Vol 18, No 11 (2016)
Articles
Chronic obstructive pulmonary disease: clinucal issues, epidemiology, risk factors and the basic therapy (review)
Abstract
Chronic obstructive pulmonary disease (COPD) is a serious medical problem. Based on the research Global Alliance Against Chronic Respiratory Diseases (GARD), the prevalence of COPD in the population to 15.3%. Installed external and internal risk factors of COPD. For patients, COPD is a significant impact of the disease on their daily activities and is often accompanied by one or more concomitant diseases and/or systemic effects. Elevated inflammatory markers significantly associated with increased all-cause mortality among COPD patients, and increased physical activity reduces systemic inflammation. It is noted that the value of dietary fiber may also be related to their anti-inflammatory and antioxidant effects. The article emphasizes that the clinical phenotypes of COPD can be a composite, because they can change under the influence of therapy and/or as a result of the usual course of the disease. At the expressed symptoms of COPD starting treatment should be their long-acting beta-2-agonists and M-holinolytics. The issue of supplemental inhaled corticosteroids and phosphodiesterase-4 inhibitors is solved according to the features of the further course of COPD.
Consilium Medicum. 2016;18(11):8-18
8-18
VIII International Conference of the World Association of Sarcoidosis and other granulomatous lung diseases: current understanding of sarcoidosis
Abstract
Sarcoidosis is an epithelioid cell granulomatosis system, which remains a mystery to medical science and clinical practice. Every year, the World Association of Sarcoidosis and other granulomatous lung diseases (WASOG) held a conference where the study of this disease was summarized. In 2016 the conference was held in Gdansk. The main provisions to the leading specialists in sarcoidosis. The etiology of sarcoidosis is unknown. There was a highly informative X-ray computed tomography, positron emission tomography, spirometry and lung diffusion capacity evaluation to assess the activity of the process and the dynamics of the patients. The data on the pathogenesis, prevalence and clinical significance of chronic fatigue syndrome and peripheral neuropathy fibers in sarcoidosis. Limited clinical studies conducted with the use of vasoactive intestinal peptide, antimycobacterial antibiotic for treatment of sarcoidosis. The significance of diagnosis of heart disease and pulmonary hypertension in sarcoidosis. Speakers noted that the treatment of pulmonary sarcoidosis approved only prednisolon and corticotropin. It was concluded that treatment should be initiated only with the progression of sarcoidosis threatening conditions and marked reduction in quality of life related to health.
Consilium Medicum. 2016;18(11):19-24
19-24
Bronchial obstruction in children of preschool age
Abstract
The frequency of bronchial obstruction (BO) in children during the first 5 years of life determines the need for differential diagnosis of various conditions and determine the tactics of patients with repeated episodes of BO. Despite the isolation of specific BO phenotypes (episodic viral and multitriggerny), shows that the difference between the phenotypes are not as accurate as previously thought, as they significantly change their characteristic in the course of the year. Preschool children with occasional but severe obstruction hospitalization are at high risk of persistent asthma in 5-10 years. The risk of asthma in children must be assessed with a view of monitoring the disease and the early initiation of therapy controls.
Consilium Medicum. 2016;18(11):25-29
25-29
Biological therapy of asthma: present and future
Abstract
This review article focuses on the present and future possibilities of biological molecules use in the treatment of bronchial asthma. Over the past 20 years there has been a breakthrough in the field of biological treatment of severe asthma with monoclonal antibody molecules. Three biological treatment (omalizumab, mepolizumab and reslizumab) is already approved for use in routine clinical practice in a number of countries, as omalizumab has long and successfully applied everywhere, including in our country.
