Ultrasound biliary system is conducted by:
- The presence of clinical or laboratory data indicating that the disease of the gallbladder or bile ducts;
- To exclude acute cholecystitis and obstruction of the common bile or common hepatic duct with acute abdominal pain;
- To dynamically monitor the previously identified changes of the gallbladder and bile ducts;
- To control the therapy carried out in order to dissolve the stones;
- To assess the functional brand name viagra status of the gallbladder, in particular the motor-evacuation function;
- As a method for dispensary observation of patients with gallstone disease and other chronic diseases of the gallbladder and bile ducts.
Ultrasound biliary system can be diagnosed following diseases:
- Gallstones - Ultrasound is the leading method for diagnosing this disease, its accuracy is 98-99%. The smallest size of the stone, diagnosed by ultrasound, is 1-2 mm. Revealed pattern depends on the size, shape, number and composition of the rocks, but the judge about their chemical nature is not possible. Causes some difficulty detecting small stones located in the neck of the bladder;
- Acute cholecystitis - in 90-95% of cases it develops as a result of obstruction of cystic duct stone, and has characteristic symptoms;
- Complications of acute cholecystitis (hydrops, empyema, perforation, abscess okolopuzyrny). Hydrocholecystis arises from violations of the outflow of bile from the bladder due to massive edema, infringement of stone in the neck or neck compression from the outside. The reason for empyema - joining a secondary infection. Perforation and abscess okolopuzyrny are a consequence of the destruction of the wall and release the contents of the gall bladder beyond it;
- Chronic cholecystitis - ultrasonography revealed seal, a thickening (or - more rarely - thinning) bubble wall, intraluminal inclusion (flakes bile zamazkoobraznaya bile, cholesterol crystals), resistant strain bladder wall;
- Cholesterosis gall bladder - it is characterized by the accumulation in the submucosal layer of the wall of cholesterol crystals. Ultrasound can quickly and accurately identify polypoid form of the disease, diagnosis of the diffuse Viagra to prevent impotence form is more complicated. Often there are multiple polyps are found on all the walls of the gall bladder;
- A cancer of the gall bladder - this is rarely encountered pathology in most cases combined with stones in the bladder and observed in elderly and senile;
- Bile duct stones - they give an acoustic shadow and are usually well visualized in any department of the biliary tract. Diagnostic difficulties arise when placing the stone in the distal common bile duct, examination of which is difficult due to gas accumulation in the intestine;
- Expansion of the common bile duct (diameter larger than 1 cm) - it is possible after removal of gall bladder drainage interventions. After some operations may develop aeroholiya, ie in the biliary tract visualized by air bubbles (small, dense, giving for a "comet tail").
Based on the results of diagnostic tests the doctor is the most effective scheme of therapy, prevention or rehabilitation. Timely diagnosis - the key to successful treatment.
Allergies how to identify
Dressing
Wednesday, December 29, 2010
Monday, December 27, 2010
Prevention of SARS
Prevention of SARS - the theme is very topical and all the waves. In most cases, when at home or in the media to pronounce the phrase "prevention of ARI, we are talking about prevention of SARS.
The main principles of prevention remain the same. In accordance with these principles, carrying out preventive SARS, we are able to act in two directions:
- Avoid contact with viruses (infection prevention).
- To increase the body's resistance to viruses.
Consider these trends in more detail.
PREVENTION OF INFECTION
Source of SARS - the people. The fewer people, the less SARS. The surest way not to hurt - to live on a farm in the forest without coming into contact with civilization. This suit is not all. Therefore, all suffer from ARI.
Vysokoveroyatny source of SARS - sick people. Conscious or forced contact with SARS patients greatly increases the chance of infection and disease.
The implications are clear: life in society - is a constant and real risk of SARS. SARS can not be avoided, but you can reduce the likelihood of disease.
Thus, prevention of infection - this sort of behavior, and based on this model - not only special medical knowledge, but most ordinary logic and common sense.
Going to school - the risk of SARS.
Go to school, dancing and singing in the choir - much greater risk of SARS.
In the dead of winter to go to the circus - a real risk of SARS.
Christmas Tree with Santa Claus and the distribution of gifts, all to the cashier at the supermarket, crowded bus - all these meetings with people. Each encounter - the risk of SARS.
All described does not mean that it is impossible to dance, go to the circus and ride a bus. Just need to be clearly understood: the more active lifestyle for your child, the more meetings and contacts - the higher the likelihood of disease.
Expose your child at risk or not - on an individual basis to solve specific family. Algorithm solutions - evaluation of pros and cons. If the price paid for the trip to the circus - a cough, a three-day snot and saline nose drops - so the price is acceptable. But if the load to a gift from Santa Claus baby gets fever, bronchitis, and a bunch of drugs and two weeks negulyanie - so expensive gift turns out ...
Parents are better than anyone else knows the ability of their child. If the rare disease and the lungs, so there are no restrictions in principle. But after two bronchitis and pneumonia, one in autumn is quite possible to dispense with the circus in winter.
At the same time, there are well-defined courses of action where the risk can be reduced or even completely prevented.
To kindergarten one stop on the bus. It may be worth up to fifteen minutes before this stop and walk? Rhetorical question, but pros are obvious - avoid the meeting with fellow passengers on the bus, save money for travel, but still get some fresh air!
