Vol 19, No 3 (2017)

Interstitial lung lesions attract the attention of the physicians and radiation physicians around the world similarity of clinical symptoms and radiological manifestations, along with a variety of pathological variants of the disease. This explains the difficulties of clinical and radiological diagnosis and differentiation of this group of lung diseases. This article focuses on the idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is the most common disease from the group interstitial lung disease and occurs predominantly in persons of middle and old age. Over the past decade there have been significant changes in approaches to diagnosis and treatment of IPF. This article contains modern data on the epidemiology of IPF, the results of new research on the pathogenesis, basic approaches to the diagnosis of the disease. In addition, presented new data on the therapy of IPF.

The variety of cavitary and destructive processes in the lungs is determined by a variety of etiological and pathogenetic factors causing these conditions. A number of states are the result of exposure to a pathological agent, and the other part of cavitary processes in the lungs caused by a complex genetic mechanism. Of special interest are destructive processes in the lungs caused by rare pathogenic agents against the backdrop of severe diseases.

The paper discusses major clinical signs, and treatment approaches allergic rhinitis (AR). The importance of intranasal steroids as basic medications. Mometasone furoate is superior to other topical steroids since it is characterized by the broadest spectrum of approved indications for use, high efficacy, very low bioavailability, and long-term experience of clinical use. A novel combination of mometasone furoate, intranasal steroid, and azelastine, topical antihistamine, for mild and moderate intermittent AR is presented. This nasal spray is the first and the only medication in Russia which combines the most effective members of their classes with different mechanism of action.

Pulmonary vasculitis is a relatively rare disease and is often a source of diagnostic errors. Pulmonary involvement, associated with the systemic vasculitis, can be the primary or even only one manifestation of systemic diseases, and phthisiologists and pulmonologists first face with pulmonary vasculitis in medical practice. The article deals with the clinical manifestations of most often disorder such as ANCA-associated necrotizing vasculitis which is also called granulomatosis with polyangiitis. This article presents, in the form of a clinical illustration, the difficulties of this disease diagnosis.

Dysfunction of skeletal and respiratory muscles is one of the most common systemic effects in patients with chronic obstructive pulmonary disease (COPD). Currently, only the methods of pulmonary reabilitation, such as physical exercise, can change the functional status of patients, to improve physical activity through the improvement of skeletal and respiratory muscles. The use of neuromuscular electrical stimulation is an important rehabilitation program in COPD patients with severe physical limitations. This is confirmed by the results of studies and clinical examples.

Ventilator-associated pneumonia (VAP), is the most common infection in critically ill patients, significantly increases the risk of death, often caused by resistant flora (Pseudomonas aeruginosa, Acinetobacter baummannii) and requires significant material costs associated with the use of antibiotics. Published guidelines that define the basic issues related to diagnosis, treatment and prevention VAP. Widely discussed various aspects of antibacterial therapy VAP that is associated with the emergence of new antimicrobial agents, complexity, urgency of the problem at the interface of fundamental and applied science, ethical, humanitarian, and clinical interests.

Allergic rhinitisis one of the most common human diseases associated with severe restrictions on physical, psychological and social aspects of life and is the cause of the reduction in quality of life.The drug of first choice in patients with symptoms of seasonal and year-roundallergic rhinitis, associated as well with intermittent and persistent currents is the second-generation antihistamines having a higher affinity for H1-receptors. The article deals with the overview of new drug among the second-generation antihistamines - bilastine (Nixar®).

Fenspiride is a non-steroidal antiinflammatory agent which has a variety of actions. The review shows the properties of the fenspiride, results of clinical trials and the recommendation of the treatment of patients with acute respiratory diseases. Anti-inflammatory therapy with fenspiride and addition to another drugs significantly improved clinical signs and symptoms to patients with acute respiratory diseases.

The goal of asthma treatment is to achieve good control of symptoms and maintain normal activity level of the patient, minimizing the risk of future exacerbations and side effects of treatment. In accordance with modern guidelines, starting with stage 3 (moderate bronchial asthma patients) is the preferred therapy combination drugs with a combination of low-dose inhaled corticosteroids and long-acting b2-agonists.A meta-analysis of several studies demonstrated that the use of free combination of budesonide and formoterol significantly: improve lung function; reduce the need for short-acting b2-agonists; to improve the quality of life; reduce the number of exacerbations requiring hospitalization, call the ambulance, or the use of systemic corticosteroids. The use of free combination of budesonide and formoterol was accompanied by a high level of compliance. The article describes the clinical cases of the use of free combination of budesonide and formoterol in patients with asthma.