Consilium Medicum. 2016;18(11):30-38
30-38
Pneumoconiosis in the practice of the attending physician
Abstract
Pneumoconiosis is an occupational disease of the lungs, which is often found in physician's general practice. Differential diagnosis of various forms of pneumoconiosis is sometimes difficult due to the similarity of their clinical symptoms and X-ray pictures with disseminated processes of different etiology. Pneumoconiosis presented a large group of diseases and classified as fibrotic and non-fibrotic. The most common forms of fibrous types are dust exposure, containing in its composition of silicon dioxide (silicosis, anthracosilicosis, asbestosis), as well as certain types of toxic and allergenic dust -berylliosis actions that can lead to death. The characteristic X-ray and CT signs of fibrotic pneumoconiosis are small reticular nodules scattered along the lymphatic and blood vessels, often with calcification. Magnetic resonance imaging can help the physician in the differential diagnosis of pneumoconiosis and lung cancer. Histological examination is necessary to detect markers of silicosis (silicotic bundle) and asbestosis (asbestos bodies) that serves as the basis for the diagnosis of pneumoconiosis. Identification of interstitial pneumonia and giant cells in heavy metal dust exposure indicates a metalloconiosis. Signs of berylliosis CT are similar to those of sarcoidosis, but the totality of the clinical and pathological features allows us to differentiate these diseases. Timely diagnosis, the decision of expert questions and pathogenetic treatment will help to keep disabled patient.
Consilium Medicum. 2016;18(11):39-45
39-45
Evaluating the effectiveness of bioregulatory drugs in the treatment of chronic obstructive pulmonary disease
Abstract
The article presents the results of studying the effectiveness of bioregulatory drugs in complex treatment of patients with chronic obstructive pulmonary disease of varying severity, including the cases when it's combined with coronary heart disease. According to the evaluation of inflammation markers in sputum, bronchial lavage and serum (interleukin-8, -10, tumor necrosis factor-α, interferon-γ, C-reactive protein) before and after the treatment shows good anti-inflammatory effect of bioregulatory modern vehicles.
Consilium Medicum. 2016;18(11):46-48
46-48
Substantiation of pathogenetic aspects and clinical application of topical decongestants
Abstract
Currently, topical decongestants and irrigation therapy, including isotonic saline solutions, are among the main components of pathogenetic therapy of acute and chronic diseases of the upper respiratory tract. These drugs are used as a single agent for the relief of edema of the nasal mucosa in the early stages of the onset of the disease, and are part of the schemes of complex treatment of ENT diseases. The existence of a huge list of vasoconstrictor sprays and drops greatly complicates the choice of drug for the relief of nasal obstruction. Furthermore, it is known that nasal decongestants are frequently a cause of side effects. According to the results of the pharmacological properties and clinical observations of SeptaNazal® spray combined with SeptoAqua® not only improves nasal breathing, but also restores the damaged nasal mucosa and prevents the development of trophic disorders in the mucous membrane of the nose.
Consilium Medicum. 2016;18(11):49-54
49-54
Controversial aspects of modern ideas about the problem of chronic tonsillitis
Abstract
The simple form of chronic tonsillitis (CT) is based on subjective symptoms not amenable to digital assessment, which leads to erroneous diagnoses and consequently the ineffectiveness of the treatment. This article analyzes the literature on the study of the etiology and treatment of CT with evidence-based medicine, and also describes the most commonly used classification of CT.
Consilium Medicum. 2016;18(11):55-58
55-58
What to choose - an antiseptic or nonsteroidal anti-inflammatory drug for the treatment of sore throat?
Abstract
Inflammatory changes in pharyngeal mucosa are observed in almost all pathological conditions arising in this anatomical area, and clinically manifested by pain in the throat. Regardless of the cause of the pain in the throat, it is necessary to know its etiology in order to determine if the patient should receive symptomatic treatment. The article outlines some of the mechanisms of action of commonly used groups of drugs for the topical treatment of sore throat.
Consilium Medicum. 2016;18(11):59-62
59-62
Current treatment regimens for patients with acute bacterial rhinosinusitis
Abstract
The paper presents the current data on the epidemiology and etiopathogenesis of acute bacterial rhinosinusitis, characterized by drug treatment options, among which the main role is assigned to antibiotic therapy. The place of amoxicillin/clavulanate in the treatment algorithm for patients with acute bacterial rhinosinusitis. The advantages of the complex treatment regimens to include not only the antibiotic (amoxicillin/clavulanate), but also a combination of a bacterial lysate OM-85. In clinical use of combined scheme with equal efficiency was significantly fewer relapses in the long-term follow-up compared to the group, where OM-85 unused.
