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Vaccination against Streptococcus pneumoniae is among the most effective measures for preventing pneumonia and reducing the rate of chronic obstructive pulmonary disease (COPD) exacerbations. The objective of this work was to evaluate the long-term effectiveness of PCV13 and PPV23 for preventing pneumonia and COPD exacerbations. The open-label, prospective, observational cohort study involved 302 male patients aged ≥ 45 years: PCV13 group (n = 123); PPV23 group (n = 32); and vaccine-naïve group (n = 147). The primary endpoint included the frequency of pneumonia episodes and COPD exacerbations per year over a 5-year follow-up period. The secondary endpoints included the dynamics of dyspnea severity (MMRC), the BODE index, FEV1, the CAT index, the SGRQ score, and the results of 6-min walk test. Vaccination with PCV13 and PPV23 significantly reduces the total rate of pneumonia during the first year after vaccination. Starting with the second year, clinical effectiveness in PPV23 group decreases compared with both PCV13 group and vaccine-naïve patients. Pneumonia by year 5 after vaccination was registered in 47% of patients in the PPV23 group, versus 3.3% of patients in the PCV13 group ( p  < 0.001); COPD exacerbations—in 81.3% versus 23.6%, respectively ( p  < 0.001). Vaccination with PCV13 significantly reduced and maintained the BODE index over the 5-year follow-up period. Although both vaccines have comparable clinical effects during the first year after vaccination, only PCV13 is characterized by persistent clinical effectiveness during the 5-year follow-up period. Patients older than 55 years who received PPV23 have significantly higher risks of having pneumonia episodes more frequently during the long-term follow-up.

[...]in patients with severe COVID-19, response to PP probably depends on the extent and localization of lung tissue changes. [...]all authors were involved in writing, reviewing and editing of the manuscript. The ethics committee of the hospitals (Sechenov First Moscow State Medical University) waived the written informed consent from patients with COVID-19, and all the procedures being performed were part of the routine care. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

[...]the necessity for oxygen therapy in the enrolled patients is also questionable. According to the data presented, the initial mean values of PaO2 were about 70 mmHg (it is not clear, while breathing room air or during O2 inhalation 2 L/min), that is, many patients simply did not require even conventional oxygen therapy. [...]the oxygen therapy algorithm in this study also differs from accepted practice.

Noninvasive ventilation (NIV) is known to reduce intubation in patients with acute hypoxemic respiratory failure (AHRF). We aimed to assess the outcomes of NIV application in COVID-19 patients with AHRF. In this retrospective cohort study, patients with confirmed diagnosis of COVID-19 and AHRF receiving NIV in general wards were recruited from two university-affiliated hospitals. Demographic, clinical, and laboratory data were recorded at admission. The failure of NIV was defined as intubation or death during the hospital stay. Between April 8 and June 10, 2020, 61 patients were enrolled into the final cohort. NIV was successful in 44 out of 61 patients (72.1%), 17 patients who failed NIV therapy were intubated, and among them 15 died. Overall mortality rate was 24.6%. Patients who failed NIV were older, and had higher respiratory rate, PaCO2, D-dimer levels before NIV and higher minute ventilation and ventilatory ratio on the 1-st day of NIV. No healthcare workers were infected with SARS-CoV-2 during the study period. NIV is feasible in patients with COVID-19 and AHRF outside the intensive care unit, and it can be considered as a valuable option for the management of AHRF in these patients. •The use of NIV is feasible in COVID-19–associated AHRF outside intensive care unit and its application can be considered as a valuable option for the management of AHRF.•Elevated D-dimer levels, higher minute ventilation and ventilatory ratio during NIV were independently associated with NIV failure.•Caring for COVID-19 patients during NIV with appropriate PPE can avoid nosocomial infections with SARS-CoV-2 in health care workers.

[...]let’s focus on the oxygenation status as a stratification tool for the selection of the appropriate respiratory support method in ARDS [8]. [...]all patients had slightly decreased compliance and low driving pressure (around 10 cmH2O) that did not change after the PEEP increase, probably, because of low lung recruitability and non-uniform distribution of the lung injury and atelectasis—(multi)local but not diffuse lung injury [12]. [...]incorrect interpretation of the EIT data can lead to lung overdistension due to inappropriately high PEEP. [...]the authors followed the concept of the «optimal» individual PEEP as the combination of minimum collapse and minimum overdistension.

