No 10 (2014)

Based on clinical cases, the article discusses the etiology, classification, clinical manifestation, and principles of diagnosis and treatment of iron deficiency anemia; iron deficiency anemia is an independent risk factor for myocardial infarction and in-hospital mortality for men, and serious cardiovascular events for men and women.

On the example of celiac disease, modern approaches to treatment of multifactorial hereditary diseases are considered. Etiopathogenic basis of these diseases includes functionally weakened variants of certain genes («predisposition» genes), and their damaging effect is implemented on the background of unfavorable environmental factors. Celiac disease is chronic, multi-syndrome, autoimmune, genetically determined disorder characterized by persistent gluten intolerance with structural and functional changes in the intestinal mucosa and abnormal processes of membrane digestion and absorption of nutrients in genetically predisposed individuals. Modern data on the diagnosis and treatment of celiac disease are presented.

This article is devoted to the concept of «responsible self-treatment» of patients with heartburn and discusses the requirements for OTC (OTC; Over-the-Counter) drugs, and compares various schemes of symptomatic therapy using antacids, H2-blockers, prokinetics, and proton pump inhibitors. Based on the pharmacokinetic and pharmacodynamic characteristics and results of clinical trials, the efficacy and safety of different proton pump inhibitors used in the «responsible self-treatment» of patients with reflux disease are characterized.

Treatment of patients with severe recurrent herpes infection remains one of the urgent problems of modern virology and is a difficult task. Typically, the disease is accompanied by the formation of secondary immunodeficiency manifested by disturbances in the system of natural killer cells, the development of hyporesponsiveness of systems of specific cytotoxicity, failure of interferon system. Herpes simplex virus replication always occurs against the background of violations in the interferon system; so, therapy aimed to the activation of Th1-cytokine response contributes to the reduction of virus activity and accelerates clinical recovery. Maximum therapeutic effect can be achieved with a combination of acyclic antiviral agents (acyclovir, valaciclovir, famciclovir) and the medications correcting immune cytokine response. Correction of immunologic disorders in recurrent herpes infection can be achieved by using interferons and interferon inducers as part of combined treatment of this disease.

The article considers the problem of the topical treatment of bacterial and ulcerative necrotic lesions of different origin, including trophic ulcers of various etiologies, infected wounds, burns, bedsores, pyoderma, and dermatosis complicated by secondary infection. The classification of trophic ulcers is presented. The data on the effectiveness of a 2 % silver sulfathiazole cream in different bacterial infections of the skin and soft tissues, including own author’s observations are demonstrated.

The examination and verification of the diagnosis of 70 patients with bacterial vaginosis were performed. These patients were divided into two groups depending on the method of treatment. Main group of 35 patients has received treatment with chlorhexidine (Hexicon) and lactic acid (Femilex). Comparison group of 35 patients was treated with chlorhexidine (Hexicon) only. It was found that combination therapy of bacterial vaginosis using chlorhexidine and lactic acid is the optimal method of treatment of this disease.

The article presents the current guidelines on the pharmacological treatment of systemic scleroderma according to the European League Against Rheumatism. The main groups of drugs used in various clinical manifestations of systemic scleroderma - skin lesions, sclerodermic renal crisis, pulmonary hypertension, gastro-oesophageal reflux, and arthritis - are discussed. It is emphasized that modern guidelines on the treatment of systemic scleroderma have summarized and analyzed extensive experience of foreign experts, which in combination with the experience of the national rheumatology integrated in national guidelines on rheumatology, should help the practitioner to effectively treat the patients and improve disease prognosis.

Modern macrolides firmly won their place in the treatment of inflammatory diseases of the respiratory tract due to the high antibacterial activity against Gram-positive cocci, Haemophilus pertussis, Corynebacterium diphtheriae, Moraxella, Legionella, Campylobacter, Listeria, Spirochetes, Chlamydia, Mycoplasma, Ureaplasma, anaerobes and some protozoa. The combination of additional effects that are not associated with an antimicrobial effect, opens up new prospects in the application of macrolides. In this review, characteristics of roxithromycin presented in more detail; this drug has been used successfully in the clinical practice due to the optimal parameters of pharmacokinetics and good tolerability.