Introduction. About 40% of patients with bronchial asthma on dual therapy with inhaled glucocorticosteroids and long-acting β2-agonists do not achieve asthma control.

Aim. To evaluate the efficacy of triple therapy (fluticasone furoate, umeclidinium bromide, vilanterol) in a single inhaler in patients with bronchial asthma in real clinical practice.

Material and methods. The study included 43 patients with bronchial asthma from municipal outpatients’ clinics in Ekaterinburg and the Sverdlovsk region. The clinical-functional and clinical-economic efficiency of therapy was evaluated for 6 months before and after the appointment of a triple combination (fluticasone furoate, umeclidinium bromide, vilanterol) in a single inhaler

Results and discussion. Of the 43 patients, 39 patients were included in the analysis. During 6 months of triple therapy in a single inhaler, the  mean ACT value increased from 13  (Q1–Q3: 12–14) to 21  points (Q1–Q3: 20–22) (p <   0.001), the  proportion of patients with uncontrolled asthma decreased from 100% initially to 15.4% at 6 months of therapy (p< 0.001). By the 6th month of therapy, all patients refused to take systemic glucocorticosteroids (p = 0.003), there was an increase in FEV1 from 73.0% (Q1–Q2: 70.0–75.0) to 82% (Q1–Q2: 80.0–86.5) (p < 0.001). The number of ambulance calls (from 0.28 ± 0.46 per 1 patient at baseline) and hospitalizations (from 0.67 ± 0.84 per 1 patient at baseline) decreased to 0 (p >< 0.001) after 6 months of treatment with the  study drug. Savings in  the management of  1  patient for  6  months on a  triple therapy in  a single inhaler amounted to 10523 rubles, and the prevented economic damage for 39 patients for 6 months of therapy is 410418 rubles. Conclusion. The triple therapy in a single inhaler made it possible to improve asthma control and respiratory function, stop taking systemic glucocorticosteroids, reduce the number of hospitalizations and emergency calls, while reducing direct costs per unit of efficiency.>< 0.001). The number of ambulance calls (from 0.28 ± 0.46 per 1 patient at baseline) and hospitalizations (from 0.67 ± 0.84 per 1 patient at baseline) decreased to 0 (p< 0.001) after 6 months of treatment with the  study drug. Savings in  the management of  1  patient for  6  months on a  triple therapy in  a single inhaler amounted to 10523 rubles, and the prevented economic damage for 39 patients for 6 months of therapy is 410418 rubles.

Conclusion. The triple therapy in a single inhaler made it possible to improve asthma control and respiratory function, stop taking systemic glucocorticosteroids, reduce the number of hospitalizations and emergency calls, while reducing direct costs per unit of efficiency.

Introduction. Taking into account the prevalence of asthma and especially severe atopic asthma which requires carefully selected and expensive therapy, the appearance of the domestic biosimilar omalizumab among biological therapy drugs makes the choice of treatment for this category more affordable. The article presents the results of an observational open prospective clinical trial of the omalizumab biosimilar in severe athopic asthma patients.

The purpose of this study was to evaluate the efficacy and safety of the domestic production biosimilar in the real clinical practice.

