[Diagnosis and treatment of obstructive sleep apnea in internal medicine]. / Opyt diagnostiki i lecheniia sindroma obstruktivnogo apnoé vo sne v klinike vnutrennikh boleznei.

130 inpatients (94 males and 36 females, mean age 51.8 +/- 9.1 years) with suspected obstructive sleep apnoa (OSA) were examined clinically, were questioned and underwent night cardiorespiratory monitoring. A definite OSA diagnosis was made in 83 patients. Sleep continuous positive airway pressure (CPAP) was applied in 40 patients who had moderate and severe sleep respiratory impairment. The treatment was effective in 31(77%) patients who stopped snoring, improved sleep quality and daytime sleepiness. In half of the hypertensive patients elimination of apnoa lowered blood pressure without drugs in day hours. Patients with chronic respiratory insufficiency improved gas exchange. In pulmonary hypertension CPAP therapy reduced pressure in the pulmonary artery. It is concluded that diagnosis and effective individual therapy of most CPAP patients can be provided in therapeutic hospital departments.

[Comparative study of the effect of carbon dioxide on the generation of active forms of oxygen by leukocytes in health and in bronchial asthma]. / Sravnitel'noe issledovanie vliianiia dioksida ugleroda na generatsiiu aktivnykh form kisloroda leikotsitami v norme i pri bronkhial'noi astme.

The study was conducted by using leukocytes isolated from 74 apparently healthy donors and 60 patients with bronchial asthma. The generation of active oxygen forms was determined by luminolo- and lucigenin-dependent chemiluminescence techniques and NTC-reaction. The findings suggest that at the tension close to the blood tension of 37.5 mm Hg and the high tension of 146 mm Hg is a powerful natural inhibitor of leukocytic generation of active oxygen forms. At an exacerbation, the inhibitory effect of carbon dioxide on the leukocytic generation of active oxygen forms decreased in most (70%) patients with bronchial asthma, which potentiates the free radical mechanism of development of bronchial asthma. It may be held that the literature-described use of carbon dioxide for the treatment of bronchial asthma is justifiable only in a lower proportion of patients who have preserved a high sensitivity to the inhibitory effect of carbon dioxide on the generation of active oxygen forms.

[Changes in the sensitivity of leukocytes to the inhibiting effect of CO2 on their generation of active forms of oxygen in bronchial asthma patients]. / Izmenenie chuvstvitel'nosti leikotsitov k ingibiruiushchemu vliianiiu CO2 na generatsiiu imi aktivnykh form kisloroda u bol'nykh bronkhial'noi astmoi.

30 bronchial asthma (BA) patients and 15 donors were exposed to 8.3% and 20.8% CO2 to bring out leukocytes sensitivity to CO2 by generation of active oxygen (AO) in bronchial asthma. CO2 effects on leukocyte AO generation were defined by luminol-dependent chemiluminescence (CL) before and after the exposure to CO2. It was found that in healthy subjects 8.3% and 20.8% CO2 noticeably inhibits leukocyte CL. However, in 70% of asthmatics with BA exacerbation leukocyte sensitivity to CO2 inhibition diminished. This was normal in 30% of BA patients. With BA aggravation, leukocyte sensitivity to CO2 tended to a decrease. Remission brought a complete or partial recovery of the above sensitivity. Thus, on the one hand, CO2 is involved in BA pathogenesis in terms of its inhibitory effect on AO generation by leukocytes; on the other hand, only in 30% of BA patients high CO2 concentrations as a treatment may be justified.

[Aevit and glutamic acid in the treatment of patients with bronchial asthma]. / Aevit i glutaminovaia kislota v lechenii bol'nykh bronkhial'noi astmoi.

To elucidate the effect of antioxidants aevit and glutaminic acid on the course of bronchial asthma (BA) and free radical processes in this disease, 54 BA patients were divided into 2 groups: glucocorticoid-untreated and glucocorticoid-treated. Each of two subgroups made of these groups either received antioxidants (AO) or not. The response was assessed by clinical BA symptoms and free radical processes reflecting production of active oxygen forms by leukocytes (PAOFL) and free radical peroxidation (FRPO). PAOFL was studied using luminol-dependent chemiluminescence (CL). CL basal and stimulated values were calculated. FRPO was measured by plasma levels of malonic dialdehyde. Aevit and glutaminic acid treated BA patients improved clinically and exhibited reduced CL of PAOFL and malonic dialdehyde in plasma compared to BA patients on conventional therapy or conventional therapy plus glucocorticoids. Aevit and glutaminic acid are recommended for BA patients.

