[About new possibilities for optimizing the postoperative period in tonsillectomy]. / O novykh vozmozhnostyakh optimizatsii postoperatsionnogo perioda pri tonzillektomii.

Tonsillectomy is one of the most frequent surgical interventions in otorhinolaryngology. This surgical is always accompanied by the development of reactive inflammatory phenomena and pain syndrome. The effectiveness and safety of tonsillectomy can be improved through the use of topical treatment in the postoperative period, including antiseptics in the form of a spray. An observational study was conducted at the Department of Otorhinolaryngology of the Russian University of Medicine of the Ministry of Health of the Russian Federation, the purpose of which was to evaluate the clinical efficacy, tolerability and safety of Viroxynol for oral and throat mucosa in patients after tonsillectomy. As a result of the analysis of the data obtained, it was found that the use of Viroxynol for the mucous membrane of the oral cavity and throat in the treatment of patients in the early postoperative period causes a pronounced clinical effect, reduces the need for additional medications, allows faster reduction of pain syndrome against the background of relief of reactive inflammatory phenomena, improves the quality of life of patients, accelerates the healing process, reduces the risk of bacterial inflammation. The drug may be recommended for use in patients after tonsillectomy.

[FGF23 tumor induced osteomalacia with localization of neoplasm in the tympanic cavity]. / FRF23-indutsirovannaya osteomalyatsiya opukholevogo geneza s lokalizatsiei novoobrazovaniya v barabannoi polosti.

Tumor induced osteomalacia is a rare paraneoplastic syndrome caused by mesenchymal tumors that secrete fibroblast growth factor 23 (FGF23). Patients complain of progressive bone pain, muscle weakness and brittle fractures. Delayed diagnosis of osteomalacia caused by a tumor is often found in clinical practice. When verifying the exact localization of the neoplasm, radical removal within healthy tissues is recommended. The article considers a clinical example of FGF23 tumor induced osteomalacia with localization of neoplasm in the tympanic cavity.

[New effects of a topical antimicrobial (agent) in the treatment of acute tonsillopharyngitis]. / Novye effekty topicheskogo antimikrobnogo preparata v lechenii ostrogo tonzillofaringita.

Sore throat is the leading symptom of acute tonsillopharyngitis associated with previous acute respiratory viral infections, including COVID-19. The pathogenesis of these nosologies is based on the cumulative result of the primary direct damaging effect of viruses and secondary alternative inflammatory changes in the mucosal epithelium in the focus of infection, which, against the background of changes in the functions of the regional microbiota, leads to the development of viral-bacterial inflammation that goes beyond the protective-reparative level. In the treatment of acute tonsillopharyngitis after exclusion of GABHS etiology, topical etiotropic drugs are often used. It is desirable to achieve a uniform distribution of active ingredients, and to maximize the use of additional pharmacological capabilities (irrigation-eliminative action, reparative effect). To build up the evidence base for the effectiveness of just such medicines on the basis of the Department of Otorhinolaryngology of the Moscow State Medical University named after. A.I. Evdokimov, an observational prospective comparative study was conducted, using, in addition to the clinical assessment method, cytomorphological approaches (cytomorphometry). The results of the study demonstrated that gargling with a solution of hydroxymethylquinoxylindioxide (Dioxydin 0.25 mg/ml solution for topical application) in adult patients with acute tonsillopharyngitis provides rapid relief of pain, a decrease in the severity of inflammation symptoms, and also makes it possible to achieve limitation of the degree of destruction of the epithelium in the height of inflammation and a more complete and rapid recovery of the damaged mucous membrane by the time of recovery.

[Modern H1 antihistamines in the treatment of patients with allergic rhinitis and comorbid acute respiratory infections]. / Sovremennye H1-antigistaminnye sredstva v terapii patsientov s allergicheskim rinitom i komorbidnymi ostrymi respiratornymi infektsiyami.