Materials and methods. The study involved 10 adult patients aged 19 to 55 years with a diagnosis of moderate to severe uncontrolled persistent asthma treated with mediun to high dose ICS and second&more controller (ACQ-5 ≥ 1,5, FEV1 < 80% of the predicted normal value). For 26 weeks all patients received the omalizumab. The evaluation of the efficacy was provided taking into account asthma symptoms improvement the results of ACQ-5, FEV1, PEF, asthma exacerbations and the use of health resources. Results. According to the results of data analysis due to omalizumab all patients demonstrated reducing daily asthma symptoms, nocturnal awakening and night time symptom, shortness of  breath and SABA using. An  asthma control improvement was observed after 1 month treatment (Δ ACQ-5 1.6 [1.2; 2.4], p = 0.0002 compared to the baseline data) with a continued tendency to further increase during 6 months of the study. A statistically significant increase in FEV1 was noted (initially, FEV1 56.7% [51.25; 61.8] of the predicted; after 1 month, FEV1 67.5% [63.45; 70.6] of the predicted, p = 0.00003; after 6 months, FEV1 80.6% [80.55; 84.05] of the predicted, p >< 0.001). Omalizumab biosimilar used allowed to reduce the background asthma therapy. No asthma exacerbation was registered due to 26 weeks omalizumab treatment. Conclusions. Based on the results of the study, it was shown that the administration of the omalizumab biosimilar to patients with severe atopic asthma improves control over the symptoms, lung function and reduces the amount of asthma exacerbations, and has a good safety>< 80% of the predicted normal value). For 26 weeks all patients received the omalizumab. The evaluation of the efficacy was provided taking into account asthma symptoms improvement the results of ACQ-5, FEV1, PEF, asthma exacerbations and the use of health resources.

Results. According to the results of data analysis due to omalizumab all patients demonstrated reducing daily asthma symptoms, nocturnal awakening and night time symptom, shortness of  breath and SABA using. An  asthma control improvement was observed after 1 month treatment (Δ ACQ-5 1.6 [1.2; 2.4], p = 0.0002 compared to the baseline data) with a continued tendency to further increase during 6 months of the study. A statistically significant increase in FEV1 was noted (initially, FEV1 56.7% [51.25; 61.8] of the predicted; after 1 month, FEV1 67.5% [63.45; 70.6] of the predicted, p = 0.00003; after 6 months, FEV1 80.6% [80.55; 84.05] of the predicted, p < 0.001). Omalizumab biosimilar used allowed to reduce the background asthma therapy. No asthma exacerbation was registered due to 26 weeks omalizumab treatment.

Conclusions. Based on the results of the study, it was shown that the administration of the omalizumab biosimilar to patients with severe atopic asthma improves control over the symptoms, lung function and reduces the amount of asthma exacerbations, and has a good safety.

Introduction. One of the antileukotriene drugs for the treatment of bronchial asthma and allergic rhinitis with and without polyposis is montelukast. The presented article presents the  results of  the analysis of  the effectiveness, safety and impact on the quality of life of patients, the use of the singular, in various forms of allergic rhinitis and associated comorbid conditions.

Aim of the study. To assess the impact on the quality of life of patients, the effectiveness and safety of the use of montelukast in the complex therapy of patients with allergic rhinitis and comorbid diseases.

Materials and methods. A simple, blind, randomized, controlled clinical trial involved 97 patients divided into 4 groups: patients with moderate allergic rhinitis; allergic rhinitis of moderate severity and bronchial asthma; severe allergic rhinitis and bronchial asthma; severe allergic rhinitis, bronchial asthma and polypous rhinosinusitis. In parallel with the comparison of drug tolerability, safety and clinical symptoms (rhinorrhea, nasal congestion, itching, sneezing, bronchopulmonary manifestations), the quality of life was assessed using a special SNOT-22 questionnaire.

Results. The use of the antileukotriene drug montelukast in the complex therapy of allergic rhinitis and related comorbid conditions significantly improved the clinical symptoms and quality of life of patients over the entire period of treatment in all groups. There was an increase in the suppression of leukotriene-mediated effects when using montelukast, more in the group of people with allergic rhinitis and bronchial asthma, such as symptoms of the allergic triad, mucus hypersecretion, bronchospasm, eosinophilia, increased vascular permeability, etc.

Conclusion. In the treatment of patients with allergic rhinitis and morbid conditions, Singular has demonstrated an inhibitory effect on cysteinyl leukotrienes, high bioavailability, good tolerability and safety.