Mom, Dad and Mike went out in the evening stroll. The purpose of a walk - replenishment of food brand name viagra stocks in the local supermarket. Neither the pope nor by Misha in the supermarket no good there. And they may well run-play, while mom is shopping. Use a triple: no one is a mother of the soul, no one close to Misha is not coughing and did not sniff, plus the child has the opportunity to run an additional half-hour, work up an appetite and improve sleep.
Children suffer from SARS more often than adults. Find the virus into contact with children is much easier than dealing with adults. Risk of contracting SARS in the puppet theater or a child's birthday than in the usual theater or on grandma's anniversary.
The more children - the greater the risk. The kindergarten № 1 Nastenka will have 10 classmate, and in kindergarten № 2 - 20. Clearly, where the risk is less. And it is not surprising that the first version twice the price of the second.
Readers are important to understand that, in citing these examples, the author does not impose your family to model behavior. Just too often we over it all and do not think we do not understand that the risk is quite possible to manage.
Therefore, all what we're talking about - is not a prescription, not an instruction, not imperative. It's just information for consideration.
Separate item, which is to reflect, - contacts with patients. Once again: the people - the risk sick people - particularly at risk. Only special needs should get you in the midst of a flu epidemic to go to the clinic. And healthy Basil does not necessarily provedyvat flu grandmother.
You cite Nastenka in kindergarten. And then out of ten, five bandmates - with a runny nose. This does not mean that tomorrow Nastya is sure to be cold. And does not mean that in a kindergarten child not to be led. But the degree of risk you will appreciate for sure. And estimating, understand that, firstly, the probability of ill close to 100%, and secondly, this kindergarten is clearly not worth the money paid for it.
But another, better nursery - no!
A flu grandmother did not live in a separate apartment, and in the adjacent corridor!
And do not go to the clinic does not work, because you just do not get very need help!
And people do not communicate do not get any!
Otherwise, how can the bus to school Misha's no getting. And daddy walk with Misha can not, he is busy at work, so my mother, together with Misha go to the store to shop. And in general: One can not sit at home bezvylazno - grandfather of the circus tickets purchased tomorrow at the Marina's classmate's birthday - we will walk the whole class!
In general, we have gradually come to a conclusion: the restriction of contacts with people (children) in general and to sick people (children) in particular - is a wonderful, very effective, but hardly implemented method for preventing SARS.
So, whether we like it or not want, but contact with a lot of people have the time.
What to do?
To use another option of prevention - to influence the transmission of respiratory viruses, the mechanism of direct contamination.
For each method of dissemination of SARS can be called a very specific preventive measures. So let's discuss them in detail.
First note that all methods of prevention of infection can be analyzed in two ways:
- Actions of patients, so as not to infect healthy people.
- Actions healthy, so as not to be infected from sick (really sick, maybe patients, healthy carriers of the virus).
There is, perhaps, yet a third direction - of the state (the authorities), so patients do not infect healthy - conducting quarantine measures: school closures, bans on mass gatherings, etc. The implementation of this path is not subject to readers of this book, so to speak here in fact, nothing - and everything is clear and obvious.
Airborne route of infection
With regard to children "of the patient - it's usually the parents of the patient.
Patients with SARS should be sick at home!
This is an obvious rule that is constantly violated. Broken always and everywhere - and adults and children worldwide. Snotty kids go to kindergarten (no one to stay home) and school (now the control of Mathematics). Sneezing mom goes to work. It can not go, because it works the head and she now receive visitors. Coughing dad goes on a mission ... Even our district pediatrician Anna Nikolaevna runs home with a stuffy nose. And what if no one more run?
What else should the patient? Cover your mouth and nose with a tissue when coughing and sneezing and blowing nose, try not to cry, no sputter, no hugging and kissing - all of these recommendations, it would seem, is so well known, available and obviously that did not require detailed justification. Another issue is that to get people in droves to make due - almost unreal. All that we can - from childhood cram our children answers to obvious questions about what is good and what is bad. And let the good cop-bad list includes not only the global "Thou shalt not kill", "Thou shalt not steal", "do not lie," "Love ...", but private, primitive practice "sit at home", "do not forget a scarf," " Cover your mouth "," do not yell, "breathe away", "Put on a mask ...
By the way, about "Put on your mask." Gauze, cotton-gauze and modern disposable masks of nonwovens - one of the most common ways of preventing SARS. In the season of SARS in hospitals is introduced so-called. "Mask mode": medical staff wears a mask, unmasked visitors do not overlook, posted schedules - when the masks should be changed.
Readers familiar with Chapter 2.2. Devoted to viruses, some imagine their size and are well aware that any, even the tightest mask to stop the virus is impossible. Then the question: what are masks necessary? The fact that viruses are found in large numbers in the mucus and phlegm. That's a drop of mucus and sputum, a few meters fluttering around the patient talking, coughing, sneezing and blowing nose, are the main source of infection, first, bystanders, and, secondly - everyday items.
Thus, the main task of the mask - to detain these drops, and even to some extent limit the ingress of the virus in the environment. It is obvious that the mask did not change fundamentally, the patient continues to breathe, and most ordinary breath enough to air containing viruses and exhaled by one person, becoming inhaled air for another person.
In addition, a mask very quickly saturated with sputum, and actually becomes a reservoir of the virus. Therefore, the mask recommend intensive iron and ironing change no less than 4 hours.
Once again, we emphasize that given the size of viruses and the size of "holes" in the gauze mask, no mask can not prevent viruses in the air in the respiratory tract of healthy humans. That is, the masks are not needed healthy! They put the sick, and they (the masks) are just ineffective remedy is healthy.
