Vol 9, No 4 (2012)

Rupatadine is a new agent for the management of diseases with allergic inflammatory conditions. Rupatadine is a dual inhibitor of H 1- and platelet-activating factor (PAF)-receptors and possesses a broader profile of antiallergic properties inhibiting allergy target cells and secretion of different mediators involved in the early- and late-phase of allergic response. Rupatadine is a real example of poly-functional anti-allergic remedy.

Background. The purpose of this study was to investigate the prevalence and incidence of allergic rhinitis (AR) and bronchial asthma (BA) among different groups of population of Samara region during 2001—2010. Methods. Material for analysis was taken from the statistic forms of municipality hospitals of Samara and the Samara region (form No. 12) during 2001—2010 in comparison with the corresponding indicators of Volga federal region (PFO) and the Russian Federation. Results. Prevalence of BAin all groups of patients in the Samara region in 2009 was revealed. These indicators were more than such indicators in Russian Federation — among children on 25%, in teenagers on 38%, in adult on 50%. Prevalence of AR among children and teenagers exceeded indicators in Russian Federation — among children on 44%, teenagers — on 68%. The incidence of asthma in adults is 2,5 times higher than the incidence of AR (95,8—30,5 per 100 thousand). Conclusion. High prevalence of AR and asthma in the Samara region with a tendency to increase, the discrepancy indices studied data from epidemiological studies that require further implementation of international recommendations for diagnosis, treatment and prevention of AR among general practitioners.

In this article problems in care of severe atopic dermatitis (AD) are considered. The main medications for AD treatment are topical corticosteroids, topical calcineurin inhibitors and emollients. In spite of adequate topical therapy the disease often gets a severe recurrent course with frequent exacerbations. In such cases treatment is considered to be a difficult problem and quite often it is necessary to use systemic preparations: corticosteroids, immunosupressors, cytostatics. They are able to reduce and control exacerbations fast and effectively, but because of side effects these preparations shouldn’t be applied for a long time. Considering increase of severe AD cases, now great attention is given to immunotherapy. In the article the retrospective analysis of data about 56 severe AD patients who underwent a course of complex treatment including plasmapheresis and intravenous immunoglobulins is presented.

В обзорной статье представлена информация для практических врачей о дифференциальной диагностике «хронического насморка», классификации ринитов и современных рекомендациях ARIA по диагностике и лечению аллергического ринита. Особое внимание уделено необходимости назначения интраназальных глюкокортикостероидов (ИНГКС), приведены сравнительные сведения об их эффективности и безопасности. Описаны свойства ряда препаратов, доступных для применения российскими врачами, в том числе мометазона фуроата — препарата, давно известного в России и имеющего серьезную доказательную базу.

The article presents allergic conjunctivitis as an allergic disease affecting the occular surface and it’s modern treatment.

Background. Clinical and immunological estimation of efficiency of different special formulas in children with atopic dermatitis due to food allergy. Methods. Fifty four children with atopic dermatitis aged 0,5—3 years old were examined. Children were divided into three groups on the base of their diet therapy. The 1 st group included 15 patients on the hypoallergenic milk-free diet, the 2 nd group (18 patients) was fed by goat milk formula, and the 3 rd group (21 children) was fed by special formula with high hydrolyzed protein. The dynamics of serum levels of IgE and IgG antibodies to cow milk protein and its fractions, and dynamics of cytokine levels (IL-4, IL-5, and IL-10) were measured during different types of diet therapy. Results. The positive skin changes during diet therapy included decrease of erythema, exudation and itching, gradual regression of rash. In 3 months of therapy complete clinical remission was achieved in 10 (66,7%) children in the 1 st group, in 14 (77,8%) children in the 2 nd group and in 15 (71,7%) children in the 3 rd group. The significant decrease of levels of IgG antibodies levels to cow milk protein and its fractions in children during different elimination diets was determined. The significant decrease of levels of specific IgE antibodies to cow milk protein (p<0,05) was registered only in children who were fed with goat milk formula; in children of other groups significant changes of this marker were not revealed. The significant decrease of IL-4 serum level was found in children of 2 nd group. Conclusion. The efficiency of diet therapy in children with atopic dermatitis depends on the correct choice of special food based on results of allergological examination.