Влияние соблюдения базисной терапии на частоту госпитализаций у больных бронхиальной астмой

The aim of the study was to investigate the influence of compliance to basic therapy for asthma on rate of exacerbations. The asthma patients were interviewed with a specialized questionnaire before and after their studying at asthma-school. The authors revealed that only 12.7 % of the patients were fully compliant with a physician's recommendations on basic therapy and 23.1 % were not before studying; after that the proportion was 69.6 % and 0.7 %, respectively. Before attending the asthma-school, 61.8 % of the patients had 2 or more admissions to a hospital for a year, this number reduced to 4.4 % after school. Therefore, the results highlight a direct relationship between compliance to the basic therapy for asthma and the rate of hospitalizations. This allows significant reduction in hospital admission due to thorough keeping to the physician's recommendations on basic therapy for asthma.Цель исследования — оценить, как соблюдение базисной терапии влияет на частоту госпитализаций. Проводилось анкетирование больных бронхиальной астмой с помощью специализированной анкеты-вопросника до и после обучения в астма-школе. Выявлено, что до обучения в астма-школе полностью выполняли рекомендации врача по базисной терапии всего 12,7 % пациентов, не выполняли 23,1 %, после обучения — 69,6 и 0,7 % соответственно. До обучения 61,8 % больных госпитализировались 2 и более раз в течение календарного года, после обучения — 4,4 %. Таким образом, показана прямая зависимость между соблюдением базисной терапии и частотой госпитализаций и возможность значительного ее снижения в случае выполнения пациентами рекомендаций врача относительно базисной терапии

Эффективность сальгима при стационарном лечении бронхиальной астмы

An investigation of clinical efficacy, safety and dispensation in airways of 0.1% salbutamol hemisuccinate nebulized solution was performed in moderate to severe bronchial asthma patients under a 10-day inpatient treatment. The analysis showed the Russian β2-agonist to be an effective medication for bronchial asthma inpatient treatment. It fits to all safety requirements and has the equal efficacy but more beneficial cost-effectiveness compared with the foreign analog Ventolin.Было проведено исследование клинической эффективности, безопасности и распределения в дыхательных путях 0,1% раствора  альбутамола гемисукцината ("Сальгим") при ингаляции через небулайзер у больных с бронхиальной астмой среднетяжелого и тяжелого течения на протяжении курсового 10-дневного лечения в условиях стационарного лечения. Анализ проведенной работы свидетельствует, что отечественный β2-агонист адренергических рецепторов является эффективным препаратом при лечении бронхиальной астмы на госпитальном этапе, отвечает всем требованиям безопасности и при одинаковой эффективности обладает лучшим соотношением цена-качество по сравнению с лечением зарубежным аналогом вентолином

Диффузно-очаговый фиброз легких при приеме ингаляционного наркотического вещества

.

Бенакорт™ — первый отечественный ингаляционный глюкокортикостероид для ингаляций через небулайзер

The study was designed to investigate efficacy, safety and tolerability of Benacort in patients with moderate to severe acute asthma. The study involved 30 patients (19 females and 11 males, the mean ages, 46.2 ± 18.6 yrs and 54.3 ± 13.6 yrs respectively) with mild, moderate to severe asthma. They were divided into 2 groups: 20 patients with moderate acute asthma who received budesonide 1 000 to 2 000 mcg daily, and 10 patients with severe acute asthma, receiving the drug 2 000 to 4 000 mcg daily. Benacort was given via nebulizer 15 to 20 minutes after an inhaled bronchodilator. We monitores lung function parameters (LFP's), cardiovascular function, glucose and cortisol blood levels. The study resulted in a stable positive improvement in LFP's. The therapy allowed reducing systemic steroid doses in steroid dependent asthma. The treatment failed in severe resistant asthma requiring systemic steroids to be administered. The therapy with Benacort did not impact cardiovascular function, glucose level and baseline cortisol level. Eighty three per cent of the patients reported good and excellent tolerability of the drug, 5 patients (17 %) complained of the mouth dryness which did not require to cancel the treatment. The cost of the course treatment with Benacort was 3 times cheaper compared with the foreign analogue Pulmicort suspension (AstraZeneca).Целью работы являлось изучить эффективность, безопасность и переносимость Бенакорта у больных со среднетяжелым и тяжелым обострением бронхиальной астмы (БА). В исследование были включены 30 больных (19 женщин и 11 мужчин; средний возраст — 46,2 ± 18,6 лет и 54,3 ± 13,6 лет соответственно) с легким, среднетяжелым и тяжелым течением БА. Пациенты были распределены на 2 группы: 1-ю группу составили 20 человек с обострением средней тяжести, получавшие будесонид в дозе от 1 000 до 2 000 мкг / сут., 2-ю группу составили 10 больных с тяжелым обострением, получавшие будесонид в дозе от 2 000 до 4 000 мкг / сут. Ингаляции препарата проводились с помощью небулайзера "Turbo Boy" через 15–20 мин после ингаляции бронхолитика. Мониторировали функцию внешнего дыхания (ФВД), сердечно-сосудистой системы, уровень глюкозы и кортизола крови. Достигнута стойкая положительная динамика показателей ФВД. При стероидозависимой БА удавалось снизить дозу системных стероидов. Невыраженный эффект наблюдался в случаях тяжелого течения БА, резистентного ко многим бронхолитическим и противовоспалительным препаратам, что требовало назначения системных стероидов. Ингаляции Бенакорта не влияли на функцию сердечно-сосудистой системы, уровень глюкозы крови и базальный уровень кортизола. 83 % больных отмечали хорошую и отличную переносимость, 5 пациентов (17 %) отмечали незначительную сухость во рту в первые дни лечения, не требовавшую отмены препарата. Стоимость курсового лечения Бенакортом приблизительно в 3 раза дешевле, чем зарубежным аналогом Пульмикортом-суспензией фирмы "AstraZeneca"

