scholarly journals Subacute cough in preschool children: differential diagnostics and differentiated therapy under ambulatory practice

2021 ◽  
pp. 46-55
Author(s):  
S.A. Mokiya–Serbina ◽  
◽  
T.V. Litvinova ◽  
N.I. Zabolotnyaya ◽  
◽  
...  
Keyword(s):  
Preschool Children ◽  
Respiratory Tract ◽  
Evidence Based Medicine ◽  
Respiratory Infections ◽  
Differential Diagnostics ◽  
Evidence Based ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Outpatient Practice ◽  
Based Medicine

The multifactorial nature of subacute cough, combined with the anatomical and physiological characteristics of preschool children, the impossibility of their full examination in outpatient practice, complicates its diagnosis. An algorithm for the differential diagnosis of acute respiratory infections accompanied by subacute cough in preschool children has been developed, it can contribute to the early identification of its causes and targeted treatment of the disease that caused the cough. A sequence of diagnostic measures is proposed, it includes anamnesis of life and diseases with a list of key questions that should be asked when collecting anamnesis in children with prolonged cough; objective examination of the child; determination of the tactics of further management (inpatient or outpatient); the choice of therapy that is comparable to the intended diagnosis; and evaluation of ongoing therapy. The emphasis is made on the importance of a full-fledged collection of anamnesis, taking into account the data of the time and conditions of the disease, and clinical data for making a presumptive diagnosis in an outpatient practice. It is recommended to carry out trial therapy if the diagnosis is difficult. The article presents modern approaches to the diagnosis of bronchial asthma in children with recurrent virus-induced vising. The modern approaches to the diagnosis and treatment of acute respiratory infections of the upper and lower respiratory tract are outlined in accordance with the principles of evidence-based medicine. It is noted that the most effective methods of treating cough are etiological and pathogenetic approaches, which consist in eliminating or weakening the action of factors that cause cough. It is emphasized that if treatment is impossible or insufficient, symptomatic cough therapy should be carried out. The main directions of symptomatic treatment of cough have been substantiated, which include measures to improve the drainage function of the lungs and restore adequate mucociliary clearance. The expediency of using ambroxol and acetylcysteine preparations was confirmed. Attention is also paid to the use of centrally acting antitussives. Discussion of the problem «to treat or not to treat subacute cough in acute respiratory infection of the upper respiratory tract» from the standpoint of evidence-based medicine is shown. No conflict of interest was declared by the authors. Key words: children, subacute cough, acute respiratory infections.

scholarly journals Principles of drug therapy for acute bacterial rhinosinusitis: from evidence-based medicine to practice

2018 ◽  
Vol 26 (1) ◽  
pp. 106-116
Author(s):  
D. S. Pshennikov ◽  
I. B. Angotoeva
Keyword(s):  
Evidence Based Medicine ◽  
Therapeutic Approach ◽  
Bacterial Resistance ◽  
Diagnostic Errors ◽  
High Rate ◽  
Differential Diagnostics ◽  
Evidence Based ◽  
Wide Range ◽  
Acute Bacterial Rhinosinusitis ◽  
Based Medicine

The problem of treatment of acute rhinosinusitis (ARS) is extremely important due to high prevalence of the disease. According to statistical data the ARS affects from 6% to 15% of population and does not show any tendency to reduction. These figures are associated with a high rate of acute respiratory viral infection (ARVI) which directly leads to rhinosinusitis. But, however, despite the fact that practically every individual experiences from 2 to 5 episodes of ARVI every year, only 0.5-2% of them are complicated with acute bacterial rhinosinusitis (ABRS). Despite this low percentage of bacterial infection, in 80% of cases systemic antibacterial treatment is prescribed which further worsens the problem of bacterial resistance in the world. The main difficulty in determination of therapeutic approach to ABRS is associated with absence of reliable methods of differential diagnostics of viral and bacterial etiology of the disease. Because of low sensitivity and specificity, none of additional visualization methods of ABRS diagnosing such as radiography, ultrasonography, computed tomography, can be used as a routine laboratory method. Thus, the main method of differential diagnostics of viral and bacterial ARS remains analysis of clinical data which leads to a high rate of diagnostic errors and to polypragmacy. Nowadays there exists a wide range of medications for treatment of ABRS in the pharmacological market. The choice of therapeutic approach by our international colleagues is mostly based on the requirements of evidence-based medicine. Russian scientists, besides evidence-based medicine principles take into account the pathogenesis of the disease. In this article different groups of medications for treatment of ABRS are presented. Some of them do not meet the requirements of evidence-based medicine so far, but they are included to the Russian standards and are used for management of ABRS.

