[Efficacy and safety of topical combination therapy in patients with acute otitis externa].

AIM: To study the structure of the microbial landscape in patients with acute otitis externa, as well as to evaluate the efficacy and safety of the combined drug chloramphenicol/clotrimazole/beclomethasone/lidocaine (Candibiotic) as an empirical therapy of this disease. MATERIALS AND METHODS: In this retrospective study of real clinical practice, outpatient records of 963 patients who applied to the KDO of the Sverzhevsky Research Clinical Institute of Otorhinolaryngology with symptoms of otitis externa in the period from 2017 to 2022 were selected. Additional analysis was carried out on the clinical records of patients who received the combined drug Candibiotic. The endpoints of this analysis included data on the clinical and microbiological efficacy of therapy, as well as safety information. RESULTS: According to microbiological testing, 60.6% of microorganisms belonged to bacterial flora, 26% were bacterial-fungal associations, 11.6% were monofungal flora, in 1.8% of cases there was no growth of microorganisms. The most frequently isolated microorganisms were: Pseudomonas spp (n=291; 29.16%), Staphylococcus spp. (n=214; 21.4%), Candida spp. (n=194; 19.4%), Aspergillus spp. (n=133; 13.3%). Most of the patients (71.0%) received Candibiotic. In 69.7% of patients, the resolution of the clinical symptoms of otitis externa occurred within 7 days of therapy with Candibiotic. Complete eradication of microorganisms occurred in 87% of cases. Adverse events were recorded only in 3 (0.04%) cases. CONCLUSION: The study demonstrated an extremely high level of clinical efficacy and safety of therapy in patients with acute external infectious otitis who received the Candibiotic, which can be used as an initial empirical therapy in patients with otitis externa.

[Hearing care aspects in universal face mask use during the COVID 19 pandemic]. / Motivirovannost' k slukhoprotezirovaniyu v usloviyakh masochnogo rezhima pri pandemii COVID-19.

BACKGROUND: Typical cloth and medical masks, which are mandatory to wear during the COVID 19 pandemic, create visual barrier, obscure linguistic and nonverbal communication and interaction. Ski-slope hearing loss patients often don't admit their auditory insufficiency and do not use hearing aids due to acceptable speech intelligibility by using visual access to the mouth and other potential facial cues. PURPOSE: To assess the impact of universal face medical masks in public places on motivation to using hearing aids of patients with ski-slope hearing loss. PATIENTS AND METHODS: All the 504 patients (18-65 years old), who applied for < hearing care assistance and for the first time bought hearing aid were included. 266 patients (group A) applied from June to November 2020, when wearing facial masks was mandatory; 238 patients (group B) applied from June to November 2019, when wearing facial masks wasn't required. In both groups patients, who fulfilled the following criteria, were selected: 1) binaural mild to severe sensorineural ski-slope hearing loss lasting more than 3 years; 2) no progression of hearing loss within the last 3 years; 3) pure tone audiometry <20 dB HL at 125-1000 Hz frequencies; 4) hearing care with mono- or binaural hearing aids with the receiver-in-the-canal open-type. Questionnaires were administered to eligible patients in group A to assess the motivational components of acquiring hearing aids. RESULTS AND DISCUSSION: In group A, 74 (28%) patients received hearing aids according to the inclusion criteria, and in group B, 46 (19%) patients received hearing aids (p=0.033). Significant factors determining hearing aid acquisition were lack of visual contact when wearing a mask, communication difficulties in noisy environments and lack of intelligibility in a concert hall or lecture. CONCLUSION: Patients' motivation to hearing care grows in mandatory wearing facial masks conditions during the COVID-19 pandemic leading to an increase in patients using hearing aids.

