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Comparison of the state of 83 patients with histologically confirmed sarcoidosis observed with a 10 year interval revealed remission in 47% of the cases. The main factors having negative effect on prognosis of the disease included extrapulmonary symptoms, the use ofcorticosteroids (at all stages, especially at stage I and in Lofgren syndrome) and antituberculosis drugs, positive TB test. Risk factors of relapses were stage II sarcoidosis, the use of systemic corticosteroids in patients with Lofgren syndrome and antituberculosis drugs, initially low FEV1/FVLC ratio and the number of lymphocytes in peripheral blood.

Fibrosing alveolitides (FA) are common diseases, as yet insufficiently known to practitioners. In most cases, objective and subjective difficulties arise in diagnosing FA in the outpatient setting. The course of FA has been analyzed in 48 patients from their first visit to a polyclinic to admission to a specialized pulmonology unit. There is a high rate of outpatient diagnostic errors that may be accounted for by the similarity of many lung diseases, at their onset in particular, by small-scale studies and district therapists' little experience in working with patients with FA. The results of comprehensive examinations of patients with FA in a specialized clinic are given.

The effectiveness and safety of treatment with vobenzyme supplemented to the standard antibiotic therapy have been compared in 60 patients. Addition of vobenzyme to the standard antibiotic therapy significantly reduces the number and degree of respiratory symptoms has a pronounced effect on the activity of inflammation, leads to a more complete reversal of pulmonary parenchymatous infiltration on a roentgenogram, contributes to the achievement of the maximum efficiency of treatment, and substantially diminishes residual respiratory symptoms of pneumonia economically expediently and safety at a late follow-up.

After 3 weeks or more of treatment, 36 patients who were found to have X-ray signs of pneumonia (pulmonary infiltrative changes, fever, productive cough, weakness) were randomized into two matched groups (a study group and a control one). 77.7 and 55% of control and study group patients changed and continued antibacterial therapy. The study group patients were additionally given intravenous infusions of 400 ml of ozonized sodium chloride solution (pO3) containing 1.6 microg/ml of O3 twice weakly for 21 days. Blood ozonization considerably accelerated the resolution time of X-ray infiltrative changes so that they were undetectable in all study group patients by week 4 while they were only in 61.1% of the control groups. Blood ozonization used in combination with antibiotics permitted caused a sputum negative reaction against Chlamydia and Mycoplasma 2-3 weeks earlier. Infusions of pO3 just after the first ozonization made it possible to eliminate a clinical sign of chronic infection, such as weakness, to accelerate productive cough relief on day 10, and to reduce the number of fever patients. Ozone therapy for protracted pneumonias substantially enhances the efficiency of antibiotic treatment.

Idiopathic interstitial pneumonias are well-known to be mainly characterized by restrictive ventilation dysfunctions and a diminished lung diffuse capacity. No separate significance is generally attached to bronchial obstructive disorders that may be detected along with restrictive ones in some patients. The made analysis of the ventilation capacity of the lung in 53 patients with idiopathic interstitial pneumonias has revealed impaired bronchial patency in 47.2% of the cases, which gives grounds to study this problem in future.

The clinical efficiency of inhalational antibacterial therapy for Stage II chronic obstructive pulmonary disease (COPD) was evaluated in 100 patients who had been randomized to an inhalational fusafungine group (n = 50) and a systemic (per os or parenteral) antibiotics group (n = 50). Inhalational antibacterial therapy for exacerbations of Stage II COPD was found to be as effective as systemic use of antibiotics. Moreover, side effects of inhalational therapy were much less pronounced.

