[Glucosaminylmuramyl dipeptide in treatment of respiratory tract diseases]. / Gliukozaminilmuramildipeptid v terapii infektsionnykh zabolevanii respiratornogo trakta.

INTRODUCTION: Immunomodulators are used as part of a comprehensive therapy of respiratory tract diseases. The systematization of the accumulated data on the use of glucosaminylmuramyldipeptide (GMDP) has great scientific and practical interest. PURPOSE: To study the data on the effectiveness and safety of GMDP in the treatment of infectious diseases of the respiratory tract. MATERIAL AND METHODS: Literature search was carried out in Scientific Electronic Library (elibrary.ru), Google Scholar, ScienceDirect, Cochrane library, Pubmed/MEDLINE and search engines. The level of evidence reliability and methodological quality of researches were assessed. RESULTS: 17 full-text publications were selected based on the results of 13 prospective clinical trials with acceptable methodological quality (including one blind placebo-controlled trial). The effectiveness of GMDP in acute respiratory viral infections, influenza, recurrent respiratory tract infections, rhinosinusitis and chronic tonsillitis was demonstrated. DISCUSSION: An important advantage is that a significant part of the studies was performed with the participation of the child population. Since the use of GMDP in multiple therapy significantly reduces antibiotic consumption (often unjustified). It seems reasonable to estimate the pharmacoeconomic costs of managing adult patients with respiratory tract diseases. Further research can improve understanding of the role of GMDP in the treatment of various medical conditions. CONCLUSION: The use of GMDP in the treatment of respiratory tract diseases makes it possible to faster achieve a clinical effect, reduce the number of relapses, lengthen the relapse-free period, as well as to potentiate the effect of antibacterial therapy (if necessary), reducing the need for antibiotics.

[Implication of functional platelet activity in pathogenesis of Q-fever].

AIM: To ascertain the role of platelets in pathogenesis of clinical symptoms in patients with Q-fever. MATERIAL AND METHODS: We studied hemostasis with estimation of functional platelet activity in 49 patients with Q-fever. RESULTS: Hemorrhagic syndrome (HS) occurred in 34.4% patients with Q-fever (QF) during seasonal rise of morbidity. HS manifested with petechiae (12%), hematomas (32%), nasal bleeding (17%), stomatorrhagia (9%), melena (12%). Characteristics and duration of such symptoms as weakness (100%), myalgia (72%), arthralgia (52.9%) suggested hemocoagulatory disorders as a cause of the symptoms appearance. At the height of the disease thrombocytopenia was accompanied with inhibition of platelet aggregation activity, but regression of the clinical symptoms was associated with an increase in platelet count and platelet hyperaggregation. Fibrinogen content was elevated during hospitalization in 50% patients. CONCLUSION: Clinical manifestations of HS are typical for Q-fever prevalent in the Astrakhan Region. Hemostatic disorders because of altered functional activity of platelets were registered in all the cases and evidence for pathogenetic unbalance of homeostasis in Q-fever patients.

[Clinical and epidemiological description of acute intestinal infections in children of the lower Volga region].

In accordance with the results of laboratory diagnostics, carried out by bacteriological, serological and PCR methods, the etiological structure of acute bacterial and viral intestinal infections, most frequently occurring in children of the Astrakhan region, is presented. An important role of viral diarrhea cases, prevailing among the total number of cases of intestinal infections in children, is emphasized. The data on the irregular distribution of morbidity by months, especially in viral intestinal infections and salmonellosis with the prevalent involvement of children aged up to 2 years into the epidemic process, are presented. Infections affect mainly children given artificial feeding, as well as those with complicated premorbid state and frequently having acute respiratory viral infections.