[Results of the observational (non-interventional) research 'Analysis of therapeutic efficiency of the polyvalent Piobacteriophag (Secstaphag) in the treatment of acute sinusitis']. / Rezul'taty provedennogo nabliudatel'nogo (neinterventsionnogo) issledovaniia 'Analiz terapevticheskoi éffektivnosti preparata piobakteriofag polivalentnyi (Sekstafag) pri lechenii ostrogo gnoinogo sinusita'.

He article describes an observational (non-intervening) research 'Analysis of the therapeutic efficacy of the Polyvalent Piobacteriophage (secstafag) in the treatment of acute sinusitis'. The obtained results prove the effectiveness of the drug in the treatment of this ENT pathology.

[Peculiarities of clinical course of inflammatory diseases of the oropharynx of various etiologies and possibilities of local therapy]. / Osobennosti klinicheskogo techeniia vospalitel'nykh zabolevanii rotoglotki razlichnoi étiologii i vozmozhnosti mestnoi terapii.

The article covers the problems of diagnosis and treatment of inflammatory diseases of the oropharynx. The authors consider the main nosological forms of focal inflammation in the throat, discuss the role of ß-hemolytic streptococcus group A in the genesis of angina and chronic tonsillitis and their complications. The authors discuss the influence of irritants - smoking, alcohol, cold air, gastroesofareal reflux on the development of chronic inflammation of the oropharynx mucosa. Leading clinical symptoms in oropharyngeal diseases and the main methods of their treatment are presented. The authors conclude that the most effective treatment of focal inflammation in the throat is the use of combined topical drugs. As a choice for local therapy of pharyngeal diseases, the authors offer a combined drug Doritiricin, effectively and safely relieving pain syndrome and local inflammatory response.

[Fungal adenoiditis and tonsillomycosis in children: features of diagnosis and therapy]. / Gribkovyi adenoidit i tonzillomikoz u detei: osobennosti diagnostiki i terapii.

The purpose of the work is to study the current state of the problem of diagnosing and treating fungal adenoiditis and tonsillomycosis in children. This article summarizes the literature data on the predisposing factors and characteristics of the occurrence of fungal infections of adenoid vegetations and tonsils in children. The works present modern approaches to the diagnosis and treatment of children with fungal adenoiditis and tonsillomycosis, depending on the selected genus and the type of fungus. Based on the conducted research, performed on the basis of "The Sverzhevskiy Otorhinolaryngology Healthcare Research Institute", we found that the incidence of fungal adenoiditis in children is 16.4%, and the incidence of tonsillomicosis in children with chronic tonsillitis is 21.5%. The most frequently detected strain in this pathology is C. albicans. In the presented study, a justification of the chosen treatment regimen was made on the basis of the data obtained during microbiological (bacteriological and mycological) studies.

[Bacteriophages therapy in otorhinolaryngology. History and contemporaneity]. / Fagoterapiia v otorinolaringologii. Istoriia i sovremennost'.

Bacterial infections of the upper respiratory tract in the structure of the incidence of the population ranked second. Recently in practice there are more and more cases of a protracted course of the disease, chronic inflammation, as well as various kinds of complications. The abuse and misuse of antibiotics has contributed to the growth of antibiotic-resistant bacterial strains. This problem is named one of the most pressing for public health in the world. In this regard, the topical issue is the search for alternative drugs foe treating infectious diseases. Bacteriophage preparations that have a 100-year history and have gone a long way in development have shown their effectiveness as an alternative to antibiotics, and as an additional therapy in the treatment of certain bacterial infections. This review includes data from various studies available in English, as well as the results of domestic reports published in Russian scientific literature.

[The use of Gliathiline in patients with sensorineural hearing loss]. / Ispol'zovanie preparata Gliatilin u bol'nykh neirosensornoi tugoukhost'iu.

