Topical antibiotics for acute rhinosinusitis in children

The authors presented an overview of the existing data on inhalation therapy with antibacterial drugs in acute rhinosinusitis and exacerbation of chronic rhinosinusitis in children. The overview includes general information about the etiology and features of the course of acute rhinosinusitis. It also contains indications for systemic and topical antibiotic therapy in acute rhinosinusitis specified in the Russian clinical guidelines. The advantages of using a combination preparation of thiampheni-col and N-acetylcysteine by inhalation therapy for acute rhinosinusitis in children and adults are considered separately. A clinical case of a 15-year-old female patient with complaints of persistent rhinitis over the past 4-5 years is discussed. Historical information: a patient had a runny nose over the last 4-5 years: persistent, viscous nasal discharge with moderate nasal congestion. Nasal symptoms worsened with episodes of acute respiratory illness, and nasal discharge became mucopurulent. The child was preliminarily diagnosed with chronic rhinosinusitis (incomplete remission), moderate course. To reduce the severity of the symptoms of the disease, which were present at the time of examination, the following were recommended: daily one-to-two irrigation of the nasal cavity with slightly hypertonic (1.5-3%) solutions of sea water, followed by a toilet of the nasal cavity; in case of episodes of colds with the appearance of mucopurulent secretions, inhalation therapy in a pulsating mode of the inhaler with a solution of thiamphenicol and N-acetylcysteine at a dose of 500 mg once a day (in the first half of the day) for the next 10 days and further; the use of a nasal spray of mometasone furoate, 200 mcg per day during inhalation therapy for another 3 weeks. At the follow-up examination after 10 days of treatment, the patient reported a significant decrease in the severity of nasal symptoms, which coincided with an improvement in the rhinoscopic status. It can be concluded that the use of topical antibacterial drugs by inhalation therapy for acute rhinosinusitis, despite all its advantages, is not an equivalent substitute for systemic antibiotic therapy in the treatment of severe and especially complicated forms of the disease. The inhalation therapy is recommended in the presence of indications for systemic antibiotic therapy, since it is an auxiliary method of treatment, the action of which is aimed at enhancing the effect of systemic antibiotics

Prevalence of psychopathological symptoms at rheumatological in-patients, contribution to subjective life quality assessment

The article presents the results of a cross - sectional /correlational study on the assessment of the prevalence of psychopathological symptoms in rheumatologic in-patients and their associations with quality of life.В статье представлены результаты кросс – секционного и корреляционного исследования, посвященного оценке распространенности психопатологической симптоматики у пациентов с ревматической патологией и ассоциаций психопатологических симптомов с качеством жизни

Evaluation of probiotic lactobacillus as adjuvants for nasal immunization with chimeric pneumococcal vaccine

