Изучение эффективности, безопасности и оценка удовлетворенности ингаляционной терапией препаратом Тобрамицин-Гобби при синегнойной инфекции у детей с муковисцидозом

Study of efficacy, safety, and patient satisfaction with inhaled tobramycin (Tobramycin-Gobbi) in children with cystic fibrosis and pseudomonas infectionAim of the study was to assess efficacy and safety of Tobramycin-Gobbi in CF, as well as the patients’ satisfaction with the treatment.Methods. 35 children from 6 to 18 years with CF were enrolled in this non-interventional prospective cohort multicenter study. All children had P. aeruginosa in the respiratory tract (newly diagnosed, recurrent, or chronic infection). The children received inhalation treatment with Tobramycin-Gobbi in the following cycles: 28-day treatment/28-day break, for 6 months. The studied parameters included respiratory function, bacterial cultures of the respiratory tract with a bacterial count, growth and body weight, antibiotic therapy for the respiratory episodes. The children and parents filled in a questionnaire “Treatment satisfaction assessment” and assessed their state of health on the visual-analog scale before and after each treatment cycle.Results. P. aeruginosa was eradicated in 17.7% of cases (6 patients, including 2 newly diagnosed, 3 recurrent infections, and 1 chronic infection), reduced bacterial count, decreased number of courses of antibiotic therapy, improvement of FEV1. Adverse reactions were reported by one patient.Conclusion. The efficacy, safety, and tolerability of Tobramicine Gobbi were confirmed in the patients with newly diagnosed, recurrent, and chronic infection caused by P. aeruginosa.Антибактериальная терапия (АБТ) синегнойной инфекции при муковисцидозе (МВ) остается основным фактором, определяющим функцию легких и продолжительность жизни больных. Основным патогеном, который определяет степень тяжести течения МВ, продолжительность и качество жизни пациентов, является Pseudomonas aeruginosa.Целью исследования явилось изучение эффективности, безопасности и оценка удовлетворенности ингаляционной терапии препаратом Тобрамицин-Гобби при синегнойной инфекции у детей с МВ.Материалы и методы. В неинтервенционном проспективном когортном многоцентровом исследовании принимали участие дети (n = 35; возраст – 6–18 лет) с установленным диагнозом МВ, наличием синегнойной инфекции (первый высев, рецидивирующая и хроническая инфекция), наблюдавшиеся в 8 российских центрах МВ. В течение 6 мес. дети получали ингаляционную терапию указанным препаратом циклами по 28 дней ингаляций / 28 дней перерыв. Контролировались показатели респираторной функции, бактериальная флора дыхательных путей с оценкой степени обсемененности, показатели массы тела и роста, применяемая АБТ по поводу респиратор- ных эпизодов. Дети и их родители заполняли анкету пациента «Оценка удовлетворенности препаратом», при этом отмечалось самочувствие по визуальной аналоговой шкале до начала лечения и после каждого цикла приема препарата.Результаты. На фоне терапии в 6 (17,7 %) случаях (2 – с первичным высевом, 3 – с рецидивирующим, 1 – с хронической синегнойной инфекцией) выявлено отсутствие высева P. аeruginosa, уменьшение степени обсемененности, сокращение числа курсов АБТ, улучшение показателей объема форсированного выдоха за 1-ю секунду. Зарегистрированы нежелательные побочные реакции (n = 1).Заключение. Показана эффективность препарата Тобрамицин-Гобби при первичном высеве, интермиттирующей и хронической инфекции, вызванной P. аeruginosa, его безопасность и хорошая переносимость

The role of polymorphism of antioxidative activity genes in the formation of disabling pathology of the central nervous system in preterm newborns

The study aims to establish the role of polymorphism of genes encoding antioxidant enzymes in the development of CNS pathology in extremely premature newborns. In 72 examined newborns we determined the total antioxidant ability and allelic polymorphism of the sod2 and GCLC genes. During the work carried out, we were able to identify that the existence of the C/T genotype of С60Т polymorphism of the sod 2 gene in extremely premature newborns is a risk factor for the development of ischemic CNS injury. The findings broaden the understanding of the role of the antioxidant mechanism in protecting the CNS of extremely premature newborns and are the subject of further studies

The capability of chest computed tomography in the diagnosis of bronchopulmonary dysplasia outcomes in premature infants

Purpose of the study was to establish clinical and radiological features of bronchopulmonary dysplasia (BPD) outcomes in children. Materials and methods. A prospective follow-up study of 132 premature infants with infant respiratory distress syndrome (IRDS) was analyzed. BPD was developed in 66 cases. At a late childhood, clinical and radiological outcomes of the transferred conditions were diagnosed on the basis of anamnesis, clinical examination, and results of chest computed tomography (CT). Results. Clinical recovery was observed significantly more frequently in the outcome of IRDS without BPD development (69.6% versus 31.8% in the case of BPD development). In patients with BPD in the anamnesis, the odds ratio of asthma developed in the late childhood was 5.304 times higher than in children who had IRDS. The majority (62 cases, 93.9%) of children who had IRDS did not have structural changes in lung tissue according to CT (p = 0.000), 21 (31.8%) children with BPD had abnormal CT. In BPD, typical radiological findings were hypoattenuated lung areas (p = 0.020) and areas of pulmonary fibrosis (p = 0.016). Conclusion. Chest CT could be assigned to the patients with BPD in the anamnesis to assess lung tissue structural changes and diagnose outcomes of the disease