An impact of acute exacerbation of COPD (AECOPD) on the course and the prognosis of chronic obstructive pulmonary disease depends on severity of the exacerbation. Moderate and severe exacerbations are considered as clinically significant events. Clinical studies investigating a role of inhalational therapy for the risk of AECOPD differed significantly in important parameters and the patients involved were not fully described in the real clinical practice. Tiotropium alone did not demonstrate any benefit over other inhalational therapies, such as inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations and long-acting muscarinic antagonist (LAMA)/LABA combinations, for risk reduction of moderate to severe exacerbations. A benefit of tiotropium/olodaterol combination over tiotropium for the reduction of risk of clinically significant exacerbations was first shown in DYNAGITO study; patients’ groups in this study did not differ in a rate and a spectrum of adverse events including cardiovascular events. An efficient bronchodilating therapy should be administered to all patients with COPD as it could improve dyspnea and prevent exacerbations. Further escalation of treatment in patients with frequent exacerbations of COPD should be personalized according to clinical course and causes of AECOPD.

No abstract

Particular attention is paid to atopic dermatitis (AD) as one of the earliest and most frequent clinical manifestations of allergy in children. AD is a multifactorial disease, the development of which is closely related to genetic defects in the immune response and adverse environmental influences. It was found that the action of these factors determines the rate of development of AD, especially in young children. One of these factors is a violation of the intestinal microbiota, which plays an essential role in the development of the child's immune system and has a protective effect in the formation of atopy. It has been shown that 80-95% of patients with AD have intestinal dysbiosis, while, along with a deficiency of lactobacilli and bifidobacteria, there is an excessive growth of Staphilococcus. The use of modern molecular genetics technologies made it possible to obtain a fairly complete understanding of the number, genetic heterogeneity and complexity of the bacterial components of the intestinal microbiota, while clinical studies have shown the importance of its interactions with the host organism in the formation of various forms of pathology. It has been established that the human intestinal microbiota is an evolutionary set of microorganisms that exists as a balanced microecological system in which the symbiotic microflora is in dynamic equilibrium, forms microbial associations that occupy a certain ecological niche in it, and is one of the most important factors affecting human health. The gut microbiota plays an important role in the pathogenesis of atopic dermatitis, which causes immunosuppression, but the exact mechanism of its action is still unclear. It is widely known that probiotics act on the immune system. These are living microorganisms with immunomodulatory effects that stimulate Th1 cytokines and suppress Th2 responses, which are being investigated for the treatment of several diseases. The most commonly used probiotics are part of the intestinal microflora such as lactobacilli, bifidobacteria and enterococci. The purpose of this article: to systematize the information available today on the influence of the composition of the intestinal microflora on the immunopathogenesis of atopic dermatitis.

Цель-провести ретроспективный анализ медикаментозной терапии больных бронхиальной астмой в Оренбургской области за 2014 г. Материал и методы. Материалом для анализа явилась сводная таблица за 2014 г. (в формате Excel) Управления фармацевтической деятельностью Минздрава Оренбургской области, содержащая персонифицированные характеристики больных бронхиальной астмой, сформированная по данным заявок из медицинских организаций. Анализ терапии проводился в соответствии с объемом отпущенных лекарственных средств, современным принципам фармакотерапии больных бронхиальной астмой, с учетом их степени тяжести и уровня контроля. Результаты и их обсуждение. Проведен анализ фармакотерапии 7373 пациентов с бронхиальной астмой, что составило 72% от числа диспансерных больных. В структуре отпущенных лекарственных средств на 1-м месте стоят препараты базисной терапии-49%. Препараты скорой помощи заняли второе место (38,6%) от общего числа лекарственных средств. Препараты по сопутствующим заболеваниям составили 12,4%. Наряду с недостаточным количеством препаратов для базисной терапии выявлена тенденция к назначению высоких доз лекарственных

вершенствовании противотуберкулезных мероприятий в Российской Федерации». Прил. 7. Инструкция по организации диспансерного наблюдения и учета контингентов противотуберкулезных мероприятий. Prikaz Minzdrava Rossii ot 21.03.2003 № 109 «O sovershenstvovanii protivotuberkuleznyh meroprijatij v Rossijskoj Federacii». Pril. 7. Instrukcija po organizacii dispansernogo nabljudenija i ucheta kontingentov protivotuberkuleznyh meroprijatij. Эйсмонт, Н.В 6.. Организация комплексных противотуберкулезных мероприятий в стационарных учреждениях длительного пребывания: автореф. дис. ... канд. мед. наук / Н.В. Эйсмонт.-М., 2002.-С.3-13.