The data on the efficacy of antivirals and their impact on the virologic and immunologic indices in HCV- and HBV-infected children are presented. The best therapeutic effect in the management of children with chronic virus hepatitis was provided by combined antiviral therapy of different action. In the treatment of babies the drugs of choice could be viferon or cycloferon, for the 2-year older children with chronic hepatitis B the combination of viferon + cycloferon should be recommended and for those with chronic hepatitis C the combination of interal + cycloferon could be used. The cycloferon combination with interferons-а makes it possible to generate the Th1 cellular immune response, to minimize the side effects of interferons and chemotherapeutics and to improve their tolerability. The complex therapy of patients with chronic hepatitis B and lambliasis, using cycloferon and macmiror, provided stable effect, less frequent relapses of lambliasis and minimum side effects of the specific therapy. The repeated isolation of lamblia within a 1-year observation period was recorded only in 16.6% of the children treated with cycloferon vs. the control (40.0%).
The clinical course of various forms of chronic laryngitis, including contact granulomas not only persistant and relapsing, but also inclined to oncologic pathology due to hyperplastic changes in the larynx resulting in malignization was described. Inhibition of the leukocyte interferon-synthesizing activity was observed in more than 88.1% of the subjects. Pathogenic viruses were isolated from 48.2% of the patients, EBV and mycoplasma prevailing. High direct correlation between chronic laryngitis and Herpes viruses was shown. The presence of three-component virus associations in the larynx mucosa was likely indicative of the bening process malignancy. The use of the interferon inductor cycloferon in the complex surgical and medicamentous management of chronic laryngitis was shown valid. The rate of the relapses lowered to1.7 episodes a year.
The induction profile of endogenous interferons of three types under the action of meglumine acridone acetate and sodium acridone acetate, as well as the characteristics of the kinetics of their accumulation and circulation in the blood of experimental animals are described. Meglumine acridone acetate provided balance in induction, production and circulation of the interferons in the blood vs. sodium aeridone acetate under the same conditions. The optimal dose of meglumine acridone acetate (2.0-3.5 mg/mouse) with effective, consecutive and overlapping induction-production of the interferons ensured their prolonged (for 72 hours) circulation in the blood after a single administration.
The efficacy of a 1.5% reamberin solution possessing detoxicating, antihypoxant, antioxidant, and membrane-protective properties, used as a component of the complex infusion therapy in children with acute Epstein-Barr virus infection, has been estimated. The dynamics of the inflammatory process in children treated by the drug complex including reamberin is characterized by rapid relief of general symptoms, improvement of state, and reduction in length of the febrile period of disease as compared to patients treated with glucose-saline solutions and basic therapy. The administration of reamberin in children contributed to the early elimination of metabolic shifts by the period of convalescence, as evidenced by improvement in some laboratory parameters, including protein-synthesis function of the liver.
The review describes endogenous interferon inductors that belong to antiviral drugs and contain different chemical compounds. Among the groups identified by the authors, there are promising and most effective medicines inducing different types of interferon in the body, as well as their mechanism of action. The paper shows the synthesis of endogenous interferon and the level of its accumulation in the organs and tissues. The clinical effects of methylglucamine acridonacetate (cycloferon) are depicted in patients with major viral (influenza, acute respiratory viral and arboviral infections, and viral hepatitis) and bacterial (brucellosis, tuberculosis) infections, or endometrial hyperplastic processes. Cycloferon is shown to be used as an etiotropic and antipathogenic drug.
Peculiarities of the kinetics of accumulation and duration of circulation of three types of interferon under the action of acridonacetic acid salts have been studied. Optimum doses of meglumine salt of acridonacetic acid are established, which ensure efficient and consistent induction of three interferon types, ensuring their prolonged circulation in the blood.
Peculiarities of the kinetics of accumulation and duration of circulation of three types of interferon under the action of acridonacetic acid salts have been studied. Optimum doses of meglumine salt of acridonacetic acid are established, which ensure efficient and consistent induction of three interferon types, ensuring their prolonged circulation in the blood.
Comparative placebo-controlled study entrolled 647 patients with verified diagnosis of chronic virus hepatitis B (HBeAg+), not previously subjected to antiviral therapy (with nucleotide analogues or interferons). The drug under the investigation was cycloferon, an earlier interferon inductor. The antiviral combination therapy of the main group patients (323 subjects) included the use of cycloferon + lamivudine for 48 weeks and the therapy of the control group patients (324 subjects) included the use of lamivudine + placebo for 48 weeks. The cycloferon and lamividine combination antiviral therapy was shown preferable vs. the lamivudine + placebo therapy by biochemical remission, virusological response, seroconversion by HBeAg by the 48th week of the treatment and HBsAg clearance. The conbination therapy provided lower frequency of the relapses within 24 weeks of the observation. The higher efficacy of the antiviral combination therapy was evident of the impact of the antiviral activity of cycloferon itself and its immunomodulating and interferon-inducing activity on elimination of the virus-infected hepatocytes. The use of the 48-week course of the antiviral combination therapy is advisable as the prime treatment in the management of patients with HBeAg-positive chronic hepatitis not previously treated with nucleoside analogues and as a variant of therapy for lamivudine-refractory patients.
