[Allergic rhinitis: what is the patient's choice of drug based on? Russian study's results]. / Allergicheskii rinit: na chem osnovan vybor lekarstvennogo preparata patsientom? Rezul'taty rossiiskogo issledovaniya.

BACKGROUND: Allergic rhinitis (AR) is a disease that significantly affects the quality of life (QOL) of the patients. Scientific researches that reveal the reasons for the uncontrolled course of AR and the low level of QoL in patients are rare. OBJECTIVE: Of this study was to establish how often patients with moderate AR seek medical care or prefer to choose a drug on their own in a pharmacy. MATERIAL AND METHODS: The study consisted of an online survey of 328 adults over the age of 18 who bought drugs in a pharmacy for treatment of AR. The respondents were divided into two groups: 1) those who bought the drug according to the recommendation of a doctor (164), 2) those who chose the drug on their own (164). RESULTS: The study revealed a dissonance between the severity of clinical symptoms of AR and how patients assess their QoL. The majority of patients estimated the symptoms of AR as moderate, but the disease itself was characterized as mild, not interfering with daily activity and sleep. The more severe the manifestations of AR were, the more often patients did not seek medical care from a doctor, preferring an independent choice of drugs, the help of a pharmacist, or focusing on long-standing doctor's recommendations. 48% of patients have never visited a doctor for AR. We have found a discrepancy between the optimal choice of drugs for the treatment of AR and the patient's attitude to this choice. 95% of patients purchased oral antihistamines from the pharmacy, 71% - decongestants, 26% - vitamins and food supplements. Although topical steroids were recommended by a doctor in 57% of cases, only 37% of patients bought intranasal corticosteroids in a pharmacy. When choosing a drug, 36% of patients preferred the advice of pharmacists; almost 50% followed advice from relatives and friends, 23% of patients used information from the Internet. CONCLUSION: This study confirmed a tendency towards a decrease in patient adherence to modern AR therapy algorithms. Patient seeking medical care for AR is extremely low. It is required to optimize the education of primary care physicians and pharmacists, develop educational programs for patients.

[On the problem of voice rehabilitation in the case of unilateral vocal fold paresis]. / O reabilitatsii golosa pri odnostoronnem pareze golosovykh skladok.

BACKGROUND: Unilateral vocal fold paresis (UVFP) significantly deteriorates the patient's quality of life. The leading role in the rehabilitation of the patients presenting with UVFP belongs to stimulation therapy which consists in the activation of muscle re-innervation of the larynx and the compensatory mechanisms allowing to achieve the most complete closure of the vocal folds during phonation. AIM: The objective of the present study was the optimization of the conservative treatment of patients with UVFP. MATERIAL AND METHODS: Fifty patients at the age varying from 18 to 70 years presenting with UVFP (the duration of the disease less than 6 months underwent the comprehensive treatment including electrostimulation of the larynx, vitamin therapy, and speech therapy. The patients were divided into two groups: A and B comprised of 25 subjects each. Those of Group A were given, in addition to the standard treatment, a 1.5 month-long course of Neuromidin therapy. The results of the treatment were evaluated with the use of laryngostroboscopy, flowmetry, the GRBAS scale, acoustic voice analysis (lingWaves), and the VHI questionnaire. RESULTS: The restoration of vocal fold mobility was achieved in 20% and 8% of the patients of groups A and B respectively. The clinical effect was absent in 12% of the patients in Group A and 28% of the patients in Group B. The differences between groups were statistically significant (p<0.05). In the remaining cases, the positive dynamics of the flowmetric characteristics, GRBAS and VHI data, maximum phonation time, Jitter, DSI, frequency and dynamic ranges as well as the intensity of voice were documented in 68% of patients in Group A and 64% of patients in Group B). CONCLUSION: The results of the study confirm the usefulness of the combined treatment of UVFP consisting of electrostimulation of the larynx together with speech therapy and application of cholinergic drugs. The addition of Neuromidin to the conventional scheme of conservative treatment can further improve its efficiency from 72% to 88%.

[The comparative study of the effectiveness and safety of various nasal packing techniques in the patients suffering nasal bleeding].