The results of treatment of 38 patients suffering from sensorineural hearing loss with the Gliatilin (solution 3 ml intravenously for 10 days, capsules 400 mg 3 times a day or solution for ingestion 600 mg 2 times a day for 3 months) are presented. All patients in dynamics were given a comprehensive audiological, neurological examination, as well as an assessment of psycho-emotional status and cognitive function. Subjective improvement of ear noise tolerance by patients by 40 days of observation and continuation of this trend during the whole period (100 days) outside of the form of the medicinal preparation is noted. A reliable improvement in the 50% speech intelligibility threshold by day 100 of observation was established in patients of both groups, with a tendency towards earlier (on day 70 of the study) onset of this effect when taking the drug inside as a solution. The Gliatilin has been proven to reduce anxiety and depression, as well as reliably improve cognitive function. Thus, Gliatilin (injection solution, ingestion solution, capsules) can be used to improve the subjective tolerance of ear noise, speech intelligibility and quality of life of patients in chronic sensorineural hearing loss.

[The influence of Memoplant monotherapy on the dizziness]. / Vliianie preparata Memoplant v rezhime monoterapii na golovokruzhenie.

The objective of the present work was to study the influence of the dry extract from the leaves of Ginkgo biloba EGb 761 (used as monotherapy at a dose of 120 mg twice daily during 4 months) on the vestibular function of the patients presenting with cochleovestibular pathology of peripheral and mixed genesis. We present the results obtained by the objective and subjective methods for the evaluation of the vestibular function as well as the neurological and psychoemotional state of the 40 patients that was carried out during the four months of memoplant monotherapy. It is concluded that monotherapy with the use of the dry extract from Ginkgo biloba leaves can be applied for the purpose of improvement of static and dynamic balancing state. Moreover, this memoplant preparation can be used as a means of prophylaxis of recurrent dizziness that in addition reduces the severity of anxiety and depression without producing adverse side effects.

[Topical preparations for therapy of tonsillar pathology].

This paper highlights clinical and diagnostic aspects of tonsillar pathology with special reference to modern methods for the treatment of pharyngeal diseases of different etiology. A detailed characteristic of local symptomatic therapy is presented including the use of NSAIDs (non-steroidal anti-inflammatory drugs). These agents have advantages over other medications for local therapy due to high anti-inflammatory and analgesic activities. Also, they significantly improve the patients' quality of life. The use of a local anti-inflammatory drug is a major component of the treatment of inflammatory pharyngeal pathology. Regardless of the nature of the disease, either bacterial or viral.

[Relevance of the chronic tonsillitis problem].

This study was designed to analyse dynamic characteristics of planned and emergency surgical care provided to patients with chronic tonsillitis (CT) in 3 large hospital of Moscow during the period between 2002 to 2006. The number of planed surgical interventions for the treatment of chronic tonsillitis performed during 5 years decreased almost two-fold. In contrast, the total number of urgent operations for surgical drainage of paratonisillar abscess in all clinics of the city during the last 10 years increased by a factor of 2. Results of bacteriological studies of species composition of microflora in patients with CT suggest the relationship between the incidence of this pathology and acute rheumatic fever. Analysis of activities aimed at the prevention of chronic tonsillitis (based in the first place at specialized dispensary facilities) has demonstrated that the number of patients involved in relevant monitoring programs is rather small and those in need of radical sanation of inflammatory CT foci are not referred for surgical treatment at the early stages of the disease as required by the current diagnostic and therapeutic algorithm for the management of chronic tonsillitis.

[Combined local therapy in oropharyngeal diseases].

A pilot trial of efficacy of the drugs lisobact and stomatidin in local treatment of acute pharyngitis and combined therapy of tonsillitis and paratonsillar abscess included 82 patients with tonsillitis (n=30), paratonsillar abscess (n=30) and acute pharyngitis (n=22) aged 15-72 years. Effectiveness of the treatment was assessed by changes in clinical symptoms, pharyngoscopic picture and results of bacteriological studies. It was found that treatment with lisobact and stomatidin diminished considerably bacterial contamination of the paratonsillar abscess and pharyngeal mucosa. Local treatment with lisobact and stomatidin for paratonsillar abscess in combination with systemic antibacterial drug reduces the time of hospital stay, in tonsillitis patients - of disability. High compliance to lisobact and stomatidin treatment was observed.

