No 6 (2015)

The article describes the basic approach to the treatment of H. pylori-infection in accordance with Maastricht recommendations. The main indicators characterizing the effectiveness of treatment are suggested. The tactics of treatment in case of resistance to the components of the conventional therapy is discussed in detail. The criteria, which are sufficient for H. pylori eradication to prevent gastric cancer, are proposed. The need to find the simple and reliable methods for determining the of H. pylori sensitivity to antibiotics without a biopsy of the gastric mucosa is emphasized.

Over the past 10 years, fundamental and clinical studies have established a little-known role of vitamin D in the development and functioning of the central nervous system. The article presents the results of a systematic analysis of more than 2,000 studies of neurotrophic and neuroprotective effects of vitamin D, and relationships between vitamin D deficiency, reduction of learning ability, memory disorders in children and adolescents, alexithymia, and the risk of early stroke and the risk of demyelinating diseases (amyotrophic lateral sclerosis) at a young age. It is shown that the use of vitamin D for recovery after traumatic brain injury, in paroxysmal vertigo and epilepsy is justified.

Methicillin-resistant Staphylococcus aureus (MRSA) are the leading causative agents of nosocomial infections; they were first described in 1961 in England, and now are spreading worldwide. The most important feature of MRSA is resistance to most в-lactam antibiotics, as well as the high incidence of associated resistance to antibiotics of other groups. Of particular concern is the emergence and spread of MRSA with reduced susceptibility to vancomycin and isolates resistant to daptomycin, linezolid, tigecycline and ceftaroline. Isolates with reduced susceptibility to these drugs are already registered in the Russian Federation. This review summarizes recent data on the expantion, antibiotic resistance, and molecular epidemiology of MRSA. The modern pharmacotherapies for the treatment and prospects of therapy of MRSA-infections are discussed.

In patients with frequent catarrhal diseases, it is necessary to exclude serious pathology. In most cases, the appointment of immunomodulatory therapy in patients with recurrent respiratory diseases is not justified. For this group of patients, it is necessary to minimize the pharmacological impact using rehabilitation. Patients with uncontrolled allergic respiratory diseases (allergic rhinitis and bronchial asthma) are predisposed to acute respiratory diseases, acute respiratory viral infections and complications such as sinusitis and bronchitis. In case of detection of immunodeficiency states mediated by chronic persistent viral infection, administration of antiviral therapy with double action (inosine pranobex - Isoprinosine) would be appropriate. Inhibition of replication of persistent viral infections in these patients leads to restoration of immune function and reduces the frequency of relapses.

The article presents the results of the 5-year follow-up of 52 patients with irritable bowel syndrome (IBS) in outpatient settings. Patients were managed by gastroenterologist (32 patients) and therapists (20 patients). It was noted that management of patients by gastroenterologist significantly reduces the hospitalization rate and length of stay on sick leave compared with management by therapists, also providing the better quality of life for patients.

Severe community-acquired pneumonia (SCAP) is a special form of the disease, which is characterized by high mortality and high health care costs. Given the high frequency of diagnostic errors in SCAP in Russia and the widespread practice of irrational use of medicines, guidelines for practitioners have been developed; the adherence to these guidelines will contribute to improving treatment outcomes in persons with SCAP aged 18 years and older. This publication contains the main statements of clinical practice guidelines for the diagnosis and treatment of adult patients with SCAP.