[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.

[Pharmacoeconomics of ulcers: a view from Saint-Petersburg]. / Farmakoékonomika iazvennoi bolezni: vzgliad iz Sankt-Peterburga.

Only in Saint Petersburg the application of omeprazole, hiconcil and fromilid in the treatment of adult patients with duodenal ulcer could save up to 26 million rubles per year due to the decrease in the number of recurrences. Yet these funds are still wasted with the persistence worthy of better application, since most general practitioners do not realize either economic or even clinical value of eradication. The above-mentioned calculations provide a ground for reflections on the improvement of methods of advanced training for specialists with the use of pharmacoepidemiological and pharmacoeconomic grounds for the selection of optimum remedies for the treatment of duodenal ulcer. A thorough clinical and economic evaluation of our actions, methods and preparations for treatment will make it possible to enhance the efficiency and quality of treatment, to avoid not only considerable undesirable drug reactions but also unjustified social costs in the way it is done in many countries.

[The clinical and economic efficacies of short courses of azithromycin in acute sinusitis]. / Klinicheskaia i ékonomicheskaia éffektivnost' korotkikh kursov azitromitsina pri ostrom sinusite.

A randomized study of a 3-day course of azithromycin therapy (500 mg once daily) vs. a 10-day course of co-amoxiclav therapy (625 mg thrice daily) in patients with acute sinusitis was performed with an account of the GCP criteria. One hundred patients in 2 groups each of 50 persons were enrolled. The estimates of the patient body temperature, headache, pain on palpation in the area of the accessory nasal sinuses, nasal cavity stuffing, nasal discharge nature and the nose mucous membrane appearance were recorded prior to the treatment, in 72 hours and on the 10th-12th and 26th-30th days of the treatment. The microbiological analysis of the punctate from the accessory nasal sinuses was undertaken before the antibiotic therapy and 72 hours after its start. The economic analysis included the cost of the antibiotic therapy course, hospitalization term, medical manipulations and laboratory tests as well as the cost/efficacy index. The frequency of the relapses within 6 months after the cure was estimated in the two groups compared. In 72 hours and on the 10th-12th days after the treatment start the efficacy of azithromycin was significantly higher than that of co-amoxiclav. The cure was stated in 41 (82 per cent) and 26 (52 per cent) patients on the 10th-12th days, in 6 (12 per cent) and 21 (42 per cent) patients the improvement was stated and the fail was stated in 3 (6 per cent) and 2 (4 per cent) patients respectively. The efficacy of the drugs on the 26th-30th days after the treatment start did not differ. The isolates of Staphylococcus aureus and Streptococcus pyogenes were the main pathogens. The bacteriologic eradication was recorded in 29 (90.6 per cent) patients treated with azithromycin and only in 18 (69.2 per cent) patients treated with co-amoxiclav. Adverse reactions and relapses of the disease within 6 months after the cure were more frequent in the patients treated with co-amoxiclav. The cost of the azithromycin therapy was significantly lower. It was shown that the shortened course of the azithromycin therapy provided earlier cure of the patients with acute sinusitis, better tolerance of the drug, less frequent adverse reactions, lower cost as compared to the use of co-amoxiclav and no relapses.

[Comparative trial of 3-day azithromycin versus 10-day coamoxilav course efficacy in acute sinusitis]. / Sravnitel'noe issledovanie éffektivnosti lecheniia ostrogo sinusita azitromitsinom (3-dnevnyi kurs) i ko-amoksilavom (10-dnevnyi kurs).

