scholarly journals Clinical and functional features of bronchial asthma AMONG MALE ADOLESCENTS

2019 ◽  
pp. 88-94
Author(s):  
Т. A. Zhadova ◽  
М. V. Tarasova
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Young Men ◽  
Bronchial Obstruction ◽  
Sustained Remission ◽  
Male Adolescents ◽  
Examination Protocol ◽  
Functional Features ◽  
Remission Phase ◽  
Stage 1

The study is aimed at studying the clinical and functional features of BA in young men of military age. Methods. A total of 346 men aged 16–28 years (mean age 18 ± 1.7) were examined. The examination protocol corresponded to the algorithm “Medical Examination of Young Men and Draftees with Bronchial Asthma” in 2008. All patients underwent a general clinical and specific allergological examination, a functional lung examination assessing the reversibility of bronchial obstruction. Results. The diagnosis of BA was confirmed in 283 patients, and newly diagnosed in 23 (8.1%) patients. The mild BA was identified in 277 (97.9%) young men. The majority of patients - 240 (84.8%) - were in the remission phase of the disease, and 5 (1.8%) of them had a sustained remission. Allergic BA was diagnosed in the absolute majority of the examined - 261 (92.2%) people, and predominantly mild intermittent BA in 209 patients (73.8%). Symptoms of allergic rhinitis were reported by 198 (70%) patients with allergic BA and 85 (30%) patients with mixed asthma. House dust, library dust were the most common allergens. 68.2% of patients had the burdened heredity of BA and/or atopy. Most of the examined (79.9%) showed no significant changes in the respiratory function, however, 172 (60.8%) patients showed positive results of the β2-agonist test. At the time of the examination, 56 (19.8%) patients received antiasthma basic therapy, the other used only bronchodilators. Replacement of short-acting bronchodilator monotherapy for a combination of above bronchodilator and inhaled corticosteroids as an adjuvant therapy for stage 1 or 2 GINA patients ensures the early and regular administration of the baseline drug and eliminates the problem of excessive dependence on fast-acting bronchodilators. Conclusion The allergic phenotype of the disease with a predominance of milder form dominates in adolescents with asthma. Treatment with a fixed combination of beclomethasone salbutamol 250 μg/100 μg (SabaComb®) can increase compliance, improve the efficacy of the therapy and reduce the risk of BA exacerbations.

scholarly journals Mechanisms of formation of airway hyperreactivity in view of phenotypical heterogeneity and clinical deviation of bronchial asthma in adolescents (literature review)

2021 ◽  
pp. 47-54
Author(s):  
О.К. Koloskova ◽  
◽  
О.О. Shakhova ◽  
S.І. Tarnavska ◽  
O.V. Vlasova ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
High Body Mass Index ◽  
Airway Hyperreactivity ◽  
Extremely Low Birth Weight ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Bronchial Inflammation ◽  
Mechanisms Of Formation

Bronchial asthma is a disease characterized by recurrent episodes of variable bronchial obstruction, chronic bronchial inflammation, bronchial hypersensitivity and remodulation. Modern therapy of the disease was aimed at these links of pathogenesis, and this concept postulated the need for long-term use of anti-inflammatory drugs and, above all, topical inhaled corticosteroids. However, it should be recognized that the coherent inflammatory theory currently requires revision and new understanding, or even replacement with a new theory, which, considering these characteristics of the disease as an epiphenomenon, will serve as a basis for new approaches in treatment and prevention. The aim of our work — to analyze the mechanisms of formation of bronchial hyperreactivity, taking into account the phenotypic heterogeneity and clinical deviation of bronchial asthma in adolescence (based on the analysis of scientific sources). It is extremely important to determine the risk of transition of the adolescents' bronchial asthma into adulthood, when chronic obstructive pulmonary diseases might develop. Among the main predictors of this risk such factors as age, obesity, early puberty, body weight at birth and in the newborn period and sex can be distin guished. Thus, some authors associate the risk of persistence of the disease with its onset in early childhood, and others — at the age of 6 years old. High body mass index and early onset of puberty are considered to be the predictors of persistent bronchial asthma. It is noted that low and extremely low birth weight of premature infants or rapid weight gain in the neonatal period are associated with a decrease in lung ventilation and the risk of persistent asthma in the future. It is believed that bronchial asthma in children is more common in boys than in girls, in contrast, during puberty, allergic diseases and asthma are more common in girls. Conclusions. The above mentioned literature data give reason to believe that, despite advances in the scientific understanding of the pathogenesis of the main characteristics of bronchial asthma, there are great difficulties in using them in practice. Moreover, current inflammatory paradigm of bronchial asthma needs to be revised because it being a dogma becomes unproductive from a clinical point of view. No conflict of interest was declared by the authors. Key words: asthma, adolescents, hyperreactivity, remission.

