bronchial obstruction
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2022 ◽  
Vol 24 (1) ◽  
pp. 6-7
Author(s):  
Prasad Panse ◽  
◽  
Kenneth Sakata

No abstract available. Article truncated after 150 words. A 37-year-old woman complaining of chest pain and cough underwent resection of a mediastinal foregut duplication cyst complicated by a 10-day hospitalization with a prolonged air leak. Seven years later, she presented with worsening cough and shortness of breath, complaining of similar symptoms intermittently in the 7 years between her surgery and presentation. Chest CT showed a hyperattenuating lesion obstructing the medial basal segmental airways, with bronchoscopy revealing suture and a pledget obstructing the medial basal segmental right lower lobe bronchus. The pledget and suture were successfully removed. Repeat bronchoscopy several months later showed no residual airway foreign body, although medial basal subsegmental bronchial stenosis prevented advancement of the bronchoscope distally; this finding correlated with the CT impression of airway stenosis or occlusion in this region on the follow up CT. Bronchogenic cysts result from abnormal lung budding and development of the ventral foregut during the first trimester (1). Many …


2021 ◽  
Author(s):  
Thibaut Capron ◽  
Axel Bartoli ◽  
Stanislas Rappacchi ◽  
Clarisse Gautier ◽  
Faiza Bettayeb ◽  
...  

Abstract Background: Chronic obstructive pulmonary disease with emphysema lead to respiratory disability beyond bronchial obstruction. The functional impact of pulmonary vascular lesions in emphysema remains unknown. We investigated pulmonary vascular adaptation to exercise in patients with extended emphysema.Methods: Chest magnetic resonance imaging was used to quantitatively assess right-heart function, pulmonary artery and distal pulmonary blood flow. This was performed at rest and during cycling exercise with a magnetic resonance imaging-compatible cyclo-ergometer. Seven emphysematous patients without pulmonary hypertension were compared to 7 healthy non-smokers matched in gender and age.Results: At rest, cardio-pulmonary hemodynamics and distal pulmonary vascular parameters were similar in both groups. Intrasubject adaptation to exercise in emphysematous patients was characterized by a higher increase in right-ventricular ejection fraction (ΔRVEF +8.1 vs. -2.4 %, P=0.046) though a lower right-cardiac output (4.41 vs. 5.79 L/min, P=0.04) at exercise. Accounting for right-cardiac output variation, the distal pulmonary vascular yield index trended to be decreased in patients (ΔPBF/ΔQf -0.78 vs. +18.83 %, P=0.18).Conclusions: Pulmonary vascular adaptation to exercise is impaired in emphysematous patients without identified pulmonary hypertension.Clinical trial registration NCT 04126616.


Author(s):  
V. K. Kozlov ◽  
O. A. Lebed’ko ◽  
N. V. Morozova ◽  
S. V. Pichugina ◽  
E. I. Yakovlev ◽  
...  

Introduction. The results of long-term observations of children with chronic bronchopulmonary diseases occurring with bronchoobstructive syndrome and poorly responding to standard therapy are presented. To optimize treatment, it is necessary to accurately determine the nosological variant of the pathology, to identify the main causes of the formation of dysontogenetic disorders.Aim. To study the main nosological options and clinical and diagnostic criteria for chronic obstructive pulmonary diseases in children to justify an individual approach to treatment and follow-up.Materials and methods. 148 children with chronic bronchopulmonary diseases occurring with bronchial obstruction syndrome (excluding bronchial asthma and cystic fibrosis) were exаmined according to the differential diagnostic algorithm developed by us, including anamnestic, clinical, X-ray, functional and morphological methods.Results. The main group of 148 cases consisted of 73 children (49,3%) with lung malformations with insufficiency of the muscular-elastic and cartilaginous framework of the trachea and bronchi, local malformations, with impaired lung growth and development, causing bronchial obstruction. Acquired variants of chronic obstructive pulmonary diseases in children were noted by us in the form of chronic obstructive bronchitis (25.2%) and in the outcome of bronchopulmonary dysplasia (11.5%), chronic obliterating bronchiolitis (6.1%), gastroesophageal reflux disease (0.7%). Acquired local forms of obstruction (foreign object, scar stenosis, tumors) were noted in 4.5% of cases. Hereditary lung diseases, including primary ciliary dyskinesia, were detected in 2.7% of cases.Conclusion. Chronic obstructive pulmonary diseases are diseases of various etiology and pathogenesis that occur at an early age in children with perinatal disorders against the background of various lung malformations, bronchial dysplasia, lung tissue malformations and are the pathomorphological basis for the further formation of chronic obstructive pulmonary disease in adult patients.