Consilium Medicum. 2016;18(11):63-66
63-66
The importance of local anti-inflammatory drugs in the initial treatment of sore throat
Abstract
Frequency assignment of antibacterial drugs in the treatment of sore throat in Russia is unreasonably high. Sore throat is one of the most common reasons for visits to doctors for outpatient reception. Purpose of systemic antibiotic therapy is justified only in the case of streptococcal disease etiology. Much attention is paid to the early appointment of the local anti-inflammatory drugs, can prevent further infection. The basic requirements are met by the drug Strepsils Intensive, which not only helps to relieve pain in the throat, but also acts on the cause - inflammation. Strepsils Intensive has a dual action: anti-inflammatory, analgesic.
Consilium Medicum. 2016;18(11):67-72
67-72
XXVI National Congress on Respiratory Diseases
Abstract
18-21 октября 2016 г. в Москве прошел XXVI Национальный конгресс по болезням органов дыхания. Форум является одним из крупнейших мероприятий в области медицины. Выступления ведущих специалистов разных направлений дают возможность участникам обновить и пополнить знания в области пульмонологии. Обширная программа мероприятия включала симпозиумы, круглые столы, школы, мастер-классы по множеству научных тем: бронхиальная астма, хроническая обструктивная болезнь легких, туберкулез, антитабачные программы, инфекции дыхательных путей и др. Предлагаем читателям краткий обзор некоторых событий. Докладчики: Синопальников А.И., Бакрадзе М.Д., Лазарева Н.Б., Курбачева О.М., Ненашева Н.М., Бердникова Н.Г.
Consilium Medicum. 2016;18(11):73-78
73-78
AIDS: the truth everyone must know
Abstract
29 мая 2016 г. в Москве прошла презентация книги «СПИД. Правда, которую должен знать каждый», где состоялась встреча с одним из авторов и главным героем произведения - профессором Жан-Клодом Шерманом. Представляем читателям краткий обзор прошедшего мероприятия.
Consilium Medicum. 2016;18(11):80-82
80-82
Causal therapy of influenza and other acute respiratory viral infections in children
Abstract
The paper presents the epidemiological and etiological features of the seasonal incidence of acute respiratory infection (ARI) in 2015-2016. We analyzed the modern features and principles of rational causal treatment of influenza and other acute respiratory viral infections. The paper presents the mechanism of action of drugs on the basis of the release of active antibodies to interferon-γ. The review is devoted to the results of clinical trials, as well as its own data on the safety and effectiveness of drugs based on the release of active antibodies to interferon-γ in the treatment of influenza and SARS non-influenza etiology in children.
Consilium Medicum. 2016;18(11):83-86
83-86
The establishment of regional programs of vaccination of patients with chronic obstructive pulmonary disease on the basis of a comprehensive analysis of the effectiveness of vaccination
Abstract
The article presents the main points justifying the need to establish vaccination of respiratory diseases of regional programs. Based on the experience of vaccination in patients with chronic obstructive pulmonary disease in the City pulmonology center of Chelyabinsk in 3 years an analysis of the epidemiological criteria, the results of clinical and pharmacoeconomic efficiency was made. Coefficients calculated actual effectiveness of patients vaccinated with the pneumococcal conjugate vaccine Prevenar 13 (PKV13), which has a stable positive dynamics throughout the 3 years of follow up. Due to the long-term preservation effect of vaccination with PKV13 reduces total health system costs for 3 years to 11 357 rubles (78%). The conclusion about the need to take into account regional data in the preparation of vaccination programs.
Consilium Medicum. 2016;18(11):88-91
88-91
Rehabilitation on the Southern coast of the Crimea. Whether it is actual today?
