No 15 (2012)

Acute otitis media is acute inflammation of the middle ear cavity, which is manifested by ear pain, hearing loss, and fever. The disease is caused by viruses, bacterial and fungal flora, and their associations. Predisposing factors include the auditory tube dysfunction, inflammatory diseases of the nose and paranasal sinuses. Combined treatment of patients with acute otitis media should include measures designed not only to normalization of the function of auditory tube, but also to relief of rhinosinusitis. For this purpose, the use of well-tolerated and effective antibacterial topical drug framycetin is reasonable.

In recent years, increased interest in mucoactive drugs is caused by two reasons: better understanding of the pathophysiology of chronic obstructive pulmonary disease (COPD); in particular, it was found that the lungs are constantly secrete a variety of oxidants produced endogenously as a result of metabolic reactions, and exogenously in response to aeropollutant exposure, including components of tobacco smoke; and evidence that some of mucoactive drugs (N-acetylcysteine, carbocisteine) have antioxidant properties. In this context, special attention should be paid to carbocisteine (S-carboxymethylcysteine, also available carbocisteine lysine salt - S-carboxymethylcysteine lysinate) - mucoregulatory drug with anti-oxidant and anti-inflammatory properties, which are now widely used in the treatment of patients with COPD. The numerous clinical studies suggest that long-term (6-12-month) use of drug in COPD patients is accompanied by reduction of frequency of disease exacerbations and improvement of quality of life for patients.

Chronic obstructive pulmonary disease (COPD) is one of the most common human diseases, and this allows talking about the global epidemic of the disease, the true scale and consequences of which are yet to be determined. Recurrent exacerbations of disease corresponding with the rate of decrease of lung function, decline in the quality of life, and mortality are the quintessence of COPD. In the complex treatment of patients with acute exacerbation of COPD, antimicrobial drugs which have testing by time, and maintaining high activity against pathogens and remaining the one of the therapeutic preferences of the modern physicians, occupy a special place. These include and cefixime - the first III generation oral cephalosporins. The antibiotic is characterized by the long half-life (3-4 hours) among of all oral cephalosporins, which allows to appoint it once a day. Cefixime is active against most bacterial pathogens of nonsevere COPD exacerbations - Haemophilus influenzae, Moraxella catarrhalis, susceptible strains of Streptococcus pneumoniae, Gramnegative enterobacteria. Many clinical studies have demonstrated the clinical efficacy of cefixime in excess of80-85 % and comparable to that of «respiratory» fluoroquinolones and amoxicillin/clavulanate.

Pain syndrome is most common manifestation of acute inflammatory diseases of the pharynx. The evaluation of the effectiveness of pain relief was performed in 37 patients of both sexes aged 21 to 46 years with acute inflammatory diseases of the pharynx, who received Tantum® Verde. The majority of patients (31 of 36) have evaluated the efficacy of pain relief as good, adequate and rapid (within the next minute after use of drug) after the first administration of the drug.

Acute bronchiolitis is a widespread disease and one of the leading causes of hospitalization and death among infants. Measures aimed to ensuring adequate oxygenation and water balance in patients with bronchiolitis are generally recognized. The effectiveness of all other existing methods for the treatment of acute bronchiolitis is a subject for serious debate. Development of causal treatment of viral lower respiratory tract infections is underway. The therapeutic antibody to RS-(respiratory syncytial) virus, palivizumab, is currently used for prevention of RS-virus bronchiolitis in children with severe comorbidities. Inhaled β-agonists relieve the symptoms of bronchial obstruction, but do not affect the duration of the disease, the frequency of hospitalization and length of hospital stay in children. Hypertonic solution of sodium chloride is promising according to the results of many international studies. We present your own successful experience of treatment of bronchiolitis with inhaled bronchodilators in combination with a 3 % sodium chloride.

The article presents the literature review on the evaluation of relationship between interstitial lung diseases and digestive diseases against the background of hypoxia, hypoxemia, and chronic inflammation of the respiratory system; data on the impact of gastroesophageal reflux disease on alveolitis are also presented.

In this article presents the results of a study of tiotropium bronchoprotective effect and comparison of its clinical efficacy in chronic obstructive pulmonary disease (COPD) patients, depending on a bronchial reactivity level. Bronchial hyperresponsiveness (BHR) was decreased after the first dose of tiotropium and was maintained at 6 months of therapy (р < 0,05). The BHR reduction at the end of the treatment period was accompanied by a significant decrease symptoms expression and frequency of COPD exacerbations, improvement of quality of life in comparison to baseline parameters (p < 0,05) and patients without BHR. Tiotropium improves clinical-functional status of COPD patients and significantly reduces of bronchial reactivity level in the initial high values. COPD patients with BHR phenotype respond to tiotropium therapy better than patients without BHR.

According to available data, 85-95 % of patients with bronchial asthma (BA) suffer a concomitant allergic rhinitis (AR), and BA is diagnosed in 20-50 % of patients with AR. Second generation antihistamines, one of which is desloratadine, play the leading role in the treatment of AR. The article presents the results of use of desloratadine (Lordestin) in 23 patients with BA combined with persistent AR. Pronounced positive effect of Lordestin was recorded in 19 patients. Reductions of AR symptoms was accompanied by disappearance or decrease in the amount of eosinophils in nasal smears and almost complete normalization of concentration of eosinophils in peripheral blood. The AR symptoms were decreased in 4 patients, but concentrations of eosinophils in nasal smears and in the blood remained the same. It is emphasized that the emergence of new highly effective, safe and economically available antiallergic drugs, such as Lordestin, improve access to quality treatment for more patients with AR in combination with BA.