2021 ◽  
Vol 99 (11) ◽  
pp. 43-46
Author(s):  
E. M. Zhukovа ◽  
L. G. Vokhminovа

Clinical testing of the forced oscillation test (FOT) yielded criteria for bronchial obstruction: an increase in viscous respiratory resistance (VRR) (Rfo, Rin, Rex); the frequency dependence of VRR. The study of VRR promoted detection of bronchial malpatency in additional 20% of pulmonary tuberculosis patients who had no lung ventilation disorders, as evidenced by spirometry.


2021 ◽  
Vol 11 (3) ◽  
pp. 34-42
Author(s):  
A. A. Derevoedov ◽  
A. V. Zholinsky ◽  
V. S. Feshchenko ◽  
I. T. Vykhodets ◽  
A. A. Pavlova

Respiratory disorders caused by exercise are expressed in the development of exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA), which are observed in athletes, especially in cyclic sports, much more often than in the population. Ventilation impairments are exacerbated by inhaled allergens, industrial pollutants and adverse environmental conditions, which increase the risk of EIB and asthma symptoms in athletes. The use of β2-agonists can prevent or eliminate ventilation disorders, however, it requires taking into account current anti-doping rules, which allow the use of certain substances in sports without a request for therapeutic use. The studies of the influence of β2-agonists on functional indicators of athletes and sports performance do not allow to make an unambiguous conclusion about its results. Medications with β2-agonists, approved for use in sports in the form of inhalation, do not have a significant effect on the performance of athletes at major sports competitions. At the same time, the systemic use of these substances and the use of any form of terbutaline caused a positive dynamics in functional indicators, which could lead to an illegal increase in the effectiveness of sports performance. Most of the conclusions about the effect of β2-agonists on outcome are based on a small number of studies, their heterogeneity, and an insignificant number of observations. It is necessary to continue studying the effects of β2-agonists in the course of randomized clinical trials in order to individualize therapy and prevent bronchial obstruction in athletes


Author(s):  
Т.В. Таютина ◽  
А.В. Лысенко ◽  
Т.М. Казарян ◽  
Д.С. Лысенко

Более чем у 500 пожилых пациентов с ХОБЛ оценивали частоту применения спиральной КТ легких и эхо-КГ сердца с диагностической целью и для контроля за течением болезни. Проведенное исследование показало, что, несмотря на высокую клиническую значимость показателя ОФВ(объем форсированного выдоха за 1-ю секунду), сам показатель при постановке диагноза ХОБЛ у пожилых пациентов является крайне неспецифичным. Высокая специфичность КТ легких обусловливает необходимость использования данного диагностического метода у пожилых пациентов для выявления морфологических изменений легких при наличии клинических признаков бронхиальной обструкции и отрицательных данных спирометрии. Необходимо усилить роль эхо-КГ при диагностике хронического легочного сердца и стратификации тяжести основного заболевания у пожилых больных ХОБЛ. In more than 500 elderly patients with COPD, the frequency of spiral computed tomography (SCT) of the lungs and echo-CG of the heart was evaluated for diagnostic purposes and to monitor the course of the disease. The study showed that despite the high clinical significance of the FEV indicator (the volume of forced exhalation in the first second), the indicator itself is extremely non-specific when diagnosing COPD in elderly patients. The high specificity of lung CT makes it necessary to use this diagnostic method in elderly patients to detect morphological changes in the lungs in the presence of clinical signs of bronchial obstruction and negative spirometry data. It is necessary to strengthen the role of echocardiography in the diagnosis of chronic pulmonary heart disease and stratification of the severity of the underlying disease in elderly patients with COPD.


