Vol 16, No 11 (2014)


Antibiotic therapy of infectious exacerbations of COPD: a place of levofloxacin

Dvoretsky L.I.


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.
Consilium Medicum. 2014;16(11):5-12
pages 5-12 views

COPD therapy: indacaterol possibilities

Knyazheskaya N.P.


The number of patients suffering from COPD is much higher than reported in hospitals. Late diagnosis of COPD is one of their current problems, as in the early stages of the disease for a long time, patients consider themselves healthy, and the symptoms (such as cough, sputum production and the emergence of dyspnea on exertion) are often attributed to other causes. It should be emphasized that COPD is not only a great health problem but also an extremely complex social problem as the high degree of social exclusion of patients is present, mostly in elderly people. A central place in the pharmacotherapy of COPD is taken by bronchodilators, the use of which reduces the severity of dyspnea and increased exercise tolerance. Currently in clinical practice a class of b2 - agonists with fast and ultra-long (24-hour) action such indacaterol (Onbrez® Breezhaler®) has gained a wider use. An important feature of the drug is its high level of cardiac safety. Use of Onbrez® Breezhaler® will reduce the number of exacerbations, as well as increase exercise tolerance and improve the quality of life of patients with COPD.
Consilium Medicum. 2014;16(11):13-17
pages 13-17 views

Antileukotriene drugs in the treatment of bronchial asthma

Baranova I.A.


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).
Consilium Medicum. 2014;16(11):18-22
pages 18-22 views

The clinical significance of brain natriuretic peptide in patients with chronic obstructive pulmonary disease

Karoli N.A., Borodkin A.V., Kurnosova M.A., Rebrov A.P.


The main causes of dyspnea in patients of the older age group are chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). These diseases share common risk factors, similarities and common clinical pathogenesis. In recent years, important principles of diagnosis of CHF consist of using a tool and laboratory (BNP and NT-proBNP) markers. Currently, it is securely and strictly evidence-based, that the detection of elevated concentrations of BNP and NT-proBNP indicates the presence of the patient's myocardial dysfunction and heart failure. The article presents data on the role and significance of natriuretic peptides in the diagnosis of the presence and severity of heart failure in patients with COPD.
Consilium Medicum. 2014;16(11):23-27
pages 23-27 views

Violations of respiratory function in the combined chronic obstructive pulmonary disease and coronary heart disease

Ignatova G.L., Antonov V.N., Rodionova O.V.


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.
Consilium Medicum. 2014;16(11):28-32
pages 28-32 views

Rezolyutsiya Sammita spetsialistov‌ po antimikrobnoy terapii

Kozlov R.S., Zavalko T.A., Kulagina V.V., Kupaev V.I., Lyamin A.V., Miroshnichenko A.P., Mishchenko O.V., Sedykh M.I., Solov'eva I.L., Stadler V.V., Tanaeva N.I., Fishchenko S.F.
Consilium Medicum. 2014;16(11):33-36
pages 33-36 views

Biological markers of inflammation in community-acquired pneumonia

Zaytsev A.A., Ovchinnikov Y.V., Kondrateva T.V.


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.
Consilium Medicum. 2014;16(11):36-41
pages 36-41 views

Anti-inflammatory effect of fenspiridum

Bezlepko A.V., Bezlepko E.A.


Analysis of data from clinical studies on the effectiveness and safety of the drug with anti-inflammatory effect fenspiridum in treatment of infections of the lower and upper respiratory tract in children and adults, provides the basis for a wide application in the treatment of SARS, acute diseases of the upper respiratory tract (tracheitis, bronchitis) ENT disease, chronic obstructive pulmonary disease (COPD). In the open comparative study of seven years in parallel groups the efficacy and safety of fenspiridum in patients with mild and moderate COPD was researched.When comparing the results of the study the benefits of combination therapy with bronchodilators fenspiridum and in patients with mild to moderate (forced expiratory volume in 1 second over 60%) degrees of severity, in comparison to conventional therapy were revealed.
Consilium Medicum. 2014;16(11):42-47
pages 42-47 views

Modern approaches to the treatment and prevention of inflammatory diseases of the upper respiratory tract

Svistushkin V.M., Mustafayev D.M.


