No 6 (2016)

Optimal physical development of children and adolescents involved in sports require high concentration of vitamin D. It is well known that prevention of numerous diseases, comorbid with deficiency of vitamin D, is effective at a concentration of 25(OH)D more than 30.0 ng/mL. At the same time, the optimum functioning of the muscles and reliable improvement of sports results achieve at a concentration of 25(OH)D more than 40.0-50.0 ng/mL. The article deals with the molecular and physiological mechanisms of vitamin D effects on the muscles and the results of clinical studies of athletes.

Chronic spontaneous urticaria (CSC) - a skin disease which is mediated by mast cell degranulation and characterized by the appearance of blisters, itching and angioedema during more than 6 weeks without any specific reasons. Purpose of review: discussion of modern international consensus documents on treatment of CSC, as well as the advantages and disadvantages of use of omalizumab -a new biological agent for the treatment of this disease.

The study was aimed to the identification of adverse factors of use of anticoagulant therapy (ACT) for the selection of patient’s groups at high risk of bleeding during treatment with oral anticoagulants. The research is conducted on the basis of the University Clinical Hospital № 1 First MSMU n.a. I.M. Sechenov and includes 325 patients with non-valvular atrial fibrillation receiving various ACT for the prevention of thromboembolic complications (TEC). Mean duration of follow-up period - 24 months. Among 325 patients included in the study, more than 95% of patients continue to receive anticoagulants and continue monitoring in anticoagulant therapy control office. A total of 37 bleeds were recorded, including 19 «small» and 18 «major». In most cases, bleeding complications were detected in patients with CHA2DS2-VASc scores= 1, 4 and 8, and HAS-BLED scores=4. In patients with history of acute cerebrovascular accidents (ACVA), bleedings have occurred significantly more often than in patients without ACVA. Number of major bleedings in patients on warfarin was significantly higher than in patients on oral anticoagulants, and the number of small bleedings in patients on warfarin was significantly lower (p<0.05). It should be noted that the frequency of major bleedings on warfarin was significantly higher than on any of the new oral anticoagulants - dabigatran, rivaroxaban, and apixaban. During follow-up period, TECs were observed only in 3 patients (0.9% of the total number receiving ACT). It is emphasized that the effective and safe ACT requires systematic monitoring of patients receiving this type of therapy. The most optimal way to monitor this patient cohort is considered to be anticoagulation therapy control office.

The study was aimed to the evaluation of the efficacy and safety of complex homeopathic preparations (CHP) in patients after injuries and surgeries on the upper respiratory tract. The effectiveness of drug therapy in trauma and postoperative was evaluated in dynamics in 101 patients receiving CHP and in 63 patients who received conventional drug therapy. The leading indicator for the assessment of wound healing process was a dynamics of status localis; also, microbiological examination and evaluation of the respiratory function of the nose by the front active rhinomanometry. The results of treatment were assessed at 1, 3, 5, 7, 14 day, and 1 and 6 months after injury or surgery on the basis of the dynamics of clinical symptoms, laboratory parameters and instrumental methods. The results revealed high efficiency of CHP, significantly accelerating the timing of reduction of pain, signs of local inflammation and providing faster recovery of patients after injuries and surgical interventions that can reduce the duration of hospitalization.

Diseases of the mucous membranes (epiteliopathies) are characterized by relapsing course, severe inflammatory tissue reactions and resistance to various therapeutic effects. Methods of traditional medicine are not always effective in diseases associated with disorders of the mucous membranes, and often have side effects. An alternative is the use of the drug Mucosa compositum - complex preparation for regeneration of the mucous membranes of the human body. The results of our own research allow us to recommend the drug Mucosa compositum against the background of basic therapy for children with diseases of the respiratory tract, out the period of exacerbation, especially in the presence of concomitant diseases of the digestive system.

The article contains a literature review devoted to the prevalence, etiological pathogenetic mechanisms, clinical presentation and methods of diagnosis and treatment of inflammatory diseases of the upper respiratory tract: acute rhinosinusitis and acute otitis media. Convincing evidence of the need for antibacterial therapy in these diseases are presented. The algorithm of the modern antibacterial therapy of inflammatory diseases of upper respiratory tract in the outpatient settings is discussed.