The aim of this study was to evaluate changes in lung ventilation and lung diffusing capacity (DLCO) of cystic fibrosis (CF) patients during 1 year after lung transplantation. Methods . Complex lung function was monitored in CF patients underwent bilateral lung transplantation in 2012 – 2016. Results . CF patients ( n = 12; mean age, 26.4 ± 4.4 years) were included in the study. Median follow-up after the lung transplantation was 19 (12–57) months. Consistent improvement in lung function parameters and DLCO was observed in 3 months after lung transplantation and maintained during 1 year. The ratio of forced expiratory volume in 1 sec to forced vital capacity was higher the normal level and the bronchial resistance was lower the cut-off values, i.e. the patients did not have bronchial obstruction. The total lung capacity (TLC) decreased to normal according to the anthropometric characteristics of the recipient. Meanwhile, change in the TLC structure, such as non-significant reduction in the vital capacity (VC) together with increase in the functional residual capacity (FRC), residual volume (RV) and RV/TLC ratio, have been developed. Consistent increase in FRC and RV could be explained by changes in the shape and the elasticity of the chest wall after the surgery. DLCO also improved, but was still slightly decreased. Conclusion . The lung function and DLCO improved in a year after bilateral lung transplantation in CF patients. Effects of different factors on postoperative lung function parameters need to be further investigated.

DLCO

Vital capacity

10.18093/0869-0189-2017-27-2-206-215

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Факторы, влияющие на качество жизни больных с бронхиальной астмой

Пульмонология (2021)

А. Г. Чучалин А С Белевский Igor Smolenov Н. А. Смирнов Я. Г. Алексеева

The aim of this study was to evaluate a role of different demographic factors and asthma symptoms on quality of life In asthmatic patients. This wide-spread population-based study included 2100 adults aged 18 to 74 years from 22 regions of Russia (1050 patients with well-controlled asthma and 1050 patients with poorcontrolled asthma). Influence of demographic factors (age and gender of a patient, occupation, education level, employment, family status, number of family members, personal Income, smoking history) and features of asthma course (duration and severity of the disease, need in bronchodilators, nighttime asthma symptoms, asthma control, current therapy) was estimated. A Russian analogue of general questionnaire MOS — SF36 and a Russian version of the specific Asthma Quality of Life Questionnaire (AQLQ) were used in this study. The independent factors influencing on the quality of life in asthma patients were established. The most Important factors were the disease control and nighttime asthma symptoms. Current therapy of asthma Influenced on the quality of life controversially. Combined therapy with Inhaled corticosteroids and long-acting p-agonists provided the most improvement In the quality of life.

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POTENTIAL FOR USE OF NON INVASIVE LUNG VENTILATION IN PATIENTS WITH DECOMPENSATED CHRONIC HEART FAILURE

PULMONOLOGIYA (2011)

С. Н. Авдеев K. A. Popova G. V. Nekludova А. Г. Чучалин

Summary. This open controlled singlecentre study was designed to evaluate efficacy of non-invasive lung ventilation (NIV) in patients with decompensated chronic heart failure (DCHF). Inclusion criteria were inpatient DCHF complicating ischaemic heart disease (IHD) or dilated cardiomyopathy (DCM); the ejection fraction of the left ventricle (EFLV) < 35 %, NYHA functional classes III–IV, age > 40 years, increase in dyspnea during previous 7 days. The study involved 33 patients (22 males and 11 females, mean age, 58.94 ± 9.76 years; EFLV, 28.84 ± 5.47 %). The patients were randomized into 2 groups: the 1 st group (n = 22) was treated with the conventional therapy (inhibitors of angiotensinconverting enzyme, nitrates, digoxin, diuretics, statins) and NIV (BiPAP or CPAP, 6–8 h / day). The 2nd group (n = 11) received medications only. The 1 st group patients demonstrated more remarkable improvements in dyspnea, heart beat rate, breathing rate and lung function compared to the 2 nd group patients (p < 0.01). Treatment with HIV increased EFLV, reduced the LV size, decreased blood levels of BNP (p = 0.015), IL6 (p = 0.015) and CRP (p = 0.006). In the control group, there were no significant changes in central haemodynamics, lung function, BNP concentration or systemic inflammation markers to the 10–14 th days of therapy. NIV was well tolerated; no serious adverse event was recorded during the study. Therefore, NIV could greatly improve dyspnea, central haemodynamics, lung function, and LV dysfunction and reduce systemic inflammation in patients with DCHF.