A suspension of multidrug resistant clinical Mycobacterium tuberculosis (MBT) strain, at a concentration of 1 x 10(8) microbes per ml, resistant to streptomycin (S), rifampicin (R), isoniazid (I), and kanamycin (K), was in vitro treated for 60 minutes with dissolved ozone (pO3) at a concentration of 0.5-4 microg/ml). Then it was placed in the Lowenstein-Jensen media containing various concentrations of S, I, R, and K. Following 3 months, drug susceptibility was determined by the number of cultured colonies and MBT was used to prepare a suspension at the same concentration, which was again treated with pO3 by the same procedure and placed to the media containing the drugs. A session was thrice repeated. After each pO3 treatment, MBT resistance to I decreased and it completely disappeared after triple treatment. Each pO3 treatment caused a reduction in MBT resistance to R, but it was high (640 microg/ml). After double pO3 treatment MBT resistance to S decreased, but it was recovered after its third ozone treatment. All pO3-untreated control cultures showed a growth of more than 100 colonies. Sixty-eight BALC/s mice were in vivo inoculated via intravenous injections of the clinical MBT strain resistant to S, I, R, and K. The mice were divided into 5 groups: 1) intact mice; 2) those inoculated and untreated; 3) those treated with 1; 4) those treated with I and peritoneally given pO3, 0.5-4 microg/ml); and 5) those given pO3. The animals began dying at month 4 of inoculation. By month 5, all mice, other than intact and pO3-treated ones, died. Passage of MBT from the month by month 4 showed a reduction in their resistance to I in the groups treated with pO3. When the mice were treated with I alone, damages to their livers and spleens were greater than when they were untreated. With co-administration of I and pO3, the damage was least. Treatment provoked a rapid change of MBT to granular and L-forms and MBT was undetectable in its typical form after 1-2-month therapy. The altered MBT formed an untypical histological pattern of tuberculous inflammation in mice in the presence of characteristic cellular cooperation. Clinical studies indicated that 1-6-month concurrent use of chemotherapy and pO3 in patients with drug-resistant tuberculosis eliminated drug resistance of isolated MBT to one of the drugs (I, R, K) in 97.3%, MBT became at once susceptible to I, R, and K in 47.2%. I and/or R were successfully used in the treatment of more than a third of the patients. The studies have demonstrated that most patients with drug-resistant pulmonary tuberculosis can be treated with the most effective drugs provided that systemic intravenous injection of pO3 is made.

Objective: This study aimed to compare the clinical efficacy of two anti-inflammatory medications (fenspiride and inhaled beclomethasone [beclomethasone dipropionate]) in patients with stable chronic obstructive pulmonary disease (COPD) over 6 months. Design, methods and patients: This was a randomised comparison of 58 patients with COPD, divided into five treatment groups: fenspiride (stages 1 and 2), beclomethasone (stage 2), and two control groups (stages 1 and 2). In addition, 64 patients with exacerbations of COPD were evaluated over a 2-week treatment period during which they received either fenspiride or prednisolone. Clinical signs and symptoms of COPD were evaluated every 2 months (aggregated numerical index of signs and symptoms), as were lung function tests (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC) and a 6-minute walking test. Results: Statistically significant reductions in all evaluated COPD signs and symptoms were achieved with fenspiride in stage 1 COPD. Fenspiride therapy significantly reduced the indices of sputum parameters (8-fold decrease), incidence of dry rales (6-fold decrease), dyspnoea (4-fold decrease) and cough (2.5-fold decrease). In comparison with beclomethasone, fenspiride was superior in stage 2 COPD. In patients with stage 2 COPD, reductions were less marked, but remained significantly superior in the fenspiride group in comparison with the beclomethasone group and the control groups. In patients with exacerbations of COPD, fenspiride had equivalent efficacy to that of systemic corticosteroids. Conclusion: Anti-inflammatory therapy with fenspiride in addition to bronchodilators significantly improved clinical signs and symptoms, external respiratory function tests and physical activity tests in patients with stage 1 COPD. Adjunctive fenspiride therapy was superior to inhaled beclomethasone in stage 2 COPD. Anti-inflammatory therapy in COPD may be more effective at an early stage of this disease.

The paper describes the diversity of manifestations of sarcoidosis, which determines the extent of this process. The present study revealed skin and joint lesions in most cases and identified the involvement of peripheral lymph nodes, eyes, heart, thyroid, kidney, spleen, liver, and pancreas. Sarcoidosis of the pleura, pericardium, subcutaneous fat, and ovaries was most common. The systemic manifestations of sarcoidosis were found only in half of the examinees, which is most likely to suggest the complexity of diagnosis, the poor awareness of the most accessible and most used study methods, and the frequency of spontaneous remissions.

To study clinicolaboratory signs of respiratory infection in patients with bronchial asthma (BA).Respiratory infection and its influence on BA were studied in 108 BA patients (66 female and 42 male, mean age 51.0 +/- 15.2 years) with symptoms of bronchitis and non-nosocomial (n = 71) and nosocomial (n = 37) pneumonia. The patients referred for medical care and started antibacterial therapy (ABT) after 4.7 +/- 2.8 days of respiratory infection (RI). Before assignment to the trial BA exacerbation ran for 9.8 +/- 6.0 days.RI preceded BA exacerbation in 62% patients with pneumonia. BA exacerbation preceded RI in 66% patients with bronchitis. RI ran with moderate and severe intoxication. Severity of BA exacerbation correlated with severity of RI Antibacterial treatment was uneffective and the drugs were changed for others in 18% bronchitis and 16% pneumonia patients. Laboratory signs of inflammation were more obvious in pneumonias than in bronchitis and did not depend on the disease severity. External respiration function at RI onset was significantly affected in all the patients.Respiratory infections aggravate the course of BA and damage external respiration function.

