Vol 12, No 3 (2015)

Background. The recurrent vulvovaginitis is one of the most common diseases of the female reproductive system. In women the sensitization to various allergens can contribute to recurrences of vulvovaginitis. The purpose of the study was to compare the prevalence rate of hypersensitivity to aero-, food and contact allergens in patients with chronic vulvovaginitis of different origin. Methods. In cross-sectional study 88 patients of reproductive age were divided into the following groups: 52 women with chronic vulvovaginitis [18 patients with recurrent vulvovaginal candidiasis (VVC), 17 patients with bacterial vaginosis (BV), 17 patients with non-specific vaginitis (NSV)] and 36 control patients. Laboratory studies included measurement of vaginal Ph, vaginal eosinophil count by microscopy, and serum IgE level by ELISA. All patients underwent the skin prick tests with aero-, food and fungal allergens, and patch skin tests with contact allergens. Results. The patients with VVC had the highest rate of sensitization to fungal allergens in skin allergy test (p=0,0002). The rate of positive patch-tests result with at least one allergen was higher in this group of patients (66,7%) and in patients with NSV (88,2%) compared to patients with BV (17,6%) and control group (8,3%) of women (p<0,0001). The total IgE level was significantly higher in women with chronic vulvovaginitis 114,5±158,5 IU/mL compared to the control group of women - 48,7±74,8 IU/mL (p=0,0229). Also the patients with chronic vulvovaginitis had the highest levels of antibodies to Aspergillus fumigatus (p=0,0524) and Candida albicans (p=0,2294). Conclusion. Allergic inflammation can play a key role in the recurrence of vulvovaginitis and the resistance to standard therapy in this group of patients.

This paper has summarized some questions of allergic rhinitis and allergic conjunctivitis classification, diagnosis and treatment. The rapid onset of effect, high efficiency and low bioavailability determine the feasibility of local antihistamines to treat AR and AK, especially in case of a local failure.

Materials and methods. This study enrolled 87 patients with AD different manifestations in its acute phase. Most children were with moderate AD. In over 50% of cases we detected the erythemato-squamous form of AD (ES). 9 patients with severe manifestations had a lichenoid form. Skin smears were taken before starting therapy. The identification of staphylococcal types was performed and their antibiotic sensitivity was tested by means of the automated microbiology analyzer «Walka-way 96 plus», Siemens Healthcare Diagnostics, Germany. Results. The study proved that S. aureus and S. epidermidis (SA and SE) were mostly isolated from skin lesion: the coagulazo-negative staphylococci (CNS) included S. haemolyticus, S. warneri, S. hominis, S. saprophyticus and S. sciuri. 12,7% cases showed no bacterial growth. No difference between SA or CNS and the disease severity was recorded. CNS were proved to colonize more frequently the skin of patients with erythemato-squamous AD while SA was a more frequent colonizer in chronic AD with lichenization (р=0,081). All staphylococci were penicillin-resistant. Among CNS, 8 out of31 SE strains, 1 S. haemolyticus and 1 S. sciuri were oxacillin-resistant. Conclusion. Therefore, we can state that alongside with SA colonization and regardless of AD severity CNS skin lesion colonization is detected in patients with AD. Moreover, CNS colonization accompanies acute inflammatory changes and in some cases demonstrates oxacillin-resistance. These findings suggest the need for further research into the role that CNS play in AD progression.

The proportion of patients with controlled asthma has increased over the last 15 years, however, still there is a significant proportion of patients who do not achieve control of the disease, and therefore have a high risk of exacerbations, hospitalizations, and poor quality of life. Patients with severe asthma, for which there were limited additional pharmacotherapy are the major problem. For the first time in recent years in the treatment of asthma a new class of drugs appeared: longacting anticholinergics - tiotropium which had been entered in stepwise therapy of asthma by GINA 2015. The definition of severe asthma, the role of the cholinergic nervous system in bronchial asthma, mechanism of action and clinical efficacy of tiotropium in severe bronchial asthma adults are described in the article.