Acute and chronic infectious and inflammatory diseases of the upper respiratory tract occupy a leading position in the structure of the pathology of the world’s population and remain the most frequent reason for patients seeking medical care. The prevalence and frequency of this disease in this nosological group makes a decisive contribution to the structure of the causes of temporary disability, which entails significant negative social and economic consequences. In this aspect, the spread of resistance of pathogens to etiotropic drugs and the insufficient arsenal of pathogenetic drugs stimulate the medical community to search for alternative approaches to the treatment of patients with respiratory pathology. One of these therapeutic areas is the use of immunomodulators, the most commonly used group of which are bacterial lysates. In the modern literature, sufficiently convincing data have been accumulated on the effectiveness of the use of bacterial lysates of systemic action, as a result of which the immune cells of the gastrointestinal tract are activated, which in turn leads to the restoration of autoregulation of the immune response throughout the body, and a decrease in the frequency of infectious and allergic diseases. The latest developments of domestic pharmacologists are topical bacterial lysates, the principle of which is based on the local activation of mucosal immunity in the respiratory tract. The undoubted advantage is that bacterial lysates, with all their effectiveness, do not harm the human microbiome, practically do not cause side reactions, combine well with other drugs, and can also be used at any stage of the disease, including for prophylactic purposes.

Modern otology faces challenges in treating tympanic membrane (TM) perforations. Instead of surgical intervention, alternative treatments using biomaterials are emerging. Recently, we developed a robust collagen membrane using semipermeable barrier-assisted electrophoretic deposition (SBA-EPD). In this study, a collagen graft shaped like a sponge through SBA-EPD was used to treat acute and chronic TM perforations in a chinchilla model. A total of 24 ears from 12 adult male chinchillas were used in the study. They were organized into four groups. The first two groups had acute TM perforations and the last two had chronic TM perforations. We used the first and third groups as controls, meaning they did not receive the implant treatment. The second and fourth groups, however, were treated with the collagen graft implant. Otoscopic assessments were conducted on days 14 and 35, with histological evaluations and TM vibrational studies performed on day 35. The groups treated with the collagen graft showed fewer inflammatory changes, improved structural recovery, and nearly normal TM vibrational properties compared to the controls. The porous collagen scaffold successfully enhanced TM regeneration, showing high biocompatibility and biodegradation potential. These findings could pave the way for clinical trials and present a new approach for treating TM perforations.

Introduction. The issues of epidemiology, etiopathogenesis, diagnostics and clinic of acute catarrhal rhinosinusitis are considered, the possibility of using the herbal medicinal product Sinupret extract in the treatment of patients with acute viral rhinosinusitis is substantiated. Objective. To evaluate the efficacy and safety of using the drug Sinupret extract in patients with acute viral rhinosinusitis. Material and methods. A comparative study of the efficacy and safety of clinical use in patients of the drug Sinupret extract in patients with acute viral rhinosinusitis was carried out in comparison with symptomatic treatment. Results and discussion. After analyzing and processing the results obtained using statistical methods for the main group, a faster rate of decrease in the severity of complaints (data with the use of the MSS visual analogue scale), the severity of inflammation in the nasal cavity and nasopharynx, the amount of discharge from the nose and its viscosity were confirmed. Restoration of respiratory function according to rhinomanometry and mucociliary transport according to the results of the saccharin test also occurred more quickly in patients of the main group compared to the control group. The effectiveness of using Sinupret extract is also confirmed by the results of photoplethysmography. Conclusions. The use of the drug Sinupret extract not only contributes to a more rapid improvement in the general well-being of patients and a decrease in the severity of complaints, but also leads to an improvement in the objective picture of the disease (rhinoscopy, the results of anterior active rhinomanometry, saccharin test) compared with the control group, favorably affects the quality life of patients, causes a decrease in economic and social costs against the background of the development of acute viral rhinosinusitis.

