Experience with the use of oral probiotic Streptococcus salivarius K12 for the prevention of recurrence of pharyngotonsillar

Relevance. Pharyngotonsillitis (PhT) is one of the most common recurrent upper respiratory tract diseases. Viruses are the most common cause of disease (Respiratory viruses, Enterov iruses, Herpesviruses), 30% are of bacterial origin. The most serious types of PhT are associated with group of β-hemolytic streptococcus (GAS) - Streptococcus pyogenes, in which antibiotic therapy is the first choice of therapy. In order to reduce the use of antibiotics, to prevent relapses of pharyngotonsillar episodes, a specific probiotic therapy was carried out using Streptococcuss alivarius K12 (SsK12). K12 (SsK12) is a probiotic strain that inhibits the growth of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in vitro. Materials and methods. A study was conducted in 90 patients with recurrent pharyngotonsillitis (PhT) of bacterial origin, in whom Streptococcus pyogenes was isolated during bacteriolog ical examination. The course of treatment for patients of all groups was 30 days. Patients of group 1 (30 people) were treated with standard methods. In 30 patients of group 2 (30 people), in addition to standard therapy, the respiratory probiotic "Bactoblis" was used for a course of 30 days. In 30 patients of group 3, standard therapy was carried out with the use of the respiratory probiotic drug "Bactoblis" and additional sanitation of the lacunae of the palatine tonsils by vacuum extraction. As a result, in patients of groups 2 and 3, the frequency of PhT episodes significantly decreased, and the use of antibiotics decreased too. The most persistent effect of treatment was in patients of group 3 - the quality of treatment and prevention increased, the number of exacerbations decreased, the severity of clinical manifestations, and the drug load decreased. Individual intolerance to the components of the drug has not been identified. However, 6 months after the observation was started, the clinical and laboratory parameters of the main groups began to deteriorate, approaching those of the control group, and more stable therapeutic effect was observed in patients of group 3. Conclusions. The authors consider it expedient to perform tonsil sanitation twice a year, with further use of the drug "Bactoblis" in patients suffering from PhT. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants

Эпидемическая ситуация по туберкулезу у детей в Калужской области в 2014-2018 гг.

Purpose: to study tuberculosis situation in children in Kaluga Region in 2014-2018.Subjects and methods. Tuberculosis incidence in children was analyzed and compared with tuberculosis rates in adults in 2014-2018. The primary infection of children with tuberculous mycobacteria, the structure of Dispensary Groups III and IV were studied. All new tuberculosis cases in children aged 0 to 17 years in 2014-2018 were analyzed.Results. In 2014-2018, there were mixed trends in tuberculosis incidence in children in Kaluga Region. The rate of tuberculosis incidence growth made 0.9%, which was higher than the growth in the overall incidence rate and indirectly indicated the presence of infection sources among adult population. No statistically significant correlation was found between the overall incidence of tuberculosis and the incidence of tuberculosis with a positive result of sputum test (r = 0.9; p > 0.05), as well as between the incidence of tuberculosis with with a positive result of sputum test and tuberculosis incidence in children (r = -0.48; p > 0.05). This points out at defects in the work of laboratory service as well as a poor detection of children exposed to infectious tuberculosis cases. In Kaluga Region, the average incidence in children registered as contacts of a tuberculosis case made 809.7 ± 306.1 per 100,000 children exposed to tuberculous infection in 2014-2018.Цель: изучить эпидемическую ситуацию по туберкулезу среди детского населения в Калужской области в 2014-2018 гг.Материалы и методы. Проведены анализ заболеваемости туберкулезом у детей и ее сравнение с эпидемиологическими показателями по туберкулезу у взрослых в 2014-2018 гг. Изучены первичная инфицированность детей микобактериями туберкулеза, структура III и IV ГДУ. Проанализированы все случаи впервые выявленного туберкулеза у детей в возрасте от 0 до 17 лет в 2014-2018 гг.Результаты. Показатели заболеваемости туберкулезом детей в Калужской области в 2014-2018 гг. имели разнонаправленные тенденции. Темп прироста показателя составил 0,9%, что выше прироста показателя общей заболеваемости и косвенно свидетельствует о наличии источников заражения среди взрослого населения. Не установлено статистически значимой корреляционной связи между показателями общей заболеваемости туберкулезом и заболеваемостью с бактериовыделением (r = 0,9; p > 0,05), а также между заболеваемостью с бактериовыделением и заболеваемостью туберкулезом у детей (r = -0,48; p > 0,05). Это указывает на дефекты в работе бактериологической службы, а также недовыявление детей из контактов с бактериовыделителями. Заболеваемость детей, состоящих на учете по контакту с больным туберкулезом, в Калужской области составила в среднем в 2014-2018 гг. 809,7 ± 306,1 на 100 тыс. детей из контактов

Факторы, влияющие на эффективность лечения больных туберкулезом с множественной и широкой лекарственной устойчивостью