Dilated Cardiomyopathy

10.18093/0869-0189-2011-0-2-41-48

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Medical ethics in the history of medicine. The phenomenon of “holy doctors”: the historical portrayal of Ye.S. Botkin

History of Medicine/ru (2017)

А. Г. Чучалин Irina V. Siluyanova

Phenomenon

History of medicine

10.17720/2409-5834.v4.3.2017.07g

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Efficacy and safety of gemifloxacin in the treatment of acute exacerbation of chronic obstructive pulmonary disease: open prospective multicentre study

PULMONOLOGIYA (2008)

С. Н. Авдеев Г. Е. Баймаканова E. N. Gaidar Г. Л. Игнатова И. В. Лещенко

Objective: to study the clinical and antibacterial efficacy and safety of gemifloxacin in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AE COPD) hospitalized into pulmonology departments. Study design: open non-comparative prospective study. Settings: 25 different pulmonology centres in Russia. A total of 222 patients with AE COPD (156 males and 66 females, mean age 56,4 ± 11,9 years) were included in the study. The majority of patients (70.3 %) were classified as I type Anthonisen of AE COPD. All patients received oral gemifloxacin (Factive ® , Veropharm, Russia) 320 mg once daily for 7 days. Clinical and bacteriological outcomes and treatment safety were assessed at the end of therapy (7–8 days of study) and at follow up (14–16 days of study). At the end of therapy (7–8 days) statistically significant improvements were noted in all symptoms of AE COPD (improvement of cough, dyspnea, sputum volume and purulence). No clinical improvement was seen in 5.6 % of patients, so the clinical success rate of gemifloxacin therapy was 94.4 %. Sputum cultures were performed in 73.0 % of patients and in 60.4 % of them respiratory pathogens were isolated. The leading pathogens were Streptococus pneumoniae (37.7 %) and Haemophilus influenzae (27.8 %). Eradication and presumed eradication of all pathogens were 69.4 % and 26.9 %, respectively. The bacteriological success rate of gemifloxacin therapy was 96.3 %. A total of 15 patients reported adverse events (AEs), most frequent AEs was diarrhea (4.7 %). All AEs were no severe and transitory, and did not require the withdrawal of antibiotic therapy. Oral gemifloxacin had high clinical and bacteriological efficacy in hospitalized patients with AE COPD. The treatment with gemifloxacin was generally well tolerated and was convenient to patients.

Pulmonology

Gemifloxacin

Sputum culture

10.18093/0869-0189-2008-0-6-39-47

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Bronchiolitis: classification,clinical picture, anatomical pathology

DOAJ (DOAJ: Directory of Open Access Journals) (2003)

А. Г. Чучалин A. L. Chernyaev

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[Organizing pneumonia: diagnosis and treatment].

DOAJ (DOAJ: Directory of Open Access Journals) (2012)

С. Н. Авдеев Авдеев Сергей Николаевич A. L. Chernyaev Черняев Андрей Львович А. Г. Чучалин

According to current classifications, organizing pneumonia (OP) belongs to the group of diffuse parenchymatous diseases of the lungs. Morphological picture of OP is characterized by the presence of polypoid granulation tissue consisting of proliferating fibroblasts and myofibroblasts in the gap of respiratory bronchioles. In most cases OP is idiopathic. Among the causes, most significant are diffuse diseases of the connective tissue and complications of pharmacotherapy. OP develops more frequently in 50-60-year old males and females. Typical for OP is an acute/subacute course with a clinical picture of bacterial pneumonia. Mean duration of the symptoms to diagnosis is 2-6 months. Roentgenologically, OP often presents with spotted bilateral (less often unilateral) dense consolidation foci of subpleural location; pulmonary volumes are, as a rule, unaffected. OP treatment of choice is administration of glucocorticosteroid drugs. The prognosis of OP is favourable, most of the patients are completely cured by glucocorticosteroids.

Granulation tissue

Pharmacotherapy

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Integrated care pathways for airway diseases (AIRWAYS-ICPs)

European Respiratory Journal (2014)

Jean Bousquet Antonio Addis Ian M. Adcock Ioana Agache Àlvar Agustí

The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions.AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life.In the longer term, the incidence of disease may be reduced by innovative prevention strategies.AIRWAYS-ICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing.All stakeholders are involved (health and social care, patients, and policy makers).@ERSpublications AIRWAYS-ICPs: launch of a collaboration to develop multi-sectoral integrated care pathways for respiratory disease

Action plan

10.1183/09031936.00014614

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