[Possibilities of using recombinant human deoxyribonuclease I in otorhinolaryngology]. / Vozmozhnosti primeneniya rekombinantnoi dezoksiribonukleazy I cheloveka v otorinolaringologii.

ANNOTATION: Dornase alfa (Pulmozyme, Tigerase) is a purified solution of recombinant human DNase, clinically developed for the treatment of pulmonary diseases in patients with cystic fibrosis (CF). The action of the drug is aimed at destroying the viscous secretion, rich in DNA strands of neutrophils, through their fragmentation, the density of the secretion decreases, and the aeration of the lower respiratory tract improves. The similarity of pathological processes with the formation of viscous exudate on the surface of the mucous membrane in diseases of the upper respiratory tract and ear initiated studies on the use of Dornase alpha in otorhinolaryngology. MATERIAL AND METHODS: The analysis of materials of domestic and foreign authors on the effectiveness of the use of the drug Dornase alfa in otorhinolaryngology was carried out. RESULTS: The review included 132 patients (10 studies) in whom Dornase alfa was used to treat CF-associated nasal and paranasal sinus diseases. Analysis of the literature revealed only 3 studies, one of which consisted of two parts, examining the effect of Dornase alpha on middle ear exudate: two studies were demonstrated in an animal model; one - in vitro on samples of middle ear effusion which were aspirated through a myringotomy incision from patients with recurrent acute otitis media; and one in clinical 40 patients (40 ears) for hydrolysis of exudate in the tympanostomy tubes. CONCLUSION: Analysis of studies on the use of Dornase alfa demonstrates an improvement in clinical symptoms in all patients with CF and chronic rhinosinusitis. In experimental studies on an animal model, as well as in vitro research on exudate from the middle ear, Dornase alfa has demonstrated high efficacy and safety. Dornase alfa is a drug with high potential, further research is needed for wider use in ENT practice, especially in otiatrics.

[Application of new technologies in postgraduate education of otorhinolaryngologists]. / Primenenie novykh tekhnologii v poslediplomnom obrazovanii vrachei-otorinolaringologov.

The article is devoted to one of the urgent problems of modern medical education - postgraduate education, further development of skills and deepening of knowledge among otorhinolaryngologists after training in clinical residency. The long-term experience of training in advanced training cycles for both otorhinolaryngologists beginning their professional path and doctors with a long, decades-long work experience in the specialty is analyzed. The trajectory of professional development is presented, which allows structuring the acquired knowledge, distributing the stages of training over time, taking into account the priorities of students and combining training with the exchange of experience and personal communication with colleagues. The problems and the most promising directions of the development of postgraduate education of otorhinolaryngologists are considered.

[Role of topical antibacterial therapy in patients with cystic fibrosis]. / Rol' mestnoi antibakterial'noi terapii u patsientov s mukovistsidozom.

Cystic fibrosis (cystic fibrosis) is an important medical and social problem. The main clinical manifestations that determine the prognosis and outcome of this disease are changes in the respiratory and digestive systems. In recent years, there has been an understanding of the importance of assessing pathological changes in the nasal cavity and paranasal sinuses in patients with cystic fibrosis. RESEARCH OBJECTIVES: Assess the efficacy of topical antibacterial therapy in adult cystic fibrosis patients after surgery on nasal cavity structures and paranasal sinuses. MATERIAL AND METHODS: In the clinic for ear, nose and throat diseases at Sechenov University, 46 adult patients with cystic fibrosis and chronic rhinosinusitis were observed; all patients underwent extended endoscopic polysinusotomy. According to clinical studies, Isofra nasal spray is highly effective and safe in the treatment of patients with infectious diseases of the nasal cavity, nasopharynx and paranasal sinuses. FINDINGS: The use of Isofra nasal spray (the active ingredient is framycetin sulfate) in our clinic in patients with cystic fibrosis against the background of basic therapy (inhalation with bronchodilators and mucolytics, intranasal topical steroids), had a positive effect on the microbial landscape in the nasal cavity in patients with cystic fibrosis in the postoperative period and allowed to reduce the need for the appointment of systemic antibacterial drugs.