Patients with allergic rhinitis (AR) have a predisposition to frequent acute respiratory viral infections (ARVI). Inflammation of the mucous membrane of the nasal cavity and paranasal sinuses in such patients is more pronounced against the background of a combination of allergic and infectious inflammation. OBJECTIVE: To evaluate the effect of therapy using modern antihistamines on the condition and severity of symptoms in adult patients with exacerbation of AR caused by plant pollen (seasonal) (SAR) and the development of ARVI. MATERIAL AND METHODS: An observational study was conducted at the Department of Otorhinolaryngology of the Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation from April to August 2021. Included are patients of both sexes aged 18 to 65 years with a previously (at least 1 year ago) verified diagnosis of mild and moderate acute SAR in the acute stage, who sought medical help for ARVI. All patients were prescribed therapy with the inclusion of a drug belonging to the pharmacological group of antihistamines of the 2nd generation (a course of 14 days). In addition, patients received symptomatic ARVI therapy according to indications, including nasal decongestants (as needed), antipyretic and antitussive drugs. RESULTS: Based on the data obtained, it was possible to prove that the use of modern antihistamines in patients comorbid with AR and ARVI has a pronounced therapeutic effect. Theoritin provides a therapeutic effect at an early stage in relation to nasal and non-nasal symptoms of SAR/ARVI, and also quickly improves the quality of life of patients, which makes its use promising for the treatment of ARVI against the background of AR. The drug has an antihistamine activity comparable to cetirizine and surpasses it in its ability to suppress an allergic inflammatory reaction, for example on the skin, as well as in the duration of preservation of the antihistamine effect. CONCLUSION: The presented results indicate the effectiveness of theoritin and cetirizine in the treatment of patients with seasonal exacerbation of allergic rhinitis, comorbid for acute respiratory viral infections.

[Comparative characteristics of the effectiveness of local therapy in acute tonsillopharyngitis]. / Sravnitel'naya kharakteristika effektivnosti mestnoi terapii pri ostrom tonzillofaringite.

Acute tonsillopharyngitis (ATP) is an infectious inflammation of the mucous membrane and lymphadenoid structures of the oropharynx. Sore throat, as the main symptom of ATP, is the most common reason for seeking outpatient medical care or self-medication. Topical therapy of sore throat in the treatment of non-streptococcal ATP is the most effective and safe. In the article, based on their own experience and literature data, the problem of treating patients with sore throat with ATP of non-streptococcal etiology is presented. At the Department of Otorhinolaryngology of the Evdokimov Moscow State Medical University conducted a study to study the clinical features of the course of ATP and improve the results of local treatment of patients with this pathology. In the course of the study, 75 people were examined, in whom subjective and objective symptoms were assessed. Our study showed that the use of the drug Doritricin demonstrated high efficacy in the treatment of patients with ATP, which contributed to an earlier regression of inflammatory-infiltrative changes in the pharynx, as well as a faster decrease in the level of pain syndrome according to the scores of the visual-analog pain scale.

[Sore throat. Recent trends in treatment]. / Bol' v gorle. Sovremennye podkhody k lecheniyu.

According to WHO almost half of the population undergoing infectious diseases of the upper respiratory tract one third of which is inflammatory diseases of the pharynx. This article presents the therapy issue of patients with sore throat due to acute pharyngitis and/or acute tonsillitis of non-streptococcal etiology based on our own experience and literature data. Observational study was carried out at the Otorhinolaryngology department of MSUMD n.a. A.I. Evdokimov in order to evaluate efficacy and tolerability of complex local drug Doritricin. The study involved 52 patients, objective and subjective manifestations of the disease were evaluated. Obtained data indicate the effectiveness and safety of Doritricin, as well as the possibility of reducing the number of drugs used during treatment.

[The new possibilities for the treatment of chronic cough associated with postnasal drip]. / Novye vozmozhnosti terapii khronicheskogo kashlia pri postnazal'nom zateke.

