[A comparative study of the effectiveness of azoximer bromide and surgery on the quality of the life of patients with chronic rhinosinusitis without nasal polyps]. / Sravnitel'naya otsenka vliyaniya azoksimera bromida i khirurgicheskogo lecheniya na kachestvo zhizni patsientov s khronicheskim rinosinusitom bez polipov.

OBJECTIVE: The aim of this study was to compare the effects of azoximer bromide and surgery on the quality of life of patients with chronic rhinosinusitis (CRS) without polyps. We also wanted to examine changes in the patient's emotional state and the nature of their complaints. MATERIAL AND METHODS: The results of using the Visual Analogue Scale (VAS) and the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire in patients with CRS without severe or moderate-severe polyps, before treatment and 3 months after treatment, are presented. Patients, depending on their choice, were treated with functional endoscopic intervention or a course of 6 mg/ml azoximer bromide (1 ml per day, a course of at least 10 days). RESULTS: The median [interquartile range] score for VAS in patients before azoximer bromide treatment was 6.7 [6.3; 7.05] points, after treatment 4.2 [3.50; 4.70] points. The median [interquartile range] of VAS scores in patients before surgical treatment was 6.4 [6.1; 6.9] points, and after 4.8 [4.50; 5.30] points. The median [interquartile range] of the SNOT-22 score before azoximer bromide treatment was 33 [32; 36] points, after treatment - 24 [22; 25] points. The median [interquartile range] of the SNOT-22 score before surgery was 34 [32; 36] points, after treatment - 19 [18; 21.25] points. CONCLUSION: Azoximer bromide treatment and surgery improve the quality of life of patients with CRS (according to the visual analog scale and all SNOT-22 domains) during a control survey after 3 months (p<0.001). Surgical treatment has a stronger impact on the quality of life, which is more noticeable in the influence on the domains "Rhinological symptoms", "Extranasal symptoms", "Ear/facial symptoms" (p<0.05). According to the domains "Psychological dysfunction", "Sleep dysfunction", surgical intervention had no advantages in affecting the quality of life, compared with taking azoximer bromide (p<0.05).

[Potential of azoximere bromide for treatment of patients with acute inflammatory and infectious upper respiratory diseases].

AIM: To evaluate the efficacy and safety of Polyoxidonium® in patients with inflammatory and infectious upper respiratory diseases in real clinical practice. MATERIALS AND METHODS: This retrospective multicenter study included data from adults and children over 6 months old with inflammatory and infectious upper respiratory diseases (n=16 365). The exploratory endpoints included: the proportion of patients with complete relief of symptoms, demographic characteristics of patients, the frequency of prescriptions of Polyoxidonium® by disease groups, determination of the groups of concomitant drugs, most commonly prescribed treatment regimen, frequency of prescribing different Polyoxidonium® dosage forms, duration of the most common specific symptoms of acute respiratory infections during therapy, the incidence of treatment-related adverse events. RESULTS: After treatment completion, the proportion of patients with complete relief of symptoms was 40%, with positive dynamics - 99.77%. Polyoxidonium® in combination therapy was also effective in the treatment of COVID-19 and Post-COVID-19 syndrome. The median patient age was 28 years. Polyoxidonium® was most frequently prescribed for the treatment of inflammatory and infectious upper respiratory diseases in combination with antibiotics or symptomatic drugs in dosage form solution. The primary routes of administration were intranasal and sublingual. The resolution of infection symptoms occurred predominantly within the first 5 days after the initiation of therapy. The therapy appeared to be equally effective across all age groups. No Polyoxidonium®-related adverse events occurred. CONCLUSION: Treatment with Polyoxidonium® contributes to achieving favorable outcomes in patients with inflammatory and infectious upper respiratory diseases. The study drug has a high safety profile.

[Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis]. / Neitrofil'nye vnekletochnye lovushki v patogeneze khronicheskogo rinosinusita.

The review presents the current understanding of the pathogenesis of chronic rhinosinusitis. The causes of damage to the mucous membrane of the paranasal sinuses are most often the result of a combination of immunological, infectious and anatomical factors. This indicates the need for a multidisciplinary approach to the study of the pathogenesis of this pathology. There is no single universally recognized classification of chronic rhinosinusitis, which takes into account histological and immunological changes in the mucous membrane of the paranasal sinuses. The discovery of the mechanism of completion of the life cycle of neutrophils - the formation of a neutrophil extracellular trap or NETosis, different from necrosis and apoptosis, opened up new prospects in the study of the pathogenesis of inflammatory processes, including rhinosinusitis. Neutrophil extracellular traps reduce the permeability of the epithelial barrier in the mucous membrane of the paranasal sinuses. This determines their possible role in the etiopathogenesis of rhinosinusitis. In recent years, more and more attention has been paid to the feasibility, effectiveness and safety of therapy that affects the immune component of the inflammatory process, including NETosis. The data obtained in the study of extracellular traps can be used in clinical practice. It is neutrophil extracellular traps that can become a potential target in the treatment of patients with chronic rhinosinusitis.

Risk factors associated with portal vein thrombosis in liver cirrhosis: A case-control study.

AIM: To build a predictive model for PVT in cirrhotic patients. MATERIALS AND METHODS: A single centre case-control study was carried out. From the database of 1512 cirrhotic patients 94 with newly diagnosed PVT based on contrast-enhanced computed tomography were referred to the Case group. Malignant PVT was an exclusion criterion. Patients without PVT were stratified and matched according to sex, age and etiology of cirrhosis; case-control ratio was 1 : 3-4. The prevalence of PVT in the database, clinical, laboratory, instrumental parameters of the groups were evaluated. Logistic regression model was used to estimate association between variables and PVT. RESULTS: The overall prevalence of PVT was 6.2% with the highest rates among the patients with HBV infection - 16.7%, nonalcoholic steatohepatitis - 15.6%, alcohol abuse in combination with HCV infection - 11.7%. The best predictive model included variables: Child-Pugh classes B-C (coefficient of regression ß=1.853, р=0.001), ascites (ß=0.460, р=0.003), hepatocellular carcinoma without vascular invasion (ß=2.126, р=0.0001), endoscopic band ligation (ß=0.774, р=0.003), azygoportal disconnection (ß=2.734, р=0.001), portal hypertensive gastropathy (ß=0.793, р=0.017), portal vein diameter (ß=0.203, р=0.004), and local factors - ulcerative colitis flare, Clostridium difficile enterocolitis, spontaneous bacterial peritonitis, colorectal cancer, splenectomy, cholecystectomy (ß=2.075, р=0.017). The model had accuracy 85.8% (95% CI 81.7-89.4%), sensitivity - 55.1% (95% CI 43.4-66.4%), specificity - 95% (95% CI 91.6-97.3%), and AUC - 0.871 (95% CI 0.826-0.916). CONCLUSION: Child-Pugh classes B-C, severe portal hypertension, hepatocellular carcinoma without vascular invasion, and local factors were estimated as risk factors of PVT in cirrhotic patients.