Vol 16, No 11 (2014)

The main reason for the treatment of COPD patients for medical care is the development of exacerbations requiring not only the appointment of additional therapy, but hospitalization as well. Bacterial infection is the main cause of COPD exacerbations. Timely and appropriate antimicrobial therapy can significantly improve the patients prognosis. In situations with a high risk of antibiotic resistance it is preferable to secure the use of penicillins or respiratory fluoroquinolones. Among today's promising drugs for the treatment of patients with acute exacerbation of COPD is levofloxacin. High clinical and microbiological efficacy of this drug during exacerbation of COPD was demonstrated in large randomized controlled trials.

The article discusses the prevalence, pathophysiology, classification, phenotypes and approaches to therapy of bronchial asthma (BA). The role of leukotrienes in the processes of inflammation and remodeling. Particular attention is given to clinical guidelines on the use of leukotriene inhibitors in the treatment of asthma. The problem of adherence to the prescribed treatment of patients, as well as the importance of reducing the cost of treatment through the use of bioequivalent generic drugs of montelukast (Singlon).

Objective. To analyze the influence of respiratory function disorders feaatures in patients with chronic obstructive pulmonary disease (COPD) against the coronary heart disease background (CHD); to assess the effectiveness of vaccination (Prevnar-13) in patients with concomitant diseases of the respiratory passage and cardiovascular systems. Material and methods. The study included 153 male patients with COPD and coronary heart disease, stable angina pectoris I-III functional class, and 66 patients without COPD with coronary artery disease, stable angina pectoris I-III functional class is being treated at RCH №4 in Chelyabinsk 2012-2013 years. All patients underwent a comprehensive clinical examination that included a clinical assessment of the complaint and clinical history, physical, laboratory and instrumental investigations. The impact of correlations combined COPD and coronary heart disease in the main indicators of respiratory lung function and myocardial contractility. Results and Conclusions. In patients with both COPD and coronary heart disease more severe violations of respiratory function are observed, compared with patients with isolated forms. Changes in lung function occur unidirectional and parallel with changes in systolic function of the heart. There is a direct correlation between the severity of COPD and the functional class of angina. Patients with COPD and CHD prevention of pneumococcal vaccine are recommended to reduce the frequency of exacerbations and hospitalizations.

The publication is devoted to the analysis of diagnostic and prognostic capabilities of biological markers of inflammatory response as C-reactive protein and procalcitonin in community-acquired pneumonia (CAP). The author gives a detailed overview of the foreign and domestic research on the role of biomarkers in the management of patients with CAP. The results of our own clinical studies, the aim of which was to study the feasibility of the use of biomarkers (CRP, PCT) in the treatment of hospitalized patients with CAP. The study included 240 patients. It is shown that the use of «biomarker-oriented» treatment for CAP is characterized by a decrease in the duration of antibiotic use and accompanied by the better tolerated treatment.

Inflammations of the pharynx are among the most frequent causes of patients complaints to doctors of different specialties. Clinical efficacy of treatment of nonspecific infectious and inflammatory diseases of the pharynx is largely determined by individual approach to therapy and differentiated selection of the medication. Among the drugs currently used to treat diseases of the throat, a prominent role belongs to herbal medicines (eg, drug Tonsilgon N). The inclusion of the drug in the complex therapy is appropriate and enhances its efficiency, reducing the period of disease.

Recurrent respiratory papillomatosis is a disease induced by human papillomavirus of types 6 and 11. However, in the presence of a specific virus laryngeal papillomatosis is not enough for the development of the disease, it is necessary mechanisms "activation". The article analyzed the association of HLA alleles DQB1 0301 with laryngeal papillomatosis. In patients with laryngeal papillomatosis is often met allele DQB1 0301, which was observed in 77.8% of patients. In the comparison group, this allele was determined only in 11.1% of patients. The resulting pattern does not rule out an association with laryngeal papillomatosis allele DQB1 0301 major histocompatibility complex.

The article presents the concept of the achievement of anesthesiological safety during endoscopic operations on the larynx. The base of concept is the goal-directed selection of jet ventilation technique and the insertion of insufflation catheter as consistent with the nature of pathological object, its localization, extension and kind of endolaryngeal operation. Safety of the fulfillment of endoscopic laryngeal operations is ensured by the effective cooperation of otorhinolaryngologist and anesthesiologist at all stages of the diagnostic and surgical treating process, which includes the preoperative patient examination and coordination of actions during the perioperative period. The practical realization of concept made it possible to reduce sharply the quantity of complications with the use of jet ventilation methods.

Polypoid rhinosinusitis (PRS) is a chronic inflammatory disease of the mucous membrane of the nasal cavity and paranasal sinuses, and it is often a manifestation of systemic disease of the respiratory tract. This article discusses the etiology, pathogenesis, classification of the disease, and the advanced options of treatment and recommendations from the perspective of the European rhinologic society.

One of the most common causes of hearing loss is adhesive otitis media. In modern ENT practice there is a large variety of treatments for this disease. Along with conservative methods used by a variety of surgical procedures, the possibility of using the proteolytic enzymes and, in particular, Longidaza not only suppresses hyperplasia of the connective tissue, and inhibits the inflammation which is a frequent cause of hyperplasia.