Likely to suffer from contact with the virus is largely related to two important parameters:
- The concentration of virus in the air.
- Virus activity.
Both of these parameters the most fundamental way connected with the characteristics of the air we breathe.
The concentration and activity of viruses determine the main epidemiological principles SARS PREVENTION: viral particles for hours and days remain active in the dusty, dry, warm and still air, and almost instantly killed in the air clean, cool, moist and moving.
Basic, applied, practical conclusion from this situation is that the likelihood of infection is closely linked with the rate of air in the room. The more intense the air, the lower the concentration of viruses in the air, the less chance of infection.
It is with this is largely due the fact that SARS season ends when all the houses the windows and vents.
High concentration of virus in the air, you can create only on the premises. Outdoors it is practically impossible, so get while walking can be just kissing, cuddling with the patient.
Why does the bad weather, more children ill with SARS? It is not because of wind, rain and cold! Just in bad weather children are walking less and communicate more with people like it on the premises!
Recommendations for practical realization of the main epidemiological principles of prevention SARS.
· Frequent and regular airing of the premises as a means of prevention - better all the masks and all drugs combined.
· Air is desirable when all are healthy, and always - when at least someone in the house is sick.
· More children in the room - the more often and more intensively it should be aired.
· Elementary and obvious steps in children's institutions: went for a walk - ventilated kindergarten, school bell rang - all quickly went into the corridor and ventilate the class.
Another way to reduce the concentration of virus in a residential area - this air treatment by exposure to, for example, fatal to the virus with ultraviolet rays (kvartsevanie, etc.).
Unfortunately, the effectiveness of these procedures is low. You can kill the virus in the air, but the source and reservoir of infection remains a patient man. It is worth it to go into the room - and a very short time once again filled the air viruses.
Contact the path of infection
We already wrote about that, settled on household items and dry mucous droplets of virus particles can remain active for several days. Besides viruses in large numbers are in the hands of the sick, so the handshake, paper money, door handles, tap in the bathroom, etc. - wonderful ways to contact the spread of infections.
Ten hand-shaking - and your hands are guaranteed there is a virus. It remains only to scratch your nose.
Kindergarten. Ten children, one with a cold, crawling together on one carpet. In turn fed the same teddy bear. I need hardly say that the aforementioned teddy bear and a carpet - Storage of viruses and the real source of contact infection.
Since the mechanisms of contact spread of viruses are obvious, obvious, and ways to prevent:
· Frequent wet cleaning: all that you can wash and wipe with a damp cloth - to regularly wash and scrub;
· Regular wiping with disinfectant solution contact common items of use - the above-mentioned door handles, etc.;
· Handwashing - frequent and thorough;
· Regular treatment with wet hands hygienic and disinfectant wipes;
• In child care institutions make every effort to ensure that the subject of joint use of children (eg toys) could be subjected to wet and hygienic processing.
Waterway infection
Characteristic of the very few viruses, the most typical - adenovirus. Specific mom and dad do not have the opportunity to influence how the treated water in the basin. That is, the prevention of infection by water - a water park of the workers and the control of sanitary-epidemiological services. All that can ordinary fans of public bathing - to know that the massive water treatment - an additional risk factor. This does not regarded as a call not to go swimming. But if your city outbreak of adenovirus infection, "find" it, swimming is much easier than skating.
Intestinal route of infection
Enteroviruses - a very common pathogens of acute respiratory viral infection with fecal-oral mode of transmission. The classic "disease of dirty hands" with the standard and obvious way of prevention - wash hands, utensils separate, order in the toilets.
Concentration of virus can be reduced not only in the inspired air, but also directly in the airways. With this in mind, one of the most safe, effective and inexpensive ways to prevent SARS - regular drip (pshikane) in the nose very familiar salt solutions.
Saline solutions reduce the concentration of virus in the nasal passages. Quite similar to regular gargling (anything important here the fact rinse) reduce the concentration of virus in the nasopharynx. And it definitely makes sense when the real threat of infection, when to avoid contact with sick can not.
Concentration of virus can not only reduce: inhaled viruses can in principle be destroyed by antiviral drugs.
From Chapter 10.15, we know that antiviral drugs "in general" does not exist, but there are drugs that can selectively act on the influenza virus.
Thus, prophylactic administration is appropriate only when there is an explicit threat of influenza virus infection - sick someone from family members, many cases of disease in a kindergarten or school. We emphasize once again: not just SARS, namely the flu!
Can realistically be applied two drugs - rimantadine (in the case of influenza A virus) and oseltamivir. But even when these drugs are used for prevention, appointed they still need a doctor. Firstly, because only a doctor has reliable information about how the virus is associated with a rise in the incidence and, secondly, because both of the mentioned funds are diverse, but well-defined contraindications, age restrictions and schemes of dosing.
So, we know the main ways of preventing infection. The saddest thing is that the huge number of factors contributing to the spread of SARS, no mother, no father can not influence.
Queue in front of doctors' offices in the children's clinics, visits to child care obviously sick children, cultural events in the midst of a flu epidemic, scored public transport, queues in shops, the indispensability of special and "consciousness" of workers, when you cough teacher continues to lead the lessons and cashier in Supermarket deals with hundreds of people, covering mask stuffy nose ...
