[Combination drugs in the therapy of acute respiratory viral infections: Evaluation of clinical and economic effectiveness].

AIM: To make a comparative clinical and economic evaluation of the use of the combination drug Influnet in the treatment of acute respiratory viral infections (ARVI). SUBJECTS AND METHODS: A total of 103 medical records of outpatients with uncomplicated mild and moderate ARVI were studied. There were three groups: 1) 35 patients who received therapy with Influnet; 2) 31 patients who took Rinza; 3) 34 patients who were on treatment without the combination drug. RESULTS: Analysis of comparative clinical effectiveness of the drugs revealed that the use of Influnet was accompanied by the rapider alleviation of fever and other ARVI symptoms and by its shorter treatment duration (4.5 ± 0.5 days) versus that of Rinza (5.5 ± 1.4 days) and monocomponent drugs (5.6 ± 1.2 days). Economic analysis showed that in terms of indirect costs associated with shorter temporary disability in patients with ARVI, Influnet therapy was more economically sound for them. CONCLUSION: The results demonstrate the higher clinical and economic feasibility of Influnet therapy for ARVI versus its alternative therapy. Combination drugs cause fewer adverse reactions than a combination of monocomponent drugs used to treat ARVI and are more cost- effective for the patient.

[Applying of assessment scales for patients with severe community-acquired pneumonia in young patients].

One of the most important issues in the management of patients with community-acquired pneumonia is the correct initial assessment of the severity of the patient's condition. In the context of outbreaks of pneumonia among soldiers performing military service, this position is crucial. Up to date specialized scales were developed and used in clinical practice allowing assessing a risk on the basis of an adverse outcome, objectifying the decision on the choice of the place of treatment of a patient with community-acquired pneumonia. Various prognostic scales have their advantages and several disadvantages; in particular the possibility of their use to date has not been studied in the management of patients with pneumonia of organized groups. This publication is a brief description and analysis of the possibilities of applying the most well known scales in young people.

[Clinical diagnostic and organizational aspects of providing care to patients with pulmonary sarcoidosis in the Armed Forces].

The data on the epidemiology and aetiology of sarcoidosis, the current classifications are presented. The basic provisions of the legal framework of medical management of patients suffering from sarcoidosis are given. The authors provided an analysis of the characteristics of diagnosis and treatment of sarcoidosis in the military, based on which we propose an algorithm of examination of patients with respiratory sarcoidosis in military health care facilities the Russian Defence Ministry, the recommended treatment regimens and order dynamic observation of patients. Invited to provide skilled care to patients with respiratory sarcoidosis selection based on the Main Military Clinical Burdenko Hospital specialized centre (department with bunks for the treatment of patients with sarcoidosis).

[Antibiotic therapy regimens for mild community-acquired pneumonia in patients with risk factors for ineffective treatment: clinical and economic comparisons].

AIM: To evaluate the clinical efficiency, tolerance, and pharmacoeconomic parameters of treatment for mild community-acquired pneumonia (CAP) in patients with risk factors for ineffective treatment with levofloxacin (Glevo) versus original levofloxacin and standard pharmacotherapy regimens for mild pneumonia (real practice). SUBJECTS AND METHODS: An open-label comparative randomized trial was conducted in parallel groups of 147 patients aged > or = 18 years with mild CAP and risk factors for ineffective treatment. Group 1 included 61 patients (59 men and 2 women; mean age 23.3 +/- 11.2 years) receiving levofloxacin (Glevo) 500 mg/day; Group 2 comprised 41 patients (39 men and 1 woman; mean age 26.4 +/- 13.4 years) treated with original levofloxacin 500 mg/day; Group 3 consisted of 45 patients (all men; mean age 23.7 +/- 9.9 years) on standard therapy. The trial was performed in 3 pulmonology centers. RESULTS: The use of the respiratory fluoroquinolone levofloxacinto treat mild CAP in the patients with risk factors for failure for its therapy demonstrated a higher efficiency than the antibiotic regimens used in real clinical practice. This suggests that physicians underestimate risk factors and do not always make a rational choice of an antimicrobial agent in the given clinical situation. CONCLUSION: The generic form of levofloxacin (Glevo) is as clinically effective as its original drug in the treatment of CAP and characterized by its optimal pharmacoeconomic parameters.