In recent decades, attention to lung diseases associated with bronchiectasis has increased significantly. Despite the availability of modern effective therapy methods, primarily inhalation therapy, the problems of improving mucociliary clearance, reducing hypersecretion in pathologically deformed bronchi do not lose relevance. In patients with bronchiectasis, cystic fibrosis, COPD with bronchiectasis, methods of kinesitherapy to improve lung drainage function come to the fore. One of modern effective methods of kinesitherapy is the use of simulators with positive expiratory pressure. This includes the PARI O-PEP and the PARI PEP S system. These simulators are effective and easy to use. The PARI PEP S system is attached to a nebulizer and the patient can perform basic mucolytic therapy with exhaled resistance, which is more effective in influencing lung drainage function. The use of expiratory simulators is even more effective if included in a pulmonary rehabilitation course, conducted in conjunction with the improvement of breathing pattern (breathing pattern) through the use of aspiratory simulators, with training of the upper and lower muscle groups that are affected by chronic infectious process. The use of hardware methods to improve lung drainage function, such as vibration and compression therapy, is important to manage exacerbations of bronchiectasis. Due to the pandemic of new coronavirus infection (COVID-19), it is necessary to prevent worsening of the course or exacerbation of lung diseases associated with bronchiectasis, so the daily use of physical training, aspiration training and expiratory exercise machines is essential.

The pandemic of  coronavirus infection COVID-19 (Coronavirus Disease 2019), caused by a  new strain of  coronavirus SARSCoV-2  (severe acute respiratory syndrome coronavirus 2), has caused high mortality worldwide. The clinical manifestations of COVID-19 are nonspecific. Diagnostics includes clinical, laboratory and radiological data. The importance of introducing information systems into medical practice in order to improve the quality of medical care is noted. It is stated that the development of medical artificial intelligence is associated with the development of artificial intelligence programs designed to help the clinic in making a diagnosis, prescribing treatment, as well as predicting the outcome of the disease. Such systems include artificial neural networks, fuzzy expert systems, and hybrid intelligent systems. The article analyzes data from a number of studies on the use of artificial intelligence for diagnosing COVID-19, predicting the risk of mortality and studying risk factors for severe course and lethal outcome in various groups. Using clusters of predictors, models have been developed to predict mortality and understand the relationship of various characteristics and diseases with mortality from COVID-19. The article also summarizes the key factors that worsen the prognosis for COVID-19. Scales for detecting or predicting the development of COVID-19-induced “cytokine storm” are marked as a separate item.

Introduction. Morbidity and mortality of COVID-19 actualizes the identification of groups with the greatest risk of primary and re-infection, persons in need of priority vaccination or revaccination.

Objective. To study the factors affecting the content of IgG antibodies to the S-protein SARS-CoV-2 in convalescents after suffering COVID-19 for 6 months.

Materials and methods. The study of  the Military Medical Academy and the  Helix Laboratory Service was carried out from 06/01/2020 to 08/01/2021 on the basis of the Military Medical Academy and the Helix centers. The study included 1421 people – both sexes from 18 to 70 years old. 1205 with asymptomatic and mild disease (outpatient group). 216 with moderate or severe form (inpatient group). The outpatient group underwent a quantitative determination of IgG to the spike (S) protein SARS-CoV-2 by immunochemiluminescence analysis at 30, 45, 60, 90, 180 days from diagnosis. The diagnosis was verified by a positive RT-PCR result. The inpatient group underwent an identical study on the 1st, 14th, 45th, 60th, 90th and 180th days from the moment of admission to the hospital. The diagnosis was verified in the same way.

Results. In convalescents, post-infectious immunity is formed from 30 days. Older age was associated with a more pronounced production of IgG to the S-protein SARS-CoV-2, mainly in older women. Moderate and severe course is characterized by higher concentrations of IgG to the SARS-CoV-2 S protein. A high level of IgG to the S-protein SARS-CoV-2 persists for up to 90 days, with a subsequent decrease by 180 days. Body weight, days of oxygen therapy, hyperthermia, the volume of lung tissue lesions and the level of C-reactive protein correlate with the concentration of IgG to the S-protein SARS-CoV-2. The use of glucocorticoids (GCS) is characterized by the presence of a higher concentration of IgG to the S-protein SARS-CoV-2 up to 6 months. There is a dose-dependent effect of using GCS.

