编号 4 (2015)

According to modern notions, bronchial asthma in children is allergic inflammation in the respiratory tract, accompanied by bronchial hyperreactive to different stimuli. Acute respiratory viral infection plays a key role in strengthening the inflammatory process in bronchial asthma in childhood. Repeated episodes of respiratory illnesses accompanied by bronchial obstruction, as a rule, form or exacerbate bronchial hyperreactivity. As an independent clinical phenotype of bronchial asthma in children excrete the virus-induced bronchial asthma. Effective anti-inflammatory drugs for the prevention of exacerbations of virus-induced bronchial asthma at the present stage are presented leukotriene receptor antagonists.

Chronic obstructive pulmonary disease (COPD) is characterized by persistent obstructive limitation of ventilatory function which is caused by increased chronic inflammatory response to pathogenic particles or gases. The condition is partially reversible, but usually progresses.The paper reviews the basics of COPD patient clinical evaluation, laboratory tests and diagnostic procedures used for examination in this disease. Differential diagnostic criteria between COPD and asthma are presented and signs that may be helpful in differentiating COPD and other respiratory disorders are described. Current classification of COPD (GOLD 2011/2013) is provided. The paper outlines the basic principles of stable COPD pharmacotherapy including anticholinergics, P2-agonists, inhaled corticosteroids, and some other medications (theophylline, antioxidants, phosphodiesterase-4 inhibitors), as well as their combinations.

This paper reviews the etiology, diagnosis, and treatment of acute respiratory viral infections (ARVI). Today there are a number of challenging problems of ARVI pharmacotherapy. Firstly, an effective causative treatment is possible only for influenza infection. Secondly, diversity of clinical manifestations of ARVI (fever, headache, weakness, runny nose, cough, etc.) requires concurrent administration of multiple medications of different pharmacological groups. And finally, difficulties in differentiating viral and bacterial infections have led to excessive administration of antibacterial drugs thus giving rise to emergence and ongoing spread of antimicrobial-resistant pathogens. An attractive alternative for ARVI patient presenting with several symptoms is the use of combined drugs. The ability to simultaneously relieve multiple symptoms of viral infection has brought about extraordinary popularity of these drugs.

This article is devoted to the treatment of bronchial asthma in adults and adolescents according to current federal clinical guidelines and international GINA 2014 guideline. Goals of asthma therapy, criteria for disease control, categories of drugs for the treatment, and stepped pharmacotherapy of bronchial asthma are presented.

Improvement of methods for nursing of infants with very low and extremely low birth weight leads to an increase in their survival and the emergence of a growing number of children with bronchopulmonary dysplasia. The article presents the current recommendations for the prevention and treatment of bronchopulmonary dysplasia based on the results of randomized clinical trials.

The article presents the results of the monitoring of antibiotic resistance of 815 strains of Staphylococcus aureus, the leading causative agents of infectious complications after endoprosthesis replacement of hip and knee joints during 2010-2013. A comparative analysis of the activity of antibiotics depending on the resistance of Staphylococcus aureus isolates to methicillin was performed. The data on the distribution of strains of methicillin-resistant Staphylococcus aureus (MRSA) according to the minimum inhibitory concentration of vancomycin, daptomycin and ceftaroline are presented. Based on the own authors’ research and scientific literature data, analysis of potentials for the application of various antibacterial drugs for the treatment of prosthetic joint infection was performed, and the most active antibiotics against MRSA were identified.

The article describes the changes in the cellular and humoral immunity in acute intestinal infections of various etiologies, including rotavirus, detected during examination of 145 children aged 5 months to 14 years; the correlation between the degree of immunological disorders and clinical features of the disease in childhood is shown. The most significant changes in cytokine status are associated with increased interleukin-10 levels, which is a marker of intoxication. Additionally, children with rotavirus infection have reduced levels of induced interferon-а and-y, that justifies the application of interferon-a-2b, which is contained in the drug Viferon. Inclusion of Viferon and probiotic Bifiform Kids along with basic therapy in complex treatment for children with rotavirus allows to improve the dynamics of clinical and immunological parameters, and reduce the number of cases of SARS during the 6 months follow-up after the acute period of the disease by 1.5 times.

Optimal pharmacotherapy of bronchial asthma (BA) in children allows to control the symptoms and reduce risk of exacerbations. Main group of drugs used for the treatment of asthma include inhaled glucocorticosteroids (IGCS). Use of IGCC as background therapy in children of different ages is supported by international and national guidelines. Due to high anti-inflammatory activity, IGCC are justified as the first stage of background therapy of BA. Inhaled corticosteroids may also be effective in the treatment of acute exacerbations of BA in children. One of the most studied and widely used inhaled corticosteroids is budesonide. Due to excellent safety profile and the possibility of using of different inhaled forms, budesonide can be effectively used in the treatment of BA in children.