No 3 (2014)

Mass vaccination has proved the efficiency in disease decrease. Now there was a necessity of expansion of a national schedule, because we have the new data about structure of disease and death rate of children and modern international recommendations. One of mechanisms of realization of the modern approach to vaccination is creation of regional programs. Vaccines prevention development defines necessity of expansion of scientific researches, modernizations the system of monitoring adverse effect after vaccination, perfection a training of professional and information work with the population.

This review examines the current issues of the pathogenesis of respiratory infections; the current data on the basic principles of pharmacotherapy of acute respiratory viral diseases are presented, the advantages and disadvantages of modern antiviral and symptomatic treatment are detailed. The principles of choice of combined drugs with antipyretic and analgesic actions, and distinctive features of their pharmacological effects depending on the composition are discussed. The role of succinic acid in the human body and the benefits of modern combined preparations containing antioxidant complex are demonstrated.

The problem of diagnosis and treatment of lower respiratory tract infections (laryngitis, tracheitis, bronchitis, pneumonia) in children is discussed. It is noted that all methods of etiologic diagnosis of acute respiratory infections (ARI) are retrospective. Principles and the nature of therapeutic measures in ARI are determined by leading clinical syndromes: hyperthermia, laryngeal stenosis, seizures, intoxication, bronchial obstruction, respiratory failure, and epidemiologic situation. Prevention of ARI includes primarily the prevention of contacts in the epidemic season, cold water treatment, and the use of interferon preparations and other agents to enhance nonspecific resistance that recently gaining popularity.

The article presents the results of clinical and laboratory evaluation of the use of domestic immunobiological drug in the treatment of acute respiratory viral infections in 120 children aged 6 months to 14 years. The findings suggest the clinical and laboratory efficacy in the absence of side effects and allergic reactions.

Due to the prevalence of acute viral upper respiratory tract infections in children, one of the leading positions in pediatrics occupies acute rhinosinusitis, acute otitis media, and acute tonsillitis. In the most cases, these diseases resolve without intervention of against the background of symptomatic treatment. Systemic antibiotic therapy is required in at-risk patients, as well as in patients with severe or complicated course of acute rhinosinusitis and acute otitis media, and in children with acute streptococcal tonsillitis. Nevertheless, in clinical practice the majority of children treated with antibiotics even in case of proven viral etiology of disease. This review is aimed to awareness of pediatricians with the positions of the leading international guidelines for diagnosis and treatment of acute diseases of upper respiratory tract in children, based on the principles of evidence-based medicine.

The article is devoted to the efficiency of application of Ribomunyl for the prevention of respiratory infections in children. Ribomunyl is the ribosomal immunomodulator of bacterial origin. It is composed of ribosomal fractions of Streptococcus pneumoniae, S. pyogenes, Haemophilus influenzae, Klebsiella pneumoniae, as well as cell wall proteoglycans of K. pneumoniae. All double-blind, placebocontrolled studies have shown high efficiency of Ribomunyl in preventing recurrent ENT and bronchopulmonary infections. The drug reduced the number, severity and duration of infectious episodes, antibiotic courses, concomitant medications (antitussives, expectorants, antipyretics, etc.) and the number of days missing school or missing work of parents. Decrease of need to use antibiotics during treatment with a Ribomunyl is important; this reduces the likelihood of antibacterial resistance.

Complex treatment of patients with respiratory diseases along with other pathogenetic therapy includes drugs that reduce the viscosity and elasticity of sputum. In inflammatory diseases of the respiratory system, removal of accumulating sputum from the respiratory tract is a major challenge. Synthetic mucolytics are the most effective drugs affecting sputum. However, representatives of this group have different properties. For example, the ambroxol acts as secretomotor agent: it is able to restore the mucociliary transport due to activation of the movement of the cilia. In addition, the mechanism of action of ambroxol is associated with the stimulation of tracheobronchial secretion with reduced viscosity due to changes in the chemistry of its mucopolysaccharides. A very important property of ambroxol and its derivatives is the ability to stimulate the production of surfactant, increasing its synthesis, secretion and inhibits the breakdown. Ambroxol potentiates the antibacterial effect of the major groups of antibiotics. In recent years, publications describing the anti-inflammatory and antioxidant properties of ambroxol are available.

The article examines the concepts of classical and clinical homeopathy. Meeting points and differences between these two methods are discussed; detailed historical background and main stages of development of homeopathy are presented.