The article describes the clinical forms of chronic hyperplastic laryngitis, characterized by persistent and recurrent course, a tendency to the formation of oncological pathology, at the expense of hyperplastic changes in the larynx, leading to a malignancy of the inflammatory process. It was demonstrated the bacterization of larynx by Epstein-Barr virus (EBV) and Mycoplasma in imbalance of system of interferon. Clinical recovery, depending on the clinical form of the disease, using cycloferon, was observed in 57.4% of patients. The inclusion in the complex of the medical support of chronic hyperplastic laryngitis inducer of interferon - cycloferon, provided the reduction of the number of relapses.
There is a tendency to increase the role of education process in the life of the individual, caused by necessity of new knowledge, experience and skills, which is the effective measure to adapt human being to the current social and economic conditions. The idea of education as a relatively short period of life is gone. It becomes obvious, that use of forms and types of adult education becomes limited and inefficient. The development of the modern education system involves training with a high level of independence and leadership of the individual student; provision by vocational education institutions a wide range of educational services; adequate to the needs of the labor market; variability of methods and forms of education; active use of the modern educational technology as one of the most convenient ways of training.
647 patients with HBeAg positive chronic hepatitis B who have not previously received antiviral therapy were participated in randomized, post-marketing, double-blinded, placebo-controlled clinical trial. Interferon inducer cycloferon was presented as study drug. 323 patients with chronic hepatitis B (HBV) with "wild" HBeAg(+) strain of HBV were treated with cycloferon and Lamivudin for 48 weeks. Control group included 324 patients with similar pathology, treated with Lamivudin and placebo for 48 weeks. The study has shown the benefit of cycloferon+lamivudin treatment in comparison with lamivudin monotherapy. Improving of liver histology in 48 weeks of the therapy was observed in 71% of patients in Study group in comparison with 57% in control group (p<0.01). Combined therapy has resulted in decrease of relapse by 24 week of the follow-up period (13% vs. 86%, p<0.001). The higher efficacy of cycloferon+lamivudin in patients with HBeAg positive chronic hepatitis B has proven the role of own antiviral effect of interferon inducer cycloferon, interferon effect of cycloferon in the elimination of virus-infected hepatocytes, as well as the presence of an immunomodulatory effect of the preparation, aimed at the elimination of HBeAg and HBsAg with the following seroconversion. 48-week course of combined antiviral therapy of HBeAg-positive patients with chronic hepatitis B is recommended as first-line therapy for patients with HBeAg-positive chronic hepatitis B, who have not previously received nucleoside analogues, as well as alternative therapy of Lamivudin-refractory patients.
There is represented the current classification of interferon inducers of various chemical groups related to antiviral agents, described the mechanisms of synthesis of different types of endogenous interferon in blood serum. The effectiveness of methylglucamine acridonacetates in integrated treatment of chronic hepatitis C, tuberculosis with HIV infection background, chronic brucellosis, arboviral diseases, including West Nile fever , as well as influenza and acute respiratory infections are shown. For successful treatment of acute and chronic diseases with endogenous interferon inducers should be applied as early as possible, at an average level of viremia , to enhance the effect of drugs with the directed etiotropic action and immunomodulators , which achieves the optimal pharmacotherapeutic effect.
The clinical course of various forms of chronic laryngitis, including contact granulomas not only persistant and relapsing, but also inclined to oncologic pathology due to hyperplastic changes in the larynx resulting in malignization was described. Inhibition of the leukocyte interferon-synthesizing activity was observed in more than 88.1% of the subjects. Pathogenic viruses were isolated from 48.2% of the patients, EBV and mycoplasma prevailing. High direct correlation between chronic laryngitis and Herpes viruses was shown. The presence of three-component virus associations in the larynx mucosa was likely indicative of the bening process malignancy. The use of the interferon inductor cycloferon in the complex surgical and medicamentous management of chronic laryngitis was shown valid. The rate of the relapses lowered to 1.7 episodes a year.
The article describes formation of the doctors professional competences as the result of the competence approach implementation in the continuous medical educational process. Personal and professional growth guaranties success of the professional activities, when as professional competence is considered as potential for effective labor activities.