[Modern approaches to immunization of patients of rheumatologic profile].

Recently, the importance of comorbid infections in rheumatology has increased significantly, which have a significant impact on morbidity and mortality, especially in immuno-inflammatory rheumatic diseases (IIRD). In this regard, vaccination is becoming increasingly important in the prevention of infections in these patients. This review presents an updated version of the recommendations for vaccination of adult patients with IIRD, prepared by experts of the European Union League against Rheumatism (EULAR). There is a low (suboptimal) vaccination coverage of these patients, partly due to the low frequency of referral by doctors. The role of the rheumatology team in solving the problems associated with immunization of patients with IIRD is emphasized, as well as the importance of joint decision-making taking into account the needs and preferences of patients. The issues concerning the use of vaccines against influenza, pneumococcal infection, hepatitis B.

[Vaccination in rheumatology: Evolution of views on the problem]. / Vaktsinatsiia v revmatologii: évoliutsiia vzgliadov na problemu.

The problem of coinfections that are due to both a rheumatic disease (RD) itself and the need to use immunosuppressive drugs deserves apparent attention in modern rheumatology. Coinfections substantially affect morbidity and mortality rates, especially in diffuse connective tissue diseases. The data available in the literature on the above subject matter suggest that vaccination is a powerful method for prevention of infectious diseases that are the most important problem for patients with RD.

Infective Endocarditis: Current Approaches to Antibacterial Therapy.

The problem of infective endocarditis (IE) continues to maintain its importance because of the high mortality rate and severe complications. Modern IE is a polyetiologic disease, the onset and development of which may be due to the pathogens, components of an extremely extensive list, enlarging almost every year. The serious obstacles in the effective antimicrobial therapy refer to the growing resistance of the IE pathogens to antibiotics and the increasing etiologic role of the previously very rare infectious agents. Timely information of physicians about modern IE treatment methods is of great practical importance. The basic principles of antibiotic therapy of IE with taking into account the latest recommendations of the experts of the European Society of Cardiology (2015) are described.

[Use of anti-B-cell therapy in case of antisynthetase syndrome as the severest subtype of polymyositis/dermatomyositis].

Antisynthetase syndrome encompassing a symptom complex with severe interstitial lung disease is the severest subtype of polymyositis and dermatomyositis. The characteristic feature of antisynthetase syndrome is the insufficient efficiency of traditional therapy with glucocorticosteroids and cytostatics, which determines the prognosis of the disease and the need for new therapeutic approaches to treating these patients.

[Use of fluoroquinolones in rheumatology]. / Primenenie ftorkhinolonov v revmatologii.

The efficacy and tolerance of 3 fluoroquinolones (ciprofloxacin, pefloxacin, lomefloxacin) were studied in 157 patients with rheumatic diseases concurrent with infection-induced abnormalities. Infection cure was achieved in 123 (78.6%) patients, as evidenced by clinical, microbiological, and serological studies. The tolerance of fluoroquinolones was regarded as good, satisfactory, and poor in 114 (72.6%), 37 (23.6%), and 6 (3.8%) patients, respectively. All representative drugs of the fluoroquinolones series produced typical adverse reactions. The authors consider it expedient to make further clinical studies to test the optimal treatment regimens and to expand indications for the use of fluoroquinolones in this group of patients.