More than 100 different events took place from October 29 to November 1 during the XXIX National Congress on Respiratory Diseases. In this year the organizers have paid special attention to the problems of the treatment of severe asthma.       

The fact that lung diseases are mainly affected by poor ecology is a common misconception. Congress experts noted that this factor in the short term has the greatest impact on the cardiovascular system. Smoking, both active and passive , is much more harmful to the lungs . According to the Russian Ministry of Health , 1 million 119 thousand patients suffering from bronchial asthma are registered in the country , that is, about 1 % of the total population. But not all patients go to the doctor for help. By Unfortunately, many self-medicate.                 

From such pernicious independence patients were asked to refrain chief pulmonologist of Ministry of Health of the Republic of Tatarstan, a. M. N. Alexander Wiesel : “ Unfortunately, patients come with information taken from questionable sites, and, worst of all, they begin to self-medicate – this is extremely dangerous. I ask for information from official sources on behalf of the entire medical community . For example, the website of the Ministry of Health of Russia, regional Departments of Health, and the Russian Respiratory Society. ”           

Head Specialist pulmonologist Russian Ministry of Health, d. M. N. Sergei Avdeev confirmed that only in the last year a major breakthrough has been made in the treatment of severe forms of bronchial asthma , although three years ago it seemed to experts that nothing fundamentally new would happen in pulmonology . Effective combinations of drugs have appeared, and most importantly, now pulmonologists can abandon the use of steroid drugs that stop lung diseases, but destroy the body. The fact is that at the disposal of doctors there are four new drugs for biological therapy: benralizumab, dupilumab, mepolizumab, reslizumab. Biological therapy is quite convenient; it should be taken on average once a month. “Today, more than 1.5 thousand Russians receive such therapy. To provide targeted assistance, a special register of patients with severe bronchial asthma has been created. ”                  

So far, doctors are studying the pros and cons of biological therapy, but note that it is not cheap. Of course , in almost all regions of Russia there is a regional benefit, in addition, there is a Federal benefit and almost all significant drugs are on the list. Patients with asthma may receive basic therapy by quota. The issue of targeted therapy with highly expensive drugs is being addressed in specialized centers for patients with severe bronchial asthma.           

According to the president of “Russian Respiratory Society”, the chief freelance pulmonologist DMD, d. M. N. Andrei Belevsky , in the treatment of the patient play a role not only modern drugs. It is important that doctors are able to correctly select therapy, taking into account the individual characteristics of each patient: “The Russian Respiratory Society” is the author of the professional standard of a pulmonologist. This is a very important document that regulates that a pulmonologist has the right to independently perform spirography and spirometry, which was not the case before . ” Andrey Belevsky noted that special educational programs were developed not only for pulmonologists, but also for therapists, general practitioners and other specialists.            

Natalya Kravchenko , Executive Director of the Russian Respiratory Society, added that the professional community implements many different programs. For example, in Moscow it is the “Pulmonology of a megalopolis” within the framework of which complex clinical cases are discussed several times a month. And in the Kaliningrad region an interesting project was tested, when postmen were trained to work with pulse oximeters so that they could conduct lung tests for pensioners. Total surveyed postmen 2 thousand. People and have 600 of them are having problems with breathing. Now these citizens are being treated by specialists. The forces of the Russian Respiratory Society are promoting the prevention of lung diseases among children of primary school age. For example, the guys were asked to draw pictures on the topic of clean air. The best works were combined into an exhibition, which was shown to participants in the National Congress on Respiratory Diseases.                  

Experts noted that for the prevention of lung diseases, vaccination against pneumococcal infection can be done annually . This is especially important for those who work in close contact with a large number of people (doctors, teachers, and so on) and the most prone to lung diseases patients.      

Alexander G. Chuchalin , vice president of the UNESCO Intergovernmental Committee for Bioethics, the chairman of the Russian National Committee on Bioethics Committees of the Russian Federation for UNESCO, Academician of Russian Academy of Sciences, answered a few questions on Bioethics:       

“Bioethics will develop, be filled. The focus will be on artificial intelligence, reproductive health plus the human genome. Bioethics is interdisciplinary, at the junction of several experts. There should be a special group of experts that is empowered to make an ethical decision. 

For example, the role of a psychologist in oncological practice is very important. This is indeed a very important topic. Which doctor can tell you that you have cancer? Can a radiologist say, or any other specialist? This problem is caused by the fact that the patient is not prepared. Most likely, it should be presented as “ you have such a problem, I propose the following ways to solve it .”       

There should be ethical responsibility to the doctor. Absolutely surely there should be a Code of Ethics for the doctor. Ethics is an understanding of conflict, good and evil. And in order for the doctor to do no harm, he must possess the tool of empathy, how to empathize with a sick person. My new work, The Library of Bioethics, in 10 volumes, will be donated to university libraries. Incidentally, the issues of bioethics abroad are also acute. We have great intellectual potential, but it does not work in society. ”