AIM: To investigate the validity of a short-term course of azitromycin in acute sinusitis (AS). Comparison of clinical and bacteriological effects, tolerance of azitromycin and co-amoxiclav. MATERIALS AND METHODS: 50 AS patients were given a single 500 mg daily dose of axitromycin for 3 days and 50 such patients received co-amoxiclav 625 mg 3 times a day for 10 days. The examination performed before the treatment, 72 hours, 10-12 and 26-30 days after its beginning assessed the presence of fever, head ache, pain at palpation at the site of the sinuses projection, nasal breathing and discharge. X-ray examination and microbiological analysis of the puncture biopsy from the nasal sinuses were conducted before treatment and on its day 10-12. RESULTS: On the treatment hour 72 and day 10-12 azitromycin efficiency was significantly higher than that of co-amoxiclav. Recovery on the treatment day 10-12 was registered in 41(82%) and 26(52%) patients, improvement--in 6(12%) and 21(42%), no effect--in 3(6%) and 2(4%) patients, respectively, for azitromycin and co-amoxiklav. On the treatment days 26-30, 45 and 43 patients recovered, respectively. The causative agents were mainly S.aureus and Str.pyogenes. Eradication of the pathogens in response to azitromycin occurred in 29, to co-amoxiclav in 18 patients. The latter caused side effects more frequently. CONCLUSION: Azitromycin vs. co-amoxiclav provides cure in acute sinusitis for a shorter time, is better tolerated and less toxic.

[Acupuncture therapy in the treatment of patients with bronchial asthma]. / Iulorefleksoterapiia bol'nykh bronkhial'noi astmoi.

Erythron membrane impairment was investigated using membrane -active drugs (obsidan, delagil, morphium, ethanol) to specify indications to acupuncture in bronchial asthma (BA). The patients were studied during the treatment and followed up for a year. It was found that both immediate and long-term results of acupuncture were related to patterns of the membrane impairment. BA patients with a sharp, greater than 1.5 fold diminution of microcyte count upon delagil test should be assigned to repeated courses of acupuncture during a year. To monitor the treatment effect, it is recommended to define osmotic resistance of the red blood cells in obsidan test in addition to clinicofunctional indices.

[The clinical pharmacology of drugs for the therapy of the broncho-obstructive syndrome]. / Klinicheskaia farmakologiia lekarstvennykh sredstv dlia terapii bronkho-obstruktivnogo sindroma.

The pharmacodynamic and pharmacokinetic characteristics of different bronchodilators are presented. The principles of their rational combination with drugs of other groups are given.

[The effect of morphine and naloxone on histamine- and serotonin-induced bronchospasms]. / Vliianie morfina i naloksona na bronkhospazm, vyzvannyi gistaminom i serotoninom.

The effects of morphine and naloxone on bronchospasm induced by histamine and serotonin were studied on conscious rats. Morphine was found to increase histamine-induced bronchospasm and to prevent serotonin-induced bronchoconstriction. Naloxone prevented histamine-induced bronchospasm and exerted no effect on serotonin-induced bronchospasm.

[Features of erythrocyte aggregation in various forms of bronchial asthma]. / Osobennosti agregatsii éritrotsitov pri razlichnykh formakh bronkhial'noi astmy.

A model of aggregation of erythrocytes was used to study the characteristic features of membrane disorders in different forms of bronchial asthma. It was found that erythrocytic aggregations depended on the form of bronchial asthma, primarily due to the characteristic features of the erythrocytic cellular membrane. In infectious-dependent bronchial asthma and chronic obstructive bronchitis erythrocytic aggregation was increased while in atopic bronchitis it tended to decrease.

[Features of absorption of cortisol by peripheral blood cells in patients with bronchial asthma]. / Osobennosti pogloshcheniia kortizola kletami perifericheskoi krovi u bol'nykh bronkhial'nu astmoi.

Hydrocortisone absorption by lymphocytes and red blood cells was reduced in patients with bronchial asthma (BA). Adrenaline produced the stimulatory effect on hydrocortisone absorption by lymphocytes and red blood cells in practically normal subjects and in BA patients in whom that effect was decreased. In patients with the steroid-dependent clinico-pathogenetic pattern of BA, hydrocortisone absorption by lymphocytes was reduced to a considerable degree. It is stressed that cellular mechanisms of glucocorticoid insufficiency are implicated in the BA pathogenesis.