The objective of the present study was to improve the methods for mechanical nasal bleeding (NB) control. To this effect, the authors undertook a prospective comparative study of the effectiveness and safety of two mechanical techniques for nasal tamponade in the patients suffering from nasal bleeding. A total of 48 patients with NB and concomitant arterial hypertension were recruited for the study. In 20 of them, nasal bleeding was arrested with the help of an Epistop-3 three-balloon silicone catheter; in the remaining 28 patients, the gauze packs were used for the purpose. The conditions of the nasal cavity were assessed on the day when the pack was removed and during the next three days by the endoscopic technique and calculation of the mucociliary transport (MCT) time. The subjective assessment of the quality of life by the patients was taken into consideration. The study revealed no relapses of NB in the first group while hyperemia, oedema of nasal cavity mucosa, fibrinous pellicles and crusts were less manifested than in the control patients; moreover, the function of ciliated epithelium and the patients' quality of life were less affected (p<0.05). In the control group, recurrent NB episodes occurred in 42.9% of the patients. It is concluded that the application of the Epistop-3 catheter reduces duration of the rehabilitation period in the patients with NB. The device is fairly well tolerated by the patients; it is less injurious to the intranasal mucous membrane than the gauze pack.

[Presbiphonia. Age-related changes in the acoustic voice characteristics].

The objective of the present study was the comparative analysis of acoustic parameters of the voice in the subjects of different age groups. The phonetographic analysis involved 85 relatively healthy subjects (40 men and 45 women) divided into two age-matched groups. Group 1 included mature adults at the age of 43-59 years (n=43), group 2 was comprised of the aged and elderly persons (60-85 years, n=42). It was shown that the frequency of the primary tone decreases with age not only in women but also in men even though the decrease is less pronounced in the latter group. The process of ageing is accompanied by the narrowing of the frequency and dynamic range of the voice, the increase of Jitter, and the decrease in the strength of the voice. As a result, the dyshonia severity index (DSI) shifts toward negative values. These changes are more pronounced in women compared with men. Age-specific negative dynamics of maximum phonation time was not documented.

[Acoustic analysis of the voice in singing children].

The present acoustic analysis of the voice is based on the data obtained from 54 singing children (19 boys and 25 girls). They were divided into two groups of 27 subjects each, with one including premutational-age the other mutational-age children (from 8 to 12 and from 13 to 16 years respectively). <> software package was used to analyse phonetograms and spectrograms of the voice and to study the speech profile. The acoustic parameters measured included voice frequency range, strength, and Jitter, maximum phonation time, and dysphonic index (DSI) depending on the age of the singing children. Premutational acoustic voice characteristics were essentially similar in boys and girls unlike mutational ones that differed dramatically, in the first place due to their substantial change in boys. The boys' voice underwent marked narrowing of the frequency range and its shift toward lower values, the jitter increased, and DSI became negative (-1.7+/-2.6). On the contrary, the voice frequency range in girls broadened and shifted toward both high and low frequencies; the girls showed only small amounts of Jitter and high DSI (2.4+/-2.2).

[A nasal cycle in healthy children].

A nasal cycle was studied in 10 healthy children (5 boys and 5 girls) aged 11-17 years (mean age 14.1+/-1.9 years). Registration of the nasal cycle was conducted for 7 hours by means of long-term nasal monitoring with Rhinocycle rhinoflowmeter (Interacoustics, Denmark). The nasal cycle was presented as a graphic image of fluctuations of a relative volumetric flux (RVF) in the relative units in accordance with linear dependence of pressure in the air flow to its volume. The nasal cycle in all healthy children was irregular, with mean fluctuation rate 1.3+/-0.6 h. There were no significant differences by RVF between the right and left parts of the nose in 8 children. In girls the nasal cycle most often was partially coinsiding, partially fluctuating while in most boys (in 4 of 5) the nasal cycle was irregular bilateral and fluctuating. It was found that the cycle was not longer or regular with the child's growth.

[Bioparox effects on nasal mucosa in acute catarrhal rhinosinusitis].

An open, randomized, comparative trial of the drug bioparox was made in 50 patients. Nasal cavity function and its changes in response to bioparox administration were studied with the saccharin test and measurement of ciliary motor activity (CMA) using a special computer program. Significant suppression of the transport function and CMA in all the patients with catarrhal rhinosinusitis was observed. SMA on the inferior turbinated bone and septum was minimal, being low on the middle turbinated bone. After 7 days of bioparox administration mean value of CMA rose 2-fold. Thus, it is demonstrated that bioparox inhalations have no negative effect on nasal ciliated epithelium. On the contrary, it enhances its recovery.

[Application of polymeric endoprostheses in surgery of external ear]. / Primenenie polimernogo éndoprotezirovaniia v khirurgii naruzhnogo ukha.

Biocompatible polymeric endoprostheses EFOS are offered for endoprosthetic reconstruction of the external acoustic meatus in atresia. Such endoprostheses are safe for the adjacent tissues. Moreover, such prostheses contain antibacterial drugs (quinoxidine, dioxidin) and substances promoting tissue regeneration (orotic acid derivatives). This provides good epithelization of the walls of the newly established external acoustic meatus and sufficient lumen of the organ. The removal of the endoprosthesis is recommended on the postoperative day 90-120 in the outpatient setting.

