No 14 (2017)

Acute bronchitis (OB) is a clinical diagnosis characterized by the development of dry or productive cough, an infection of the lower respiratory tract in the absence of chronic lung diseases and pneumonia. The most frequent pathogens are rino-, enteroviruses, influenza A and В viruses, parainfluenza, corona, metapneumovirus and respiratory syncytial viruses. Bacteria are responsible for only 1-10% of cases of AB. Since AB is considered a clinical diagnosis, in most cases, the isolation of AB from a complex of acute respiratory viral diseases is meaningless. Additional tests are necessary to exclude pneumonia and specific pathogens of the influenza virus and Bordetella pertussis. In routine management of patients with AB, antibacterial drugs should be avoided. AB in most cases is resolved spontaneously; to alleviate the course of the disease, symptomatic therapy can be applied.

The review is devoted to the evaluation and analysis of modern ideas about the etiology, diagnosis and treatment of systemic vasculitis. An evaluation of studies on the efficacy and safety of drugs prescribed in the treatment of systemic vasculitis has been conducted. The statistical data of the European Vasculitis Study Group are presented. There is a need for continuous monitoring of the course of the disease, which minimizes the risk of complications and death associated with both the disease and complications of therapy.

Chronic obstructive pulmonary disease (COPD) has become one of the leading non-infectious problems of medicine over the last three decades. The presence of three groups of inhaled drugs, each of which is well studied in COPD, has empirically led to the use of triple combinations in the treatment of COPD. Data on the effectiveness and prevalence of triple therapy (TT) are still fewand sometimes contradictory, which made this literature review as relevant. The results of randomized clinical trials of combinations of fluticasone furoate/ vilanterol/umeclidinium, budesonide/formoterol fumorate/glycopyrronium bromide and beclomethasone dipropionate/formoterol fumorate/glycopyrronium bromide, as well as combinations of tiotropium bromide with budesonide/formoterol fumorate and a combination of tiotropium bromide with a fluticasone propionate/salmeterol are presented. TT, which includes two long-acting bronchodilators and an inhaled glucocorticosteroid, is widely used in actual clinical practice in different countries, despite the fact that indications for its use are limited to severe COPD with severe symptoms and frequent exacerbations. Conducted clinical studies have proved the safety of TT, but the evidence base for the effectiveness of TT remains insufficient. Obviously, this variant of therapy should be studied not only in COPD with different severity, but also among patients with different phenotypes. On the one hand, this will allow to optimize treatment, on the other hand, to save the resources of the healthcare system and patients.

The article presents the mechanisms of cough occurrence in acute respiratory diseases. The high prevalence of this pathology among children and adults, as well as the need to use mucoactive drugs, in particular plant-based preparations, has been noted. The data on the effectiveness of the clinical application of phytopreparation Eucabal with mucolytic, expectorant, anti-inflammatory and immuno-modulating properties are presented.

Chronic tonsillitis indicates the presence of a permanent site of infection in the child’s body. This is explained by the damage of adenoid tissue of tonsils and formation of a stable inflammatory reaction, which not only suppresses and exhausts immune system, but can cause even «autoimmune breakdown.» The adenoiditis, nasal polyps, sinusitis, and allergy contribute development of chronic inflammation of the tonsils. In such cases, the use of antihomotoxic therapy increases the adaptive capacity of the child’s body, promoting elimination of toxins from the cells and connective tissue.