Local and systemic oxidative stress in chronic suppurative otitis media

Introduction. One of the antileukotriene drugs for the treatment of bronchial asthma and allergic rhinitis with and without polyposis is montelukast. The presented article presents the  results of  the analysis of  the effectiveness, safety and impact on the quality of life of patients, the use of the singular, in various forms of allergic rhinitis and associated comorbid conditions.Aim of the study. To assess the impact on the quality of life of patients, the effectiveness and safety of the use of montelukast in the complex therapy of patients with allergic rhinitis and comorbid diseases.Materials and methods. A simple, blind, randomized, controlled clinical trial involved 97 patients divided into 4 groups: patients with moderate allergic rhinitis; allergic rhinitis of moderate severity and bronchial asthma; severe allergic rhinitis and bronchial asthma; severe allergic rhinitis, bronchial asthma and polypous rhinosinusitis. In parallel with the comparison of drug tolerability, safety and clinical symptoms (rhinorrhea, nasal congestion, itching, sneezing, bronchopulmonary manifestations), the quality of life was assessed using a special SNOT-22 questionnaire.Results. The use of the antileukotriene drug montelukast in the complex therapy of allergic rhinitis and related comorbid conditions significantly improved the clinical symptoms and quality of life of patients over the entire period of treatment in all groups. There was an increase in the suppression of leukotriene-mediated effects when using montelukast, more in the group of people with allergic rhinitis and bronchial asthma, such as symptoms of the allergic triad, mucus hypersecretion, bronchospasm, eosinophilia, increased vascular permeability, etc.Conclusion. In the treatment of patients with allergic rhinitis and morbid conditions, Singular has demonstrated an inhibitory effect on cysteinyl leukotrienes, high bioavailability, good tolerability and safety.

/pdf/opportunities-for-correction-of-individual-links-of-the-1773mnib.pdf

Opportunities for correction of individual links of the pathogenesis of allergic rhinitis and bronchial asthma with assessment of the quality of life of patients

Introduction. The relevance of the search for effective methods of treatment of various forms of laryngitis is associated with a high frequency of occurrence, which has a certain seasonality. Optimization of treatment tactics is dictated by the variability of etiopathogenetic mechanisms, with a certain similarity of clinical symptoms, and the reactivity of the mucous membrane to inflammation. The methods of treatment described in the literature are diverse and lead to the search for therapeutic adjustments.Objective. To increase the effectiveness of the treatment of various forms of acute laryngitis using the multicomponent drug Homeovox® in complex therapy.Materials and methods. A randomized simple controlled clinical trial involved 132 patients with acute laryngitis of various etiologies. Efficacy in terms of recovery time and safety were evaluated in two parallel groups: group 1, patients with acute laryngitis on the background of acute respiratory viral infection and group 2, patients with acute laryngitis on the background of a new strain “omicron”, COVID-19. In the course of treatment, both groups were divided into 2 subgroups: 1st – patients who received standard conservative therapy and the 2nd – persons who, in addition to complex therapy, received the drug – Homeovox®. Treatment results were assessed using the VAS scale, quality of life was assessed using the SNOT-22 questionnaire, cognitive functions were evaluated using standard psychological tests.Results and discussion. The use of the multicomponent preparation Homeovox®, which has multidirectional mechanisms of action in the complex therapy of patients with various forms of acute laryngitis, improved clinical symptoms, quality of life and recovery time. Good portability, high efficiency and safety were noted.Conclusions. The use of the preparation Homeovox® in the treatment of various forms of acute laryngitis has demonstrated its ability to quickly stop the symptoms of the disease and significantly improve the quality of life of patients.

