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Biomedical subjects

V P Sereda

Publications and source records attributed to V P Sereda.

8 recordsLinked to original sources
PubMed2005

[Analysis of maintenance therapy in hospitalized patients with exacerbation of bronchial asthma: a six-year observation].

The subjects of the study were 504 patients with bronchial asthma (BA) exacerbation, hospitalized in Saint Petersburg Hospital #32 in 1997 - 2004; the maintenance therapy in these patients was analyzed. Severe exacerbations were diagnosed in 256 (51%) of the patients, moderate--in 200 (40%), and mild--in 48 (9%). The study revealed that 78% of patients had been given instructions on their preventive anti-inflammatory therapy, informed about the doses of medications and the duration of the therapy. However, only 13% of the patients received anti-inflammatory therapy that was adequate to the severity of the illness, and only 32% of all the patients demonstrated correct technique of using meter dose inhalers. Correlations (p < 0.05) were established between these factors and poorer asthma control (R = -0.07) and the severity of the exacerbations (R = -0.41). Seventy-seven per cent of BA patients hospitalized for severe exacerbations either did not received inhaled glucocorticosteroids (IG) or received them irregularly, and only 8% of the patients received adequate anti-inflammatory therapy. The main causes of inadequate therapy were low compliance (46%) and poor level of patients' knowledge (22%). Unavailability of medications was reported only by 29% of the patients. The main cause of poor compliance was fear of corticosteroid therapy side effects; and the most common scenario of not following physician's recommendation was premature discontinuation of IG therapy. In conclusion, the rational way of the maintenance therapy optimization is correct choice of preventive anti-inflammatory medications and adequate inhalation delivery systems, patients' education, and overcoming of poor compliance at hospital stage. This is of particular importance in frequently hospitalized patients with BA.

Acute Disease↗
PubMed2004

[Efficacy of nebulized budesonide in severe exacerbation of bronchial asthma].

The study was undertaken to examine the clinical effectiveness of nebulizer inhalations of budesonide suspension during severe attacks of bronchial asthma (BA) and the possibility of its use versus systemic glucocorticosteroids (GCSs). Sixty-eight patients admitted for a severe attack of BA were examined. The forced expiratory volume per sec (FEV1) was less than 40% and the peak forced expiration rate (PFER) was less than 150 l/min. First-line therapy included inhaled salbutamol (5-10 mg within 1.5-2 hours), oxygen, and intravenous prednisolone (120 mg). Thirty-two patients showed a good response to first-line therapy (a more than 50% increase in FEV1) as compared with the normal values) (Group 1) and 36 patients with concurrent obstructive lung disease (COLD) had an inadequate response (FEV1 was less than 40% of the normal values) was found in 32 patients (Group 2). Then the patients were randomized: 16 patients from Group 1 took budesonide, 4 mg/day, the other 16 received intravenous prednisolone, 120 mg/day. In Group 2, the efficacy of the drug added to therapy with oral prednisolone, 30 mg/day, was evaluated: 18 patients were given budesonide, 4 mg/day, and 18 received placebo. In patients with a good response to primary therapy, positive clinical and functional changes were found on day 6 of treatment. Group 2 patients receiving budesonide showed a significantly (p < 0.05) more marked positive changes in BA symptoms, FEV1, and PFER, which allowed a course of therapy with systemic GCSs to be reduced. Nebulized budesonide may be used instead of systemic GCSs to treat exacerbated BA if there is a good clinical and functional response to first-line broncholytic therapy, which is indicative of successful abatement of bronchospasm. If there is a poor response to first-line therapy in patients with more severe BA concurrent COLD, the early use of budesonide suspension in addition to systemic GCSs may enhance the efficiency of therapy for BA attacks and reduce the volume of systemic steroidal therapy.

Administration, Inhalation↗
PubMed2003

[Left ventricular diastolic function in patients with bronchial asthma].

The aim of the study was to evaluate the diastolic function of the left ventricle (LV) in patients with bronchial asthma (BA) in relation to the phase and severity of the disease. Seventy four patients with BA, including 16 with mild persistent BA, 39 with moderate BA, and 19 with severe BA were examined in different phases of the disease. Echocardiography and Doppler study of intracardiac blood flow were performed and external respiratory function was studied. Thirty six healthy persons matched by age, gender, body weight, and blood pressure values made up a control group. Most characteristics of LV diastolic relaxation were found to become much worse in BA, which is due to bronchial obstruction, hypoxemia, dilatation, hypertrophy, and altered diastolic filling of the right ventricle (RV). LV diastolic filling improved when an exacerbation of BA attenuated. Worsening BA severity was ascertained to lead to decreased early LV filling, which is associated with enhanced bronchial obstruction, progressive RV hypertrophy and dilation, concentrated LV remodeling. The most likely mechanism of impaired transmitral blood flow in progressive BA is the impaired LV and RV interaction and pulmonary hemodynamic rearrangement. The revealed LV diastolic dysfunction in patients with BA of various severity and in different phases of the disease were not found to depend on heart rate changes.

Adult↗