[Clinical and structural comparisons in a child with disseminated herpetic infection].

Herpes infection is one of the most common types of virus infections in children. Diagnosis of herpes infection in infants is complicated due to low-grade ambiguous clinical symptoms and compromised Immune system. Brain herpes infection is the most severe type of the herpetic diseases. The role of neurovisual methods (transcranial ultrasonography, computer tomography) is increasing in cases of herpetic encephalitis development.

[Perioperative management of focal liver diseases by ofloxacin]. / Izuchenie perioperatsionnogo primeneniia ofloksatsina pri ochagovykh obrazovaniiakh v pecheni.

Perioperative use of ofloxacin for prophylaxis was investigated in 20 patients with focal hepatic formations (hemangioma, adenocarcinoma, echinococcosis). First dose of ofloxacin (200 mg) was given intravenously 15 min before operation. After operation ofloxacin was used intravenously (400 mg daily) for 5 days. Pharmacokinetic investigation demonstrated that perioperative intravenous use of ofloxacin provided concentrations in blood and hepatic tissue satisfactory for potential microflore inhibition. Immunological monitoring demonstrated positive dynamics on 5-7 days after operation. dynamics depended on nosology of the focal hepatic formation. Ofloxacin use for prophylaxis in the operated patients with focal hepatic formations was efficient for profilaxy of postoperation infective complications.

[Clinical and laboratory efficacy of the novel difluoroquinolone Sparflo (sparfloxacin) in therapy of skin and soft tissue infections]. / Kliniko-laboratornaia éffektivnost' novogo diftorokhinolona Sparflo (sparfloksatsina) pri lechenii infektsii kozhi i miagkikh tkanei.

Results of clinical trial of new difluoroquinolone--Sparflo (sparfloxacin, Dr. Reddy's Laboratories Ltd) are presented. Sparfloxacin was used in the treatment of 24 patients at the Department of Wounds and Wounds infections (11 patients) and at the Department of burn wounds (13 patients) of the A.V. Vishnevsky Institute of Surgery. After the treatment with sparfloxacin pathogen eradication was stated in 18 patients, eradication with superinfection--in 13 patients, persistence--in 3 patients. Thus bacteriological efficacy amounted to 87.5 per cent. Pharmacokinetic data demonstrates long-term sparfloxacin circulation in the organism of patients with burns--elimination half-life amounted to 20 hours. Overall after the sparfloxacin use the favourable clinical effect was stated in 100 per cent patients--18 patients (75%) had clinical cure and 6 (25%)--clinical improvement. The drug tolerance was good. It is concluded that clinical and laboratory investigation demonstrated high efficacy of sparfloxacin (Sparflo, Dr. Reddy's Laboratories Ltd) in the treatment of patients with skin and tissue wounds of different localization and genesis, complicated with infections.

[Use of ceftriaxone in the prevention of postoperative purulent complications after surgery on the stomach and small intestine]. / Primenenie tseftriaksona v profilaktike posleoperatsionnykh gnoinykh oslozhneniii pri operatsiiakh na zheludke i tonkoi kishke.

Ceftriaxone was administered intravenously in a single dose of 1.0 g 15 minutes prior to surgical intervention for peptic ulcer and gastric or duodenum tumor in 31 patients at the age of 33 to 74 years. In all the patients primary adhesion of the surgical wound was recorded. No signs of local or general infection were observed. The indices of the total blood count, urinalysis and blood biochemical analysis came to normal by the 5th or the 7th day of the postoperative period. The levels of ceftriaxone in the blood, urine, stomach wall, small intestine tissues and subcutaneous fat were evaluated. The indices of the cellular and humoral immunity in the pre- and postoperative periods in the patients prophylactically treated with ceftriaxone were analyzed.