No 1 (2016)

Chronic cough refers to a multidisciplinary medical health problem, due to the different causes of cough, complications, diagnostics difficulties. Patients with complaints of cough are among the most frequent visitors of primary care physicians, internists, pulmonologists, otorhynolaryngologists, pediatricians. The most common causes of chronic cough are upper respiratory diseases, bronchial asthma, and gastroesophageal reflux disease. This so-called triad of cough. There is a category of «unclear» (idiopathic) cough. Modern understanding of the mechanisms of chronic cough is associated with the concept of hypersensitive cough syndrome. Management of chronic cough includes protussive and antitussive therapy.

Article is devoted to antibiotic treatment of exacerbations of chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD), according to current clinical guidelines. It is noted that between the severity of the disease and the type of pathogen there is a described correlation. Modes of antimicrobial therapy, taking into account the likely exacerbation of pathogens depending on the severity of COPD are presented. In addition to the eradication of the pathogen, an important role in the prescription of antibiotic plays the possibility of increasing the length of time of remission. Among the major groups of antibiotics clinical efficacy was noted equally for each of them. Nevertheless the use of "respiratory" fluoroquinolones and amoxicillin/clavulanate, was characterized by a higher microbiological efficacy and lower incidence of recurrence of the disease compared with macrolides. Special attention is paid to vaccine preventable exacerbations of CB/COPD.

The article reviewed the results of the large multicenter clinical trials in patients with chronic obstructive pulmonary disease (COPD). The main causes and risk factors that affect the severity and outcome of COPD. The high correlation between diabetes and the metabolic syndrome with the degree and severity of COPD decompensation. The data show the relationship between the formation of restrictive disorders and obesity. The results of clinical trials have shown the efficacy of roflumilast in patients with moderate to severe COPD. It is concluded that the comorbid conditions have a significant impact on the course of COPD, with particular care in such cases are not well understood, hence the need for further research in this direction.

Torasemide - loop diuretic has high favorable pharmacodynamic properties. The article presents data on the clinical efficacy of torasemide in patients with chronic heart failure, arterial hypertension and patients with cirrhosis and ascites.

This article discusses the effectiveness and safety of the mineralocorticoid receptors blockers, spironolactone and eplerenone (Espiro) in the treatment of patients with chronic heart failure (CHF). We consider the importance of early diagnosis of chronic circulatory failure and methods used for this. We present the results of major international clinical trials evaluating spironolactone and eplerenone, as well as indications and contraindications of their prescription. The results clearly showed that adding mineralocorticoid receptors inhibitors to the standard therapy of patients with chronic heart failure (ACE inhibitors, angiotensin receptor blockers II, β-blockers, diuretics) significantly increase the effect of the treatment, improve hemodynamics, quality of life and reduce the mortality rate of patients.

Pathology of cardio-vascular system continues to lead the statistics of mortality worldwide. According to the researchers, in addition to the major risk factors for coronary heart disease, there is another equally important factor is the behavior of type A. The connection type of behavior And coronary heart disease is confirmed by the results of numerous studies. The brightest and most dangerous manifestation of coronary heart disease is acute coronary syndrome. The study of personality traits with the behavior of type A causes the formation of this type is very important. Proven prognostic value type of behavior A in the development of coronary heart disease, but its role as a prognostic sign of progression of coronary heart disease and outcomes of acute coronary syndrome is not defined and does not receive adequate coverage in the literature.

One of the greatest achievements of the modern world is the increased duration of human life. However, this becomes a serious problem: as more people survive to old age, they are more likely to encounter diseases of old age, including diabetes mellitus type 2, cardiovascular diseases and cancer. Developing new ways of improving health in old age, therefore, is a priority for biomedical research. Still there is a lack of new and effective treatments. One of the current alternative strategies for the development of medicines is becoming repurposing of existing drugs for treatment of other diseases. Metformin is one of these drugs, which are being explored new points of application. Retrospective epidemiological studies indicate a possible association between metformin and decreased cancer risk, as confirmed in animal studies in vitro. Also special attention is currently given to the key role of microbiota in regulating age-associated diseases and the potential role of metformin in modulating its function. These data should provide the impetus to conduct randomized controlled trials to confirm or refute these additional benefits of metformin.