Cough is considered to be one of the leading clinical symptoms associated with the pathological changes in the respiratory system. Notwithstanding a great variety of therapeutic pharmaceutical products possessed of the antitussive action, physicians tend the give preference to the preparations producing the combined effect. The present article reports the results of the clinical study designed to evaluate the effectiveness and safety of the application of rengalin exhibiting the combined antitussive, anti-inflammatory, and broncholytic action in the patients presenting with the postnasal drip syndrome. The comparison of the therapeutic effects of rengalin with those of other therapeutic modalities frequently employed for the management of postnasal drip give evidence of the high efficiency of this product for the optimization of the treatment of this condition and the associated chronic cough.

[15-year experience of moxifloxacin in the treatment of patients with bacterial rhinosinusitis].

The article summarizes 15 years of experience of the use of moxifloxacin (Avelox) in Russia in patients with acute bacterial rhinosinusitis. Emphasize its high bactericidal activity against a broad spectrum of microorganisms- from basic agents to the atypical and anaerobic microflora. The results of these studies suggest the continued effectiveness of the dosage of 400 mg a short course (7 days) over 15 years of practical use of the drug, which in its clinical efficacy is superior to amoxicillin/clavulanate, cefuroxime axetil and levofloxacin. The safety profile of moxifloxacin, studied at the population level is not associated with an increased risk of adverse effects in compliance with the dosing regimen, taking into account the indications and contraindications.

[The causes of the development of cicatrical stenosis of the larynx and trachea in the patients presenting with Guillain-Barré syndrome].

The problem of rehabilitation of the patients presenting with post-intubation stenosis of the larynx and trachea remains unresolved despite the development of new methods for the diagnostics and treatment of this condition. One of the indications for long-term artificial lung ventilation is the severe form of Guillaine-Barret syndrome associated with paralysis of breathing muscles, development of bulbar symptoms, and disturbances of trophic process in the skin and mucous membranes. However, prolonged (mean 26 days) artificial lung ventilation may result in the formation of many-layer stenosis of the larynx and trachea whereas disturbed trophic processes in the skin and mucous membranes coupled to inadequate innervation complicate the postoperative conditions of the patients and promote restenosis of the tracheal lumen.

[Treatment of patients with complicated tonsillogenic infection].

The number of patients with pyo-inflammatory complications associated with chronic tonsillitis has increased in the recent years. The objective of this paper was to analyse the frequency of stenotic conditions caused by purulent complications of tonsillogenic infection. An algorithm is proposed for diagnostic examination and treatment of patients with descending tonsillogenic infection suffering obstruction of the upper respiratory tract.

[Variants of tracheostomy depending on etiology of laryngeal and tracheal stenosis].

The results of tracheostomy and prevention of airway stenosis depend much on preoperative examination, adequate management of postoperative period. Introduction of the treatment algorithm including rational surgical approaches, wide-spectrum antibiotics, drugs improving tissue repair, local and general antihypoxic therapy significantly raises effectiveness of post-tracheostomy rehabilitation.

[Medical ozone in combination with low-frequency ultrasound therapy in the treatment of patients with chronic purulent otitis media]. / Lechenie bol'nykh khronicheskim gnoinym srednim otitom preparatami meditsinskogo ozona v komplekse s nizkochastotnoi ul'trazvukovoi terapiei.

The authors propose a method of endoural ultrasound therapy in parallel with local introduction of ozonized physiological solution for patients with otitis media purulenta chronica. Locally used was the solution containing ozone in concentration 10 mg/l. Low-frequency ultrasound therapy was conducted using Tonsillor-2 unit with special intraauricular wave guides. Treatment outcomes in 132 patients are analysed for 5 years. The response was registered in the majority of cases.

[Immunological status of patients with juvenile angiofibroma of the skull base]. / Immunologicheskii status bol'nykh iunosheskoi angiofibromoi osnovaniia cherepa.

Immunological status was studied in 20 patients with juvenile angiofibroma of the base of the skull (JABS). An imbalance in the immune system was found, especially in cellular immunity (low number of T-helper and high level of T-suppressor lymphocytes, subnormal index of their proportion). The number of activated T-cells decreased, while that of NK-cells increased. JABS patients have an elevated level of serum IgA.

[Juvenile angiofibroma of skull base: diagnosis and treatment]. / Diagnostika i lechenie iunosheskoi angiofibromy osnovaniia cherepa.

