that characterize the sputum microbiome of patients with localized forms of pulmonary tuberculosis need to be confirmed in independent large-scale studies to further understand the role of the sputum microbiota in the development of localized forms of pulmonary tuberculosis. Determination of Prevotella titers in the sputum of these patients holds promise for the diagnosis of localized forms of pulmonary tuberculosis and the search for their genomic markers.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135205763","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":"Significance of N-acetylcysteine in clinical practice","authors":"I. V. Leshchenko, N. A. Esaulova","doi":"10.18093/0869-0189-2023-33-5-679-688","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-679-688","url":null,"abstract":"N-acetylcysteine (NAC) is a mucolytic and antioxidant with a variety of properties. The clinical use of NAC spans more than 35 years, during which the emphasis has been on a multifaceted action and broad spectrum of therapeutic indications. Information is available on the efficacy of NAC in the prevention of contrast-induced nephropathy, studies on the role of NAC in the treatment of pulmonary and coronary disease, etc. The purpose of this review is to analyze the efficacy and safety of NAC in respiratory clinical practice. Conclusion. NAC is a drug with a unique variety of properties and treatment options. The drug has proven its efficacy and safety in real pulmonology practice.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135363480","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":"Dynamics of functional changes in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge","authors":"A. V. Chernyak, M. Kh. Mustafina, Zh. K. Naumenko, E. N. Kalmanova, K. A. Zykov","doi":"10.18093/0869-0189-2023-33-5-611-621","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-611-621","url":null,"abstract":"Morphological examination reveals microcirculation disorders in combination with small areas of lung damage in the long term after COVID-19. Therefore, the function of the respiratory system should be assessed after COVID-19. Aim of this study was to evaluate the dynamics of respiratory dysfunction in patients with COVID-19-associated lung injury using a complex examination of lung function (spirometry, body plethysmography, and lung diffusion testing) one year after hospital discharge. Methods. 60 patients (38 men/22 women, aged 39 to 80 years) with a diagnosis of “COVID-19-associated interstitial process in the lungs” were examined. Lung function (spirometry, body plethysmography, and lung diffusion capacity testing) was examined in all patients twice, at 1 – 6 months (visit 1) and at 12 – 24 months (visit 2) after hospital discharge. Results. At visit 1, 60% of patients had restrictive pulmonary ventilation disorders. Obstructive ventilation disorders were detected in only 1 patient. Decreased lung diffusion capacity (D CO corr. ) was found in 78% of patients. At visit 2, obstructive disorders were detected in 1 patient, and the frequency of restrictive ventilation disorders was 29%. Decreased DL CO corr. was noted in 57% of cases. The parameters of pulmonary ventilation and pulmonary gas exchange function differed significantly between visits. Significant correlations were found between changes in the functional parameters of the respiratory system and disorders identified at visit 1 after hospital discharge. Conclusion. Thus, there is a decrease in the lung diffusion capacity and the rate of restrictive ventilation disorders even one year after severe COVID-19-associated lung injury. However, our results suggest a marked improvement in respiratory system function over time.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135363476","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":"New concept and algorithm for the management of patients with chronic obstructive pulmonary disease","authors":"S. N. Avdeev, I. V. Leshchenko, Z. R. Aisanov","doi":"10.18093/0869-0189-2023-33-5-587-594","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-5-587-594","url":null,"abstract":"Currently, chronic obstructive pulmonary disease (COPD) is a global problem and one of the leading causes of death worldwide. COPD therapy includes pharmacological and non-pharmacological approaches that can significantly reduce clinical symptoms and decrease the frequency of exacerbations of the disease. Methods. The updates of guidelines for the diagnosis and treatment of COPD is expected to have a significant impact on patients with COPD in clinical practice. Simplification of the treatment algorithms and inclusion of triple therapy will help clinicians provide appropriate and timely treatment to patients with COPD with a focus on reducing the risk of future exacerbations. Recognition of mortality reduction as a treatment goal in COPD supports the increased use of triple therapy, the only pharmacologic intervention shown to improve survival in patients with COPD. Conclusion. Although further guidance and clarification are needed in some areas, such as the use of blood eosinophil count in treatment decisions and the implementation of post-hospitalizaton treatment protocols, the recent guideline updates will help clinicians address current gaps in patient care.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135756440","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":"Skin test based on Mycobacterium tuberculosis antigens (ESAT-6 and CFP-10) for the detection of tuberculosis infection in world practice","authors":"О.Е.Русских, Е.В.Савинцева, Д.А.Кудлай, Н.П.Докторова, П.Г.Сысоев, O. E. Russkikh, E. V. Savintseva, D. Kudlay, N. Doktorova, P. Sysoev","doi":"10.18093/0869-0189-2023-33-4-559-567","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-4-559-567","url":null,"abstract":"According to experts, 2 billion people in the world are infected with the causative agent of tuberculosis. A priority task in the diagnosis of tuberculosis infection is the use of accurate, accessible and scalable tools. The tuberculin skin test (TST), or Mantoux test, and the interferon gamma release assay (IGRA) are currently used to diagnose tuberculosis infection. In 2022, the World Health Organization (WHO) identified a fundamentally new class of skin tests for the early detection of tuberculosis infection, the so-called Mycobacterium tuberculosis antigen-based skin tests (TBST). These tests include Diaskintest (Russia), C-Tb (India), and C-TST (China) and pose an alternative to the tuberculin skin test and the IGRA. The aim of this work was to conduct a systematic review of domestic and foreign literature sources on the use of a new skin test based on M. tuberculosis antigens (ESAT-6 and CFP-10) to detect tuberculosis infection (Diaskintest) in world practice. Conclusion. According to the literature data, including the published results of meta-analyzes on the use of skin tests, it has been shown that recombinant tuberculous allergen test, as a new skin test based on M. tuberculosis antigens (ESAT-6 and CFP-10), or TBST, has high sensitivity and specificity for the detection of tuberculosis infection. Its sensitivity and specificity are significantly higher than those of the tuberculin test. TBST skin test results are comparable to those of IGRA, have a favorable safety profile, combined with high laboratory test specificity and ease of performance and assessment of the result in one cut (cut-off > 0 mm – any size papule is considered positive). Thus, TBST is a valuable tool for early detection of TB infection. Taking into account the volume of scientific clinical studies on recombinant tuberculous allergen test in the world practice, more than 10 years of experience in clinical practice in Russia and the CIS countries, it can be concluded that recombinant tuberculous allergen test is currently the leading test for mass diagnosis of tuberculosis infection not only in Russia, but also in the world.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74213224","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}