[Efficacy of polymer suture material "kapromed" in otorhinolaryngological practice]. / Opyt primeneniya polimernogo shovnogo meteriala "kapromed" v otorinolaringologicheskoy praktike.

When used in suturing, polymer material capromed containing antimicrobial substances proved its efficacy in laryngectomy, plastic reconstruction of pharyngo- and tracheostoma, management of operative wounds on the neck, especially in patients with laryngeal cancer preexposed to radiation treatment and other surgical interventions on ENT. Compared to conventional suture materials (silk, lavsan, catgut, capron), capromed improved the outcomes of surgical treatment, reduced the number of pyoinflammatory complications.

[A combined approach to the treatment of paranasal and nasopharyngeal inflammation in childhood]. / Kompleksnyi podkhod k lecheniiu vospalitel'nykh zabolevanii okolonosovykh pazukh i nosoglotki v detskom vozraste.

105 patients with chronic purulent sinusitis and chronic adenoiditis were divided into two groups. 85 patients of the study group before adenotomy were subjected to non-puncture cleansing of the nasal cavity and paranasal sinuses using [symbol: see text] sinus catheter. 20 patients of the control group underwent adenotomy without prior cleansing. Adenotomy in patients of the study group was not associated with any complications, 25 of them required no surgery. 5 controls developed abnormal intraoperative bleeding, 10 controls had high temperature for 3 days. Complications of adenotomy were registered in 3 controls.

[Endoprosthesis of the frontonasal anastomosis after extranasal radical operations using biocompatible tubular polymeric materials]. / Endoprotezirovanie lobno-nosovogo soust'ia posle ékstranazal'nykh radikal'nykh operatsii s primeneniem biosovmestimykh trubchatykh polimernykh materialov.

The authors present pilot experience of extranasal radical operations on the frontal sinuses with the use of polymeric tube endoprostheses made of biocompatible polymeric materials EFOS 1, 2, 3 containing antimicrobial drugs (dioxidin, chinoxidin) and active substances promoting regeneration and epithelization (orotic acid derivatives). The above technique was employed in operations on frontal sinuses in 12 patients. Polymeric endoprostheses EFOS provide adequate lumen of the formed frontonasal anastomosis, reduce the occurrence of postoperative complications and recurrences as well as hospital stay.

[Endoscopic study on the effects of controlled pressure on the mucosa of the nasal cavity and paranasal sinuses]. / Endoskopicheskoe issledovanie vliianiia upravliaemogo davleniia na slizistuiu obolochku polosti nosa i okolonosovykh pazukh.

Endoscopy with fiber endoscope Olimpus FNL-10 was performed to study the effects of controlled pressure on nasal mucosa. In 15 patients with aggravated chronic purulent sinusitis maxillary mucosa alterations were assessed using sinus-catheter and maxillary microsinusotomy. 12 patients with the same diagnosis underwent nasal mucosa examination with sinus catheter . The experiments with controlled pressure in the nasal cavity and paranasal sinuses demonstrate that the above pressure causes no damage to the mucosa, though it enhances hyperemia and diminishes edema in the area of osteomeatal complex as a result of changing the pressure (+) and (-).

[Use of sinus catheter "Iamik" in children]. / Osobennosti primeneniia sinus-katetera Iamik v detskom vozraste.

Sinus catheters were inserted in 44 children (mean age 8.5 years) suffering from acute and chronic purulent polysinusitis. In 33 outpatients sinus catheterization was combined with nasal irrigation providing a persistent therapeutic effect on the inflammation focus. In view of good treatment results both methods are offered for inpatient and outpatient pediatric practice of treating sinusitis.

[Sinus-catheter "Iamik" in the treatment of combined forms of acute suppurative sinusitis]. / Lechenie sochetannykh form ostrykh gnoinykh sinusitov pri pomoshchi sinus-katetera Iamik.

The efficacy of "YAMIK" sinus catheter versus conventional sinus punctures has been tried in acute purulent polysinusitis. "YAMIK" provides atraumatic evacuation of the discharge from all the sinuses on one side as well as introduction of the drugs into the sinuses via natural shunts by means of controlled intermittent pressure produced in the nasal cavity and paranasal sinuses. The methods was tested in 101 patients with acute purulent polysinusitis versus punctures of the maxillary and frontal sinuses in 30 controls. The differences in the outcomes were insignificant, through the catheter has the advantage of more rapid sinus cleansing. The authors recommend the above catheterization as pathogenetic, usable in inpatient and outpatient settings.