scholarly journals Combination of asthma and chronic obstructive pulmonary disease: features of etiology, pathogenesis, diagnosis, pharmacotherapy

2016 ◽  
Vol 97 (3) ◽  
pp. 394-400 ◽  
Author(s):  
O M Uryasev ◽  
S V Faletrova ◽  
L V Korshunova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Diagnostic Criteria ◽  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
World Population ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

Bronchial asthma and chronic obstructive pulmonary disease are the most common obstructive diseases of the respiratory system. 230 million people suffer from chronic obstructive pulmonary disease, from bronchial asthma - 300 million people worldwide. Annually 200-300 people in Europe and 2.74 million of world population die from chronic obstructive pulmonary disease, from asthma - 250 thousand people a year. The social and economic significance of these diseases determine the need for in-depth study of their combination in the same patient. Each disease has its own phenotypes, but in 10-20% of patients, there are symptoms of both chronic obstructive pulmonary disease and asthma. In spite of clear diagnostic criteria, in some cases it is difficult to distinguish these diseases. Morphological basis of these diseases is a chronic inflammation in the bronchial tree that causes damage to the epithelial continuity that initiates bronchoconstrictive reaction and leads to irreversible airway obstruction attributable for both severe bronchial obstruction and chronic obstructive pulmonary disease. However, the treatment strategy of bronchial asthma and chronic obstructive pulmonary disease has significant differences, it is important to have a clear diagnostic criteria to distinguish different phenotypes, including those of combined phenotype of asthma and chronic obstructive pulmonary disease. Rational starting therapy of asthma and chronic obstructive pulmonary disease overlap syndrome includes drugs acting on the pathogenic mechanisms of both diseases, and is a combination of inhaled corticosteroids with combined bronchodilator therapy - long-acting β2-agonists and long-acting anticholinergics.

COMBINED CORRECTION OF THE CONDITION OF PATIENTS WITH ARTERIAL HYPERTENSION AND OBESITY

2020 ◽  
pp. 31-35
Author(s):  
Golovanov S.A. ◽  
Kuznetsov I.A. ◽  
Rasulov M.M.
Keyword(s):  
Posterior Wall ◽  
Biologically Active ◽  
Basic Therapy ◽  
Active Supplement ◽  
Functional Features ◽  
Dimensional Echocardiography ◽  
Stage 1 ◽  
Two Dimensional Echocardiography ◽  
Lipid Spectrum ◽  
Diastolic Functions

Patients from 30 to 50 years old, suffering from arterial hypertonia of stage 1-2 and obesity of 1-2 degree, were exam-ined. Pharmacological correction of cardiovascular disorders and changes in lipid metabolism with the use of dietary supplements "Triastin" against the background of basic therapy of patients with AH and OB with enalapril was car-ried out. In addition to the basic therapy, biologically active supplement Triastin was used in the amount of 2 cap-sules per day for 21 days in 2 cycles for 6 months as an additional hypolipidemic agent. Anthropometric research was carried out using unified methods. Obesity was assessed, as well as the lipid spectrum of the blood. The systolic and diastolic functions of the left ventricle, the size of the aorta, atria and right ventricle, the thickness of the interventric-ular septum in diastole (TMZhPd), the thickness of the posterior wall in diastole (TZSD) were determined using two-dimensional echocardiography. The study revealed a more pronounced and stable decrease in the level of blood pres-sure, lipid profile and side effects of basic therapy, improved myocardial remodeling and its functional features.

Clinical and functional peculiarities at patients with bronchial asthma, chronic obstructive pulmonary disease and overlap of asthma-chronic obstructive pulmonary disease

2020 ◽  
Vol 24 (4) ◽  
pp. 80-86
Author(s):  
V. I. Trofimov ◽  
D. Z. Baranov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Bronchial Asthma ◽  
Blood Test ◽  
Chronic Obstructive ◽  
Inflammation Markers ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Functional Features ◽  
Lower Airways

BACKGROUND: a comparative analysis of laboratory and instrumental tests at patients with bronchial obstructive diseases seems very actual due to the wide prevalence of these diseases. THE AIM: to evaluate characteristics of spirometry as well as allergic (total IgE, sputum eosinophils) and infectious (blood and sputum leucocytes, ESR, CRP, fibrinogen) inflammation markers at patients with bronchial obstructive diseases. PATIENTS AND METHODS: 104 case histories of patients with bronchial asthma, chronic obstructive pulmonary disease and overlap were analyzed including age, duration of smoking (pack-years), laboratory (clinical blood test, biochemical blood test, general sputum analysis, sputum culture) and instrumental (spirometry, body plethysmography, echocardiography) tests. Data were processed statistically with non-parametric methods. RESULTS: COPD patients were older than other groups’ patients, had the highest pack-years index. ACO patients were marked with maximal TLC and Raw, minimal FEV1, FEF25-75, FEV1/FVC. Patients with COPD had the highest inflammation markers (leucocyte count, CRP, fibrinogen). CONCLUSION: high active inflammation may cause severe lower airways possibility disorders at patients with COPD. Data related to a possible role of K. pneumoniaе in the pathogenesis of eosinophilic inflammation in lower airways are of significant interest. Patients with ACO occupy an intermediate position between asthma and COPD patients based on clinical and functional features.