Conclusion. The formation and maintenance of the level of neutralizing antibodies for 6 months depends on the severity of the disease, the gender and age of the patients, and the fact of using GCS. This must be taken into account when carrying out therapeutic and preventive measures, planning vaccination.

Introduction. Pregnant women may be at increased risk for severe COVID-19 illness. Pregnant women are more likely to be hospitalized at ICU, needed the mechanical ventilation compared to nonpregnant women of childbearing age. Building on the experience of the effective use of the exogenous surfactant for influenza A/H1N1 treatment of pregnant women with COVID-19, the surfactant therapy has also been included in the treatment.

The objective. To evaluate the effectiveness of surfactant therapy in the integrated treatment of severe COVID-19 pneumonia of pregnant women and postpartum women.

Materials and methods. The study included 135 pregnant and postpartum women with severe COVID-19 pneumonia. All of them received antiviral, anticoagulant, anticytokine and anti-inflammatory therapy. 68 patients (main group) with an initially more severe course of the disease and a greater degree of lung damage (p = 0.026) received inhalations with Surfactant-BL, 67 patients (control group) did not receive the  surfactant therapy. Patients received Surfactant-BL through a  mesh-nebulizer at a  dose of 75 mg 2 times a day for 3–5 days.

Result. Patients of the main group showed decreasing risks of requiring the noninvasive ventilation (27.9% vs. 52.2%, р = 0.014) and artificial lung ventilation (2.9% vs. 11.9%, p = 0.047), the length of stay in the intensive care unit (ICU) was reduced (10.6 vs. 13.1 inpatient days, р = 0.045). Сomplications such as pneumomediastinum and pneumothorax occurred less frequently in the surfactant therapy group (24.2% vs. 52.4%, p = 0.037) with a high extent of lung damage (CT-3–4). With early surfactant therapy in the standard oxygen therapy stage or high-flow oxygenation, gas exchange indicators were restored faster, thus avoiding mechanical ventilation and has reduced the duration of intensive care (р = 0.004) and prevented deaths.

Conclusion. The use of surfactant therapy for pneumonia associated with COVID-19 in pregnant and postpartum women against the background of ongoing complex therapy helps to prevent further lung damage, reduce the mechanical ventilation risk and improve oxygenation earlier, especially with early start of surfactant therapy.

Introduction. An urgent problem in many countries of the world is the growth of comorbid diseases and conditions associated with the pathological use of the Internet, including functional somatic disorders, which include asthenic syndrome.

Purpose of the study. To study the frequency of occurrence of asthenic syndrome schoolchildren with different online behavior during the coronavirus pandemic.

Materials and methods. The method of random sampling was used to examine 1 148 adolescents at the age of 11–18 years, of which 535 (46.6%) were boys and 613 (53.4%) were girls. The frequency of occurrence was analyzed in the entire sample of the surveyed, as well as in the comparison groups, formed by gender: 1 gr. – boys (n = 535), 2 gr. – girls (n = 613), age: 1 gr. – 11–14 years old (m + d) (n = 837) and 2 gr. – 15–18 years old (m + d) (n = 311), type of online behavior: 1 gr. – with adaptive use of the Internet, 2 gr. – with maladaptive internet use, 3 gr. – with pathological use of the Internet and type of Internet addiction.

Results. The frequency of adaptive use of the Internet was 37.0%, with maladaptive – 49.9% and with pathological – 13.1% of the total sample of  the surveyed. The content structure of  the online behavior of  Tuvan schoolchildren includes the  presence of a game Internet addiction in 4.4% of the surveyed, dependence on social networks – in 12.5%, mixed IА – in 2.4% and undifferentiated IА – in 5.0%. The frequency of asthenic syndrome is 12.2% of all surveyed.

Conclusion. A more pronounced association of asthenic syndrome in schoolchildren with maladaptive online behavior indicates the negative impact of the computer and the Internet on the body and justifies the need for a personalized approach to these contingents.