/pdf/treatment-and-prevention-of-various-forms-of-laryngitis-on-1j9xum9g.pdf

Treatment and prevention of various forms of laryngitis on the background of acute respiratory infections

   The State Report on the state of sanitary and epidemiological well-being of the population in the Russian Federation speaks of the continued growth of respiratory infections, reaching more than 33 million cases and amounting to more than 606 billion rubles of direct economic damage in 2021. Of particular importance is the new coronavirus infection SARS-CoV-2, and manifestations of its various new genovariants, for example, variant B.1.1.529 called omicron, causes various inflammatory nosologies on the part of the mucous membranes of the ENT organs (acute rhinosinusitis, acute tonsillopharyngitis, acute otitis media). The viral agent, damaging the epithelium of the upper respiratory tract, creates favorable conditions for the activation of the microbial flora. Identification of a respiratory agent is most often carried out only in severe cases of the disease, so the basic diagnosis is based on clinical symptoms. The relevance of studying the rational use of antibacterial drugs in the treatment of community-acquired respiratory infections in practical otorhinolaryngology is associated not only with the frequency of occurrence, but with a high risk of complications. As a rule, antibacterial drugs are actively used in the complex therapy of acute bacterial etiology of the upper respiratory tract. Due to the high variability and increasing antibiotic resistance, antimicrobial agents are not always rationally used for outpatients. In this context, as noted in the clinical guidelines, one of the topical issues is the rational dosed use of antibacterial drugs in accordance with the pharmacokinetics, pharmacodynamics and efficacy of prescribing a cephalosporin antibiotic in the form of dispersible tablets in the treatment of patients with acute inflammatory diseases of the upper respiratory tract and ear, as an example, clinical cases.

Effective antibiotic therapy for community-acquired otorhinolaryngological respiratory infection (clinical description)

Possibilities of tropical treatment of bacterial ENT infections

Fragments of bone tissue of the temporal bone, obtained during reconstructive-sanitizing operations in patients with chronic purulent otitis media, were studied by light and electron microscopy. An analysis was made of the degree of structural changes in bone tissue in chronic inflammation at the cellular and tissue levels after a histomorphological study in microwave decalcification. The method of diagnosis reliably allowed to differentiate the diseases characterized by the rarefaction of bone tissue, due to chronic inflammation, and also to determine the processes of transformation of bone tissue. The method of diagnosis reliably allows to differentiate diseases characterized by the rarefaction of bone tissue due to chronic inflammation, as well as to determine the processes of bone tissue transformation, however, the study is time-consuming, long-lasting and expensive.

Evaluation of structural changes of bone in chronic purulent otitis media

TO STUDY The effect of the elemental composition of bone tissue on the destruction of the structures of the temporal bone in chronic suppurative otitis media. PATIENTS AND METHODS The study included 331 patients aged 16-75 years with a verified diagnosis of chronic purulent otitis media, subject to surgical treatment. Depending on the diagnosis and method of surgical treatment, patients are divided into groups: patients with tubotympanic otitis media and epitympanic-antral otitis media after reconstructive sanitation otosurgery in comparison with the control group. The elemental composition of the bone tissue of the cavities of the middle ear obtained intraoperatively was evaluated by x-ray fluorescence spectroscopy. Elements in the bone tissue of the cavities of the middle ear obtained intraoperatively were evaluated by spectrophotometric method. The data are processed by descriptive statistics methods and are presented in the form of a median and a range between quartiles with an estimate of the reliability of the intergroup differences by the Mann-Whitney U-criterion. RESULTS A comparison of the indicators characterizing the elemental composition of the temporal bone tissue in patients with forms of chronic otitis media demonstrates the progression of the severity of pathological bone remodeling according to various options. In the dynamics of observation in patients with morphological signs of purulent destruction of the structures of the temporal bone, not only the most profound imbalance in the levels of calcium and phosphorus was revealed, but also the limitation of the levels of silicon and sulfur in a progressive and recurrent course at different periods of the disease. CONCLUSION X-ray fluorescence spectroscopy allows an elemental chemical analysis of bone remodeling according to the pathological type and reliably differentiate purulent diseases of the temporal bone. The results are promising from the point of view of developing new prognostic approaches in otosurgery in the management of patients with chronic purulent otitis media, involving the combined use of morphological research methods with microelement analysis of the temporal bone bone tissue.

Changes in the elemental composition of the temporal bone in patients with chronic suppurative otitis media

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Evaluation of structural changes of bone in chronic purulent otitis media

Changes in the elemental composition of the temporal bone in patients with chronic suppurative otitis media