Thus, all that we've already written about the prevention of infections, logically leads us to quite a definite conclusion: of course we can struggle to try and reduce the probability of encountering the virus, we can reduce the concentration of virus in the room and in the airways. Nevertheless, this meeting must be held. And the virus in the respiratory tract gets. And not just any virus, but quite real causative agent.
What will happen? At this stage, ie at a time when a bad virus hit the airways in a dangerous concentration, further developments are already determined by the state immunity, the body's ability to withstand a child and not get sick.
IMPROVING THE STABILITY OF THE ORGANISM TO VIRUSES
Increased resistance to viruses, possibly through actions in the following areas:
- Maintain the health and revitalization of local immunity.
- Creation of specific immunity (vaccination).
- Application immunotropic funds.
Consider all these points in detail.
Maintaining the health and revitalization of local immunity.
This way to prevent SARS - the most, perhaps, important and most effective. In its basis - ensuring the normal functioning of the mucous membranes of the respiratory tract, control of the state rheology of sputum.
Fluid mucus (saliva, snot, phlegm) - the main weapon of the local immunity. Dry mouth or nose - local immunity "shut down": it means that all the conditions to get sick.
What determines the state of the mucous membranes and the rheology of mucus in a healthy child? The answer to this question, we already know very well: first, the parameters of the air he breathes, and secondly, from the "system" mode of dressing and drink - propotel, time did not drink - that's mouth was dry, and thirdly, from the diet - it's hard to "work" of local immunity, if the mouth is constantly some kind of food, and fourthly, by inhalation of any dust and chemical hazards, which increase the burden on local immunity.
From the foregoing, it is logical to follow specific, practical recommendations:
· Maintain optimal temperature and humidity of indoor air. And not only where you live! Take an interest in the kindergarten at the school - whether the administration knows what should be the humidity, whether in the garden at least one humidity sensor, at least one moisturizer, what mode of ventilation of premises, how often and what wash floors. Try to reach consensus. After all your hard earned money is much more productive to invest in a moisturizer than a pharmacy. And it may be wise to encourage cleaner Aunt Pasha, so she washed the floors are not 1 times with bleach (in the bedroom of a kindergarten !!!), and 3 times, but ordinary water;
· Fresh air. Often, at any time of year. Proper Dress, possibly limiting sweating. If, after running dry in the mouth and the child asks for something to drink - be sure to take a walk drinks. Ensure that the child drank a lot while playing sports;
· Restriction on feeding in the intervals between feedings: remember that saliva has a pronounced antiviral activity. Permanent Food - decrease in activity of saliva. It is clear that when the food in your mouth so saliva "deals" are not viruses, and food;
· Cleanliness in rooms, dust removal, restraint in the use of household chemicals;
· Always be careful that the child draws in her mouth! There is nothing surprising in the fact that after the child pogryzet felt-tip pen out of toxic plastics from him (the child, of course) will drop local immunity;
· Control the process of cleaning teeth: if after the procedure, the child notes a dry mouth - Change your toothpaste. Do not use toothpaste without direct medical guidance of a dentist;
• In situations where humidify the air in a residential installation Viagra is suitable whether you fails, use to moisten the mucous membranes brine.
All of the above - well we know the parameters of lifestyle. And all this is a direct illustration of the fact that effective prevention of SARS, based on maintaining the health of local immunity - is not one-off event, it is a direct fulfillment of older people of their debt - a parent, vospitatelskogo, teacher. Debt, was not only to give birth, raise and teach, but also to create for our children normal conditions of existence ...
Thus, normal conditions, we, as far as they could, provided. But not everyone can live in a country house, and negotiate with the head of a kindergarten - it is mostly a pipe dream. And not because it is a head without understanding this. Just her but you still have to agree with the sanitary station, which requires cleaning floors with disinfectant solutions, monitors the temperature of the air, but it is not interested in humidity and how much time takes a walk. This is just some examples illustrating the fact that even knowing - that local immunity is good and what is bad, we do not always have the opportunity to do the right thing.
Therefore, constant efforts to improve, enhance local immunity by certain medications. And these drugs - stimulants local immunity - there.
Immediately, we note that local and general immunity are so closely intertwined that clearly distinguish them almost impossible. Any tool that stimulates local immunity, in varying degrees affects the total. Therefore, with respect to the names of drugs, correct to say "immune stimulators with a predominantly local action" - but essentially it does not change.
Modern local immune stimulants are fragments of bacterial cells, which, after ingestion or application to mucous membranes significantly increase the concentration of protective substances (immunoglobulins, lysozyme, etc.) in the mucus and phlegm. Drugs in this group demonstrated their effectiveness as a prophylactic against SARS, and in relation to the bacterial ARD. Another important plus - prevention of bacterial complications of SARS.
Bacterial stimulators of local immunity is deservedly popular among doctors and patients. They are safe, effective enough. At the same time never forget that the concentration of protective substances in the mucus and phlegm is significant only when this mucus and this mucus liquid. No even the most expensive and best stimulant of local immunity could not show their medicinal properties, if not previously be optimized parameters of air, if not protected from drying out mucous membranes.
Once again, in other words. You gave the child the medicine, and number of protective immunoglobulins in the mucus increased by 100 times. If the mucus is dry, so the number will not make any difference: in the dry mucus immunoglobulins simply do not work. "
Creation of specific immunity through vaccination
This is, by and large, a dream: that's to be done for vaccination against SARS and forget it! But since SARS - a few hundred a wide variety of viruses, vaccination is not. You can not protect against all, but you can create a vaccine against any one, specific virus.
