INTRODUCTION: Clinical observations ascertain a comorbid development of chronic obstructive pulmonary disease (COPD) and lung cancer (LC). Here, a more favorable prognosis for patients with LC depends on detection of the disease in early stages, when radical treatment is possible. This determines the importance of a detailed examination of the function of the external respiration using modern methods to identify predictors of lung cancer. AIM: To study the peculiarities of disorders in the apparatus of external respiration (AER) in patients with LC developed with the underlying COPD (LC + COPD). MATERIALS AND METHODS: A clinical and functional examination of 33 individuals was conducted — 10 healthy (control group), 12 patients with COPD and 11 patients with LC + COPD, using methods of spirography, pneumotachography and body plethysmography. RESULTS: In patients with COPD, as well as in those with LC + COPD, a statistically significant decrease in the median values of vital capacity of lungs (VCL), forced expiratory volume in 1 second (FEV1), flow-volume curve (PFER, MEF50, MEF75) and an increase in respiratory minute volume (RMV), residual lung volume (RLV), the ratio of residual lung volume to total lung capacity (RLV/TLC) and bronchial resistance (Raw) were revealed. It was found that in patients with LC + COPD, the median values of VСL, RLV/TLC, Raw did not differ, while the values of flow-volume curve were reduced as compared to patients with COPD. The observed decrease in the air flow rate parameters in the absence of differences in Raw indicates the extrapulmonary causes of these changes. CONCLUSION: In the course of the study, high reserve capacities of the apparatus of external respiration were found. The obtained parameters turned out to be of low informative value for diagnosis of development of LC with the underlying COPD. In patients with LC + COPD, the study of AER function, in addition to spirography and pneumotachography, should include body plethysmography, to avoid overdiagnosis of broncho-obstructive syndrome.
The review summarizes and analyzes the results of domestic and major foreign studies of recent years concerning gender characteristics of the epidemiology and development mechanisms of metabolic syndrome and urolithiasis as an associated disease. A deep understanding of gender aspects in the pathogenesis of these pathologies can form the basis for development of high-quality diagnostic algorithms and pathogenetically grounded approaches to treatment.
Aim. To evaluate the possibility of using lung ultrasound for diagnosing COVID-19 pneumonia in patients of the respiratory hospital of Siberian State Medical University (SSMU).Materials and methods. An analysis of lung ultrasound data was carried out in 39 patients (17 men and 22 women aged 33–78 years) with COVID-19 pneumonia. Lung ultrasound was performed in all patients in addition to radiography performed at the prehospital stage and in 15 patients who underwent computed tomography (CT) of the lungs.Results. In the majority (61.6%) of cases, during the ultrasound examination, COVID-19 pneumonia manifested itself as interstitial lung disease. The white lung phenomenon and a combination of the aforementioned interstitial changes were recorded with the same frequency (5.1%), while pulmonary consolidation in addition to interstitial changes was visualized in 10.2% of cases. Interstitial lung disease was bilateral in 83.3% of patients and unilateral in 16.7% of cases. The inferior lobes of the lungs were affected in 60.0% of cases, middle lobe – in 30.0% of cases, and superior lobes – in 15.0% of patients. The ultrasound examination detected changes in the lungs in 32 patients, while radiographic changes were present in 35 cases. Bilateral inflammation was more often detected by radiography than by ultrasound. When comparing the data of lung ultrasound and CT, the agreement between the methods was found in 66.7% of cases, and the discrepancy between the findings of the two methods was observed mainly in patients with a large number of affected segments of the lungs and localization of the disease in the superior lobes according to CT.Conclusion. Lung ultrasound is a valuable tool that can be used to stratify risk in patients at any stage of diagnosis and treatment in the context of the COVID-19 pandemic due to availability, speed of implementation, and the absence of a need for patient transportation.
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