The COVID-19 (COronaVIrus Disease 2019) pandemic caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2) continues to be a global threat to people and health systems. As of March 21, 2022, there are more than 460 million cases and more than 6 million deaths worldwide, and more than 17 million and 360,000 respectively in the Russian Federation. Due to the rapid spread of the new coronavirus infection, since the beginning of the pandemic, tremendous efforts have been made to create new pharmacological agents to reduce morbidity and mortality, and tactics have been used to repurpose existing medications in treatment regimens for patients with COVID-19, particularly statins. Statins represent one of the most widely used and prescribed classes of drugs in the world. The hypolipidemic properties of statins are actively used to treat hyperlipidemia and primary and secondary prevention of cardiovascular diseases and their complications. Statins have a known safety profile, are inexpensive and accessible. In addition to their hypolipidemic effects, statins have a wide range of pleiotropic anti-inflammatory, antiviral, and antithrombotic effects potentially useful in the treatment of COVID-19. Presumably, the use of statins can reduce SARS-CoV-2-induced organ and tissue damage and improve lung function. The use of statins, particularly atorvastatin, as one of the most effective, widely prescribed and studied drugs in this class, as a safe, affordable and relatively inexpensive therapy may be a promising therapeutic approach in the fight against a new coronavirus infection.

Introduction. Extensive drug resistance (XDR) M. Tuberculosis (MBT) is considered the main factor that reduces the effectiveness of the treatment of TB patients around the world, including Russia. A significant role in improving the effectiveness of chemotherapy (CT) in people with resistant TB belongs to the introduction of new anti-TB drugs, the first of which was bedaquiline (LP-002281).

Objective. To assess the profile of an XDR-TB patient receiving bedaquiline and the efficacy of chemotherapy regimens including bedaquiline in patients with XDR pulmonary tuberculosis.

Materials and methods. The study is retrospective, non-comparative, descriptive. The data of 88 patients who received bedaquiline in the XDR-TB treatment regimen in anti-tuberculosis institutions of the Saratov region in 2017–2018.

Results. Patients with chronic TB prevailed – 50/88 [56.8%, 95% CI 46.3–67.4], every fourth patient had a history of surgery. The cessation of bacterial excretion, confirmed by bacterioscopy, was achieved in 51/67 [76.1%, 95% CI 65.7–86.5] patients; by cultural method – in 47/67 [70,1%, 95% CI 59.0–81.3]. Negative sputum smear in a significant proportion of patients 43/51 [84.3%, 95% CI 52.4–75.9] was observed after 12 weeks of therapy, negative cultures in 36/47 [76.6%, 95% CI 41.6–65.9] – after 16 weeks.

Discussion. Compared to individual patient analyzes – 43% success rate in the treatment of XDR-TB, in our cohort of XDR-TB patients treated with bedaquiline, the  success rate was 53.4%, which is consistent with data from a  large study describing the safety in 2017, tolerability and efficacy of bedaquiline and could be higher in the absence of “discontinuations from treatment”.

Conclusion. The regimens of treatment of patients with XDR-tuberculosis with the inclusion of bedaquiline are effective in terms of the termination of bacterial excretion, confirmed by bacterioscopy and culture in patients with a complex course of a specific process with previous ineffective therapy.

Accepted, basic therapy of cystic fibrosis (CF), until recently, was symptomatic and aimed at slowing down pathological processes, mainly from the respiratory system and gastrointestinal tract, caused by a defect in the CFTR gene. New strategic opportunities have emerged since 2012 and are aimed at correcting a defect in a gene or its product. A mutation in the cystic fibrosis gene disrupts the function of the cystic fibrosis transmembrane conductance regulator protein (CFTR or CFTR in English transcription), which is located on the surface of the apical membrane of epithelial cells and functions as a chloride channel. The basic achievement for the new CF therapy was the discovery of small molecules that restore the processes of synthesis, transport to the membrane, or the  functioning of  the defective CFTR protein. The effectiveness of  drugs that restore CFTR function is related to the ability of the molecules to deliver an adequate amount of the CFTR protein to the surface of the epithelial cell and/or improve its functional activity. Among them, correctors and potentiators for pharmacological modulation of ion transport are distinguished in clinical practice. Correctors are medicinal substances that allow the mutant CFTR protein to pass through the system of intracellular quality control and take the correct location on the apical membrane (with class II mutations). The action of potentiators is aimed at restoring (activating) the function of the ion channel formed by the mutant CFTR protein (class III–IV mutations). The purpose of this article is to analyze the literature sources, the results of clinical trials on the use of CFTR modulators, including combinations of a potentiator and a corrector. Their effectiveness and safety were evaluated. Literature sources (20) are used and own clinical observation is given. A positive assessment of the action of the modulator, the combination of a potentiator and a corrector, its safety and good tolerability is given. In conclusion, the place and indications for prescribing drugs of this class, the number of patients in the Russian Federation in need of such treatment are determined.

Introduction. Cystic fibrosis (CF) is a  hereditary disease with genetic heterogeneity and clinical polymorphism. Expanding the range of knowledge about the characteristics of the course of the disease in different regions is important to achieve the goal of improving the quality and life expectancy.

Purpose. Comparative analysis of the features of the course of CF in the subjects of the Southern Federal District, Stavropol Territory.

Methods. Data from the National Register of Patients of the RF MV 2016 were used. Results: there are clinical and genetic features between the regions of the Southern Federal District and the Stavropol Territory of the North Caucasus Federal District and in general with the Russian Federation. Analysis of the data showed differences in indicators: the proportion of patients aged ≥ 18 is the lowest in the Republic of Crimea (14.9%), in the Rostov region the lowest average age of patients (9.0 ± 6.3), and the lowest age of diagnosis 2.2 ± 3.1 years. Late terms of diagnosis were revealed in the Stavropol Territory (4.0 ± 8.0 years), but here there is one of the highest average age of CF patients (14.1 ± 11.5), the proportion of adult patients (23.3%) and the lowest allelic frequency of F508del, which is determined by the high number of patients with a “soft” genotype. There is a high proportion of patients with an undetermined genotype. A low proportion of two identified genetic variants of the CFTR gene is registered in patients of the Republic of Crimea. A low frequency of Burkholderia cepacia complex and Achromobacter spp was revealed, and a high infection with non-tuberculous mycobacteria was revealed in the Rostov region. FEV1 in children and adults was lower in Rostov Region and Stavropol Territory. In all regions, there is a discrepancy between the seeding of flora and azithromycin therapy and the severity of the genotype with the use of pancreatic enzymes.

Conclusions. Analysis of the data of the registry, which allows substantiating the need to study the regional characteristics of the course of CF in order to differentiate the planning of measures to improve the quality of medical care for patients with CF.

The article describes the features of mucolytic therapy in patients with cystic fibrosis, as the leading pathogenetic mechanism of the disease lies in the compromised mucociliary transport due to the presence of viscous secretions. Particular attention is paid to the key mucolytic drug (endonuclear mucolytic) dornase alfa, which has three clinical effects: powerful mucolytic, anti-inflammatory and antibacterial. The extracellular DNA cleavage in secretions results in a decrease of bronchial mucus viscosity, and a decrease in elastase and IL-8 concentrations in sputum results in the reduction of lung tissue destruction in chronic bacterial inflammation. The authors pay attention to the adherence to the drug policy, possible dosing regimens and drug use variants to achieve a clinical effect. Also, the article extensively covers the results of international clinical studies on the use of dornase alfa in cystic fibrosis. The authors presented their own clinical observation – the experience of clinical and functional control over the efficacy of the drug when comparing two groups of children with cystic fibrosis: those who received (2018–2021) and those who did not receive dornase alfa (1995–1998 – before it was introduced into clinical practice). The remarkable thing is that the results of FEV1, MEF 50, MEF 75, PEF were significantly higher in the group of modern children with cystic fibrosis, who receive dornase alfa continuously as part of the backbone therapy, than in children of the same age 25 years ago. It has been substantiated that dornase alfa is one of the main components of the backbone therapy for patients with cystic fibrosis, which should be prescribed on an ongoing basis after the diagnosis has been established, under the functional control of its efficacy

A literature review presents the efficacy and safety of the new glycopyrronium bromide/formoterol fumarate (GP/FF) combination in the treatment of patients with chronic obstructive pulmonary disease according to the PINNACLE 1, 2, 3, 4 studies. There are 4 fixed LAMA/LABA combinations which used in world practice, as well as in Russia: vilanterol + umeclidinium bromide, glycopyrronium bromide + indacaterol, olodaterol + tiotropium bromide and aclidinium bromide + formoterol. The GP/FF combination also approved in Russia, is currently present in Global Initiative for Chronic Obstructive Lung Disease (GOLD). A new method of co-suspension delivery via the Aerosphere inhaler has been developed for this combination. The efficacy and safety in GP/FF MDI compared to its monocomponents and tiotropium bromide were assessed in phase III clinical trials PINNACLE 1, 2, 3, 4. The GP/FF combination showed an improvement in the morning and after 2 hours parameters of FEV1 compared to monocomponents and placebo. Data from PINNACLE studies showed an improvement in the quality of life associated with a decrease in compared with the baseline level of the overall score on the scale of the St. George’s Hospital Respiratory Questionnaire (SGRQ) in 24 weeks against those taking GP/FF in contrast to monocomponents and placebo. The use of GP/FF showed a significant reduction in the
use of salbutamol compared with placebo. A pooled analysis of PINNACLE 1, 2, 4 demonstrated that GP/FF improved lung functionand reduced the risk of COPD exacerbations compared with monocomponents and placebo. According to the results of the analysis, there was also no increase in the number of the most frequently recorded side effects.

Respiratory diseases take the lead in the infectious pathology pattern of various organs and systems and are the most common. Acute bronchitis is inflammation of the bronchi due to a viral infection and is characterized by a persistent cough that can be productive or dry. The authors consider the use of herbal preparations as an effective symptomatic product for the treatment of cough of various origins. Medicinal herbs are widely used in medicine due to many useful properties and do not have any serious side effects. Ivy leaf (Hedera helix) extract preparations are common cough medicines available over the counter that are approved by the European Medicines Agency (EMA). Ivy (Hedera helix) leaves contain various biologically active components, but saponins are the main substance. Saponins are natural compounds that have a variety of biological effects. According to literature data, the action of saponins is determined not only by their bronchodilator and mucolytic properties: among additional therapeutic options of saponins are high anti-inflammatory activity, as well as antimicrobial, antifungal and antiviral effects. The article shows the potential for use of ivy saponins as carriers of pharmaceutical substances, which can significantly reduce the effective doses of certain drugs. Preparations containing ivy leaf extract are safe and approved for use even in new-borns. Also, herbal preparations with antiviral, immunomodulatory and anti-inflammatory potential become the object of study as a new strategy for treating COVID-19.

Introduction. The goal of the surgical treatment of patients with chronic otitis media is to eliminate the consequences of the inflammatory and destructive disease while preserving the anatomy of the middle ear and improving auditory function. According to the literature, the outcome of middle ear reconstructive surgery for the surgeon and the patient in most cases remains unpredictable. The development of an integrated approach to predicting the results of reconstructive sanitizing surgery will make it  possible to select the most effective surgical tactics in terms of treatment time and type of surgical intervention.

Aim. To develop a methodology for personalized prediction of the result of operations on the temporal bone in patients with chronic otitis media and substantiate the choice of optimal surgical tactics, taking into account clinical and functional parameters.

Materials and methods. A retrospective study was carried out to compare the data of patients with the use of the author’s personalized prognosis method: “A method for predicting the result of tympanoplasty” and “A method for predicting the degree of  hearing loss in otosurgery for chronic otitis media” with the results of surgical treatment of 263 patients with chronic otitis media, operated on in hospitals in Moscow. Chelyabinsk in 2018–2020.

