[Assessment of inhalation technique in patients with bronchial asthma and chronic obstructive pulmonary disease].

AIM: Investigate inhalation techniques using different inhalers types and their effect on the course of disease. MATERIALS AND METHODS: This cross-sectional study included 110 patients with asthma, chronic obstructive pulmonary disease using the inhaler at least one month. Inhaler errors performed during demonstration were evaluated for each patient and entered in the check-lists. We also collected information about co-morbidities, education, mMRC dyspnea score, rate of exacerbations, and performed spirometry. RESULTS: 80.9% of patients used metered-dose inhaler, 20.9% - single-dose and 21.8% - multiple-dose dry powder inhaler, 22.7% - soft-mist inhaler. Inhaler errors were made by 80.9% patients. The mean number of mistakes in metered-dose inhaler use was 2±1.6, single-dose powder inhaler -1.5±1.3, multiple-dose dry powder inhaler - 1.25±1.4, soft-mist inhaler - 0.68±0.7 (р=0.003). Age, diagnosis, duration of disease, education level, inhalers usage by relatives have no influence on the inhalation technique. A number of errors was related to female gender (р=0.007) and usage of more than 2 inhalers (r=0.3, p=0.002), previous instruction about inhalation technique (r=0.3, p=0.001). On the other hand, there were correlations between the number of errors and degree of bronchial obstruction, asthma control, severity of dyspnea by mMRC score, exacerbation rate. CONCLUSION: Patients with bronchoobstructive diseases perform many inhaler errors, that substantially influences the severity and course of asthma and chronic obstructive pulmonary disease.

[Prevalence of thyroid diseases in the Primorye Territory: ecological and hygienic aspects].

The paper presents the results of an ecological and hygienic assessment of the prevalence of thyroid diseases in the Primorye Territory. The analysis has indicated that the morbidity rates from different nosological entities depend on the bioclimatic zone, environmental and geochemical situation. Varying correlations were established between the soil concentrations of chemical elements (nickel, zinc, arsenic, silver, cobalt, and lead) and the degree of thyroid abnormalities in adults, adolescents, and children. The occurrence of thyroid abnormalities in adolescents and adults does not depend unambiguously on the content of iodine in the environmental objects. Arsenic, lead, and cobalt having a significant toxicity affect high morbidity among these population groups.

[Hygienic assessment of the impact of environmental factors of the Primorye Territory on the incidence of thyroid diseases].

The paper gives the ecological and hygienic characteristics of the Primorye Territory. It describes bioclimatic zones and ecological tension areas. The results of studies of the prevalence of thyroid diseases (diffuse endemic goiter, multinodular endemic goiter, subclinical hypothyroidism) associated with iodine deficiency in relation to the bioclimatic zone and the ecological situation are shown. The findings permit the planning and implementation of therapeutic-and-prophylactic measures for prevention iodine deficiency among the population of the Primorye Territory.