Caroli Disease (Clinical Observation)

The incidence of Caroli disease is estimated to be 1 case per 1 million people; as a result, there are very few available clinical observations. At the moment, the treatment of Caroli disease is limited to symptomatic therapy and the prevention of complications, as well as to corrective surgery and liver transplantation.Aim. The aim of this observation is to describe one case of a rare congenital liver disease – Caroli disease – characterised by a segmented non-obstructive fibrocystic dilation of the intrahepatic bile ducts.Key findings. A 21-year-old woman was hospitalised with the signs of a systemic inflammatory reaction, hepatosplenomegaly, jaundice, portal hypertension, hepatocellular insufficiency, as well as with the manifestations of cytolytic and cholestatic syndromes. At the age of 8, she was diagnosed with a cyst of the bile ducts, which was treated with cystoenteroanastomosis. At the age of 20, in connection with high portal hypertension, portocaval shunting was performed and a mesenteric-caval anastomosis was applied. During the present hospitalisation, an expansion of the intrahepatic bile ducts was revealed by ultrasound and MSCT of the abdominal cavity with contrast, which made it possible to diagnose Caroli disease.Conclusion. A case of Caroli disease is described, which resulted in continuously recurrent cholangitis and biliary cirrhosis. This state required liver transplantation. Caroli disease should be included in differential diagnosis in patients suffering from the fever of unknown origin and cholestasis syndrome. An early diagnosis of Caroli disease is important for preventing complications, improving the quality of life and increasing the life expectancy of patients suffering from this rare disease

CHRONIC PHARYNGITIS: ETIOLOGY, PATHOGENESIS, TREATMENT. NEW APPROACHES TO THE ESTIMATION OF ETIOPATOGENESIS

The work discusses modern issues of etiopathogenesis, treatment of chronic pharyngitis. The results of the application of a modern method for the diagnosis of mass spectrometry of microbial markers (MSMM), which allows to detect the microorganisms in a biofilm, in a “sleeping state” under the protection of mucin are presented. With the help of this express method, it is possible to conduct a determination of the content in a smear from the pharynx 57 biomarkers of microorganisms at the same time 2 hours after delivery to the laboratory. It was found that 100% of the examined patients with a recurring course of HF (n = 62) increased the total content of microorganisms, which indicates the need for antibacterial therapy; 87% of patients have elevated levels of endotoxin, which is a sign of general intoxication; 71% of patients have reduced plasmalogene content and these patients may be at increased risk for lipid metabolic disturbances; in 100% of the examined patients with frequent exacerbations of CP in the pharynx the nasopharyngeal microflora (coccal) is determined, as well as new etiopathogenetically significant microorganisms (not detected by PCR and cultures), among which there are 7 transient microorganisms (normally in the orifice their level = 0), 11 resident (6- found in the throat in the norm in the minimum level and 5 in the high content). Also, with the help of MSMM, a significant or moderate increase in the content of herpes, cytomegalovirus was detected in the majority (75%) of patients, which indicates the important role of the viruses of the herpes group in the etiopathogenesis in the recurrent course of CP; level of Candida spp. elevated in half of patients; the content of normal microflora is increased in 71% of patients, which indicates the preservation of local resistance in patients with chronic HF, examined by the authors. Thus, the use of MSMM for chronic fever allows to identify new etiopathogenetic microorganisms, on this basis to prescribe a more effective therapy. Thus? it is possible to carry out personified, more effective treatment