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.
Consilium Medicum. 2014;16(11):48-51
pages 48-51 views

Antibacterial therapy and prevention of exacerbations of chronic obstructive pulmonary disease

Zaytsev A.A., Sinopalnikov A.I.


The article reviews current approaches to antibiotic therapy and prevention of exacerbations of chronic obstructive pulmonary disease (COPD) and presents the epidemiology of the disease, the etiology of exacerbations, indications for antibiotic therapy and tactics antibiotics with current clinical guidelines. Particular attention is paid to the prevention of infectious exacerbations of COPD, including the presented research on the analysis of the prophylactic efficacy of bacterial lysates in patients with COPD.
Consilium Medicum. 2014;16(11):51-54
pages 51-54 views

The genetic association of HLA alleles DQB1 0301 with laryngeal papillomatosis

Kolesnikova O.M.


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.
Consilium Medicum. 2014;16(11):55-57
pages 55-57 views

Current trends in the treatment of acute sensorineural deafness

Atanesian A.G.


The paper presents an overview of current information on the treatment of acute sensorineural hearing loss. It is noted that at the present time among all treatments the most effective method is steroid therapy. Presented and analyzed are the results of current research on the effectiveness of different methods of treatment of acute sensorineural hearing loss; algorithm for the treatment of acute sensorineural hearing loss.
Consilium Medicum. 2014;16(11):57-63
pages 57-63 views

Anesthesiological support safety of microsurgical operations in the larynx

Kolotilov L.V., Karpischenko S.A., Pavlov V.E.


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.
Consilium Medicum. 2014;16(11):64-67
pages 64-67 views

The role of cone beam computed tomography in the diagnosis of nasal valve dysfunction

Aleksandrov A.N., Shahnazarov A.E., Pinezhskaya A.Y.


Nasal valve region plays a key role in the formation of an adequate intranasal aerodynamics, regulating the air flow and nasal resistance. The research of the anatomy in patients before any surgical intervention aimed at alleviating nasal obstruction is mandatory. Cone-beam computed tomography is one of the leading methods in the study of the nasal valve dysfunction. This technique allows you to get high-quality image with minimal exposure to the patient, to choose the optimal surgical approach, to determine the sequence of steps in the process of operation.
Consilium Medicum. 2014;16(11):68-69
pages 68-69 views

Polypoid rhinosinusitis: a modern approach to treatment

Yalymova D.L., Vishnyakov V.V., Sosnovskaya I.V.


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.
Consilium Medicum. 2014;16(11):69-72
pages 69-72 views

Laser surgery in otolaryngology at the present stage

Karpishchenko S.A., Ryabova M.A., Ulupov M.Y.


Near-infrared lasers (diode lasers with a wavelength of 810-980 nm, laser NIAG - 1060 nm) are an extremely convenient surgical instrument. Radiation with a wavelength of 810-1060 nm is preferentially absorbed by hemoglobin, so excellent hemostatic properties are a typical characteristic of these lasers. This radiation can be effectively transmitted over a thin silica fibers and delivered in the most remote areas of the body. These features are particularly in demand in surgery of richly perfused and inaccessible for direct inspection of upper respiratory tract areas. The article provides an overview of applications of surgical lasers in the near infrared range of otorhinolaryngology, describing modes and methods of laser action in various diseases.
Consilium Medicum. 2014;16(11):73-76
pages 73-76 views

Adhesive otitis as a consequence of inflammatory diseases of the nasopharynx and the middle ear

Levina E.A.


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.
Consilium Medicum. 2014;16(11):77-80
pages 77-80 views

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