[A method for predicting the efficiency of rehabilitative treatment based on decision tree analysis].

The necessity of the choice of means and methods to facilitate optimal correction of individual reserves of the organism accounts for the importance of the search for the most efficient preventive, therapeutic, and rehabilitative modalities. One way to address this problem is to simulate prognosis of the outcomes of rehabilitative treatment. It is proposed to use a two-step method to achieve this goal. Step 1 consists of construction of the decision tree to perform categorization of all objects of interest (patients) into the previously established classes; it provides a basis for step 2 or classification proper of new observations. The original software program ensures high accuracy of prognosis of the efficiency of two scenarios of combined sanatorium and spa treatment used in the present study. A special case of application of the decision tree analysis in clinical practice is considered. It is concluded that this approach can be recommended for the use in all specialized medical and health care facilities for the management of a variety of pathological conditions.

[Prophylaxis of acute respiratory viral infections in organized communities].

There are presented the data of placebocontrolled research, which was realized for the purpose of analyze of effectiveness and safety of using of agent "Kagocel" for prophylaxis of acute respiratory virus infections among military servicemen of call-up service. Among persons, got kagocel, was marked a low number of ARVI in comparison with persons, got placebo. The highest prophylactic effect was marked for the first 2 month of getting the agent. A mild disease (ARVI) flow was marked among persons, got placebo. It has approved it self in low frequency of complications. There was shown a grand economic benefit of prophylactic using of kogocel course of treatment.

[Comparative clinical-economic analysis of antibiotic therapy in pyogenic inflammatory diseases of the lower extremities]. / Sravnitel'nyi kliniko-ékonomicheskii analiz programm antibiotikoterapii gnoino-vospalitel'nykh zabolevanii nizhnikh konechnostei.

A randomized comparative investigation was carried out in two equal groups of patients with pyo-inflammatory diseases of lower extremities (the total number 50 patients) in order to study effectiveness and tolerance to Netilmycin (1st group) and Gentamycin (2nd group) given in combination with Cefasolin. Clinical symptoms were estimated immediately after operation, in 3, 6 and 10-12 days after it. Bacteriological investigations were fulfilled immediately after operation, in 72 h and in 6-10 days after the beginning of antibacterial therapy. Clinical and biochemical investigations of blood were fulfilled before and in 10 days after the beginning of the treatment. Effectiveness of the treatment in the first group was 100%, in the second group--80%. In the second group the antibiotics were changed in 20% of cases and the average duration of hospitalization among the patients of this group was reliably longer that in the first group. The eradication rating of Netilmycin was higher than that of Gentamycin (25 strains from 25 and 20 from 25 respectively). Gentamycin had a pronounced nephrotoxic effect (elevation of the level of creatinin and urea of blood in dynamics by 21% and 32%), as compared with Netilmycin (9% and 3%). Total expenses to antibiotic therapy in the first group made up 97,650 rub, and in the second group 106,245 rub. Netilmycin in combination with Cefasolin was more effective for acute pyo-inflammatory diseases of lower extremities than a combination of Gentamycin with Cefasolin, it more rapidly resulted in reduction of clinical signs of inflammation, was better endured and more economical.

[A new principle in the analysis of the analgesic action of morphine]. / Novyi printsip analiza boleutoliaiushchego deistvia morfina.

Possible application of sensory decision theory of pain for the experimental assessment of neuropsychophysiological mechanisms of opiate analgesia has been demonstrated. The analgetic effect of morphine was found to be mediated through the influence on the measurement and estimation of pain stimulus.