Clarythromycin (Clerimed) is an antibiotic that has a high antibacterial potential, is successfully used in the treatment of moderate and severe exacerbations of Stage II chronic obstructive lung disease (COLD). Comparison of the clinical efficacy of Clerimed with beta-lactams and respiratory fluoroquinolones has indicated the equal clinical efficacy of the compared groups of drugs. A functional and laboratory monitoring of patients with an exacerbation of COLD treated with Clerimed has established that the most pronounced changes (improvement) occur within the first week of antibiotic therapy, which is typical of control patients. The side effects of Clerimed have been found to occur not more frequently than those of other antibiotics and they are considered to be slight. Clarythromycin may be recommended for the starting therapy of exacerbations of COLD in everyday practice.

To elicit efficacy of a 3-month treatment with new inhaled cholinolytic drug spiriva in patients with chronic obstructive pulmonary disease (COPD) of stage 3.Clinical symptoms (a total score of symptoms), external respiration function (ERF), pressure in the pulmonary artery were examined in 28 patients with COPD (stage 3).Long-acting thiotropium bromide relieved symptoms (the score decreased from 7.8 +/- 0.4 to 5.6 +/- 0.5), respiratory capacity rose from 68.8 +/- 2.4% to 75.9 +/- 2.5%, forced expiratory volume per 1 s increased from 41.9 +/- 2.6% to 46.6 +/- 3.2%, mean pressure in the pulmonary artery lowered from 29.0 +/- 0.8 to 25.1 +/- 1.2 mm Hg.Regular therapy with long-acting thiotropium bromide in patients with COPD stage 3 reduces clinical symptoms: dyspnea, mean pressure in the pulmonary artery. It also improves bronchial permeability.

The study was undertaken to examine the mechanisms of changes in the plasma and platelet links of hemostasis in patients with idiopathic fibrosing alveolitis in relation to the course of the disease and the possibilities of correcting the detected disorders with antiaggregatory and anticoagulative agents. Sixty-five patients were examined. All the patients were found to have the signs of hypercoagulation and a drastic change in the functional status of platelets. There was a relationship of the severity of impairments of hemocoagulation and platelet aggregation to the nature of a course of the disease. Addition of the antiaggregatory agent ticlopidine to the standard therapy exerted a normalizing impact on the functional status of platelets, which was more pronounced in the progressive course of the disease. The use of the low molecular-weight heparin fraxiparine had a beneficial effect on both components of the hemostatic system, which was more marked in the progressive course of idiopathic fibrosing alveolitis.

The outcomes of treatment were analyzed in 56 patients with ever-progressive multidrug-resistant pulmonary tuberculosis who had been long isolating Mycobacterium tuberculosis (MBT). The patients were divided into 2 groups. In the study group (n = 36), 75% isolated MBT resistant to streptomycin (S), isoniazid (I), rifampicin (R), and kanamycin (K). In this connection, 41.7% of them received only 2 second-line antituberculous drugs and 27.8% took 3 drugs. The control group (n = 20) was comparable with the study group in the rate of bacterial isolation and in the drug resistance of the causative agent. In addition to chemotherapy (CT), dissolved ozone (pO3) was intravenously injected to the patients of the study group twice a week. They received a total of 12 to 55 infusions. Four-month addition of pO3 infusions to CT eliminated the resistance of isolated MBT to I and/or R. MBT became susceptible to I in 38.9% of the patients, R in 16.7%, and to K in 11.2%. By month 4, the isolated MBT became susceptible to I, R, and K in 47.2%. The mechanisms responsible for lowering drug resistance in MBT are discussed. The clinical example shows that patients with multidrug-resistant tuberculosis may be treated with first-line drugs provided that systemic intravenous injection of pO3 is performed.

The levels of the antigen mucin 3EG5, a marker of the activity of interstitial lung diseases, were studied in the sera and bronchoalveolar swabs of patients with active tuberculosis, sarcoidosis of the respiratory organs, and idiopathic and exogenous allergic alveolitis. Its higher blood levels were detectable in patients with alveolitis (exogenous allergic ones to a greater extent) and absent in active tuberculosis and sarcoidosis. There was a correlation of the levels of the antigen mucin 3EG5 in the blood and bronchoalveolar swabs with the degree of lymphocytosis in the endopulmonal cytogram. The fact that there is a high variability of the blood levels of the antigen mucin 3EG5 in the range of nosological entities calls the differential diagnostic informative value of this parameter to question.

To study efficiency and safety of berodual in solution for inhalations delivered with the help of nebulizer in patients with exacerbation of chronic bronchitis (CB).12 patients with chronic bronchitis who had not responded to oral methylxantines in combination with expectorants received berodual for 10 days (1 ml 3 times a day).In the course of berodual treatment all the CB symptoms relieved and external respiration function improved.Berodual is effective as monotherapy of chronic obstructive bronchitis.

