КАЧЕСТВЕННАЯ И КОЛИЧЕСТВЕННАЯ ХАРАКТЕРИСТИКА ОДЫШКИ У БОЛЬНЫХ ПРОГРЕССИРУЮЩИМ ФИБРОТИЧЕСКИМ ФЕНОТИПОМ ИНТЕРСТИЦИАЛЬНЫХ БОЛЕЗНЕЙ ЛЕГКИХ, АССОЦИИРОВАННЫХ С СЕРДЕЧНО-СОСУДИСТЫМИ ЗАБОЛЕВАНИЯМИ

Aim. Analysis of quantitative and qualitative parameters of dyspnea in patients with the fibrotic phenotype of interstitial lung disease associated with coronary artery disease. Material and methods. We examined 49 patients. Among those were 9 patients with idiopathic pulmonary fibrosis, 25 patients with chronic variant of hypersensitive pneumonitis, and 14 patients with nonspecific interstitial pneumonia. The main group consisted of 25 patients with interstitial lung diseases and coronary heart disease; comparison group consisted of 24 patients without ischemic heart disease. Clinical symptoms, questionnaire results, and instrumental study data were analyzed. Results and discussion. Patients with coronary heart disease experienced increased dyspnea earlier (after 3,21 days) than patients without it (after 7,18 days; p<0,05). On functional examination, a significant decrease in pulmonary diffusion capacity was recorded in cardiac patients, p<0,05. Presence of coronary heart disease was accompanied by intensification of dyspnea according to Borg scale, decrease of distance walked in 6 min, significant decrease in pulse oximetry indices (by 7,94% in the main group and by 3,26% in the comparison group). On computed tomography, the severity of «frosted glass» was statistically higher in patients with coronary heart disease, p<0,05. Pulmonary hypertension, changes of right heart sections were observed in both groups of patients, left ventricular hypertrophy was observed only in patients of the main group. Patients with «isolated» phenotype of interstitial lung disease complained of heaviness, shortness of breath, patients with coronary heart disease complained of compression, tightness in chest, patients with pulmonary heart disease and heart failure had combination of these sensations. Conclusion. In patients with interstitial lung diseases, associated with coronary heart disease, dyspnea intensification reflects progression of lung disease, development of heart failure, and chronic pulmonary heart disease. Study of quantitative and qualitative characteristics of dyspnea is a way to specify the origin of dyspnea at the stage preceding specialized instrumental diagnostic methods.

Cardiovascular disease in women with breast cancer – a nationwide cohort study

Background There is increasing concern about cardiovascular disease (CVD) after breast cancer (BC). The aim of this study was to estimate the prevalence of different types of CVD in women diagnosed with BC compared to cancer-free controls as well as the incidence of CVD after BC diagnosis. Methods We performed a cohort study based on data from national registries covering the entire Danish population. We followed 16,505 cancer-naïve BC patients diagnosed from 2003 to 2007 5 years before and up to 10 years after BC diagnosis compared to 165,042 cancer-free controls. Results We found that 15.6% of BC patients were registered with at least one CVD diagnosis in hospital records before BC diagnosis. Overall, BC patients and controls were similar with regard to CVD comorbidity before BC diagnosis. After BC diagnosis, the incidence of all CVD diagnoses combined was significantly higher in BC patients than controls up to approximately 6 years after the index date (BC diagnosis). After 10 years, 28% of both BC patients and controls (without any CVD diagnosis up to 5 years before the index date) had at least one CVD diagnosis according to hospital records. However, the incidence of heart failure, thrombophlebitis/thrombosis and pulmonary heart disease including pulmonary embolism remained higher in BC patients than controls during the entire 10-year follow-up period. After 10 years, 2.7% of BC patients compared to 2.5% of controls were diagnosed with heart failure, 2.7% of BC patients compared to 1.5% of controls were diagnosed with thrombophlebitis/thrombosis, and 1.5% of BC patients compared to 1.0% of controls were diagnosed with pulmonary heart disease according to hospital records. Furthermore, we found that the risk of heart failure and thrombophlebitis/thrombosis was higher after chemotherapy. Conclusions Focus on CVD in BC patients is important to ensure optimum treatment with regard to BC as well as possible CVD. Strategies to minimise and manage the increased risk of heart failure, thrombophlebitis/thrombosis and pulmonary heart disease including pulmonary embolism in BC patients are especially important.

Treatment of Chronic Pulmonary Heart Disease with Traditional Chinese Medicine: A Protocol for the Development of a Core Outcome Set (COS-TCM-CPHD)

Background. Treatment of chronic pulmonary heart disease (CPHD), a common disease, has over recent years been studied using traditional Chinese medicine (TCM) due to many high-profile benefits. These can be evaluated by the measurement and analysis of related outcomes. Because of selective reporting bias and the heterogeneity of study outcomes, it is not possible to combine similar studies in a meta-analysis. Consequently, not only does the low quality of original studies fails to support evidence-based decision-making, but also the value of those clinical studies cannot be evaluated. To solve these problems, the development of a core outcome set for traditional Chinese medicines for the treatment of chronic pulmonary heart disease (COS-TCM-CPHD) is required. Methods. The development is conducted in five steps: (1) a library of outcomes through systematic review, the retrieval of libraries from two clinical trials registries, and semistructured interviews is established; (2) following data extraction and analysis of the library of outcomes, each outcome can be classified into seven outcome domains, including TCM disease, symptoms/signs, physical and chemical testing, quality of life, long-term prognosis, economic evaluation, and adverse events to form a preliminary list of outcomes; (3) stakeholder groups for participation are selected; (4) stakeholder groups are invited to participate in two rounds of Delphi surveys to score outcomes and provide additional outcomes; (5) a consensus meeting is organized to produce the final COS-TCM-CPHD. Discussion. The protocol is consistent with the guidelines defined by the Core Outcome Set-STAndardised Protocol (COS-STAP) statement and formulated with reference to Core Outcome Set-STAndards for development (COS-STAD). The COS-TCM-CPHD will improve the consistency of study reports and reduce publication bias, thereby improving the quality of TCM clinical trials and decision-making for evidence-based medicine. The study has been registered on the COMET website (http://www.comet-initiative.org/Studies/Details/1677).

Application of Gastroscopy Based on Nano Carbon in the Remedy of Chronic Pulmonary Heart Disease Caused by Helicobacter Pylori

Chronic pulmonary heart disease is a common respiratory disease. Helicobacter pylori infection can lead to the occurrence of chronic pulmonary heart disease. However, most drugs for chronic pulmonary heart disease caused by helicobacter pylori are lack of tissue specificity. At the same time, due to the blocked blood circulation in the ischemic area, the distribution of drugs in the ischemic area is often not ideal. The gastroscope technology of nano carbon can make the drug release in the focus as much as possible, and can achieve the goal of targeted treatment. This paper mainly studies the application of the gastroscope technology based on nano carbon in the remedy of chronic pulmonary heart disease caused by helicobacter pylori. After 8 weeks of treatment, the indexes of right heart function in the two groups: TAPSE and RVMPI were better than before treatment, and the improvement degree in the remedy group was more obvious than that in the control group (P < 0.05). The improvement degree of E/A and PASP was not statistically significant, the difference between the two groups was not significant (P > 0.05). In addition, the gastroscope of nano carbon can also reduce UA and TG in blood. The overall response rate was 93.75% in the remedy group, which was higher than that in the control group (P < 0.05).