Vaccine protection against photogenic gram-positive bacteria including different species ofstreptococci is an important problem of contemporary molecular biology. Streptococcal infections are mostcommon bacterial infections surpassing by the economic losses all the infections excluding influenza. The gatesof streptococcal infection, oral cavity or vagina, are covered with immune and non-immune mucosal cells thatare the first line of defenses. Subcutaneous immunization not always stimulate the local immunity on mucosalsurfaces. On the other hand, mucosal vaccination can provide an appropriate local immune response togetherwith systemic protection. However, mucosal immunization often requires usage of special and effectiveadjuvants especially in case of vaccines based on recombinant proteins.For protection against Streptococcus pneumoniae infection, two chimeric recombinant proteins (PSPF andPSP) have been tested as vaccines. Recombinant proteins PSPF and PSP carry immunogenic epitopes fromthe respiratory pathogen including PspA, Spr1875 and PsaA. PSPF structure also carries a fraction of flagellin-FliC molecule in comparison with PSP, which does not have this fragment. This portion of PSPF was includedas internal adjuvant intended for the stimulation of Toll-like receptor 5.In this work, the adjuvant capacity of two probiotic strains, Lactobacillus rhamnosus CRL1505 andL. rhamnosus L32 was evaluated. It was demonstrated that both lactic acid bacteria strains were able to provideadjuvant effects by enhancing the mucosal and systemic immune responses after their co-administration withthe recombinant chimeric protein PSPF. The adjuvant effect of both Lactobacillus strains was significantlydecreased after their thermal inactivation. However, the cell walls of bacteria showed a marked adjuvant activity.An improved protection against several S. pneumoniae serotypes after mucosal immunization of infant micewith PSPF vaccine with probiotic strains or their cell walls was also demonstrated here.The recombinant chimeric protein PSPF administered with immunomodulatory probiotic strains or theirbacterial components would be a promising vaccine for immunization of humans against S. pneumoniae,particularly in children.Одной из наиболее актуальных задач медико-биологической науки является создание вакцинных препаратов против патогенных стрептококков – самых распространенных бактериаль-ных возбудителей заболеваний человека, экономический ущерб от которых уступает лишь потерям от гриппозной инфекции. Входными воротами стрептококковой инфекции являются слизистые обо-лочки респираторного и мочеполового тракта. Парентеральный способ введения вакцин не всегда позволяет добиваться одинаково эффектив-ной стимуляции местного иммунитета на слизистых оболочках, а вакцины, вводимые через слизи-стые оболочки, способны эффективно стимулировать иммунную защиту в области введения, а также обеспечить развитие системного иммунного ответа. Введение через слизистые оболочки вакцинных препаратов белковой природы требует исполь-зования специальных эффективных и безопасных адъювантов, поскольку рекомбинантные белки обычно проявляют недостаточную ммуногенность при таком способе введения. В работе в качестве вакцинных адъювантов при мукозальной иммунизации лабораторных животных пневмококковыми химерными рекомбинантными белками PSPF и PSP были апробированы два штамма пробиотиков – Lactobacillus rhamnosus CRL1505 и L32. Рекомбинантные химерные белки PSPF и PSP несут в своей структуре несколько иммуногенных эпитопов PspA, Spr1875, PsaA и предназначены для вакцинации против инфекции Streptococcus pneumoniae. Белки, отличие которых связано с присутствием в струк-туре PSPF участка молекулы флагеллина – FliC, по-разному стимулировали иммунный ответ при совместном введении с двумя штаммами пробиотиков. Установлено, что оба исследованных штам-ма L. rhamnosus были способны оказывать адъювантный эффект при интраназальном введении вак-цинных белков, проявлявшийся в усилении секреторного и гуморального иммунного ответа на со-вместно введенный рекомбинантный химерный белок PSPF. Выраженной стимуляции продукции специфических IgA носовых смывов и IgG сыворотки крови на PSP под влиянием L. rhamnosus L32 не происходило. Адъювантный эффект от вводимых лактобациллярных препаратов существенно сни-жался после температурной инактивации бактерий, однако препарат клеточных стенок L. rhamnosus CRL1505 проявлял выраженную активность. Стимуляция иммунного ответа адъювантами приводила к усилению протективного эффекта вакцины в экспериментах на лабораторных животных, инфици-рованных S. pneumoniae. Установлено, что некоторые штаммы лактобацилл, в частности Lactobacillus rhamnosus CRL1505 и L32, могут быть использованы в качестве адъювантов в составе мукозальных вакцин, однако эта способность зависит от свойств вакцинного препарата и формы введения пробиотиков.Fil: Leontieva, G. F.. Institute of Experimental Medicine; RusiaFil: Kramskaya, T. A.. Institute of Experimental Medicine; RusiaFil: Grabovskaya, K. B.. Institute of Experimental Medicine; Rusia; RusiaFil: Filimonova, V. Yu.. Institute of Experimental Medicine; Rusia; RusiaFil: Laiño, Jonathan Emiliano. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Centro de Referencia para Lactobacilos; ArgentinaFil: Villena, Julio Cesar. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Centro de Referencia para Lactobacilos; ArgentinaFil: Alvarez, Gladis Susana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Centro de Referencia para Lactobacilos; ArgentinaFil: Danilenko, V. N.. Academy of Sciences. Institute of General Genetics. Head, Division of Fundamental Genetic Studies in Biotechnology; RusiaFil: Suvorov, A. N.. St. Peterburg State University; Rusia. Institute of Experimental Medicine. Head, Division of Molecular Microbiology; Rusi

Irrigation and elimination therapy in the treatment of rhinological pathology in children

The article presents a review of materials on the role of nasal cavity irrigation and elimination therapy (IET) in rhinological pathology in children. On the basis of separate clinical studies the clinical experience of using modern ready-made drugs for IET in paediatric practice was studied. The conclusions about the high level of effectiveness and safety of this method of treatment of inflammatory rhinological pathology in children were made

Pyoderma gangrenosum. experience of successful treatment with systemic glucocorticosteroids, azathioprine, antibiotics and phototherapy using the «PhotoDyn-750» device

The article presents the results of a clinical observation of a rare dermatosis, pyoderma gangrenosum, and results of successful complex treatment of the disease with systemic GCS, azathioprine, antibiotics and phototherapy using the «PhotoDyn-750» device

CURRENT ASPECTS OF USE OF NASAL VASOCONSTRICTORS AND ADJUNCTIVE AGENTS IN PEDIATRIC PRACTICE

Nasal forms of vasoconstrictor agents (decongestants) are one of the most frequently prescribed groups of drugs in the therapy of inflammatory diseases of the nasal cavity. The article provides an overview of the mechanisms of action of decongestants, safety and the evidence base for the efficacy of decongestants in various upper respiratory tract diseases. It is concluded that when choosing a nasal agent, the preference should be given to decongestants with a higher level of safety – modern imidazolines (primarily xylometazoline) over the “first generation” decongestants (naphazoline)

RECOMBINANT POLYPEPTIDES BASED ON C5A PEPTIDASE AS POTENTIAL VACCINE COMPONENTS AGAINST GROUP B STREPTOCOCCI

Аbstract. Gene fragments encoding N-terminal and central parts of group B streptococci (GBS) C5a peptidase were cloned in E. coli M15. The appropriate recombinant SCPB1a and SCPB3a polypeptides with molecular masses of, resp., 12.0±0.5 kDa and 11.0±0.5 kDa, were subject to expression and affinity purification. Both polypeptides  induced  specific  antibodies  production  upon  subcutaneous  immunization  of  mice.  A more pronounced immune response was detected with SCPB3a injection. Antimicrobial properties of anti-SCPB1a and anti-SCPB3a antibodies have been investigated in vitro (by opsonophagocytosis test) and in vivo (a model of generalized GBS infection in mice). N-terminal and central segments of C5a peptidase molecule have been shown to contain epitopes inducing humoral immune response with production of class G antibodies that efficiently opsonize GBS, whereas recombinant SCPB1a and SCPB3a polypeptides can be recommended for  future  implications  in  development  of  a  polycomponent  vaccine  against  GBS.  (Med.  Immunol.,  2011, vol. 13, N 1, pp 41-48