To study clinical efficiency of 12-month administration of berodual in chronic obstructive bronchitis (COB).The trial entered 33 patients with at least 2-year history of COB and forced expiratory volume per 1 sec (FEV1) not less than 45% of normal value.The best response of clinical parameters and external respiration was observed throughout 3 weeks of berodual inhalations. Dyspnea and cough were cured by the end of the treatment in 40 and 26% of the patients, respectively. Exercise tolerance has improved, FEV1 has increased for the year from 71.9 to 79.1%.Long-term berodual monotherapy is able to inhibit progression of bronchial obstruction and symptoms of COB.

The use of extracorporeal ultraviolet blood irradiation (EXUVBR) in the complex treatment of patients with chronic forms of pulmonary tuberculosis (cavernous, fibrocavernous) concurrent with chronic obstructive bronchitis (COB) has demonstrated a positive effect of the photo-modified autoblood on the course of COB. The findings have suggested that the magnitude of clinical symptoms of COB was nearly halved, the forced expiratory volume per second increased, the counts of stab neutrophils and lymphocytes and erythrocyte sedimentation rate became normal. Analysing the bacterial isolation rate showed a significant decrease in the number of Mycobacteria tuberculosis detected by luminescence microscopy after a session of EXUVBR. The latter used in pulmonary tuberculosis concurrent with COB promotes the enhanced efficiency of treatment of patients with these combined abnormalities.

Twenty nine patients with progressive pulmonary tuberculosis in the presence of diabetes mellitus were examined. Fifteen of them (a main group) had an additional course of intravenous dissolved ozone once 6-8 days (4 mg/ml per 400 ml of isotonic sodium chloride). By the end of month 2, 7 patients stopped massive bacterial expiration, which correlated with clinical improvement while a control group (n = 14) showed no clinical and laboratory changes. Following 3 months, 3 control patients stopped massive bacterial expiration. At month 6, 11 patients of the main group also did this, decay cavities became close in 8 patients while in the controls, these figures were 8 and 7, respectively. The use of systemic blood ozoning eliminated chemotherapy resistance and accelerated abacillation and healing in the decay cavities. The mechanism of action of dissolved ozone is discussed.

The paper provides the results of a follow-up of 70 patients with active pulmonary tuberculosis in whom the administration of antituberculous drugs induced eosinophilia and bronchial obstructive syndrome. To eliminate the side effects of antituberculous therapy, a plasmapheresis regimen was performed in 44 patients, the remaining patients were given only bronchodilators and antihistamine drugs. Plasmapheresis as a means for correcting drug-induced eosinophilia and bronchial obstructive syndrome was found to be more effective than drug therapy and, in some cases, enabled antituberculous therapy to be continued, without changing a combination of drugs. It is recommended that plasmapheresis should be used in cases of inadequate efficiency of conventional methods for correcting drug intolerance.

To examine erythrocytic structural and functional changes and lipid peroxidation impairments, which are caused by respiratory failure, and to study whether small-volume extracorporeal blood membrane gas exchange (SVEBMGE) can correct these disorders, a clinical and experimental studies were undertaken to examine 15 patients with tuberculosis complicated by Degree III respiratory failure. Respiratory failure was found to activate lipid peroxidation which was accompanied by lower blood antioxidative activity and correlated with the structural and functional changes of red blood cells and their population composition. The application of SVEBMGE to correct experimental hypoxemia in Degree III respiratory failure complicating pulmonary tuberculosis was demonstrated to normalize the population composition of red blood cells showed the substituting and antioxidant-stimulating effect of oxygen, by contributing to a reduction in the rate of free radical oxidation.

After analyzing comparative data on various treatments for progressive pulmonary tuberculosis combined with hepatitis, it is inferred that ozonized sorbent hemocarboperfusions are effective modality against the above condition. Ozone does not activate lipid peroxidation in blood, while it might activate electrochemical blood oxidation on the sorbent membrane and produce a direct therapeutic effect on hepatocytes.

The paper deals with the results of the joint Soviet-Hungarian study for the determination of etiology of acute pneumonias. Study included 617 patients. The bacteriologic and serologic methods were used to reveal the causative agent of the disease. Prevalence of Streptococcus pneumoniae (33-49%) in the etiologic structure of acute pneumonias was established both in the USSR and Hungary. In many cases pneumonia is also caused by Haemophilus influenzae (21-22%). In 15-31% of the cases the causative agent of pneumonia is gram-negative microorganisms. A protracted course of acute pneumonia is due to the complex associations of microorganisms including S. pneumoniae. A conclusion has been drawn to the effect that the initial antibacterial therapy should be started with administration of antibiotics that act effectively on S. pneumoniae.