A typical example of such protection is a flu vaccination.
Readers who have carefully studied Chapter 6.2, dedicated to the flu, can be skeptical smile, because an effective vaccine appears at first glance, unlikely. And really: if the virus is constantly changing, if at the same time may circulate several viruses, so what kind of vaccine may be a question?
Thus, skepticism and distrust grounded in two quite specific problems:
- The virus is changeable, so even getting immunity this year, we will be defenseless in the next, because the virus has come from an entirely different antigenic composition.
- Who knows what virus will come this year? From any virus should be vaccinated?
Nevertheless, on both issues have a specific algorithm is completely rational decision.
As soon as the virus is variable, so therefore should be vaccinated annually. Unpleasant, expensive, inconvenient, but there is no alternative. Want to not get the flu? Not "never sick", but "this year will not get sick? Do you? So, this is the year and should be vaccinated.
Well. We agree. But oppressed by doubts. Where is the guarantee that we will be grafted from the very virus that will cause an epidemic in the winter it this year? After all, look what happens. We decided as a family planting in November, because in January, is expected flu epidemic - so, at least, "said Smart's uncle on TV.
The vaccine is. Already have! But it had to cook, but it's certainly a few months. And then deliver to the pharmacy. And then sell it. That is, it turns out that the vaccine did, probably in the summer, and the virus is expected in January! Are they witches, wizards, to know in July how the virus will be in January!
And it really is not clear how such miracles are possible. Nevertheless, possible, but of no magic are not talking. And it requires an explanation.
As early as 1948, WHO created a special program that focuses on fighting the flu. This program today includes four specialized international center (in Atlanta, London, Melbourne and Tokyo) and more than 120 virological laboratories located throughout the world. Lab monitor the circulation of the virus and are constantly exchanging information with each other about what strains of virus are found in a region where they move. All results obtained are flocking to the international centers. In February of each year, the WHO Expert Committee announces the outlook on what antigenic variants of influenza virus will circulate in the coming season. Over the past 15 years, forecast accuracy was 92%. In March, the WHO laboratories carry out seed virus and send out material to vaccine manufacturers. The composition of each vaccine contains, as a rule, three types of viral antigens: two type A and one type C. From April to July is in the process of production - growing, blending, testing, testing. In August, the vaccine is packed, in September, she gets into the pharmacy, in October-December vaccination.
Current influenza vaccines are in most cases well tolerated and highly effective prevention.
Theoretically, influenza vaccination is shown to everyone who has a real chance to get sick. And any resident of the city, any child attending a children's team, the chances of ill enough. Again, it is fundamentally important that moment that if someone has a family member gets sick the flu, so everyone else a chance to survive is small.
In view of the described, vaccination against influenza - it's not so much a matter of expediency, as the question of material capabilities. But if you compare the cost of the vaccine to the cost of a two-week illness, so a definite conclusion is automatic.
Nevertheless, there are categories of people who are vaccinated against influenza clearly shown - shown at any price. These are the people (adults, children - does not matter) for which the flu - a disease not only dangerous, but deadly - it is about those who already have some kind of disease that may escalate against influenza: chronic diseases of the respiratory and cardiovascular system , renal failure, diabetes, immunodeficiency ... vaccine is very (!), we need all those over 65 years - regardless of health status.
You can argue about whether to vaccinate minors (malomesyachnoe) child who does not visit children's team, but definitely worth instill all those adults who can bring the flu into the house. One can argue whether or not to vaccinate pregnant women, but grafted on the eve of planned pregnancy, or to instill all pregnant members of the family - is quite reasonable.
A few words about what vaccines are.
Live vaccines containing live attenuated influenza virus.
Inactivated vaccine tselnovirionnye - in their composition inactivated (killed) viruses. The word "tselnovirionny" means that the virus is present entirely - it does not break down, do not share.
Split (split) vaccines contain virus particles are destroyed, its surface and internal proteins.
Subunit vaccines contain only the surface proteins - hemagglutinin and neuraminidase.
Each vaccine has its own specific list of indications and contraindications, their risk factors, their side effects, their methods of administration and dosing principles, which are connected not only with the patient's age, but also to how this vaccine - the primary (ie, the child is instilled against influenza for the first time in my life) or repeated.
Fortunately, the choice of influenza vaccines are so great that when indicated, desires, opportunities, and a doctor who will explain and advise plant can be almost anyone.
Nevertheless, it is important to be vaccinated promptly, precisely, in advance - for immunity, depending on the type of vaccine will require 7 to 20 days.
At the end of a conversation about the specific immunity of some words that immunity may not only be active (created by vaccination), but also passive - ie, formed as a result of the introduction into the body of ready-specific antibodies. In practice this is accomplished through the use of immunoglobulin - preparations obtained from blood donors. A typical example - influenza immunoglobulin that contains antibodies to influenza virus. Advantages of immunoglobulins - high efficiency, not only preventive but also curative; drawbacks - cost, the need for injections of production, the risk of "blood" of infections: after all, the basis of medicine - human blood.
Application immunotropic funds
Theoretically, everything looks quite specifically. Was done on a carefree summer. Approaching season SARS. We know that the frequency and probability of disease depends on the state of the immune system. There is more than reasonable desire to swallow some medicine, strengthen immunity. We are even willing to swallow the medicine every day, throughout the dangerous period - would be good.