The objective: to determine factors influencing treatment efficacy in patients with multiple (MDR) and extensive (XDR) drug resistant tuberculosis. Subjects and methods. The medical files of 107 tuberculosis patients (men – 75, women – 32) were analyzed, 17 of them were HIV positive. Those 107 patients were registered for treatment as per chemotherapy (CT) regimens IV-V in 2017 in Kaluga Region. 99 (92.5%) patients suffered from tuberculosis with lung tissue destruction. 60.7% (65 patients) had MDR, while 20.8% (22 patients) had XDR. Only 58.2% of patients had MDR TB confirmed by polymerase chain reaction before treatment start.Results. In 24 months, the effective course of treatment was registered in 64/107 (59.8%). The highest level of effective treatment was expectedly registered among new cases – 21/30 (70%); and the lowest level was among patients starting chemotherapy again after treatment interruption – 4/10 (40%), p > 0.05. Among 64 patients with effective treatment course, 25 (39.1%) had surgery and 39 (60.9%) had chemotherapy only. Surgical activity among the cohort of 2017 made 26/107 (24.3%). The effective treatment outcome was achieved in 8 (47%) out of 17 patients with TB/HIV co-infection, and among HIV negative patients it was reached in 56/90 (62.2%), p > 0,05.Цель: определить факторы, влияющие на эффективность лечения больных туберкулезом с множественной (МЛУ) и широкой лекарственной устойчивостью (ШЛУ) возбудителя. Материалы и методы. Проанализирована медицинская документация 107 больных туберкулезом (мужчин ‒ 75, женщин – 32), 17 из них с ВИЧ-инфекцией, зарегистрированных на лечение по IV-V режимам химиотерапии (ХТ) в 2017 г. в Калужской области. Туберкулез с деструкцией легочной ткани был у 99 (92,5%) больных. У 60,7% (65 пациентов) была МЛУ микобактерий туберкулеза (МБТ), у 20,8% (22 пациента) ‒ ШЛУ МБТ. Только 58,2% пациентов имели подтверждение МЛУ МБТ с помощью полимеразной цепной реакции перед началом данного курса лечения. Результаты. Через 24 мес. эффективно завершили курс ХТ 64/107 (59,8%) пациента. Самая высокая ‒ 21/30 (70%) ‒ частота ожидаемо зарегистрирована среди впервые выявленных больных, самая низкая ‒ 4/10 (40%) – среди больных, зарегистрированных на повторный курс ХТ после прерывания лечения, p > 0,05. Среди 64 пациентов, завершивших эффективно курс лечения, у 25 (39,1%) была сделана операция, а у 39 (60,9%) применялась только ХТ. Хирургическая активность среди когорты 2017 г. составила 26/107 (24,3%). Эффективный исход лечения среди 17 больных с ТБ + ВИЧ-и был у 8 (47%), среди ВИЧ-негативных пациентов с ТБ ‒ у 56/90 (62,2%), p > 0,05

Use of balneological methods in complex treatment of earlobe keloids

Under certain conditions, skin damage may be accompanied by a complication in the form of hypertrophic scars, keloids. A significant role in the pathogenesis of the development of keloids is attributed to immune mechanisms, neuro-endocrine disorders, hereditary factors. The most effective way to treat keloid scars is still surgical. At the same time, simple excision of keloid stimulates additional collagen synthesis, increases the risk of relapse. Traditionally used steroid drugs, metered pressure, X-rays and radiotherapy. However, these methods can lead to undesirable consequences, which justifies the search for new, less aggressive methods. To increase the effectiveness of treatment of keloids of the earlobe using a new medical complex consisting of cryotherapy, a course of injections of the drug based on hyaluronidase and a course of drawing of sulphide-peloid extracts. A study of the state of keloid scar after cryodestruction and subsequent use of the drug based on hyaluronidase was carried out in 14 people. The cryoexposure was carried out by the two-cycle method with an exposure time of 30 to 90 s. To increase the efficiency and improve the performance in the complex treatment, a spinner made of silt-sulfide peloids was used, whose components stimulate collagen resorption by fibroclasts. As a result of treatment, all patients showed a significant improvement: subsidence of paresthesia, itching, leveling the height of keloid in relation to unchanged skin. Findings. The results obtained allow us to recommend the proposed method for the introduction into the practice of cosmetologists and otorhinolaryngologists

Influence of cryodestruction of hypertrophic tonsilla lingualis on the state of immune response

The authors based on a comprehensive examination of 32 patients with tonsilla lingualis hypertrophy who underwent the cryodestruction operation established that the overall condition of patients after the operation improved. Decreased manifestations of inflammatory reactions in the nasopharynx and oropharynx, its objective state. The study of the state of the immune response showed a decrease in the activity of autoimmune reactions to the tonsilla lingualis and the restoration of the cellular component of the immune response. As for the indices of his humoral component, they were partially improved, partially unchanged. The authors believe that such a discrepancy indicates a decrease in inflammatory reactions, but the preservation of dysregulation of this part of the immune system

Resistance of the mucous membrane of the oral cavity during hypertrophy of the lingual tonsil

