No 10 (2012)

The article considers the role of biliary reflux in the pathogenesis of gastroesophageal reflux disease. Based on the results of experimental and clinical studies, the clinical significance of duodenogastroesophageal reflux in various forms of the disease is demonstrated. Current approaches to the treatment of these patients with combined therapy based on proton pump inhibitors and prokinetics are presented.

For elderly patients, the presence of several comorbid conditions (polymorbidity) is characteristic, that complicates diagnosis and treatment. In recent years, the number of patients with a combination of coronary artery disease (CAD) and gastroesophageal reflux disease (GERD) is significantly increased. All of the drugs for the treatment of isolated GERD (proton pump inhibitors, antacids, alginates, and prokinetics) are used in the treatment of GERD in patients with CAD. In the choice of therapy, physicians, however, should consider not only effective symptom regression, but also possible drug-drug interactions that allow to achieve safe therapeutic outcome.

The article presents the current understanding of periarticular pathology of shoulder joint (tendinitis, retractile capsulitis, tendon rupture of the muscles of the shoulder joint, etc.). The diagnosis of these conditions and their treatment (medical and non-drug) are considered. Non-steroidal anti-inflammatory drugs such as ketorolac and nimesulide (Nise) should be applied for relief a severe pain syndrome. It is also possible to use corticosteroids.

The most common manifestation of lower urinary tract infections is an acute cystitis. The main causative agents of acute uncomplicated cystitis (AUC) are gram-negative bacteria of the family Enterobacteriaceae. Main objectives of antimicrobial therapy for AUC include rapid relief of symptoms, vocational rehabilitation and restoration of social activity, prevention of complications and relapses. According to the Russian national guidelines in 2012, the drugs of choice for the treatment of this disease in adults are fosfomycin trometamol and furasidin potassium salt in connection with increased level of resistance of the main pathogens of AUC to fluoroquinolones, amoxicillin/ clavulanate and II and III generations oral cephalosporins.

The data on the prevalence, pathogenesis and clinical picture of acne (acneiform rash) are presented. Common approaches to the topical therapy of various forms of acne are discussed. It is noted that third generation retinoids, especially polyaromatic retinoid adapalene (Differin), a derivative of naphthoic acid with retinoid-like action, are widely used in current clinical practice. The results of clinical trials of Differin are discussed. It is emphasized that Differin is high effective drug for basic treatment of mild to moderate acne. For achievement of therapeutic efficacy, long-term use of the drug during 4-6 months is required.

The review discusses from different perspectives the modern physiotherapeutic methods of correction of the metabolic syndrome, especially abdominal visceral obesity and eating behavior using a complex therapeutic system with polyreceptor effects, a thermocapsule. It is shown that different combinations of physical methods in combination with hyperthermia (saunatherapy) and intensive systemic oxygenation can significantly activate the metabolic processes in the human body, including the process of lipolysis.

The article is devoted to assessment of the clinical efficacy of complex treatment regimens of chronic pancreatitis (mucolytic, spasmolytic, multienzyme replacement therapy) and evaluation its effect on the severity of chronic systemic inflammation in patients with this disease. Particular attention is paid to the correction of microbial- intestinal tissue complex.

Given the high prevalence of cardiovascular diseases in patients with type 2 diabetes mellitus (DM2), much attention is paid to the cardioprotective characteristics of glucose-lowering drugs. The article presents data for the effect of new drug vildagliptin, one of the incretin targeted therapies, on the functional state of myocardium in DM2 patients with coronary artery disease (CAD). Treatment with vildagliptin is accompanied by better glycemic control, reduction of glycosylated hemoglobin levels, improvement of exercise tolerance, increase of its threshold power, reduction of total time of ischemia, reduction of the size and severity of disorders of left ventricular myocardial perfusion.

The results of the evaluation of the efficacy of Zinkit (zinc sulfate) in the treatment of patients with occupational allergodermatoses in a hospital setting are presented. Patients of the main group (n = 20) received standard therapy with Zinkit; patients of the control group (n = 20) - only standard therapy. Amelioration of skin was noted in all patients, including patients treated with Zinkit. This resulted in the reduction of infiltration and the intensity of erythema, significant reduction of desquamation, and the disappearance of fissures. On the average, the area of lesions decreased by 70 % during the treatment. In the main group, these changes were observed as early as the 7th day of use of Zinkit. At the same time, comparison group showed same changes of the skin at 10-14-day of treatment only that allows to give a positive evaluation of Zinkit in the complex treatment of patients with occupational allergodermatoses.