227 young men and boys aged 9-22 years underwent treatment for juvenile angiofibroma of the base of the skull (JAFBS) in the ENT clinic of the Russian Academy of the Advanced Medical Education between 1977 and 1998. JAFBS was most frequently diagnosed at the age 15-18 years. An original clinicotopographic JAFBS classification is proposed basing on the disease spread. A complex of tests has established that JAFBS patients develop changes in hormonal and immunological statuses. Indications to ligation of the external carotid arteries and a modified nasomaxillary approach to angiofibroma providing radical removal of the tumor are described. After surgical treatment only 11.5% of the patients exhibited recurrent tumors.

Translation enhancing properties of the 5'-leader of potato virus X genomic RNA.

The double-stranded DNA copy corresponding to the 5'-nontranslated alpha beta-leader of potato virus X (PVX) genomic RNA (positions -3 to-85 according to AUG initiator) was chemically synthesized and fused to the transcription plasmids containing three different reporter genes: neomycinphosphotransferase type II (NPT II) gene, Bacillus thuringiensis coleopteran-specific toxic protein gene and beta-glucuronidase (GUS) gene. Expression of the reporter genes in vitro and in plant protoplasts (in the case of GUS gene) reveals that the alpha beta-leader of PVX RNA acts as a translation enhancer despite the presence of the upstream vector-derived sequence and irrespective of the length of the spacer sequence preceding the reporter genes.

Expression strategy of the potato virus X triple gene block.

The mode of expression of the overlapping genes of the triple block positioned internally in potato virus X (PVX) RNA was examined. The results of In vitro translation of synthetic RNA transcripts and natural PVX-specific methylmercuric hydroxide-denatured dsRNAs suggest that the 25K protein is expressed as a single translation product of the 2.1 kb subgenomic (sg) RNA and that both the 12K and 8K proteins are expressed from the same 1.4 kb sgRNA.

In vitro membrane binding of the translation products of the carlavirus 7-kDa protein genes.

Two double-stranded DNA copies of the genes potentially coding for the 7-kDa proteins of potato virus M (PVM) and potato virus S (PVS) were synthesized and cloned into T7 transcription vectors. Cell-free translation of the corresponding monocistronic transcripts yielded in both cases a single protein of approximately 7-8 kDa that contains a highly hydrophobic N-terminal segment. To analyze their membrane-binding potential, both proteins were synthesized in the membrane-enriched Krebs-2 extract. It was found that the smooth membrane fraction was enriched in the carlavirus 7-kDa proteins. The primary and predicted secondary structures of their N-terminal hydrophobic segments suggest that the latter can function as signals for translocation into the rough endoplasmic reticulum.

Translational efficiency and competitive ability of mRNAs with 5'-untranslated alpha beta-leader of potato virus X RNA.

The 5'-untranslated leader sequence of potato virus X (PVX) RNA (63 nucleotides apart from cap-structure) consists of two sub-sequences referred to as alpha-sequence (41 nucleotides with no G) and beta-sequence (42 nucleotides upstream from the first AUG). Computer-based folding predictions suggest that the 5'-proximal region of alpha beta-leader is unstructured. The second structural feature of alpha beta-leader is the presence of the sequences apparently complementary to the 3'-terminal region of 18S rRNA. The alpha beta-leader has been shown to strongly enhance the translation of the contiguous foreign gene (NPT1) transcripts in cell-free translation systems from rabbit reticulocytes (RRL), wheat germ (WG) and Krebs-2 ascite cell extract (KA). In competitive translation PVX, RNA strongly inhibited tobacco mosaic virus (TMV) RNA, in RRL and WG systems. No competition occurred between PVX and TMV RNAs in KA system. There was no correlation between the translational efficiency and competitive ability of PVX RNA in different cell-free translation systems. The competitive ability did not solely depend on the presence of alpha beta-leader in mRNA. We present evidence to suggest that alpha beta-leader together with about 150 bases of the coding sequence is responsible for the translation competitive ability of PVX RNA.