CLINICAL AND SPIROGRAPHIC FEATURES OF BRONCHIAL ASTHMA IN SCHOOLCHILDREN DEPENDING ON THE DIFFERENT REGIMENS OF BASIC ANTI-INFLAMMATORY THERAPY

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Olena Koloskova ◽  
Tetiana Bilous ◽  
Galyna Bilyk ◽  
Kristina Buryniuk-Glovyak ◽  
Olena Korotun ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
High Specificity ◽  
Clinical Feature ◽  
Clinical Group ◽  
Comparison Groups ◽  
Anti Inflammatory ◽  
High Doses ◽  
Persistent Bronchial Asthma

The aim: To study the clinical and spirographic features persistence of the bronchial asthma in schoolchildren against the background of the alternative daily doses of inhaled corticosteroids to increase the effectiveness of anti-inflammatory therapy for this disease. Materials and methods: A complete comprehensive clinical-paraclinical examination of 65 schoolchildren with persistent asthma was conducted. According to the average daily dose of inhaled corticosteroids (ICS) the patients were divided into two clinical groups. The first (I) group consisted of 46 children who received ICS in the regimen of low-to-medium equipotent doses (253.95±9.98 μg per day), and the second (II) comparison group was formed of 19 patients who controlled the pBA using high doses of ICS (494.74±5.56 μg per day). Results: The patients of the І clinical group compared to patients of the ІІ group have a higher risk of the mild bronchial obstructive syndrome during asthma attacks. In assessing the level of control of persistent bronchial asthma using the CIA-scale, it was found that in II group cases of the controlled course of the disease were observed almost two times less than in children of the I group of comparison. In conducting spirography in children of comparison groups, it was shown that the ratio of indices of bronchospasm (FEV1/ FVC) was worse in patients receiving high doses of ICS. Conclusions: So, сharacteristic clinical feature of asthma controlled by high doses of ICS is more severe nature of bronchial obstructive syndrome during the period of exacerbation (OR=1.9-3.0). In the management of persistent bronchial asthma, the Gensler index which has high specificity (94.4%) and accuracy (92.2%) should be used for disease control verification.

scholarly journals ASMANEX TWISTHALER - THE DRUG OF CHOICE AMONG INHALED CORTICOSTEROIDS

2013 ◽  
Vol 10 (6) ◽  
pp. 51-57
Author(s):  
T V Latysheva ◽  
E A Latysheva ◽  
O V Shubina
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Control Methods ◽  
Efficacy And Safety ◽  
Prior Therapy ◽  
Asthma Symptoms ◽  
Drug Of Choice ◽  
Systemic Corticosteroids ◽  
Before And After ◽  
Baseline Therapy

Goals. To reveal the clinical efficacy and safety of Asmanex in patients with moderate and severe bronchial asthma (BA), treated with inhaled and/or systemic glucocorticosteroids (GCS), depending on the severity and level of control. Methods. 40 patients (age 18 to 65 years) were treated with Asmanex with equivalent to prior therapy with inhaled corticosteroids (ICS) doses or in combination with systemic corticosteroids prior therapy (without increasing the dose of systemic corticosteroids) for 3 months. Efficacy was assessed before and after the treatment on a background of Asmanex treatment by the need of additional using of agonists of β 2-adrenoreceptors, severity of daytime and nighttime asthma symptoms, dynamics of spirometry parameters. The efficacy of Asmanex was compared with the original baseline therapy of other inhaled corticosteroids at equivalent doses using the new delivery system.

scholarly journals INTERRELATION BETWEEN POLYFUNCTIONAL MONITORING DATA IN YOUNG MEN WITH PRE- OR MILD HYPERTENSION WITH DIFFERENT BLOOD PRESSURE DAILY PROFILE

2013 ◽  
Vol 19 (1) ◽  
pp. 44-50 ◽  
Author(s):  
E. N. Kazidaeva ◽  
Yu. L. Venevtseva
Keyword(s):  
Blood Pressure ◽  
Power Spectrum ◽  
Mild Hypertension ◽  
Young Men ◽  
Holter Monitoring ◽  
Left Ventricular ◽  
Total Power ◽  
Night Time ◽  
Arterial Blood ◽  
Functional Features

