Vol 8, No 2 (2011)

The article presents information about the microbiology, epidemiology, clinical appearance and specific prevention of pneumococcal infections. Modern data on the pathogenesis and risk factors and comparative characteristics of polysaccharide and conjugate pneumococcal vaccines are discussed.

Background. To study informativeness, clinical significance and relationship between objective and subjective methods of assessing asthma control and creation an optimal algorithm. Methods. The study involved 40 patients of both sex, aged from 18 to 75 years old suffering from persistent, moderate and severe asthma , having no control. Results. All patients were assessed asthma control using methods based on subjective data (medical history, filling the questionnaires: the ACT and AQLQ; survey on the presence of comorbidity) and objective methods of examination (auscultation, PEV, spirometry, ECP in blood, content of eosinophils in induced sputum and peripheral blood). All patients were assigned to anti-asthma therapy combination therapy (ICS+LABA). The main reasons for lack of asthma control is the inadequacy of basic therapy and concomitant diseases. Symptoms and normalization of ERF occur much earlier (on day 30 of therapy) than the relief of bronchial inflammation. Adequate methods to assess asthma control are objective methods, subjective can only be used as an extra. Conclusion. The analysis of the causes of asthma control in each individual case, increased medical supervision over appointments and continuous monitoring by means of subjective and objective ways of assessing control, avoid excessive use of pharmaceutical loads, to minimize the side effects of treatment, faster to achieve better results by optimizing costs treatment.

Background. The work is devoted to the studying of the correspondence between the symptoms dynamics and the concentrations of the nitrogen oxide (NO) methabolites in the exhaled breath air condensate in patients with bronchial asthma (BA) during allergenospecific immunotherapy (ASIT) and accompanying treatment. Methods. The symptoms of BA were estimated using the Asthma Control Questionaire (ACQ). The inflammation biomarkers level (NO methabolites in the exhaled air condensate) was measured by the spectrofluorometric method of Griess. Results. During ASIT and accompanying treatment (cetirizine or levocetirizine with basis BA therapy corresponding to the observed BA severity with allergens eliminated), the symptoms reduction (decrease in the total ACQ scores) was observed along with decrease of the total concentration of NO metabolites in blood. This was observed both for the steroid- naive patients and for the patients taking the inhaled corticosteroids (IC) treatment. Conclusion: In patients with mild BA, combination of ASIT and non-steroid accompanying therapy on the basis of cetirizine or levocetirizine results in the improvement of the BA control and reduction of the allergic inflammation in airways comaparable to the analogous processes in patients with moderate BA taking the analogous therapy but with IC included.

The mechanism of action and efficiency of Nazaval representing a powder of natural cellulose, new to the Russian pharmaceutical market, creating barrier on a way of contact of allergen with a nose mucous membrane is considered. Clinical efficiency of a preparation at adults and children with a seasonal and perennial rhinitis is shown. Preventive action of Nasaval was developed in provocation tests with allergen.

The problems of clinical efficiency and safety of application of tacrolimus (Protopik) at various skin diseases are discussed in this review. High efficiency of this drug, allows to use it in treatment of different dermatosis. The clinical effect is comparable with topical corticosteroids, and the rate of adverse effects is lower. It is possible to use long applications of calcineurin inhibitors in patients with resistant forms of atopic dermatitis. Positive effects of application of tacrolimus in vitiligo, balanitis, alopecia areata etc. are described.