Kardiologiia ◽  
2021 ◽  
Vol 61 (10) ◽  
pp. 89-98
Author(s):  
N. A. Karoli ◽  
A. P. Rebrov

In medical literature, increasing attention is paid to comorbidities in patients with chronic obstructive pulmonary disease (COPD). In clinical practice, physicians often hesitate to prescribe beta-blockers (β1-adrenoblockers) to COPD patients. This article summarized new results of using beta-blockers in patients with COPD. According to reports, the selective β1-blocker treatment considerably increases the survival rate of patients with COPD and ischemic heart disease, particularly after myocardial infarction (MI), and with chronic heart failure (CHF). The benefit of administering selective β1-blockers to patients with CHF and/or a history of MI overweighs a potential risk related with the treatment even in patients with severe COPD. Convincing data in favor of the β1-blocker treatment in COPD patients without the above-mentioned comorbidities are not available. At present, the selective β1-blocker treatment is considered safe for patients with cardiovascular diseases and COPD. For this reason, selective β1-blockers, such as bisoprolol, metoprolol or nebivolol can be used in managing this patient cohort. Nonselective β1-blockers may induce bronchospasm and are not recommended for COPD patients. For the treatment with β-blockers with intrinsic sympathomimetic activity, the probability of bronchial obstruction in COPD patients is lower; however, drugs of this pharmaceutical group have not been compared with cardioselective beta-blockers. For safety reasons, the beta-blocker treatment should be started outside exacerbation of COPD and from a small dose. Careful monitoring is recommended for possible new symptoms, such as emergence/increase of shortness of breath, cough or changes in dosing of other drugs (for example, increased frequency of using short-acting bronchodilators).


2021 ◽  
pp. 42-45
Author(s):  
А. М. ЖУКЕМБАЕВА ◽  
К.С. ЛАТКИНА ◽  
Д.Д. ШЕКТИБАЙ ◽  
Т. Н. КЕМЕРХАН ◽  
А. Б. КУАНЫШ ◽  
...  

Проведен сравнительный анализ динамики клинической симптоматики, явлений бронхиальной обструкции и проходимости бронхов при проведении лечения тиотропия бромидом у 26 больных хронической обструктивной болезнью легких II стадии. Из них было 15 (57,7%) мужчин и 11 (42,3%) женщин. Средний возраст пациентов составил 51,4±2,6 года. Средний стаж курения у мужчин был равен 27,6±2,4 лет, у женщин - 22,5±3,6 лет, при этом достоверных различий между мужчинами и женщинами не было выявлено (P>0,05). Установлено, что на фоне лечения ХОБЛ тиотропия бромидом отмечалась достоверная положительная динамика и регрессия клинической симптоматики ХОБЛ, снижение обструкции и увеличение проходимости бронхов. Полученные результаты свидетельствовали об эффективности и целесообразности применения тиотропия бромида при лечении ХОБЛ на ранних этапах развития патологического процесса в амбулаторных условиях. A comparative analysis of the dynamics of clinical symptoms, the phenomenon of bronchial obstruction and bronchial permeability during treatment with thiotropy bromide was performed in 26 patients with chronic obstructive pulmonary disease of stage II, including 15 (57.7%) men and 11 (42.3%). . The average age of patients was 51.4 ± 2.6 years. The average experience of smoking was 27.6 ± 2.4 years for men, 22.5 ± 3.6 years for women, and there was no significant difference between men and women (P> 0.05). In the treatment of chronic obstructive pulmonary disease with thiotropy bromide revealed a significant positive dynamics and regression of clinical symptoms of COPD, decreased obstruction and increased bronchial permeability. The obtained results showed the effectiveness and feasibility of the use of thiotropy bromide in the treatment of COPD in the early stages of the pathological process on an outpatient basis


2021 ◽  
pp. 47-54
Author(s):  
О.К. Koloskova ◽  
◽  
О.О. Shakhova ◽  
S.І. Tarnavska ◽  
O.V. Vlasova ◽  
...  

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.


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