scholarly journals Immunology and Homeopathy. 4. Clinical Studies—Part 1

2006 ◽  
Vol 3 (3) ◽  
pp. 293-301 ◽  
Author(s):  
Paolo Bellavite ◽  
Riccardo Ortolani ◽  
Francesco Pontarollo ◽  
Valeria Piasere ◽  
Giovanni Benato ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Allergic Diseases ◽  
Upper Respiratory Tract Infections ◽  
Evidence Based ◽  
Upper Respiratory Tract ◽  
Methodological Issues ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Based Medicine

The evidence-based research of the effectiveness of homeopathic medicines in common immunologic disorders is reviewed. In part 1, we introduce methodological issues of clinical research in homeopathy, and criteria utilized to evaluate the literature. Then 24 studies (12 randomized and 12 non-randomized) on common upper respiratory tract infections and otorhinolaryngologic complaints are described. In part 2, the focus will be on allergic diseases and the effectiveness of homeopathy will be globally evaluated and discussed using the criteria of evidence-based medicine.

scholarly journals The role of human β-defensin 2 (HbD-2) and cathelicidin (LL-37) in the local protection of the upper respiratory tract in children with allergic rhinitis and bronchial asthma

2021 ◽  
Vol 26 (1) ◽  
pp. 150-155
Author(s):  
Yu.K. Bolbot ◽  
T.A. Bordiі ◽  
Ya.V. Vilenskyi
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Tract ◽  
Antimicrobial Peptides ◽  
Bronchial Asthma ◽  
Respiratory Infections ◽  
Allergic Diseases ◽  
Control Group ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory

Allergic diseases of the respiratory system seriously affect the psychological, physical and social aspects of the live of sick children, morally and financially exhausting members of their families as well. It is known that exacerbations of allergic diseases of the respiratory tract occur due to interaction with numerous triggers, one of which is a respiratory viral infection. At the same time, it is widely known that patients with allergic respiratory diseases are more prone to to acute respiratory infections. One of the reasons for this tendency often is an insufficient activity of non-specific factors of local immunity of the respiratory system – endogenous amphiphilic antimicrobial peptides, in particular the most studied their representatives - the family of defensins and human cathelicidin. Current research proves that these antimicrobial peptides are characterized by broad antiviral, antimicrobial and immunomodulatory activity. The aim of this study was to study the concentrations of local immune factors - human HbD-2 and LL-37 - in the secretion of the mucous membranes of the upper respiratory tract in children with asthma and allergic rhinitis and to clarify their role in protection against respiratory viral infections in this contingent of patients. We performed laboratory and clinical examinations of 76 children aged 7 to 18 years, of whom 24 were diagnosed with allergic rhinitis, 28 children - bronchial asthma, and 24 - bronchial asthma and allergic rhinitis. The control group consisted of 20 healthy children of the appropriate sex and age. In addition to general clinical methods, patterns of respiratory morbidity were analyzed and concentrations of antimicrobial peptides were determined: by ELISA human cathelicidin (LL-37), β-defensin 2 (HbD-2) in the secretion of the upper respiratory tract, statistical analysis was performed. It was found that children with allergic diseases of the respiratory tract are characterized by a higher frequency of acute respiratory infections with more frequent involvement of the lower respiratory tract, which led to an increase in the duration of the disease compared to their healthy peers. In children with allergic rhinitis and bronchial asthma, there was revealed a significant decrease in the concentrations of antimicrobial peptides in the secretion of the upper respiratory tract compared with the control group.

