CHRONIC OBSTRUCTIVE PULMONARY DISEASE – AB INITIO TILL PRESENT (historical literature review)

Визель, А. А.; Визель, И. Ю.

doi:10.21292/2075-1230-2019-97-2-42-49

Cited by 6 publications

(1 citation statement)

References 17 publications

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“…For patients with pulmonary ventilation heterogeneity, it may be useful to add combinations of bronchodilators that reach the distal airways. Bronchial obstruction has a negative impact on the tuberculosis course, the effectiveness of chemotherapy and the quality of life of patients with pulmonary tuberculosis [23][24][25]. The use of various bronchodilators in patients with pulmonary tuberculosis with a good clinical effect and a positive effect on the effectiveness of etiotropic therapy was described.…”

Section: Discussionmentioning

confidence: 99%

Gas Exchange in Patients with Pulmonary Tuberculosis: Relationships with Pulmonary Poorly Communicating Fraction and Alveolar Volume

Kiryukhina

Kokorina

Gavrilov

et al. 2023

JoR

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Tuberculosis-related lung damage is very different. Lung ventilation disorders have been studied in patients with pulmonary tuberculosis (TB) during the active process and after treatment, but the main causes of gas exchange changes have not been sufficiently studied. Investigation of diffusing lung capacity in combination with bodyplethysmography is useful for the interpretation of pulmonary gas exchange disorders. The aim was to determine the relationship of gas exchange with the value of alveolar volume (VA) and pulmonary poorly communicating fraction (PCF) in patients with pulmonary TB. A total of 292 patients (117/175 M/W) with verified pulmonary TB with smoking age less than 10 packs-years underwent spirometry, bodyplethysmography, and DLCO by the single-breath method. PCF was estimated calculating the difference between total lung capacity (TLC) and VA (% TLC). Patients with low DLCO had statistically significantly lower spirometric values (FVC, FEV1, FEV1/FVC, MMEF), lower TLC, higher airway resistance, RV/TLC, air-trapping volume, and PCF. The patients with low level of DLCO were divided into four groups depending on level VA and PCF. In most patients with infiltrative tuberculosis (50%), the leading syndrome of the DLCO decrease was alveolar-capillary damage. In patients with tuberculomas, the syndromes of alveolar capillary damage and pulmonary ventilation inhomogeneity were with the same frequency (43%). In patients with disseminated tuberculosis, the most frequent syndrome of the DLCO decrease was pulmonary ventilation inhomogeneity (33%), then alveolar-capillary damage (29%) and mixed (24%). In patients with cavernous tuberculosis, the leading syndrome of the DLCO decrease was mixed (39%), then alveolar capillary damage (25%) and pulmonary ventilation inhomogeneity (23%). The syndrome of gas exchange surface reduction in patients with disseminated and cavernous tuberculosis was less common (14%). In conclusion, an additional evaluation of the combination of PCF and VA increases the amount of clinical information obtained using the diffusion lung capacity measurements, since it allows identifying various syndromes of gas exchange impairment. The leading causes of diffusing capacity impairment vary by different types of pulmonary TB.

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Section: Discussionmentioning

confidence: 99%

Gas Exchange in Patients with Pulmonary Tuberculosis: Relationships with Pulmonary Poorly Communicating Fraction and Alveolar Volume

Kiryukhina

Kokorina

Gavrilov

et al. 2023

JoR

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Combined therapy of broncho-obstructive pathology: two solutions to one problem

Vizel,

Vizel

2023

Medicinskij sovet

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Chronic broncho-obstructive pulmonary diseases – bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) – are a serious clinical problem and an economic burden for practical healthcare. The purpose of the scientific review is to track the evolution of views on the use of bronchodilators and inhaled corticosteroids (ICS) in these diseases and to analyze modern approaches to treatment based on domestic and international guidelines. COPD treatment is aimed at two pathogenetic components – inflammation of the bronchi and the formation of emphysema. The basis of basic therapy remains the use of long-acting bronchodilators of two classes. Treatment of asthma is directed primarily at chronic inflammation of the airways using long-acting bronchodilators. The basis of basic therapy for asthma is the use of inhaled glucocorticosteroids. Currently, the same combinations of bronchodilators and ICS are recommended for both asthma and COPD. One direction is based on the use of ICS with formoterol, a 12-hour drug with a fast onset, in which the drug can be used on demand. The second direction is based on the constant use of ICS/LABA only on a regular basis, but with the ability to use bronchodilators on demand. In this case, ICS with high affinity are more often used. An important component of treatment is adherence to medical prescriptions and the availability of different types of drugs for patients in real clinical practice. At present, conditions have been created in Russia for the implementation of both the treatment of patients with asthma and the treatment of patients with COPD with frequent exacerbations and eosinophilia based on import substitution with modern drugs.

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Triple fixed drug combination in the treatment of patients with chronic obstructive pulmonary disease

Demko,

Sobko,

Kraposhina

2024

Medicinskij sovet

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Chronic obstructive pulmonary disease is one of the common respiratory diseases characterized by chronic inflammation, increased airway resistance and exacerbations. Treatment of chronic obstructive pulmonary disease is aimed at reducing the severity of symptoms, preventing exacerbations and progression of the disease, which significantly affects the well-being of patients. Irregular administration of prescribed drugs, as well as incorrect inhalation technique affects the well-being of patients, worsens the quality of life, increases the risk of adverse outcome. Over the past few years, the possibilities of therapy have certainly expanded, primarily due to the emergence of new combination drugs containing 2 or 3 components in one inhaler. The use of a medicament containing all three components in a single delivery device contributes to improved adherence to treatment and reduces the possibility of errors in inhalation technique. Drugs with the possibility of single use per day improve the patient’s adherence to therapy. In our clinical case, a patient with severe COPD and eosinophilia > 300 cells/µL with the administration of a double fixed combination of bronchodilators during the year showed an improvement in the condition, but a high level of blood eosinophils and frequent exacerbations remained. A personalized approach to COPD therapy will reduce the number of exacerbations, slow down the decline in lung function, and improve the quality of life of patients. The triple combination provides an effective and convenient option for supportive treatment of COPD, primarily for those whose disease is not controlled by dual ICS/LABA or LABA/LABA therapy.

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CHRONIC OBSTRUCTIVE PULMONARY DISEASE – AB INITIO TILL PRESENT (historical literature review)

Cited by 6 publications

References 17 publications

Gas Exchange in Patients with Pulmonary Tuberculosis: Relationships with Pulmonary Poorly Communicating Fraction and Alveolar Volume

Gas Exchange in Patients with Pulmonary Tuberculosis: Relationships with Pulmonary Poorly Communicating Fraction and Alveolar Volume

Combined therapy of broncho-obstructive pathology: two solutions to one problem

Triple fixed drug combination in the treatment of patients with chronic obstructive pulmonary disease

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