Objective. To examine the clinical signifi  cance of polyfunctional 24-hour Holter monitoring with simultaneous recording of electrocardiogram, blood pressure (BP) and respiratory efforts by respiratory inductance plethysmography (Incart, Russia) and functional features of young men with prehypertension or mild arterial hypertension with different profi  le of night arterial blood pressure (BP) decline («dippers», «non-dippers», «over-dippers»).Design and methods. We examined 43 adolescents and young men aged 16–26 years (mean age 19,4 ± 0,5 years). All of them underwent echocardiography («Vivid 7», GE); 48,8 % of patients were overweight or obese (body mass index, BMI > 24,9 kg/m2), and BMI was comparable in all groups. Results. Breathing disturbances (apnea/hypopnea episodes) were found in 86 % patients and were positively related with high frequency (HF) spectrum power of heart rate variability (HRV) at night-time and were not related with BMI, BP or type of night BP decline. The analysis of echocardiography revealed that in «non-dippers» (n = 18) left ventricular myocardial mass index (LVMMI) was higher (94,3 ± 16,6 g/m2) than in «over-dippers» (n = 15; 77,8 ± 10,3 g/m2, р < 0,001). In daytime «non-dippers» had lower HRV (total power spectrum and power in all three groups) and power spectrum of VLF and LF spectrum at night. The frequency of repolarization instability (transient T-wave inversion) and early repolarization syndrome was higher in «over-dippers» (66,7 %, р < 0,01). Circadian index of HR was also higher (150 %) in «over-dippers». The number of sleep apnea in «non-dippers» and «dippers» was higher (39,7 ± 29,7 and 37,1 ± 18,1 episodes per hour of sleep) than in «over-dippers» (22,3 ± 12,0 episodes per hour of sleep, р < 0,05), but the last group had more hypopneas.Conclusion. Breathing disturbances were a frequent, and, probably, physiological, fi  nding at polyfunctional 24-hour Holter monitoring in young overweight men with pre- or mild hypertension. There is a relationship between LVMMI and nocturnal BP dipping even in young men. Young «non-dippers» demonstrate the same clinical pattern as the older ones. «Over-dipper» type is characterized predominantly by lower HR at night and ECG repolarization abnormalities. 

scholarly journals Effects of the Airway Obstruction on the Skin Microcirculation in Patients with Bronchial Asthma

2016 ◽  
Vol 71 (3) ◽  
Author(s):  
Irina V. Tikhonova ◽  
N. I. Kosyakova ◽  
A. V. Tankanag ◽  
N. K. Chemeris
Keyword(s):  
Blood Flow ◽  
Airway Obstruction ◽  
Bronchial Asthma ◽  
Skin Blood Flow ◽  
Peripheral Blood ◽  
Atopic Asthma ◽  
Control Group ◽  
Bronchial Obstruction ◽  
Peripheral Blood Flow ◽  
Flow Parameters

Background: Pulmonary hemodynamic disorders depend on the inflammatory phases and severity of the obstructive syndrome. However, the effect of asthma bronchial obstruction on the state of peripheral hemodynamics remains insufficiently known. Aims: To study the effects of airway obstruction on skin blood flow parameters and its regulatory systems in patients with persistent atopic bronchial asthma in the remission state.Materials and methods: A comparative study of the skin peripheral blood flow in patients with bronchial asthma with severe airway obstruction (1st group) and without obstruction (2nd group) was conducted. 20 patients with confirmed diagnosis of atopic asthma of 50–74 years old participated in the study. All patients received basic therapy in a constant dosing of high doses of inhaled glucocorticosteroids/long-acting beta-2-agonists. The control group included 20 healthy volunteers without evidence of bronchial obstruction. The study lasted for 3 months. The forced expiratory volume in 1 s (FEV1) was used to evaluate the bronchial obstruction by spirometry technique. Skin blood perfusion changes were recorded by laser Doppler flowmetry at rest and in response to short-term local ischemia. Registered peripheral blood flow signals were examined using the amplitude temporal filtering in five frequency intervals to identify the functional features of the peripheral blood flow regulation systems. Results: Consistent two-fold decrease of the oscillation amplitudes was found in the neurogenic interval at rest (p=0.031), as well as in the myogenic (p=0.043; p=0.031) and endothelial intervals (p=0.037; p≤0.001) both at rest and during the postocclusive reactive hyperemia respectively in the 1st group of patients with bronchial obstruction (FEV1 80%) compared with the control group. No significant changes were revealed for skin blood flow parameters in the 2nd patient group (without obstruction, FEV1 80%) in comparison to control subjects.Conclusions: The presence of bronchial obstruction has a significant impact on the changes of the amplitudes of skin blood flow oscillations in patients with bronchial asthma in the myogenic, neurogenic and endothelial intervals.

Sign in / Sign up

Export Citation Format

Share Document