The history of saline nasal irrigation (SNI) is indeed a long one, beginning from the ancient Ayurvedic practices and gaining a foothold in the west at the beginning of the 20th century. Today, there is a growing number of papers covering the effects of SNI, from in vitro studies to randomized clinical trials and literature overviews. Based on the recommendations of most of the European and American professional associations, seawater, alone or in combination with other preparations, has its place in the treatment of numerous conditions of the upper respiratory tract (URT), primarily chronic (rhino)sinusitis, allergic rhinitis, acute URT infections and postoperative recovery. Additionally, taking into account its multiple mechanisms of action and mounting evidence from recent studies, locally applied seawater preparations may have an important role in the prevention of viral and bacterial infections of the URT. In this review we discuss results published in the past years focusing on seawater preparations and their use in clinical and everyday conditions, since such products provide the benefits of additional ions vs. saline, have an excellent safety profile and are recommended by most professional associations in the field of otorhinolaryngology.

The article discusses typical tasks of quantitative comparison and analysis of the effectiveness of diagnostic medical technologies. Indicators of clinical informativeness of diagnostic methods, quantitative methods for their calculation and interpretation, their importance for making diagnostic decisions are discussed. Using one of the diagnostic methods as an example, algorithms for comparing the test diagnostic test with the gold standard test according to clinical information indicators are described: sensitivity, specificity, positive and negative predictive value of test results, accuracy, likelihood ratio of positive and negative test results. The problems of constructing ROC curves by the example of diagnostic indicators of nasal obstruction: airflow and pressure, as well as the calculation and presentation of AUC (in one figure), finding diagnostic threshold points for two tests (changes in flow and resistance), and testing the statistical hypothesis about the equality of AUC of these two tests, creating a nomogram for calculating the post-test probability of illness. It is shown how, using the presented technique, it is possible to efficiently calculate all the standard operational characteristics of diagnostic medical technologies and additional useful indicators. All calculations were performed in the statistical program R. The text of the article presents program codes of the R language with explanations.

Medical article медицинская статья

The article discusses the most common causes of diseases that cause difficulty in nasal breathing. According to the analysis of medical documentation, diseases accompanied by nasal obstruction and rhinorrhea are the most common human diseases. The priority role in the development of the clinical symptoms of rhinitis is played by the release of inflammatory mediators – histamine and bradykinin. Histamine in rhinitis mediates a cascade of pathological reactions, as a result of which local vasodilation develops, accompanied by swelling of the mucous membranes; nasal congestion; increased permeability of the vascular wall; exudation of blood plasma; irritation of nerve endings; triggering reflex mechanisms by stimulating trigeminal histamine receptors. Peculiarities of the course of intermittent and persistent forms of allergic rhinitis, the pathogenesis of allergic inflammation are considered. To reliably eliminate abundant rhinorrhea, combined with nasal congestion, the authors recommend the use of a combined nasal spray, which contains phenylephrine and cetirizine (Phenylephrine + Cetirizine). Based on the analysis of literature data, the effectiveness and safety of the use of the topical form of cetirizine are substantiated. Aspects of the clinical use of the combination of phenylephrine and cetirizine in inflammatory and allergic diseases of the nasal cavity and paranasal sinuses, in the pathogenesis of which the key role is played by swelling of the mucous membrane of the nasal cavity, are examined. It is proved that the new combined nasal spray of domestic production is an effective and safe method for treating patients with manifestations of various forms of rhinitis and nasal obstruction.

Introduction. Inflammatory diseases of the lymphoid ring of the pharynx in children are widespread and account for more than 30% in the structure of ENT pathology. Lymphoid tissue, especially the palatine tonsils, largely determines the formation of local and general protective reactions of the child’s body.The aim of this work is to assess the efficacy and safety of using topical bacterial lysate in chronic tonsillitis of streptococcal and herpes viral etiology in frequently ill children.Materials and methods. The study was conducted on a sample of 31 children aged 7–17 who were treated in the pediatric department of the Saint Petersburg Research Institute of Ear, Throat, Nose and Speech inpatiently or outpatiently, which were divided into 2 groups. Group 1 consisted of 15 children with decompensated chronic tonsillitis of streptococcal etiology, who were prescribed tonsillectomy according to indications. Group 2 consisted of 16 children with chronic compensated tonsillitis, who, after an acute respiratory infection, showed signs of acute pharyngitis in the form of pain and discomfort in the throat, perspiration, low-grade body temperature. In both groups children were prescribed to take topical baclerial lysates.Results. A subjective pain relief of sore throat in patients (groups 1 and 2) was observed from day 2–3 of administration of the topical bacterial lysate. The clinical therapeutic effect resulted in decreased intensity of inflammation of the posterior pharyngeal wall, reduction in size and tenderness of regional lymph nodes from day 4–5 of administration of the drug. The clinical recovery from acute pharyngitis in children of both groups was observed in 98% of cases at visit 3.Conclusion. The persistence of pathogenic viruses and bacteria contributes to the development of secondary immunodeficiency states and participates in the formation of a kind of “vicious circle” In these causes prescription of topical baclerial lysates may be an effective conservation therapy as well as antibiotics and antiviral drugs. The drug showed its efficacy in the treatment of acute and chronic diseases of the pharynx in children of both viral and bacterial etiology.

Introduction.At the present moment, the healthcare system has faced significant problems in terms of infectious safety: an unprecedented increase in the spectrum of pathogenic microorganisms, the annual appearance of 1-2 “new” infectious diseases, an increase in the proportion of emergent infections, especially of viral etiology, against which there are no effective drugs, and the spread drug-resistant microorganisms, as well as the establishment of a direct etiological or trigger role of microbial agents in the development of somatic human pathology.The aimof our work was to evaluate the topical preparation (amylmetacresol and dichlorobenzyl alcohol) used to stop the inflammatory process and eliminate pain in patients with pharyngeal diseases.Patients and methods.We studied the antimicrobial, antiviral and anti-inflammatory effect of a fixed combination of 2,4-dichlorobenzyl alcohol 1.2 mg, amylmethacresol 0.6 mg. 20 patients with manifestations of inflammatory changes in the pharyngeal cavity underwent treatment with Strepsils resorption tablets according to the scheme. The control group consisted of 10 patients who received therapy according to the usual scheme.Results and discussion.As a result of the therapy, sore throat in patients in the first group completely disappeared amongst 15 patients, and its intensity significantly decreased amongst 5 patients. Patients noted that the use of Strepsils resorption tablets reduces the sensation of a foreign body, irritation in the pharynx and oral cavity; eliminates pain, tickle, feeling of soreness in the throat. The analgesic effect of the drug manifested itself after about 5 minutes and lasted up to 2 hours. By the end of the treatment, all patients from this group had unpleasant sensations and discomfort completely stopped.Conclusion.Amylmethacresol/Dichlorobenzyl Absorption Tablets is a well-tolerated and effective over-the-counter treatment offering functional, sensory and emotional benefits for patients with acute sore throat, providing a quick onset of effect and may be more relevant and suitable than antibiotics when pharyngitis associated with viral infections of the upper respiratory tract.