РезюмеМикрофлора кишечника в свете интегральной совокупности знаний о ее значимости для организма человека рассматривается в настоящее время как дополнительный «виртуальный» орган, продуцирующий множество биологически активных соединений, влияющих на различные свойства и функции макроорганизма: ферментацию неперевариваемых пищевых полисахаридов, поддержание оптимальных значений внутрипросветного рН и «кишечного барьера», активность иммунной системы, витаминный статус, энергетический гомеостаз, ангиогенез. Saccharomyces boulardii не является представителем естественной микрофлоры кишечника человека, но, применяемый как пробиотик, взаимодействует с ней, восстанавливая баланс короткоцепочечных жирных кислот, снижая уровни бактериальных токсинов, действуя как суррогатная нормальная микрофлора до момента восстановления и замещения естественными ее представителями. S. boulardii обладает иммуностимулирующей и противовоспалительной активностью. Результаты клинических исследований продемонстрировали эффективность применения S. boulardii при коррекции патологических состояний, ассоциированных с Helicobacter pylori, Clostridium difficile, Candida albicans, Salmonella typhimurum, Yersinia enterocolitium, простейшими рода Entamoeba, а также при лечении синдрома раздраженного кишечника и антибиотик-ассоциированной диареи. Эффективность лекарственного препарата, содержащего S. boulardii, продемонстрирована в статье результатами клинических исследований и клиническим примером. Этот лекарственный препарат зарекомендовал себя как высокоэффективное и безопасное пробиотическое средство, позволяющее предотвращать и лечить ряд заболеваний желудочно-кишечного тракта, обладающее физиологически-оптимизированным фармакодинамическим эффектом, имитирующим защитные свойства нормальной микрофлоры кишечника человека. При использовании лекарственного препарата, содержащего S. boulardii, как у взрослых, так и у детей не наблюдаются серьезные побочные эффекты, что расширяет возможности его безопасного применения в клинической практике.

Inhaled antibacterial drugs have been used since the 1940s with greater or lesser effectiveness, due to the possibility of targeted delivery of drugs directly to the infection site at concentrations higher than MICs. High local concentrations of antibacterial agents expand the possibilities of treating infections caused by multiresistant strains and reduces antibiotic resistance in the population. The inhaled delivery method is characterized by a high level of safety due to the absence of systemic toxic effects, which reduces the risk of pseudomembranous colitis and other complications of antibiotic therapy. Thiamphenicol glycinate acetylcysteinate is a combined drug that includes thiamphenicol and N-acetylcysteine, which causes its antibacterial and mucolytic activity. The results of clinical studies have demonstrated the effectiveness of TGA in the treatment of acute and chronic bronchitis, chronic obstructive pulmonary disease, community-acquired pneumonia, laryngotracheitis, rhinosinusitis and other infections of the upper and lower respiratory tract. In pediatrics, the drug is used to treat bronchitis and pneumonia, especially those that cannot be treated with other antibacterial drugs, bronchiolitis, whooping cough, and cystic fibrosis. The article presents data on the effectiveness and safety of containing TGA. A wide spectrum of antibacterial actions, the ability to form high local concentrations of antibacterial and mucolytic components in the focus of infection, a low risk of serious side effects in both adults and children are noted. The topical use of the combination drug has proven to be effective not only in bringing about a pronounced clinical improvement, but also in reducing the frequency of use of systemic antibiotic therapy. The efficacy of thiamphenicol glycinate acetylcysteinate is not inferior to macrolide antibiotics.

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BACKGROUND: High prevalence of type 2 diabetes mellitus (T2DM) and its input to the increase of mortality indicate that social and economic value of this disease and financial burden are great. Testosterone replacement therapy (TRT) enhances the effectiveness of T2DM treatment. A research was conducted to assess if Androgel therapy in diabetic men is cost-effective. OBJECTIVES: Defining of economic benefit of adding Androgel to the T2DM treatment in men with testosterone deficiency. MATERIALS AND METHODS: Economic modeling and results of other clinical studies were used in the analysis. A guildeline of The Scottish Intercollegiate Guidelines Network (SIGN) was used for clinical study selection, development of economic modelling and study design, assessment of study quality. The study analyzed clinical effects (fasting morning glycemia, glycosylated hemoglobin, HOMA index) and mortality reduce. RESULTS: It was shown that TRT can help to reduce costs of glycemic control, to increase efficiency in terms of cost-effectiveness analysis. Target HbA1c value can be reached by additional cost of 569.39 roubles for every patient. There is a possible additional income from 454.100 to 8.896.186 rubles though reduced mortality. CONCLUSION: Thus, testosterone replacement therapy was shown as cost effective due to reduced costs. The analysis demonstrated HbA1c target achievement and, as a result, reduction of the T2DM outcomes and reduced mortality. There is a possible additional income from 454.100 to 8.896.186 rubles per year.

Introduction. IBS is a functional bowel disorder that has a significant impact on patients and society, especially in terms of quality of life and medical costs.Pathogenesis. It is believed that the pathogenesis of IBS consists of several mechanisms: the syndrome of intersection of functional disorders (gut-brain), stress, visceral hypersensitivity and changes in motor skills.Visceral hypersensitivity. Changes in visceral sensitivity in IBS are characterized by central abnormalities in areas of the cerebral cortex. Motility impairment in IBS manifests itself as abnormal myoelectric activity in the colon, resulting in repetitive contractions of the small intestine and colon, which appear to cause pain.Intestinal microflora. FODMAPs are found in high amounts in some fruits, artificial sweeteners, legumes, and green vegetables and are poorly absorbed by all people. FODMAPs have enzymatic and osmotic effects that may contribute to the onset of symptoms in some patients.The principles of IBS therapy. Treatment for IBS should be based on the type and severity of symptoms. For the treatment of IBS, drugs of various pharmacological groups are used, depending on the prevailing symptoms. These include opioid receptor agonists, bile acid sequestrants, guanylate cyclase agonists, chlorine channel activators, as well as antibiotics, probiotics, antidepressants, 5-HT3 receptor antagonists, and antispasmodics.Myotropic antispasmodics. Drugs with antispasmodic activity are used to treat functional and organic diseases of the gastrointestinal tract as a basic therapy or «on demand». Mebeverine quickly and effectively relieves spasm, pain and the entire complex of intestinal symptoms, in addition, the drug reduces visceral hypersensitivity due to a local anesthetic effect. The drug has a high safety profile and has a number of advantages over drugs of the same pharmacological group.Conclusion. Myotropic antispasmodics have been shown to be highly effective in the treatment of IBS. Mebeverine occupies a special place among myotropic antispasmodics. Its combined action provides a pronounced antispasmodic activity along with a high safety profile.