Evaluation of the treatment strategy for complicated allergic rhinitis.

OBJECTIVE: Aim: To carry out a comprehensive evaluation of treatment modification for patients with seasonal allergic rhinitis (SAR) complicated by anxiety-neurotic disorders. PATIENTS AND METHODS: Materials and Methods: Patients with SAR in the acute stage on the background of anxiety disorders were studied. Immunological studies were carried out, an assessment of the dynamics of indicators of the quality of life of patients, the level of anxiety / depression was assessed. In the clinical group, a variant of therapy modification was proposed. RESULTS: Results: Significant changes in the subpopulation ratio of lymphocytes, an increase in the immunoregulatory index, which indicated the severity of the immunological process, were revealed in SAR patients in the acute stage against the background of anxiety disorders. At the same time, a significant activation of the humoral link of immunity was observed: an increase and a significant increase in IgE in the blood serum and an increase in the content of sIgA in the nasal secretion. In most patients, eosinophilia was found in the peripheral blood and in the rhinocytogram before treatment. In the study of the quality of life of patients, changes in many parameters were found. CONCLUSION: Conclusions: The combination of "Nazafort Allergy Protection" and Atarax seems to be the most successful, which significantly improved the physical and psycho-emotional state of patients with SAR, complicated by anxiety and neurotic disorders. This combination led to an increase in the stress resistance of patients.

NEUROMETABOLIC STRATEGY OF PHARMACOTHERAPY FOR PATIENTS WITH SERONEGATIVE ARTHRITIS.

OBJECTIVE: The aim: The search for optimization of the strategy of neurometabolic pharmacotherapy in patients with seronegative arthritis is relevant: ankylosing spondylitis and psoriatic arthritis, taking into account the nature of the psychological response to the disease. PATIENTS AND METHODS: Materials and methods: The study included (1st observation group) 36 patients with AS (17 men and 19 women) aged 25 to 65 years, average duration of AS - 10.9 ± 0.63 years. Degree of pathological process activity was determined taking into account the Bath AS disease activity index (BASDAI) - in accordance with EULAR criteria. The second group included 32 patients with a diagnosis of PSA (19 men and 13 women) aged 25 to 65 years according to the CASPAR 2006 criteria, the average duration of psoriasis is 13.9 ± 1.9 years, PSA - 10.6 ± 0.58 years. To study the psycho-emotional state, the Spielberger anxiety self-assessment scale was used. To identify the symptoms of depression was used Hamilton Depression Scale (HDS). RESULTS: Results: In the study groups noted a high frequency of inadequate socio-psychological response to the disease. In groups of patients with seronegative arthritis, multidirectional maladaptive reactions were noted: in ankylosing spondylitis, a hypochondriac type of response is characteristic, and in psoriatic arthritis, anxiety disorders with different response options. At the end of the observation period in both groups there was an improvement in almost all studied indicators of clinical and laboratory activity. CONCLUSION: Conclusions: There was a significant improvement in the psycho-emotional status of patients, which makes it possible to improve the quality of life of patients and contribute to the optimization of treatment and rehabilitation measures.

CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND COMORBIDITIES: MANAGEMENT OF SOMATOFORM DISORDERS.

OBJECTIVE: The aim: To perform a comprehensive evaluation of the effect of paroxetine on the degree of somatoform disorders in exacerbation of severe COPD in women. PATIENTS AND METHODS: Materials and methods: The study involved 53 female patients with severe COPD (Group D), confirmed by instrumental methods of study. At hospitalization, patients were divided into 2 groups. Patients of Group 1 (n = 21; aged 52.5 ± 0.8 years old) underwent basic exacerbation therapy. Patients of Group 2 (n = 22; aged 57.9 ± 0.4 years old) underwent basic exacerbation therapy supplemented with paroxetine for 14 days, 1 tablet (0.20 g) once a day. RESULTS: Results: The basic therapy for treatment of COPD exacerbations, supplemented with paroxetine, led to a positive clinical effect, confirmed by increase in skeletal and respiratory muscular system, increased parameters of pulmonary ventilation, increased tolerance to physical load, increased oxygen saturation, decreased heart rate and breathing rate. CONCLUSION: Conclusions: The strategy for choosing an antidepressant to provide multidisciplinary care for somatoform disorders in women with exacerbation of severe COPD (group D) should take into account the efficacy and favorable safety profile and personalization of the drug. In exacerbation of severe COPD, the degree of somatoform disorders in patients correlates with the severity of the main criteria: FVC1, the distance walked during the 6-minute step test, oxygen saturation after the 6-minute step test, end-expiratory pressure in the oral cavity.

Current strategy for treatment of comorbid states: complicated community-acquired pneumonia with arterial hypertension.

OBJECTIVE: The aim: To optimize the treatment of CAP patients with hypertension, complicated by exudative pleuritis. PATIENTS AND METHODS: Materials and methods: The study included 43 CAP patients, aged 46 to 65 years, with viral lesions along with hypertension. The average age of the patients was 52.5 ± 4.5 years. Verification of the CAP diagnosis and its formulation was performed in accordance with the order of the Ministry of Health of Ukraine No. 128 of 19.03.2007 "On the approval of clinical protocols of medical care in "Pulmonology" in all patients, pneumonia was complicated by exudative pleuritis, which was confirmed by X-ray examination. RESULTS: Results: The use of combination drugs, namely, torasemide with prolonged effect and tivortin aspartate in the treatment of patients with community-acquired pneumonia, complicated by exudative pleuritis, combined with hypertension led to more significant positive changes in the values of saturation, blood biochemical parameters, as well as accelerated recovery of patients, which was confirmed by the positive dynamics of X-ray examination. CONCLUSION: Conclusions: As a result of the treatment, all parameters of the quality of life of the patients were greatly improved, which resulted in a significant reduction in functional limitations and high social activity of the patients, which significantly reduced the cost of treatment.