Vol 6, No 4 (2009)

This publication is devoted to review of safety and efficacy of mometasone furoate for treatment of nasal polyposis. Authors present the results of last researches of this topic with high level of evidence. In the article authors review the following questions: system biovialability, using mometasone furoate as monotherapy and after surgery for treating nasal polyposis. Adverse events, safety and the reasons of unsuccessful treating were resumed.

Background. Sensitization to mould reaches 64% in frequency in some regions of the Earth. Data on indoor mycobiota influence on sensitization of patients with genetic predisposition to atopy are fragmentary and conflicting. The aim of this work is to establish a relationship between patient indoor exposure to mould and sensitization to mould allergens in Irkutsk. Methods. A total of 63 patients with persistent allergic rhinitis (AR), were examined in Irkutsk during 2006-2007. 43 patients had AR and atopic bronchial asthma (BA). Allergological examination included skin pricktests with standard allergen panel and nasal provocation tests. 69 Irkutsk" dwellings of allergic patients sensitive to moulds and non-allergic people were examined. House dust from these 69 dwellings were analyzed for fungi. Results. 76 fungal species from 20 genera were isolated from house dust of Irkutsk. Micromycetes concentration varied from 103 to l06 GFU/g of dust. The most frequent genera were Venicillium (92,8%), Aspergillus (85,5%), Cladosporium (40,6%) and Alternaria (40,6%). Prevalence of positive skin prick-tests and nasal provocation tests was as follows: Cladosporium - 65 and 60%, Venicillium - 60 and 58%, Aspergillus - 39% and 32%, Alternaria - 21 and 9% respectively. Principal-factor analysis revealed a relation between fungal concentration in patients' indoor environment and their sensitization to mould allergens. However a correlation between micromycetes concentration and sensitization to mould is expressed to a variable extent in every particular case. Conclusion. Cladosporium and Venicillium are the most common mould allergens for patients with BA and/or AR in Irkutsk. There is a relation between fungal concentration and sensitization of patients to mould allergens.

The article is devoted to natural history and problems of prediction of food allergy. In article the data about significant criterion of prediction of history food allergy are cited.

Background. The influence of HAART on the clinical manifestations of atopic dermatitis in HIV-infected children in parallel with the assessment of its effectiveness in relation to the dynamics of diagnostically important indicator of immune status and viral load. Methods. During the period from 1998 to 2008 among children in the check-up at the Moscow Regional Center of AIDS with a confirmed diagnosis of HIV infection in the formation of a group of 26 children, who retrospectively analyzed the clinical and immunological characteristics. To study the dynamics of changes in clinical manifestations of atopic dermatitis on the background of HAART, analyzed the quantitative indicators of CD4 + T-lymphocytes and assessed the changes in viral load. Results. As of 01.01.2009 years in the Moscow region reported 224 children with HIV infection, of whom 111 are under HAART children. Of the children in the HAART, 26 children (29%) to destination therapy have pronounced symptoms of atopic dermatitis (AD). All children of the group was appointed by HAART in accordance with accepted standards. Laboratory indices and clinical manifestations of AD were recorded before HAART and after 9 months after initiation of therapy. According to the results of clinical observations in the survey group of patients in 20 children (77%) 9 months after the appointment of HAART AD symptoms disappeared completely, while 5 children (19%) noted a clear improvement. Only one HIV-infected child (4%) AD was recurrent in nature. Analysis of laboratory data showed that prior to the start of HAART, quantitative indicators of CD4 + T-lymphocytes in children from this group (n = 26) was 23,69 ±4,24 per cent of the total number of lymphocytes. As a result of HAART, the proportion of CD4 + T lymphocytes increased to 29,35±2,61%. When comparing the results of the quantification of HIV RNA in plasma observed decrease in the value decimal logarithm of viral load from 5,22 ±0,21 to 1,54 ±0,71. Conclusions. Highly active antiretroviral therapy of HIV-infected children leads to a cessation of manifestation of AD not giving in to conventional therapy. This effect is realized against the background of the normalization of the indicators of CD4 + T-lymphocytes and reduction in viral load to not defined level.

Цель исследования. Оценить эффективность монотерапии препаратом Локоид® (гидрокортизона 17-бутират 0,1%) в сравнении с комбинированной терапией - Локоид® + Локобейз® Рипеа у больных с атопическим дерматитом (АтД). Материалы, и методы. В исследование было включено 40 пациентов с АтД средней степени тяжести. Пациенты были разделены на 2 группы по 20 человек методом случайной выборки. Пациенты группы 1 (п=20) наносили на пораженные участки колеи тонким слоем мазь Локоид® 0,1% 2 раза в день, пациенты группы 2 (п=20) - мазь Локоид® 0,1% 2 раза в день и увлажняющее средство Локобейз® Рипеа 1 раз в день. Длительность курса лечения - до 28 дней. Результаты. На фоне проводимой терапии на 7-й день лечения отмечено достоверное уменьшение средних значений исследовательской глобальной оценки (IGA) и индекса SCORAD в обеих группах. К 28-му дню лечения в группе 2 отмечено дальнейшее значительное уменьшение средних значений IGA и SCORAD, которое было достоверно больше, чем в группе 1. При оценке индекса сухости колеи до начала лечения среднее значение данного показателя составляло 2,8±1,5 и 2,7±1,5 в группах 1 и 2 соответственно. В ходе лечения отмечено достоверное уменьшение среднего значения данного индекса в обеих группах, однако в группе 1 среднее значение индекса сухости достоверно уменьшилось лишь на 28-й день лечения, и было достоверно выше, чем у пациентов группы 2. Средняя длительность использования препарата Локоид® (гидрокортизона 17-бутират 0,1%) в группе 1 составила 16 дней, а в группе 2 - 9 дней. Заключение. Использование Локобейз® Рипеа в комбинированной терапии с ТГКС (Локоид®) приводит к более быстрому и длительному уменьшению основных клинических проявлений АтД, в том числе сухости колеи, у большинства больных по сравнению с монотерапией ТГКС. Применение Локобейз® Рипеа в комбинированной терапии с ТГКС приводит к уменьшению длительности использования ТГКС.