Since the desire to improve immunity - an ambition Biochemical hooliganism that mass, so there is nothing unusual in the fact that demand creates supply. To meet the wishes of parents, pharmaceutical industry produces a huge amount of drugs specifically targeted prophylactic use - drugs that can affect the immune system: exercise its correction, stimulation, normalization, improvement, etc. It is not surprising that we have used an umbrella term "immunotropic tools ", implying all drugs related to effects on immunity.
There are many classifications immunotropic agents, but even the experts-immunologists have not yet agreed to the final - who and how to call. Nevertheless, the advertising of medicines is replete with clever names "immunomodulator", "immune", "immunocorrector 1, but we emphasize once more: a clear scientific distinction and specific conventional clarify the meaning of these words so far does not exist.
Specific parent, by and large, deeply care about which group of medicine is and how it operates. Main thing - that was a good judge. Give medicine - the child is not sick. Do not give a - ill.
***
Now a question for you, dear mom and dad. Very important question! After reading everything in this book was written, you admit that they can come in a kindergarten, where 10 children are running around with a runny nose, play with them all day and not get sick because you gave dityu some golden tablets?
You can imagine how sick with SARS dad came home from work, kissed, hugged the children, but they did not get sick because my mother gave them magical droplets, increasing the immunity?
The author has high hopes: savvy readers are not so naive as to believe in magic golden tablets and drops!
The child is not sick, if you do not meet with the virus.
The child is not sick, if there is to this virus-specific immunity, produced after diseases or due to vaccination.
The child has the chance not to get sick if he has a full-fledged local immunity, the effectiveness of which is determined by the parameters of the lifestyle.
There is a virus, there is no specific immunity, there is no normal way of life - a child gets sick, even if you feed him a hundred of the most-presamyh immunotropic drugs.
Immune system surprisingly complex, but surprisingly appropriate. Already studied hundreds (!) Immune processes, and hundreds of variety of substances involved in immune reactions. Mechanisms of many processes are not clear so far. Purpose of the set of immune factors is unclear so far.
One should be very presumptuous to assume a right to interfere in the immune system when no such interference can be circumvented.
Since the state of immunity to 99% by the way of life, and only at a very nominal 1% may be associated with medication, it is impossible to organize a scientific study on the preventive efficacy of whatever the drug. Impossible because no way will create an identical 99% to assess the effect of 1%.
Not surprisingly, the drug with proven efficacy for SARS prevention does not exist. But the drugs that are recommended for the prevention of SARS - a lot. And readers of this difference, I hope to grasp.
The main principles of prevention remain the same. In accordance with these principles, carrying out preventive SARS, we are able to act in two directions:
- Avoid contact with viruses (infection prevention).
- To increase the body's resistance to viruses.
Consider these trends in more detail.
PREVENTION OF INFECTION
Source of SARS - the people. The fewer people, the less SARS. The surest way not to hurt - to live on a farm in the forest without coming into contact with civilization. This suit is not all. Therefore, all suffer from ARI.
Vysokoveroyatny source of SARS - sick people. Conscious or forced contact with SARS patients greatly increases the chance of infection and disease.
The implications are clear: life in society - is a constant and real risk of SARS. SARS can not be avoided, but you can reduce the likelihood of disease.
Thus, prevention of infection - this sort of behavior, and based on this model - not only special medical knowledge, but most ordinary logic and common sense.
Going to school - the risk of SARS.
Go to school, dancing and singing in the choir - much greater risk of SARS.
In the dead of winter to go to the circus - a real risk of SARS.
Christmas Tree with Santa Claus and the distribution of gifts, all to the cashier at the supermarket, crowded bus - all these meetings with people. Each encounter - the risk of SARS.
All described does not mean that it is impossible to dance, go to the circus and ride a bus. Just need to be clearly understood: the more active lifestyle for your child, the more meetings and contacts - the higher the likelihood of disease.
Expose your child at risk or not - on an individual basis to solve specific family. Algorithm solutions - evaluation of pros and cons. If the price paid for the trip to the circus - a cough, a three-day snot and saline nose drops - so the price is acceptable. But if the load to a gift from Santa Claus baby gets fever, bronchitis, and a bunch of drugs and two weeks negulyanie - so expensive gift turns out ...
Parents are better than anyone else knows the ability of their child. If the rare disease and the lungs, so there are no restrictions in principle. But after two bronchitis and pneumonia, one in autumn is quite possible to dispense with the circus in winter.
At the same time, there are well-defined courses of action where the risk can be reduced or even completely prevented.
To kindergarten one stop on the bus. It may be worth up to fifteen minutes before this stop and walk? Rhetorical question, but pros are obvious - avoid the meeting with fellow passengers on the bus, save money for travel, but still get some fresh air!
Mom, Dad and Mike went out in the evening stroll. The purpose of a walk - replenishment of food brand name viagra stocks in the local supermarket. Neither the pope nor by Misha in the supermarket no good there. And they may well run-play, while mom is shopping. Use a triple: no one is a mother of the soul, no one close to Misha is not coughing and did not sniff, plus the child has the opportunity to run an additional half-hour, work up an appetite and improve sleep.
Children suffer from SARS more often than adults. Find the virus into contact with children is much easier than dealing with adults. Risk of contracting SARS in the puppet theater or a child's birthday than in the usual theater or on grandma's anniversary.
The more children - the greater the risk. The kindergarten № 1 Nastenka will have 10 classmate, and in kindergarten № 2 - 20. Clearly, where the risk is less. And it is not surprising that the first version twice the price of the second.