[Generation of active forms of oxygen by alveolar macrophages in patients with bronchial asthma]. / Generatsiia artivnykh form kisloroda alveoliarnymi makrofagami u bolnykh bronkhialnoi astmoi.

Generation of active oxygen forms (GAOF) by alveolar macrophages (AM) and leukocytes, the role of GAOF in provoking a bronchial asthma (BA) attack were studied simultaneously and compared in 10 asthmatics, 10 chronics with bronchitis and 5 healthy subjects. GAOF was evaluated using luminol-dependent chemiluminescence. Basal and stimulated indices of the latter, the ratio GAOF by leukocytes to GAOF by AM were estimated. In a BA exacerbation GAOF intensity proved higher than in health. Both healthy subjects and the patients had GAOF by leukocytes more active than GAOF by AM, their proportion being less in asthmatics. It appeared that in BA aggravation leukocytes generate more active oxygen forms, but AM activation surpasses that of leucocytes.

[The generation of active forms of oxygen by the blood leukocytes, lipid peroxidation and antiperoxide protection in bronchial asthma patients]. / Generatsiia aktivnykh form kisloroda leikotsitov krovi, perekisnoe okislenie lipidov i antiperekisnaia zashchita u bol'nykh bronkhial'noi astmoi.

A study was made of the generation of active forms of oxygen by leukocytes, of free radical lipid peroxidation and antiperoxide activity (APA) in 52 bronchial asthma (BA) patients depending on the disease phase and of a possibility of their correction with antioxidants. In BA exacerbation, chemiluminescence of leukocytes (CL) and plasma content of malonic dialdehyde (MDA) increase whereas plasma APA reduces as compared to the control. During remission, CL and plasma content of MDA decrease but do not reach normal. Simultaneously one can see a tendency toward plasma APA reduction as compared with the phase of exacerbation. BA patients who received antioxidants in addition to the conventional therapy demonstrated a more pronounced lowering of CL and plasma MDA content than those given the conventional therapy alone. The data obtained attest to the activation of free radical oxygen and lipid processes and to inhibition of plasma APA in BA, providing evidence in favour of including antioxidants in combined therapy of BA.

[Potential of the anticholinergic drug troventol in the treatment and diagnosis of bronchial asthma]. / Vozmozhnosti antikholinergicheskogo preparata troventola v lechenii i diagnostike bronkhial'noi astmy.

A study was made of potentialities of the Soviet drug troventol in the diagnosis and treatment of bronchial asthma. 143 patients suffering from bronchial asthma and 38 patients with pollenosis were examined for external respiratory function using a microprocessor spiroanalyzer, the immunological status and clinical symptoms. The importance of carrying out the diagnostic test with troventol in revealing latent bronchospasm was established, the bronchodilatory effect of troventol at the level of the large bronchi was demonstrated as was a decrease of the emotional manifestations together with the immunomodulatory effect. Beneficial results were attained in 67.8% of cases, satisfactory in 16.8%, and unsatisfactory in 15.4%. Untoward effects in the form of tachycardia were recorded in 3.5% of patients, bradycardia in 5.6%, dry mouth in 16.1% of patients.

[Clinical value of the acetylcholine and exercise tests and their safety provided by the use of broncholytics]. / Klinicheskaia znachimost testov atsetilkholinovogo i s fizicheskoi nagruzkoi i obespechenie ikh bezopasnosti bronkholitikami.

Study of the external respiration parameters in 144 patients with bronchial asthma and pollinosis during the acetylcholine and physical exercise tests prior to and after the administration of cholinolytics and corinfar produced the following results. Cholinolytics produced a protective effect in acetylcholine bronchospasm, troventol was more effective than atrovent, calcium antagonists has no preventive effect in exercise tolerance test.

[Prevalence of bronchopulmonary aspergillosis at the pulmonological hospital]. / O rasprostranennosti bronkholegochnogo aspergilleza v pul'monologicheskom statsionare.

The prevalence and the character of aspergillous infection were studied among 64 patients (33 men and 31 women) seen at the pulmonological hospital. Ten patients of that group were diagnosed to have bronchopulmonary aspergillosis. In all the cases, the disease was regarded as secondary one: 2 patients suffered from chronic aspergillous pneumonia and 8 patients from different patterns of aspergillous bronchitis. The risk factors of the disease development are described. The data obtained indicate that secondary bronchopulmonary aspergillosis occurs not infrequently. The estimation of the risk factors, careful clinical examination, and specific mycologic and serologic tests allow an early diagnosis of bronchopulmonary aspergillosis followed by institution of adequate treatment.