Vol 10, No 2 (2013)

Allergic rhinitis (AR) is the most common chronic respiratory disorder among adults and children world-wide. Although symptoms of AR are not life threatening, they are nevertheless frequently bothersome and adversely affect work and quality of life. Moreover, AR is often associated with co-morbid conditions such as otitis media and effusion, recurrent and chronic sinusitis, asthma. Mental consequences of AR are associated with sleep, poor school performance, and hyperactivity, which result in increased disturbances with learning, performance, behavior and mood. Epidemiological studies have indicated that the prevalence of allergic disorders including AR have increased progressively over the last three decades and presently affects up to 40% of the population world-wide. The prevalence is wider in the high-income «westernized» societies because of its well documented data, there is comparatively little information for the developing low to middle income countries. The data on the AR prevalence based on the number of visits for medical aid underestimate the real prevalence of the disease. More exact information can be gained from population studies. Numerous epidemiological researches aimed on investigation of the AR prevalence among children and adults showed wide variation of the obtained data. Anyway it allows for suggestion that the prevalence of allergic diseases and AR particularly is higher in the developed high-income countries and in families with better social status.

Background. Seasonal allergic rhinitis (SAR) presents a great problem of public health all over the world, being widespread among allergic diseases. SAR considerably impacts on social and economic aspects of life. The prevalence rate of SAR and it’s etiology need to be studied to develop the preventive measures and qualified medical attendance. There is limited knowledge concerning the prevalence rate of SAR in Russian Federation. This article presents the results of epidemiological study of pollen allergy, including SAR, in Komi Republic (KR) among adolescents and adults. We found out that SAR is the most widespread pollen allergy, and it’s prevalence rate is 12%. The most frequent etiological factors of SAR are tree pollen and cereals, but the polyvalent sensitization to all kinds of pollen is the most prevalent. The results of studying of epidermal and domestic allergens etiology role are also presented. Objective. To evaluate the prevalence rate and main etiological factors of SAR in KR. Methods. The epidemiological study was carried out in KR within the framework of international program GA2LEN. During questioning we included 2002 respondents, 1038 of them with mentioned allergy reactions in questionnaire underwent allergological examination, including skin scratch tests (men 49,3% and women 50,7%; rural dwellers 18,5% and city dwellers 81,5%). Results. Of the 1038 patients surveyed, 253 were diagnosed with SAR, with a total prevalence rate of 12,6%. There was no significant difference in sex between rural and city dwellers. In 50% of cases allergic conjunctivitis accompanies SAR. The most prevalent sensitization was to tree pollen and cereals. In 44% of SAR we estimated polyvalent sensitization to tree pollen, weeds and cereals. About 50% of patients with SAR were also diagnosed with perennial allergic rhinitis and 20% of them had sensitization to epidermal and domestic allergens. Conclusion. We evaluated the prevalence rate of SAR in KR, that is considerably higher than official data. The most prevalent etiological factors of SAR were also revealed.

Background. To estimate interrelation of clinical and functional parameters and vessel tome regulating function of endothelium in patients with bronchial asthma. Methods. 126 patients with bronchial asthma have been examined, including 29 patients with mild bronchial asthma (the first group), 32 persons with moderate bronchial asthma (the second group), 40 respondents with severe asthma (the third group) and 25 patients with steroiddependent asthma (fourth group). The control group included 27 healthy volunteers. We have assessed the parameters of external respiration, vasodilatation function, and the levels of TNFa, IL4, sCD31 in the plasma. Results. The results of the research of vessel tome regulating function in patients with bronchial asthma are presented. The existence of endothelial function of an endothelium are characterized by disturbance of vasomotor activity of endothelium, rising of sCD31 and levels of cytokines (Il-4, TNFa) in plasma was revealed. These changes deteriorate within the ages and the course of bronchial asthma. Conclusion. We have demonstrated that endothelial dysfunction is developed even at the early stages of bronchial asthma.

The article considers I and II generation of antihistamines (AGs), which are used today in medical practice. The advantages of nonsedative II generation of AGs, especially socalled active metabolites (fexofenadine, cetirizine, levocetirizine, desloratadine) are emphasized. Currently, AGs, such as fexofenadine is deservedly regarded. This is one of the most effective H1AG for therapeutic practice that combines high efficacy and safety. This is the first choice treatment for allergic rhinitis patients.

Justification of H 1-antihistamines for the treatment of itching dermatoses mentioned in the article. Positive and negative characteristics of H 1-firstgeneration drugs and general characteristic of sequifenadine are shown in the article. Major clinical studies on the safety and efficacy in patients with allergodermatoses treated with sequifenadine are described.

The role of Malassezia and Candida infection in pathogenesis of atopic dermatitis, as well as the results of Sertaconazole cream efficiency in atopic dermatitis are given in the article.