Chronic obstructive pulmonary disease (COPD) poses a significant global health burden despite being largely preventable and treatable. Despite the availability of guidelines, COPD care remains suboptimal in many settings, including high-income countries (HICs) and upper-middle-income countries (UMICs), with varied approaches to diagnosis and management. This study aimed to identify common and unique barriers to COPD care across six countries (Australia, Spain, Taiwan, Argentina, Mexico, and Russia) to inform global policy initiatives for improved care. COPD care pathways were mapped for each country and supplemented with epidemiological, health-economic, and clinical data from a targeted literature review. Semi-structured interviews with 17 respiratory care clinicians were used to further validate the pathways and identify key barriers. Thematic content analysis was used to generate the themes. Six themes were common in most HICs and UMICs: \"Challenges in COPD diagnosis\", \"Strengthening the role of primary care\", \"Fragmented healthcare systems and coordination challenges\", \"Inadequate management of COPD exacerbations\", \"Limited access to specialized care\" and, \"Impact of underfinanced and overloaded healthcare systems\". One theme, \"Insurance coverage and reimbursement challenges\", was more relevant for UMICs. HICs and UMICs differ in patient and healthcare provider awareness, primary care involvement, spirometry access, and availability of specialized care. Both face issues with healthcare fragmentation, guideline adherence, and COPD exacerbation management. In addition, UMICs also grapple with resource limitations and healthcare infrastructure challenges. Many challenges to COPD care are the same in both HICs and UMICs, underscoring the pervasive nature of these issues. While country-specific issues require customized solutions, there are untapped possibilities for implementing global respiratory strategies that support countries to manage COPD effectively. In addition to healthcare system-level initiatives, there is a crucial need for political prioritization of COPD to allocate the essential resources it requires.

To assess N-Terminal Pro C-Type Natriuretic Peptide (NT-proCNP) plasma levels in patients with chronic obstructive pulmonary disease (COPD) and evaluate of its diagnostic value for pulmonary hypertension (PH) in COPD. According to the range of systolic pulmonary artery pressure (SPAP), the COPD patients were divided into group of patients without PH (SPAP < 40 mmHg, n  = 42) and group of patients with PH (SPAP ≥40 mmHg, n  = 52). Significant differences in NT-proCNP levels were found in patients with and without PH (3.63 ± 0.95 pg/mL vs. 1.42 ± 0.35 pg/mL, p  < 0.001). Statistically significant correlations were shown between NT-proCNP levels and SPAP ( r  = 0.77, p  < 0.001), mMRC dyspnea score ( r  = 0.42, p  = 0.001), CAT score ( r  = 0.60, p  < 0.001), and SpO 2 ( r = − 0.47, p  = 0.001). Pulmonary hypertension in COPD patients was associated with higher plasma NT-proCNP levels.

To the Editor, Severe acute respiratory syndrome coronavirus (SARS-CoV)-2 outbreak that began in 2019 and spread rapidly across the world has been demonstrated to cause viral pneumonia, acute respiratory distress syndrome (ARDS) and multi-organ system failure [1]. Given the lack of scientific data, efforts are focused on an empirical search for therapeutic strategies to ensure the adequate gas exchange, including methods that can be applied in intensive care unit (ICU) setting. [...]inhaled iloprost is a well-known option for the treatment of pulmonary hypertension (PH) [4]. [...]in the current study we have analyzed the effects of inhaled iloprost on gas exchange in patients with COVID-19 associated ARDS.

Background There is still insufficient knowledge with regard to the potential involvement of mast cells (MCs) and their mediators in the pathology of coronavirus disease-2019 (COVID-19). Therefore, our study aimed to investigate the role of MCs, their activation and protease profiles in the pathogenesis of early and late lung damage in COVID-19 patients. Methods Formalin-fixed and paraffin embedded lung specimens from 30 patients who died from COVID-19 and 9 controls were used for histological detection of MCs and their proteases (tryptase, chymase) followed by morphometric quantification. Results Our results demonstrated increased numbers of MCs at early stage and further augmentation of MCs number during the late stage of alveolar damage in COVID-19 patients, as compared to the control group. Importantly, the percentage of degranulated (activated) MCs was higher during both stages of alveolar lesions in comparison to the controls. While there was no prominent alteration in the profile of tryptase-positive MCs, our data revealed a significant elevation in the number of chymase-positive MCs in the lungs of COVID-19 patients, compared to the controls. Conclusions MCs are characterized by dysregulated accumulation and increased activation in the lungs of patients suffering from COVID-19. However, future profound studies are needed for precise analysis of the role of these immune cells in the context of novel coronavirus disease.

Russia’s forests, occupying one-fifth of the world’s forest area and being one of the renewable natural resources, meet multiple needs of the economy and society for forest resources, performing the most important environmental, protective and other useful functions. The problems of forest protection and utilization are becoming increasingly diverse and complex. Illegal felling of forest plantations is one of the most widespread crimes provided for in Chapter 26 of the Criminal Code of the Russian Federation and accounts for ½ of the total number of socially dangerous acts causing or threatening to cause damage to the environment. According to experts, it is practically impossible to fully restore the forest fund damaged by illegal logging. This is primarily due to the time required to replace lost trees and shrubs, which ranges from 81 to 120 years and more for coniferous and deciduous species of seed origin, and from 41 to 70 years and more for coniferous and deciduous species of shoot origin. Reforestation requires high material costs. The objective of this research is to develop new and optimize existing approaches to counteract the illegal destruction of forest plantations. In order to achieve the desired goal, the research sets and consistently solves the following objectives: to analyze the legal norms determining the limits of legal responsibility for illegal felling of forest plantations; to determine the place of illegal felling of forest plantations in the structure of environmental crimes; to study the statistical data on the number of registered environmental crimes, convicted persons for committing environmental crimes in general and for illegal felling of forest plantations in particular; to consider the doctrinal approaches to the subject of this research; to develop the author’s proposals on the legal regulation of the fight against illegal felling of forest plantations; to develop the author’s proposals on the legal regulation of counteraction to illegal destruction of forest plantations.