No 4 (2011)

The article discusses the general and particular problems of treatment and prevention of infectious exacerbations of chronic obstructive pulmonary disease (COPD) in terms of optimizing the choice of antibiotic therapy. Applicability of use of respiratory fluoroquinolones, particularly levofloxacin, for the treatment of exacerbations of COPD and chronic bronchitis is validated. It is emphasized that the effectiveness of antibacterial drugs in a patient with infectious exacerbation of COPD, ultimately is defined by prolonged recurrence-free period of the disease. With this context, levofloxacin can be considered as optimal antibacterial drug for the treatment of exacerbations of COPD, because the main goal of antibiotic therapy in these patients - eradication of etiologically significant microorganisms. Prolonged recurrence-free period provides a low demand for antibacterial drugs, reduces the number of doctor visits and hospitalization rate, thereby improves the quality of life and reduces treatment costs.

The article discusses the problem of obstructive sleep apnea (OSA). Data for the pathogenesis, risk factors, diagnosis, clinical manifestations and treatment of this syndrome are presented. The association of OSA with cardiovascular diseases such as hypertension, stroke, and atherosclerosis is demonstrated.

The article is dedicated to the problems of diagnosis of pneumonia from point of view of evidence-based medicine. The extent of necessary examinations to confirm the diagnosis and clarification of etiologic agents is considered. The features of radiographic data in pneumonias caused by different etiological agents and data for the etiology of community-acquired pneumonia are presented. High frequency of mycoplasmal and chlamydial pneumonia is one of the features of respiratory tract disorders in young and middle age patients. Various clinical and epidemiological situations specific to different pathogens are listed. The choice of first-line antibiotic for treatment of pneumonia is considered. Most effective in suppression of various microorganisms antibacterial drugs are discussed. Programs of antibacterial therapy of pneumonia in out-patient and hospital settings are framed. The optimal time periods for antibiotic therapy are determined.

Bronchial asthma (BA) is one of the most common diseases in modern society; ineffective treatment can significantly reduce patients' quality of life, and in some cases lead to hospitalization in the intensive care unit, and even death. In 1995, a program Global Initiative for Asthma (GINA) combining the results of various studies on the diagnosis and treatment of asthma was developed. Taking into account the recommendations of GINA-2006, the main objective of BA treatment is achievement of control of the disease, which provides absent or minimally expressed symptoms, no limitations in daily activity, no or minimal need for emergency medications, and extremely low frequency of exacerbations. The article reviews current approaches to the treatment of BA.

The article is concerned with the issues of epidemiology, etiopathogenesis and clinical forms of such terrible disease as meningitis. Modern approaches to diagnosis and treatment of different variants of meningococcal infection are presented. Measures for epidemiological surveillance, prevention and antiepidemic actions aimed to early identification of patients and interruption of transmission routes of generalized form of meningococcal infection are considered.

In this article presents the results of a study of clinical efficacy of the drug Wobenzym in traditional therapy of community-acquired pneumonia in servicemen organized military groups. Based on a survey 157 patients of community-acquired pneumonia shows the benefits of combination therapy, which promotes a more rapid regression of clinical symptoms and reduce the likelihood of formation of residual radiological changes of lung tissue.