Clinical, epidemiological and etiological features of severe acute respiratory infections in hospitalized patients

2021 ◽  
Vol 19 (1) ◽  
pp. 64-70
Author(s):  
S.S. Smirnova ◽  
◽  
E.V. Lelenkova ◽  
A.Yu. Markaryan ◽  
I.V. Vyalykh ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Hospitalized Patients ◽  
Influenza Viruses ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Severe Acute Respiratory Infections ◽  
Tract Infections

Objective. To study the clinical, epidemiological and etiological characteristics of severe acute respiratory infections (SARI) in in-patients in Ekaterinburg during the epidemic season 2017–2018. Patients and methods. 403 individual medical records were studied. Etiological decoding was carried out by isolating RNA or DNA of respiratory viruses from nasopharyngeal swabs by polymerase chain reaction. Results. SARI in hospitalized patients were caused by both influenza viruses (В Yamagata – 25.2% and А(H1N1)pdm09 – 11.0%) and viruses of non-influenza etiology (respiratory syncytial virus (RS-virus) – 13.3%, rhinovirus – 12.9%, metapneumovirus – 11.0%). It was found that viruses were more often secreted in children than in adults; among children of the younger age group (0–2 years old) viruses of non-influenza etiology were detected significantly more often, and in children 7–14 years old, influenza viruses were more often isolated. Patients with upper respiratory tract infections were significantly more likely to have influenza viruses (78.9%) than patients with lower respiratory tract infections (21.1%). Conclusion. The results of the study indicate the importance of hospital surveillance for SARI from the point of view of the etiological diagnosis of respiratory infections, the study of epidemiology and typical clinical manifestations for the timely diagnosis and development of additional preventive and anti-epidemic measures. Key words: hospital surveillance, influenza, PCR diagnostics, respiratory infections, epidemiology, etiology

scholarly journals Analysis of medical and statistical measures of morbidity in officers of the Navy and Ground Forces of the Russian Federation in 2003–2018

2019 ◽  
pp. 63-98
Author(s):  
V. I. Evdokimov ◽  
I. G. Mosyagin ◽  
P. P. Sivashchenko ◽  
N. A. Mukhina
Keyword(s):  
Health Status ◽  
Respiratory Tract ◽  
Medical Service ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Armed Forces ◽  
Malignant Neoplasms ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Statistical Measures

Relevance. Professional activities of the officers of the Navy of Russia and the Ground Forces of Russia are obviously different. Due to autonomous combat missions, medical support for the officers of the Russian Navy is quite specific, with high requirements to the health status of the navy personnel.Intention. To analyze morbidity of officers of the Russian Navy and the Ground Forces in 2003–2018.Methodology. A selective statistical analysis was performed using medical reports on the state of health of personnel and activities of the medical service according to Form 3 / MED in military units, in which about 60% of the total number of officers of the Armed Forces of Russia served in 2003–2018. Commonly accepted medical and statistical morbidity indicators were analyzed by disease categories of the International Statistical Classification of Diseases and Health Problems, 10th revision.Results and Discussion. The average annual morbidity rates for Russian Navy officers were (918.9 ± 35.3) and (1014.0 ± 79.2) ‰ for the Russian Navy and Ground Forces officers, respectively; primary morbidity rates were (351.0 ± 9.2) and (473.5 ± 38.0) ‰, respectively (p < 0.01); the need for case follow-up was (151.0 ± 9.1) and (114.2 ± 9.2) ‰, respectively (p <0.05); hospital admissions (236.5 ± 11.1) and (194.6 ± 17.8) ‰, respectively; work days lost (4997 ± 183) and (4180 ± 354) ‰, respectively; dismissal rates (15.90 ± 1.36) and (12.27 ± 2.72) ‰, respectively; mortality rates were (102.53 ± 5.95) and (138.35 ± 9.49) per 100 thousand officers of the respective cohort (p < 0.01). The trends in almost all morbidity and mortality types are not consistent, which may indicate the influence of various factors, for example, military-professional ones. The consistency of the trends of dismissal rates is moderate and statistically significant (r = 0.56; p <0.05), which indicates the influence of unidirectional factors, possibly organizational ones. When assessing the military-epidemiological significance of disase categories, the following diseases ranked first: acute respiratory infections of the upper respiratory tract (J00 – J06 by ICD-10), coronary heart disease (I20 – I25), hypertensive diseases (I10 – I15), diseases of the esophagus, stomach and duodenum (K20 – K31). In the Russian Navy officers, the leading 10 disease categories included malignant neoplasms (C00 – C80), obesity and other hyperalimentation (E65 – E68); other acute respiratory infections of the lower respiratory tract (J20 – J22), infections of the skin and subcutaneous tissue (L00 – L08).Conclusion. Prevention, timely treatment and rehabilitation will help improve the health status of officers. Taking into account the rates and structure of morbidity will optimize allocation of resources the medical service of the Armed Forces of Russia.

