Permanent nasal breathing impairment significantly affects physical and emotional well-being of patients. Today, an objective analysis of the nasal obstruction degree provides identification of its possible causes and advances in the further solution of the problem of nasal breathing normalization. The article presents the results of comprehensive study of the nasal breathing function in 20 patients with persisting complaints of the nasal breathing obstruction in spite of the previously performed surgical correction of the nasal septum and inferior turbinates deformation. Based on the results of the simultaneous comprehensive evaluation of quantitative indicators of the active front rhinomanometry, rhinoresistometry and acoustic rhinomanometry of these patients, the authors determined the degree of nasal obstruction and indications for further surgical or conservative treatment.
The treatment of acute respiratory viral infection remains an urgent public health problem. There are currently a limited number of drugs used for the treatment and prevention of this pathology with proven efficacy and safety. According to current views in the field of immunology, the most important role in immune protection against both viruses and bacteria is played by molecules and receptors that form the so-called “immune synapse”, understood as a contact of cells involved in the detection of an antigen and triggering the subsequent chain of reactions to destroy it. A complex antiviral drug that has the ability to modulate rather than block the activity of its target molecules is a product containing technologically treated antibodies to interferon gamma, CD4 and domains of the main histocompatibility complex. The combined action of its components helps to reduce the infection load on the body, reduce the severity of symptoms of SARS during the first days, reduce the duration of the infectious disease. The pharmacological effect of the drug is achieved by acting on the key molecules and receptors involved in the recognition of pathogens of both viral and bacterial origin by the immune system. In addition, the product has a direct effect on IFN-γ, which results in stopping the multiplication of viruses and protecting healthy cells from infection. The use of the antibody-based drug reduces the risk of complications and helps to increase the body’s resistance to the main pathogens of viral and bacterial infections of the respiratory tract. According to the results of clinical trials, this drug has shown high efficacy and safety in the treatment of acute respiratory viral infections (ARI) in adults. The use of antibody-based medicine in paediatric acute respiratory infections and COVID-19 treatment in an outpatient setting is currently being investigated in multicentre, double-blind, placebo-controlled randomised trials.
The objective of the study is to examine the specific features of the aerodynamic processes in the nasal cavity of patients with subjective nasal obstruction, and to make a differentiated analysis of the causes of its formation. Materials and methods: the authors examined 72 patients aged 18 to 64 years with subjective complaints of nasal breathing obstructions. Of these, 36 patients had not previously undergone surgical correction of external nose and intra-nasal structures. The other 36 patients have undergone septoplasty, rhinoplasty, turbinotomy or inferior nasal concha vasotomy over the period of 2.7±0.6 years. All subjects were surveyed, nasal obstruction was assessed using VAS scale, otorhinolaryngological examination and anterior active rhinomanometry with calculation of nasal resistance and volumetric nasal flow and acoustic rhinometry with the measurement of MCA 1 before and after α2-adrenomimetic test was performed. Results: in the patients with subjective nasal breathing obstructions, who had not previously undergone surgical correction of the external nose and intra-nasal structures, the most frequently identified causes of nasal obstruction are functional (38.9%) and structural (38.9%). The combined structural and functional changes in airflow circulation were found in 22.2% (8 patients). According to the modified VAS scale, 12 patients (32.6%) in this group had an underestimation of subjective degree of nasal obstruction, compared with objectively recorded aerodynamic respiratory function parameters. Among patients who had previously undergone surgical correction of intra-nasal structures, according to objective assessment of aerodynamic parameters, 11.1% have no nasal breathing disorders, in 47.2% of patients, the main cause of nasal obstruction is the nasal mucosa reactive edema, and 36.1% of patients have unsatisfactory functional results of surgical treatment due to incomplete correction of structural disorders. Conclusion: the anterior active rhinomanometry in combination with acoustic rhinometry should be conducted if the patients have subjective nasal breathing obstructions both at the stage of planning the surgical correction of intra-nasal structures and in the remote postoperative period for differentiated analysis of the nasal obstruction causes and provision of optimal functional result.
Case-control studies are retrospective observational studies designed to determine the relationship between the outcome of interest and its potential cause. This study design has known disadvantages: possible bias in the results, selection bias in the control group, etc. In order to avoid inconsistency between the study and control groups and thus underestimating of the possible influence of intervening factors (confounder), a whole class of methods is used to ensure that case-control matching pairs are selected and matched. Objective. To discuss and demonstrate the possibility of forming groups of research subjects (impact and control) on the basis of matching variables using the optimal matching procedure and compare the results of paired and unpaired analysis. Materials and methods. The baseline data were the results of a cross-sectional study of the impact of pandemic COVID-19 on health worker behavior. An example algorithm was used to assess the impact of awareness of different aspects of SARS-CoV-2 on health professionals. The processing was done in the R software environment. Discussion. The present study had two objectives: to demonstrate a method for optimal matching of case-control pairs for specific data and to estimate the effect of certain factors on the outcome of interest. Using this method allows for maximum consistency between study and control groups on selected matching variables. This tool simplifies and automates data preparation for subsequent analysis when case and potential control data are presented in a single dataset. Thus, the example shows that with different values of the number of controls per case indicator the point and interval estimate of the odds ratio varies slightly and indicates a statistically insignificant association between the need for more information and the forced use of leave by the health professional due to various concerns about the impact of COVID-19.
This article provides the results of comprehensive examination and treatment of 98 patients with rhinosinusitis polyposa using a short session of systemic corticosteroid therapy. The authors suggest the strategies of safe treatment of patients with rhinosinusitis polyposa using corticosteroids.
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