Background. Unreasonable prescription of antibiotics to patients with acute diseases of the upper and lower respiratory tract is a significant problem of modern medicine, as it is associated with a high risk of side effects, an increase in antibiotic resistance and high economic costs. Phytopreparations can help reduce the frequency of inadequate antibiotic prescribing. Aim. To study the effect of the use of herbal medicines on changing the frequency of prescribing antibiotic drugs to patients with infectious respiratory pathology. In addition, the presence of a relationship between the appointment of phytopreparations and the duration of the course of the infectious and inflammatory process was determined. Materials and methods. Materials from the IMS Disease Analyze database were analyzed. The study included patients who were diagnosed with acute respiratory infection between January 2015 and March 2019. According to the prescribed treatment, patients were divided into two groups: the main one, whose patients were prescribed phytopreparations as therapy, and the control group without the appointment of similar treatment. Patients who were prescribed antibiotics on the day of diagnosis were excluded from the study. To assess the relationship between the prescription of phytopreparations, antibiotics and the duration of the period of temporary disability, the logical regression method was used. Results. The first group included 117 182 patients who used herbal medicines. In the control the same number of patients without the appointment of phytopreparations. The following results were obtained: the use of phytopreparations was accompanied by a rarer additional prescription of antibiotics in the process of treatment, the duration of the period of temporary disability in the main group was shorter. Conclusion. The use of phytopreparations in acute respiratory infections statistically significantly causes a decrease in the frequency of prescribing systemic antibiotics and a decrease in the duration of the period of temporary disability.

Nasal septal perforation (NSP) is a complex problem in otorhinolaryngology, which leads to impaired nasal breathing and dryness in the nose. This reduces the patient’s quality of life and leads to psychological discomfort. The treatment of nasal septum perforation is selected taking into account the clinical manifestations, perforation parameters and general condition of the patient. Currently, a large number of different surgical methods have been described in order to closing the defect of nasal septum. To date, there is no universally accepted method for closing NSP, which stimulates the search and development of new treatment options. Objective. Under experimental conditions, to study a new method for closing nasal septum perforation using a collagen scaffold together with adipose stromal vascular fraction containing multipotent mesenchymal stromal cells. Material and methods. The experiment was carried out on a model of nasal septum perforation in 24 male rabbits divided into four groups, depending on the construct, implanted into the defect zone: the 1st group was the control group — without the introduction of implantation material; the 2nd group — collagen scaffold without adipose stromal vascular fraction; the 3rd group — collagen scaffold with xenogenic adipose stromal vascular fraction; the 4th group — collagen scaffold with allogeneic adipose stromal vascular fraction with further dynamic evaluation of endoscopic control on day 14, after 1 month, 3 months, and 6 months. At month 6, the animals were removed from the experiment, followed by morphological examination in color with hematoxylin and eosin, as well as safranin and methyl green. Results. As a result of the experiment using adipose stromal vascular fraction of allogeneic and xenogenic origin, closing of perforation of the nasal septum of a rabbit for 3 months of dynamic endoscopic control, as well as according to morphological research, was demonstrated. Conclusion. Our study showed that the use of adipose stromal vascular fraction containing not only endothelial cells and pericytes, but also multipotent mesenchymal stromal cells in combination with a collagen scaffold closes the perforation of the nasal septum in a rabbit, without increasing the risk of violations of habitual vital activity.

Acute respiratory viral infections are widespread in the human population. High contagiosity, a wide variety of pathogens, the possibility of rapid changes in the genotype of the virus and, accordingly,cause the development of drug resistance, make it possible to develop epidemics, and sometimes pandemics of SARS.The clinical picture of all acute respiratory diseases consists of local and general manifestations. Local symptoms include difficulty in nasal breathing, rhinorrhea, pain and discomfort in the throat, cough, hoarseness, stuffy ears, and lacrimation. General manifestations of SARS indicate the onset of viremia, and include an increase in body temperature, general weakness, fatigue, malaise, and headache. The mechanism of SARS development determines the treatment tactics, including etiotropic, pathogenetic and symptomatic therapy.Domestic and international clinical recommendations indicate the possible use of symptomatic agents for SARS and influenza.Symptomatic treatment is one of the areas of therapy for patients with influenza and other acute respiratory viral infections and allows you to alleviate the general condition, accelerate recovery and improve the quality of life of patients. The use of combined drugs is safer for patients thenthanmonocomponent drugs, and is safe for patients, in case the instructions for use are strictly observed. Such complex medicines, which provides control of the symptoms of colds and flu within 24 hours, as domestic drug are used for patients with SARS. Due to its components, drughas antipyretic, anti-inflammatory, analgesic, anti-allergic, angioprotective and vasoconstrictive effects. The synergism of the components of the combined drug allows to increase the effectiveness of therapy of patients with acute respiratory viral infections.