scholarly journals Features of formation of the military personnel’s morbidity of acute respiratory infections of the upper respiratory tract

2020 ◽  
Vol 12 (4) ◽  
pp. 87-92
Author(s):  
A. E. Zobov ◽  
A. A. Panov ◽  
A. A. Kuzin ◽  
A. A. Kucherov ◽  
S. N. Nikishov ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Military Personnel ◽  
Military Service ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Epidemiological Analysis ◽  
Psychological Study ◽  
Military Medical Academy ◽  
Upper Respiratory

The article sets out the views on the causes of the incidence of various categories of military personnel with acute respiratory infections of the upper respiratory tract (hereinafter – ARI URT), as having the greatest military and epidemiological significance for almost all military contingents.According to the results of a study of literature data, two groups of reasons for the formation of the incidence of acute respiratory infections of the airborne diseases are identified: external (associated with the exposure of military personnel to specific factors of military service) and internal (associated with the characteristics of individual susceptibility to this group of infections).Based on the results of a retrospective epidemiological analysis of the incidence of military servicemen on conscription, the development features of the epidemic process of ARI URT in military units and compounds are shown.According to the results of a retrospective epidemiological analysis of the incidence rate of cadets at the S.M. Kirov Military Medical Academy for 2011-2017 and a comparative analysis of the reversal rate for completed cases, the presence and relatively stable proportion of military personnel exposed to frequent ARI diseases of the airborne diseases throughout the entire 6-year period has been shown period of study.The results of a combined socio-psychological study in groups of often and rarely ill cadets are shown, showing individual signs and psychological characteristics, according to which individual military personnel can be assigned to the risk contingents of increased susceptibility to ARI URT for the purpose of organizing personalized sanitary-antipyretic (preventive) measures.

scholarly journals Choice of therapy for coughing (spiral development)

2019 ◽  
pp. 60-66 ◽  
Author(s):  
V. M. Deliagin
Keyword(s):  
Respiratory Tract ◽  
General Condition ◽  
Lower Respiratory Tract ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Active Components ◽  
Herbal Preparations ◽  
Upper Respiratory ◽  
Choice Of Therapy

Acute respiratory infections – the most common diseases in childhood, accompanied by cough. Treatment of cough is determined by the disease, the nature of sputum, the the general condition of the patient. The choice can be considered justified, depending on these conditions, herbal preparations or preparations of allo-medicine, their combination. In respiratory infections of the upper respiratory tract, it is possible to use eucaball, the active components of which are thyme and plantain. For infections of the lower respiratory tract with a viscous difficult-to-expelled sputum, Espa-nac (acetylcysteine) is indicated.

Sign in / Sign up

Export Citation Format

Share Document