Abstract
In article the description of the Southern coast of the Crimea as climatic health resort for patients with diseases of respiratory organs is given. Efficiency of sanatorium treatment of patients with bronchial asthma is shown. The possibility of use of the Crimea for rehabilitation of bronchial asthma during different seasons of year, including for eliminative therapy of widespread types of pollinoses is shown. Rationality of allocation of phenotypes of a disease and the organization of repeated courses of treatment for rising of efficiency and firmness of result is proved.
Consilium Medicum. 2016;18(11):92-95
92-95
Immunomodulation as a strategy for the prevention and treatment of respiratory infections
Abstract
The article presents the results of a study of the basic properties of therapeutic molecules azoximer bromide (Polyoxidonium®). The experience of the drug in acute infectious and inflammatory diseases of the respiratory system. It has a pronounced immunomodulating Polyoxidonium® (including interferon producing) activity, has a non-specific protective effect against a broad spectrum of pathogens, not based on the direct inhibition of microorganisms, and in the regulation of host immunity. Moreover, the drug has antitoxic and anti-oxidant properties. In the acute phase of the disease it is used in combination with causal therapy and during the rehabilitation period, or for the purpose of immunization respiratory infections - as monotherapy.
Consilium Medicum. 2016;18(11):96-101
96-101
Efficacy and safety of Momate Rhino (mometasone furoate nasal spray in the form of a metered) in adult patients with perennial allergic rhinitis: a randomized multicentre open clinical study
Abstract
Intranasal glucocorticosteroids, having high efficacy with respect to nasal symptoms, are recommended as a 1-st line treatment in patients withmoderate-severe seasonal and perennial allergic rhinitis. The aim of the present study is assessment of efficacy, safety and tolerability of Momate Rhino (dosing nasal spray) manufactured by “Glenmark Pharmaceuticals Ltd.” (India) in comparison with original mometasone furoate (dosing nasal spray) in adult patients with perennial allergic rhinitis. 120 patients, 18-65 years old, diagnosed with perennial allergic rhinitis, with medical history not less than 2 years, were randomized in open multicentre clinical study in parallel groups, conducted in 6 clinical centers of the Russian Federation during the period from 15.10.2013 till 29.07.2014. The tested pharmaceutical product Momate Rhino (dosing nasal spray) showed good clinical efficacy, compared to original mometasone furoate (dosing nasal spray). Both variants of therapy guaranteed evident decrease of overall estimate of nasal symptoms severity by the end of treatment period (after 4 weeks of therapy): 1.97±2.49 in control group, receiving original mometasone furoate (dosing nasal spray) and 1.64±2.18 in basic group, receiving the tested pharmaceutical product Momate Rhino. Both products caused evident decrease of nasal symptoms overall estimate after 4 weeks of therapy: 0.70±2.05 in control group and 0.40±1.06 in basic group (Momate Rhino). No statistically significant differences between the groups were found out. Upon completion of therapy, 52 (86.7%) patients of the group, treated with Momate Rhino, estimated the therapy as “very good” and “excellent”. Medical researchers estimated therapy in Momate Rhino group as “very good” and “excellent” in 52 (86.7%) patients, as well. The tested pharmaceutical products showed high safety and good tolerance. Thereby, the research results proved that the tested pharmaceutical product Momate Rhino, dosing nasal spray, produced by “Glenmark Pharmaceuticals Ltd.” (India) has, at least, equal efficacy and safety in comparison with original mometasone furoate (dosing nasal spray).
Consilium Medicum. 2016;18(11):102-109
102-109
Assessing the impact of bioregulatory drugs on quality of life of patients with bronchial asthma
Abstract
The use of bioregulatory drugs in bronchial asthma patients was assessed via a placebo controlled trial. The necessity of the inclusion of this class of drugs in complex schemes of standard therapy of patients with bronchial asthma in order to improve their quality of life is also addressed here below.
Consilium Medicum. 2016;18(11):110-116
110-116