PubMed Health⌕ Search

Biomedical subjects

E I Shmelev

Publications and source records attributed to E I Shmelev.

At least 19 recordsLinked to original sources
PubMed2006

Comparison of fenspiride with beclomethasone as adjunctive anti-inflammatory treatment in patients with chronic obstructive pulmonary disease.

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.

Adult↗
PubMed2006

[Clarythromycin in the treatment of exacerbations of chronic obstructive lung disease].

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.

Anti-Bacterial Agents↗
PubMed2006

[Respiratory infection in patients with bronchial asthma. Clinicolaboratory characteristics].

AIM: To study clinicolaboratory signs of respiratory infection in patients with bronchial asthma (BA). MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSION: Respiratory infections aggravate the course of BA and damage external respiration function.

Adult↗
PubMed2006

[Systemic manifestations of sarcoidosis].

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.

Adult↗
PubMed2005

[The hemostatic system and correction of its impairments, by using the disaggregatory agent ticlopidine and low-molecular-weight heparin in patients with idiopathic fibrosing alveolitis].

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.

Drug Therapy, Combination↗
PubMed2005

[Long-acting m-cholinolytic thiotropium bromide (spiriva) in therapy of patients with chronic obstructive pulmonary disease (stage 3)].

AIM: 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. MATERIAL AND METHODS: 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). RESULTS: 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. CONCLUSION: 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.

Administration, Inhalation↗
PubMed2004

[Changes in drug resistance of Mycobacteria in the simultaneous use of chemotherapy and intravenous infusions of dissolved ozone].

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.

Adolescent↗
PubMed2004

[Treatment of bronchial obstruction in patients with pulmonary tuberculosis].

Whether the main points of treatment for bronchial obstructive syndrome (BOS) in chronic obstructive lung disease (COLD) can be adapted for patients with pulmonary tuberculosis (PT) was studied. For this purpose, 435 patients with PT with signs of BOS (forced expiratory volume at 1 second (FEV1) < 80% of the normal values) were examined. To establish differences in the efficiency of therapy, according to the activity of a process and to the magnitude of the impaired architectonics of the respiratory system, three main groups of observation were formed: 1) patients with infiltrative PT (IPT); 2) those with fibrocavernous PT (FCPT); and 3) those with posttuberculous pneumosclerosis (PS). According to the severity of BOS, the patients were divided into 3 subgroups: 1) 104 patients with FEV1 > 70% of the normal values; 2) 229 patients with FEV1 69-50%; 3) 102 patients with FEV1 < 50%. The patients with IPT and FCPT received the conventional antituberculous therapy under respective clinical, laboratory, and X-ray control. The patients with PS had no antituberculous therapy. All the patients underwent 3-month clinical and functional monitoring evaluating changes in life quality, by using the respiratory questionnaire of the Saint George hospital. The findings have led to the conclusion that the use of the proposed therapy for bronchial obstructive syndrome in patients with pulmonary tuberculosis was highly effective, promotes the amelioration of the degree of respiratory symptoms in patients with IPT by 2 to 8 times, in those with FCPT by more than 2-3 times, and in those with PS by 1.45-10 times. The differences in the efficiency of bronchodilator therapy depend on the baseline level of bronchial obstruction. In patients with pulmonary tuberculosis concurrent with BO, the use of current inhalation bronchodilator therapy results in a substantial increase in FEV1, which differentiates BOS in PT from COLD. The use of the proposed therapy in the multimodality treatment of patients with pulmonary tuberculosis showed no statistically significant differences in the changes in the degree of X-ray symptoms while this therapy permits acceleration of abacillation in patients with IPT by 16.8% and in those with FCPT by 14.8%. Effective bronchodilator therapy considerably enhances life quality in patients. Thus, early systematic and long-term performance of the bronchodilator therapy, based on the principles of bronchodilator therapy for COLD, in patients with PT concurrent with BOS may substantially enhance the efficiency of treatment in this category of patients.

Antitubercular Agents↗
PubMed2004

[Use of dissolved ozone in the treatment of experimental tuberculosis in mice].

Sixty-eight BALB/c mice were infected with the intravenous injections of Mycobacterium tuberculosis (MBT), a clinical strain resistant to streptomycin, isoniazid, rifampicin, and kanamycin. The mice were divided into 5 groups: Groups 1 and 2 were control (intact and infected without being treated, respectively). Group 3 mice were treated with isoniazid; Group 4 received isoniazid in combination with intraperitoneal dissolved ozone (pO3); and Group 5 was given pO3. The animals began to die at month 4 of infection. By month 5, mice died all, except for intact and pO3-treated ones. On inoculation of MBT from the lung, there was a reduction in isoniazid resistance in the pO3-treated groups. The lesion was least when isoniazid was used in combination with pO3. The mechanism responsible for that pO3 lowers drug resistance in MBT and whether it is expedient to co-administer isoniazid and pO3 in undetected drug resistance in MBT are under discussion.

Animals↗
PubMed2002

[Dissolved ozone treatment-induced change in the resistance of multi-resistant mycobacterial strain to isoniazid and rifampicin].

For 60 minutes, a mycobacterial (MBT) clinical strain resistant to streptomycin (S), rifampicin (R), isoniazid (I) was treated with dissolved ozone (PO3) at the concentration used for intravenous injection in the clinic. Then the strain was added to the Löwenstein-Jesen solid medium containing different concentrations of antituberculous agents. Following 3 weeks, drug sensitivity was determined by the number of grown colonies. Then MBT were retreated with PO3 in the same fashion, by repeating the cycle three times. At week 3, a growth of over 100 colonies was recorded in all control cultures. After each PO3 treatment of the strain, there was a reduction in its resistance to I and R. After triple treatment, MBT sensitivity to I completely recovered. In the R-containing media, there was also decrease in drug resistance, but the latter remained high (640 mu/ml). S resistance substantially lowered after the second PO3 treatment, but it restored after the third one. A mechanism responsible for lower MBT resistance to I and R under the action of "therapeutical" concentrations of PO3 is analyzed. The paper discusses whether MBT resistance can be changes at the phenotypic level rather that at the genetic one.

Antitubercular Agents↗