The article presents the results of studies that indicate that with hypertrophy of the lingual tonsil, weakening of the resistance of the oral mucosa to external influences is observed. This is due to sensitization, intoxication, depletion of the body by various pathogens that disrupt the regulation and repair processes in the body

Tuberculosis situation in children in Kaluga Region in 2014-2018

Purpose: to study tuberculosis situation in children in Kaluga Region in 2014-2018.Subjects and methods. Tuberculosis incidence in children was analyzed and compared with tuberculosis rates in adults in 2014-2018. The primary infection of children with tuberculous mycobacteria, the structure of Dispensary Groups III and IV were studied. All new tuberculosis cases in children aged 0 to 17 years in 2014-2018 were analyzed.Results. In 2014-2018, there were mixed trends in tuberculosis incidence in children in Kaluga Region. The rate of tuberculosis incidence growth made 0.9%, which was higher than the growth in the overall incidence rate and indirectly indicated the presence of infection sources among adult population. No statistically significant correlation was found between the overall incidence of tuberculosis and the incidence of tuberculosis with a positive result of sputum test (r = 0.9; p > 0.05), as well as between the incidence of tuberculosis with with a positive result of sputum test and tuberculosis incidence in children (r = -0.48; p > 0.05). This points out at defects in the work of laboratory service as well as a poor detection of children exposed to infectious tuberculosis cases. In Kaluga Region, the average incidence in children registered as contacts of a tuberculosis case made 809.7 ± 306.1 per 100,000 children exposed to tuberculous infection in 2014-2018

Factors influencing treatment efficacy in patients with multiple and extensive drug resistant tuberculosis

The objective: to determine factors influencing treatment efficacy in patients with multiple (MDR) and extensive (XDR) drug resistant tuberculosis. Subjects and methods. The medical files of 107 tuberculosis patients (men – 75, women – 32) were analyzed, 17 of them were HIV positive. Those 107 patients were registered for treatment as per chemotherapy (CT) regimens IV-V in 2017 in Kaluga Region. 99 (92.5%) patients suffered from tuberculosis with lung tissue destruction. 60.7% (65 patients) had MDR, while 20.8% (22 patients) had XDR. Only 58.2% of patients had MDR TB confirmed by polymerase chain reaction before treatment start.Results. In 24 months, the effective course of treatment was registered in 64/107 (59.8%). The highest level of effective treatment was expectedly registered among new cases – 21/30 (70%); and the lowest level was among patients starting chemotherapy again after treatment interruption – 4/10 (40%), p > 0.05. Among 64 patients with effective treatment course, 25 (39.1%) had surgery and 39 (60.9%) had chemotherapy only. Surgical activity among the cohort of 2017 made 26/107 (24.3%). The effective treatment outcome was achieved in 8 (47%) out of 17 patients with TB/HIV co-infection, and among HIV negative patients it was reached in 56/90 (62.2%), p > 0,05

Experience with the use of oral probiotic Streptococcus salivarius K12 for the prevention of recurrence of pharyngotonsillar episodes

Relevance. Pharyngotonsillitis (PhT) is one of the most common recurrent upper respiratory tract diseases. Viruses are the most common cause of disease (Respiratory viruses, Enteroviruses, Herpesviruses), 30% are of bacterial origin. The most serious types of PhT are associated with group of β-hemolytic streptococcus (GAS) - Streptococcus pyogenes, in which antibiotic therapy is the first choice of therapy. In order to reduce the use of antibiotics, to prevent relapses of pharyngotonsillar episodes, a specific probiotic therapy was carried out using Streptococcuss alivarius K12 (SsK12). K12 (SsK12) is a probiotic strain that inhibits the growth of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in vitro. Materials and methods. A study was conducted in 90 patients with recurrent pharyngotonsillitis (PhT) of bacterial origin, in whom Streptococcus pyogenes was isolated during bacteriological examination. The course of treatment for patients of all groups was 30 days. Patients of group 1 (30 people) were treated with standard methods. In 30 patients of group 2 (30 people), in addition to standard therapy, the respiratory probiotic "Bactoblis" was used for a course of 30 days. In 30 patients of group 3, standard therapy was carried out with the use of the respiratory probiotic drug "Bactoblis" and additional sanitation of the lacunae of the palatine tonsils by vacuum extraction. As a result, in patients of groups 2 and 3, the frequency of PhT episodes significantly decreased, and the use of antibiotics decreased too. The most persistent effect of treatment was in patients of group 3 - the quality of treatment and prevention increased, the number of exacerbations decreased, the severity of clinical manifestations, and the drug load decreased. Individual intolerance to the components of the drug has not been identified. However, 6 months after the observation was started, the clinical and laboratory parameters of the main groups began to deteriorate, approaching those of the control group, and more stable therapeutic effect was observed in patients of group 3. Conclusions. The authors consider it expedient to perform tonsil sanitation twice a year, with further use of the drug "Bactoblis" in patients suffering from PhT. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants