Abstract. Selection of adequate therapy for bronchial asthma (BA) by a doctor directly affects not only the level of control over the patient’s symptoms, his compliance, but also improves the patient’s quality of life and avoids his disability. Doctors and patients are already accustomed to the fact that inhaled glucocorticosteroids (ICS) are the most effective anti-inflammatory drugs for the treatment of asthma. However, the response to ICS varies among patients, so some may require a medium-dose ICS if their asthma is not controlled or if they have asthma exacerbations. Among the existing following fixed combinations of ICS/ long-acting β2 -agonists (LABA), which are approved for regular use from the 3rd step of BA treatment, only two are currently available in Ukraine — budesonide + formoterol and fluticasone propionate + salmeterol. GINA recommends the use of an ICS/formoterol combination as the preferred single maintenance and palliative therapy because studies have shown that use of this therapy as a patient-initiated symptomatic palliative therapy when symptoms worsen provides comparable benefit to short-acting β2 -agonists (SABA) for the relief of smooth muscle dysfunction. in addition to providing corticosteroids with an increase in local protection in case of increased inflammation of the respiratory tract Budesonide/formoterol fixed-dose single-inhaler therapy for basic therapy and symptom relief helps achieve the main goals of AD treatment, namely achieving symptom control and reducing future risks, fully consistent with the latest GINA guidelines. This regimen, in comparison with alternative regimens of therapy with fixed doses of other combined drugs and SABA as needed, reduces the risk of exacerbations, gives a lower steroid burden on the patient with a comparable level of BA control.
Objective was to review the literature on the diagnostic value of various methods for determining sensitization in patients with allergies, to study the parameters of the specificity and sensitivity of skin testing and laboratory determination of specific IgE. Materials and methods. 88 patients with allergic rhinitis were examined by three different methods of specific allergic diagnosis (in vivo and in vitro) in accordance with the guidelines of the ethics committee of the National Pirogov memorial medical university, all were beyond the acute period. The inclusion criteria were allergic rhinitis diagnosis (both intermittent and persistent) with proven sensitivity to domestic allergens. Skin prick test was carried out according to the classical testing procedure in accordance with regulatory documents with commercial extracts of allergens. Western blot testing for specific IgE levels was performed using RIDA qLine test systems (R-Biopharm AG, Darmstadt, Germany) and Euroline (Euroimmun). The sIgE concentration was converted to a nominal scale (grades) according to the following rules: < 0.35 IU mL-1-level 0 (negative), (0.36-0.69) IU mL-1-level 1 (boundary levels), (0.7-3.49) IU mL-1-level 2 (slightly elevated), (3.50-17.4) IU mL-1-level 3 (moderately elevated), (17.5-49,9) IU mL-1-level 4 (high levels), (50-100) IU mL-1-level 5 (very high levels) and > 100 IU mL-1-level 6 (extremely high levels). Results and discussion. The results of two systems for determining the specific IgE to D. Pteronissinus by Rida AllergyScreen and Euroline have a systematic difference in rates (-1.27 kU / l). Between the data of skin testing with D. Pteronissinus allergens and detection of specific IgE by the Rida AllergyScreen method, there is good agreement between the results, there is satisfactory agreement between the results of the research between the data of skin testing with allergens D. Pteronissinus and the detection of specific IgE by the Euroline method.
The aim of the study is the analysis of specialized scientific literature and the review of data about the modern views on the electronic devices of nicotine delivery -electronic cigarettes from the view of evidence-based medicine. In recent years, electronic cigarettes (EC) have become widespread. More than 10 years have passed since the first batch release of electronic cigarettes, and during that time, many studies have been conducted on various aspects of their use. However, the main concern of experts is the lack of a clear unanimous opinion about their health security and the EC's effectiveness as a method of tobacco control. The review presents modern data regarding existing EC modifications, the impact of their use on the human body at the cellular and systemic levels. Attention is paid to the fact that the actual physical nicotine dependence in the vast majority of cases is combined with psychological dependence, which reduces the effectiveness of other nicotine delivery devices. Data from randomized clinical trials show that further development of methods for studying the effects of the EC on the organism is very actual. In general, such studies were made to highlight key issues regarding the safety and effectiveness of e-cigarette use, including the fight against tobacco smoking. Special cautions were made to the research results that indicate the growing of popularity of e-cigarettes among teenagers, particularly in the US, Poland, Latvia, Finland and Korea. Conclusions.The EC has proven to be effective in removing of tobacco-related complaints, but so far, the EC cannot be available as safe and effective method to completely abandon smoking. Existing production regulations do not standardize either the EC itself or the liquid for them, because of which the composition (including the content of harmful to health substances) is not actually regulated. In addition, there are no data about the long-term effects of EC usage, which is a priority area for further research.Характеристика пристроїв доставки нікотину -електронних сигарет -як засобу боротьби із тютюновою залежністю A. Є. БогомоловМета роботи -аналіз спеціалізованої наукової літератури для узагальнення даних про сучасні погляди на пристрої доставки нікотину -електронні сигарети -в аспекті доказової медицини.Електронні сигарети (ЕС) набули широкої популярності, виокремившись навіть в окрему «субкультуру». Минуло понад 10 років із часу першого серійного випуску електронних сигарет, і вже здійснено чимало досліджень різних аспектів їх використання. Основну стурбованість експертів викликає відсутність єдиної думки щодо їхньої безпеки для здоров'я та власне ефективності ЕС як методу боротьби з тютюнопалінням. Наведені сучасні уявлення про модифікації ЕС, вплив їх вживання на організм людини на клітинному та системному рівнях. Звертається увага, що власне фізична нікотинова залежність збедільшого поєднується з психологічною, що знижує ефективність інших пристроїв доставки нікотину. Дані, що отримані в рандомізованих клінічних дослідженнях, показують:...
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