Readers are important to understand that, in citing these examples, the author does not impose your family to model behavior. Just too often we over it all and do not think we do not understand that the risk is quite possible to manage.
Therefore, all what we're talking about - is not a prescription, not an instruction, not imperative. It's just information for consideration.
Separate item, which is to reflect, - contacts with patients. Once again: the people - the risk sick people - particularly at risk. Only special needs should get you in the midst of a flu epidemic to go to the clinic. And healthy Basil does not necessarily provedyvat flu grandmother.
You cite Nastenka in kindergarten. And then out of ten, five bandmates - with a runny nose. This does not mean that tomorrow Nastya is sure to be cold. And does not mean that in a kindergarten child not to be led. But the degree of risk you will appreciate for sure. And estimating, understand that, firstly, the probability of ill close to 100%, and secondly, this kindergarten is clearly not worth the money paid for it.
But another, better nursery - no!
A flu grandmother did not live in a separate apartment, and in the adjacent corridor!
And do not go to the clinic does not work, because you just do not get very need help!
And people do not communicate do not get any!
Otherwise, how can the bus to school Misha's no getting. And daddy walk with Misha can not, he is busy at work, so my mother, together with Misha go to the store to shop. And in general: One can not sit at home bezvylazno - grandfather of the circus tickets purchased tomorrow at the Marina's classmate's birthday - we will walk the whole class!
In general, we have gradually come to a conclusion: the restriction of contacts with people (children) in general and to sick people (children) in particular - is a wonderful, very effective, but hardly implemented method for preventing SARS.
So, whether we like it or not want, but contact with a lot of people have the time.
What to do?
To use another option of prevention - to influence the transmission of respiratory viruses, the mechanism of direct contamination.
For each method of dissemination of SARS can be called a very specific preventive measures. So let's discuss them in detail.
First note that all methods of prevention of infection can be analyzed in two ways:
- Actions of patients, so as not to infect healthy people.
- Actions healthy, so as not to be infected from sick (really sick, maybe patients, healthy carriers of the virus).
There is, perhaps, yet a third direction - of the state (the authorities), so patients do not infect healthy - conducting quarantine measures: school closures, bans on mass gatherings, etc. The implementation of this path is not subject to readers of this book, so to speak here in fact, nothing - and everything is clear and obvious.
Airborne route of infection
With regard to children "of the patient - it's usually the parents of the patient.
Patients with SARS should be sick at home!
This is an obvious rule that is constantly violated. Broken always and everywhere - and adults and children worldwide. Snotty kids go to kindergarten (no one to stay home) and school (now the control of Mathematics). Sneezing mom goes to work. It can not go, because it works the head and she now receive visitors. Coughing dad goes on a mission ... Even our district pediatrician Anna Nikolaevna runs home with a stuffy nose. And what if no one more run?
What else should the patient? Cover your mouth and nose with a tissue when coughing and sneezing and blowing nose, try not to cry, no sputter, no hugging and kissing - all of these recommendations, it would seem, is so well known, available and obviously that did not require detailed justification. Another issue is that to get people in droves to make due - almost unreal. All that we can - from childhood cram our children answers to obvious questions about what is good and what is bad. And let the good cop-bad list includes not only the global "Thou shalt not kill", "Thou shalt not steal", "do not lie," "Love ...", but private, primitive practice "sit at home", "do not forget a scarf," " Cover your mouth "," do not yell, "breathe away", "Put on a mask ...
By the way, about "Put on your mask." Gauze, cotton-gauze and modern disposable masks of nonwovens - one of the most common ways of preventing SARS. In the season of SARS in hospitals is introduced so-called. "Mask mode": medical staff wears a mask, unmasked visitors do not overlook, posted schedules - when the masks should be changed.
Readers familiar with Chapter 2.2. Devoted to viruses, some imagine their size and are well aware that any, even the tightest mask to stop the virus is impossible. Then the question: what are masks necessary? The fact that viruses are found in large numbers in the mucus and phlegm. That's a drop of mucus and sputum, a few meters fluttering around the patient talking, coughing, sneezing and blowing nose, are the main source of infection, first, bystanders, and, secondly - everyday items.
Thus, the main task of the mask - to detain these drops, and even to some extent limit the ingress of the virus in the environment. It is obvious that the mask did not change fundamentally, the patient continues to breathe, and most ordinary breath enough to air containing viruses and exhaled by one person, becoming inhaled air for another person.
In addition, a mask very quickly saturated with sputum, and actually becomes a reservoir of the virus. Therefore, the mask recommend intensive iron and ironing change no less than 4 hours.
Once again, we emphasize that given the size of viruses and the size of "holes" in the gauze mask, no mask can not prevent viruses in the air in the respiratory tract of healthy humans. That is, the masks are not needed healthy! They put the sick, and they (the masks) are just ineffective remedy is healthy.
Likely to suffer from contact with the virus is largely related to two important parameters:
- The concentration of virus in the air.
- Virus activity.
Both of these parameters the most fundamental way connected with the characteristics of the air we breathe.
The concentration and activity of viruses determine the main epidemiological principles SARS PREVENTION: viral particles for hours and days remain active in the dusty, dry, warm and still air, and almost instantly killed in the air clean, cool, moist and moving.
Basic, applied, practical conclusion from this situation is that the likelihood of infection is closely linked with the rate of air in the room. The more intense the air, the lower the concentration of viruses in the air, the less chance of infection.
