December 11 is traditionally held World Asthma Patient Day. The MEDSI Children’s Clinic in Blagoveshchensky Lane organizes a celebration for children suffering from bronchial asthma. Gifts are waiting for the little patients, and pleasant actions await their parents. In addition, on this day, MEDSI allergists and immunologists and representatives of leading pharmaceutical companies will talk about modern methods of treating bronchial asthma and hold master classes on the use of metered-dose inhalers.
The chief physician of the MEDSI Children’s Clinic in Blagoveshchensky Lane, pediatrician, immunologist-allergologist Tatyana Semenycheva: “Now, amid the possibilities of basic therapy, bronchial asthma has become almost completely controlled. With the right treatment, the patient rarely develops seizures.
Previously, asthma was treated with non-selective bronchodilator drugs that had a lot of side effects, and did not profess the principles of basic therapy, that is, they were treated for an attack. Xanthine preparations (aminophylline, theopec), which also could provoke various undesirable effects, were given periodically or as courses of anti-relapse therapy.
Doctors also recommended living in the South, mainly in the Crimea. In the 1950-60s. “many patients preferred moving to the southern regions to permanent attacks and permanent residence on non-selective therapy.”
Treatment of bronchial asthma: from the beginnings to the present day
5 century BC e. – Hippocrates introduced the term “asthma”, which is translated from Greek as “suffocation”. Among the causes of suffocation, he singled out dampness and cold.
16th century – the Italian doctor and mathematician Girolamo Cardano described the case of a successful cure for an English clergyman. The treatment included diet, exercise, and the replacement of downy feather-bed with litter from ordinary tissue.
18th century – asthma treatment consisted of bloodletting, leeches and flies.
1868 – atropine, a substance isolated from the roots of belladonna, is recognized as one of the most effective remedies for asthma. It is able to relax the muscle wall of the bronchi and thereby increase their clearance. Atropine is still used to treat a number of diseases, including asthma.
To deliver the substance to the body, special cigarettes were used, which were used to treat asthma until the middle of the 20th century.
1900 – a chemical substance – adrenaline – was discovered in the human body – the first medicine for emergency assistance in an attack of bronchial asthma.
Adrenaline was used for injection as well as for inhalation.
1914 – Canadian doctor Sir William Osler recommends “strong coffee” in his textbook “Principles and Practices of Medicine” for relieving asthma symptoms. The composition of coffee and tea includes natural xanthines. They expand the bronchi, which ensures the normal circulation of oxygen. The main xanthine used in clinical practice is theophylline. One of the main problems with the use of xanthines is the high risk of side effects in the form of nausea, cardiac arrhythmias, and seizures.
1956 – the creation of the first metered-dose aerosol inhaler.
1950-60s – the widespread use of non-selective symptomatic agents based on isopropyl radrenaline (obtained in the process of synthesis of adrenaline derivatives). Ease of use (inhalation) and rapid relief from an asthmatic attack have led to the uncontrolled use of drugs based on this substance. This caused increased mortality of asthmatics from complications of the cardiovascular system.
1969 – salbutamol appeared, the first bronchodilator drug from the group of selective agonists. It acts quickly, in connection with which it is used to stop attacks. Used for inhalation.
1972 – the first inhaled glucocorticosteroid was released, which became the basis of modern anti-inflammatory therapy of bronchial asthma.
1991 – a long-acting selective bronchodilator drug (salmeterol) was developed, which contributed to improved control of bronchial asthma.
1995 – The Global Initiative for the Diagnosis and Treatment of Asthma, GINA, was published, which provided doctors worldwide with guidelines for managing patients with asthma based on the severity of the disease.
Today, asthma therapy consists of three components
For the treatment of bronchial asthma, basic therapy drugs are used that affect the mechanism of the disease, through which patients control asthma. Depending on the severity of the disease, the following are used:
- inhaled corticosteroids,
- antileukotriene preparations.
II Specific immunotherapy
Ksenia Bolgova, allergologist-immunologist, Medsi Children’s Clinic in Blagoveshchensky Lane: “Patients with bronchial asthma have altered immune status indicators, there are deviations from the norm. Asthmatics are often ill, prone to the development of secondary infections.
Against the background of an acute respiratory infection, asthma recurs. To reduce the risk of exacerbation, preventive therapy using antileukotriene drugs and inhaled corticosteroids is used. ”
In some cases, allergen-specific immunotherapy is used to avoid asthma attacks. If the patient suffers from hay fever, pollen allergen therapy is carried out pre-seasonally: during November-May in the form of injections or sublingual drops (starting from the age of 5).
III Auxiliary physiotherapeutic techniques
With exacerbation of bronchial asthma, various physiotherapeutic methods are used. A good therapeutic effect occurs with the use of acupuncture and sessions in salt caves.
This year, on the basis of the Children’s Clinic MEDSI in Blagoveshchensky Lane, the Competence Center for Allergology and Immunology began to operate, designed to ensure the full integrated management of children with allergic and immunological diseases. The center conducts a full range of studies, including spirography, examination of the immune and interferon status, and an individual treatment program is drawn up.
On the basis of the center, classes are organized in the “Allergo School”, where on a free basis MEDSI specialists teach children and parents how to effectively manage bronchial asthma.
Today, MEDSI includes 14 clinics in Moscow and the region, 2 Clinical and Diagnostic Centers on Belorusskaya and Groholsky Lane, 2 children’s clinics on Pirogovskaya and Blagoveshchensky Lane, 2 clinical hospitals in Otradnoye and Botkinsky Proezd, 7 clinics in the regions, 55 medical points at enterprises, 3 sanatoriums, 3 wellness centers, the Department of Family Medicine and the Emergency Medical Service. Soon it is planned to open a large multidisciplinary Clinical and Diagnostic Center on Krasnaya Presnya with an area of more than 22,000 sq.m.
As a socially responsible company, MEDSI actively supports the volunteer movement, creative initiatives, is a regular participant and initiator of charity events.
Invariably during all 19 years of the company’s activity, the basic principle of all its specialists is the formation of a responsible attitude of Russians to their own health, and attentive attitude to each patient.