Currently, much attention is paid to pathogenetic methods of treatment of community-acquired pneumonia. As a rule, pneumonia is accompanied by a violation of the balance of formation and discharge of bronchial secretions. In order to normalize the drainage function of the bronchi, both pharmacological and mechanical methods of influencing the muciliary clearance are successfully used. The comprehensive use of the entire arsenal of therapeutic capabilities allows you to minimize the duration of the patient's stay in a hospital bed, as well as speed up the process of restoring impaired lung functions after pneumonia. The study was conducted in the pulmonology Department of the district hospital of the Eastern military district. The effectiveness of using the device of vibroacoustic influence on the chest using the BARK VibroLUNG device in the treatment of community-acquired pneumonia was studied. In addition to the traditional therapy regimens, 5 to 7 sessions of hardware vibration massage were performed. In patients who received a course of vibroacoustic massage, there was a decrease in the duration of General intoxication, productive cough, and physical signs of lung tissue consolidation. Regression of the main clinical manifestations of pneumonia was accompanied by an increase in sputum discharge, simultaneously with a decrease in the time of its production. The main group of patients was characterized by the best time for normalization of acute-phase indicators, restoration of lung ventilation function, and resolution of pneumonic infiltration according to X-ray data. The use of a course of vibration exposure to the chest allowed to reduce the duration of stationary treatment by an average of 3 days.

The relevance of pneumonia remains at the forefront and has recently attracted the attention of not only the entire medical community, but also all political and economic institutions of most countries of the planet. This nosology continues to be in the center of attention, identifying one of the key causes in the frequency of mortality of the population. The presented article accumulates the most up-to-date theses regarding viral pneumonia on the basis of a review of a large number of scientific literature, domestic and foreign studies. Although the term “viral pneumonia” has been used in medical practice for more than a century, nevertheless, there is no final diagnostic algorithm and an established final concept. The article reflects special historical medical and philosophical aspects in the study of pneumonia from the time of Hippocrates to the present. The epidemiological features, etiology, and also the terminological base of viral pneumonia are updated, thereby the concept of viral pneumonia in medical categories is fixed. A promising classification of viral pneumonia according to ICD-XI is presented. Attention is drawn to the autopsy morphological characteristics of the bronchopulmonary organ complex in viral pneumonia, post-mortem descriptions are given with links to authoritative research sources. The main modern diagnostic capabilities of the scientific medical community in the detection of pneumonia are described, the issues of the formation of new diagnostic algorithms are reflected. The clinical picture of viral pneumonia is described in detail, the clinical concept of the phase course of the disease based on pathomorphological data is presented for the first time. The main modern groups of drugs for etiotropic and pathogenetic treatment of the disease are considered. The conclusion reflects the main problematic postulates and prospects for further study of the disease.

РезюмеМиокардиальный «мостик» (ММ) -врожденная аномалия развития коронарных артерий (КА), при которой эпикардиальный сегмент сосуда проходит в толще миокарда. При данной аномалии могут поражаться любые КА, однако наиболее часто она затрагивает переднюю межжелудочковую артерию. Большинство ММ ассоциировано с бессимптомным течением, однако в доступной научной литературе, посвященной проблеме ММ, имеется большое число публикаций, описывающих и доказывающих связь между ММ и симптомами ишемии миокарда, включая случаи развития острого коронарного синдрома и внезапной сердечной смерти.В настоящем обзоре авторами обобщены и представлены современные данные о частоте распространения, патофизиологических механизмах, анатомо-функциональной и клинической оценке, а также лечению ММ. У пациентов с симптомными ММ медикаментозное лечение обычно является эффективной терапией. При ее неэффективности должна проводиться комплексная анатомическая и функциональная оценка ММ для выбора наиболее безопасной и эффективной методики реваскуляризации. Чрескожное коронарное вмешательство с помощью стентов нового поколения в настоящее время рассматривается как стратегия лечения ММ. Аортокоронарное шунтирование проводится при глубоком залегании туннельного сегмента КА под миокардом или при осложнениях, связанных со стентированием. Миотомия является высокоэффективным методом лечения пациентов с ММ при поверхностном залегании интрамиокардиального сегмента КА и выполнении операции в условиях специализированных кардиохирургических центров.Отсутствие общепринятых рекомендаций, очевидно, делает необходимым проведение дальнейших исследований в области рассматриваемой проблемы для разработки и валидизации единых алгоритмов по диагностике и лечению пациентов с ММ.

Community acquired pneumonia is one of the most topical acute respiratory diseases, which is caused by high incidence rate, especially in organized groups of people, constantly changing microbial flora, the increasing resistance of bacteria to antibacterial drugs, difficulties in etiological diagnostics, and the possibility of life-threatening complications and fatalities. An innovative algorithm of etiological diagnostics of community acquired pneumonia is suggested, which includes immunochromatography express-tests of sputum for viruses detection, bacteriological sputum culture, immunoenzyme assay of blood and polymerase chain reaction of sputum and blood serum. It is shown that standard bacteriological sputum culture did not allow us to reveal causative agents of community-acquired pneumonia timely and precisely in most cases, whereas the application of more comprehensive etiological diagnostics enabled us to reveal the causative agent in the majority of the examined patients. And express methods provided an opportunity to verify the infectious agent within 1-2 days and administer early effective etiotropic treatment. It is demonstrated that modern community acquired viral bacterial pneumonia has a number of clinical and laboratory features depending on the revealed viral agents. These features may be used as additional diagnostic criteria of the disease, especially when modern methods of etiological diagnostics are unavailable. The obtained results showed the effectiveness of the use of immunochromatography express-tests of sputum, polymerase chain reaction of sputum and blood serum, and immunoenzyme assay of blood. As a result of statistical analysis, a number of characteristic clinical and laboratory predictors of certain viral-bacterial associations of modern community acquired pneumonia was determined.