Results and discussion. In the observation, the patients were divided into two groups according to the sum of points, which determined the volume, type and timing of the operation. The sum of points less than or equal to 20 was assessed as a favorable prognosis for reconstructive debridement surgery. The sum of points in the range from 21–40 was assessed as the possibility of carrying out onestage surgery for the purpose of sanitation and reconstruction, but the patient should be informed about the unfavorable prognosis for the restoration of hearing. A score greater than 40 is assessed as an unfavorable prognosis, with an indication for separate-stage surgery, indicating a socially significant hearing loss in the postoperative period in patients with chronic otitis media.

Conclusion. A personalized approach to predicting the results of surgical treatment forms groups of patients with chronic suppurative otitis media and helps in choosing surgical tactics in terms of the type, volume and timing of one-stage or separatestage reconstructive surgery and the need for reoperation for a period of one year.

Introduction. A large increase in the incidence of catarrhal rhinosinusitis determines the search for new methods of treating these patients. In this regard, the use of herbal preparations for relieving the symptoms of this nosology is of increasing interest. The article discusses the problems of using drugs based on Cyclamen europaeum (CE ) in the treatment of acute catarrhal rhinosinusitis.

Purpose of the study. Evaluation of the effectiveness of CE extract in the complex treatment of acute catarrhal rhinosinusitis.

Materials and methods. A randomized controlled study was carried out to study the efficacy of cyclamen europaeum extract in outpatients with an established diagnosis of acute catarrhal rhinosinusitis (the presence of 2 or more symptoms of acute rhinosinusitis, the presence of radiological signs of acute catarrhal rhinosinusitis.

Results. The results of the study showed that the intranasal use of drugs based on CE in acute catarrhal rhinosinusitis helps to reduce headache, reduces the abundance of nasal discharge, promotes the early restoration of nasal breathing, as well as smell and taste.

Discussion. The study objectively confirmed that the use of drugs based on CE has a positive effect on the dynamics of the course of acute catarrhal rhinosinusitis, promotes the early restoration of the epithelium of the nasal mucosa, olfactory function, and also has a positive effect on the restoration of gustatory function.

Conclusions. Based on the results of this study, it can be concluded that it is advisable to use drugs based on CE in the treatment of acute catarrhal rhinosinusitis.

Introduction. According to modern data, bronchial asthma (BA) is an independent risk factor for the development of cardiac arrhythmias (CA), and the use of long-acting β2-agonists (LABA) in basic therapy may further increase the risks of CA.

Aim. To study the structure and risk factors of cardiac arrhythmias in patients with bronchial asthma. Materials and methods. A retrospective study included 181 patients aged 69.4 ± 0.8 years, hospitalized for asthma, with the presence a CA in medical documentation.

Results. Among BA patients with CA, supraventricular CA were found in 71.3% (129) patients, ventricular CA in 16.6% (30), combined CA in 12.2% (22). In 52.5% (95) patients, supraventricular extrasystole was detected, in 35.9% (65) – atrial fibrillation, in 28.7% (52) – ventricular extrasystole, in 1.1% (2) – paroxysmal supraventricular tachycardia, in 0.6% (1) – paroxysmal ventricular tachycardia. It was found that supraventricular CA was significantly more frequent among women (χ2 = 5.974, p = 0.05). The severity of BA and the level of control are not related to the type of observed CA (χ2 = 0.755, p = 0.685 and χ2 = 3.003, p = 0.557, respectively).

Discussion. The use of a combination of ICS and LABA in basic BA therapy versus the use of ICS alone does not have a significant effect on the frequency and structure of cardiac arrhythmias (χ2 = 1.172, p = 0.556).

Conclusion. In hospitalized BA patients, supraventricular cardiac arrhythmias are most often detected, among which supraventricular extrasystole and atrial fibrillation take the main place.