It is with this is largely due the fact that SARS season ends when all the houses the windows and vents.
High concentration of virus in the air, you can create only on the premises. Outdoors it is practically impossible, so get while walking can be just kissing, cuddling with the patient.
Why does the bad weather, more children ill with SARS? It is not because of wind, rain and cold! Just in bad weather children are walking less and communicate more with people like it on the premises!
Recommendations for practical realization of the main epidemiological principles of prevention SARS.
· Frequent and regular airing of the premises as a means of prevention - better all the masks and all drugs combined.
· Air is desirable when all are healthy, and always - when at least someone in the house is sick.
· More children in the room - the more often and more intensively it should be aired.
· Elementary and obvious steps in children's institutions: went for a walk - ventilated kindergarten, school bell rang - all quickly went into the corridor and ventilate the class.
Another way to reduce the concentration of virus in a residential area - this air treatment by exposure to, for example, fatal to the virus with ultraviolet rays (kvartsevanie, etc.).
Unfortunately, the effectiveness of these procedures is low. You can kill the virus in the air, but the source and reservoir of infection remains a patient man. It is worth it to go into the room - and a very short time once again filled the air viruses.
Contact the path of infection
We already wrote about that, settled on household items and dry mucous droplets of virus particles can remain active for several days. Besides viruses in large numbers are in the hands of the sick, so the handshake, paper money, door handles, tap in the bathroom, etc. - wonderful ways to contact the spread of infections.
Ten hand-shaking - and your hands are guaranteed there is a virus. It remains only to scratch your nose.
Kindergarten. Ten children, one with a cold, crawling together on one carpet. In turn fed the same teddy bear. I need hardly say that the aforementioned teddy bear and a carpet - Storage of viruses and the real source of contact infection.
Since the mechanisms of contact spread of viruses are obvious, obvious, and ways to prevent:
· Frequent wet cleaning: all that you can wash and wipe with a damp cloth - to regularly wash and scrub;
· Regular wiping with disinfectant solution contact common items of use - the above-mentioned door handles, etc.;
· Handwashing - frequent and thorough;
· Regular treatment with wet hands hygienic and disinfectant wipes;
• In child care institutions make every effort to ensure that the subject of joint use of children (eg toys) could be subjected to wet and hygienic processing.
Waterway infection
Characteristic of the very few viruses, the most typical - adenovirus. Specific mom and dad do not have the opportunity to influence how the treated water in the basin. That is, the prevention of infection by water - a water park of the workers and the control of sanitary-epidemiological services. All that can ordinary fans of public bathing - to know that the massive water treatment - an additional risk factor. This does not regarded as a call not to go swimming. But if your city outbreak of adenovirus infection, "find" it, swimming is much easier than skating.
Intestinal route of infection
Enteroviruses - a very common pathogens of acute respiratory viral infection with fecal-oral mode of transmission. The classic "disease of dirty hands" with the standard and obvious way of prevention - wash hands, utensils separate, order in the toilets.
Concentration of virus can be reduced not only in the inspired air, but also directly in the airways. With this in mind, one of the most safe, effective and inexpensive ways to prevent SARS - regular drip (pshikane) in the nose very familiar salt solutions.
Saline solutions reduce the concentration of virus in the nasal passages. Quite similar to regular gargling (anything important here the fact rinse) reduce the concentration of virus in the nasopharynx. And it definitely makes sense when the real threat of infection, when to avoid contact with sick can not.
Concentration of virus can not only reduce: inhaled viruses can in principle be destroyed by antiviral drugs.
From Chapter 10.15, we know that antiviral drugs "in general" does not exist, but there are drugs that can selectively act on the influenza virus.
Thus, prophylactic administration is appropriate only when there is an explicit threat of influenza virus infection - sick someone from family members, many cases of disease in a kindergarten or school. We emphasize once again: not just SARS, namely the flu!
Can realistically be applied two drugs - rimantadine (in the case of influenza A virus) and oseltamivir. But even when these drugs are used for prevention, appointed they still need a doctor. Firstly, because only a doctor has reliable information about how the virus is associated with a rise in the incidence and, secondly, because both of the mentioned funds are diverse, but well-defined contraindications, age restrictions and schemes of dosing.
So, we know the main ways of preventing infection. The saddest thing is that the huge number of factors contributing to the spread of SARS, no mother, no father can not influence.
Queue in front of doctors' offices in the children's clinics, visits to child care obviously sick children, cultural events in the midst of a flu epidemic, scored public transport, queues in shops, the indispensability of special and "consciousness" of workers, when you cough teacher continues to lead the lessons and cashier in Supermarket deals with hundreds of people, covering mask stuffy nose ...
Thus, all that we've already written about the prevention of infections, logically leads us to quite a definite conclusion: of course we can struggle to try and reduce the probability of encountering the virus, we can reduce the concentration of virus in the room and in the airways. Nevertheless, this meeting must be held. And the virus in the respiratory tract gets. And not just any virus, but quite real causative agent.
What will happen? At this stage, ie at a time when a bad virus hit the airways in a dangerous concentration, further developments are already determined by the state immunity, the body's ability to withstand a child and not get sick.
IMPROVING THE STABILITY OF THE ORGANISM TO VIRUSES
Increased resistance to viruses, possibly through actions in the following areas:
- Maintain the health and revitalization of local immunity.
- Creation of specific immunity (vaccination).
- Application immunotropic funds.
Consider all these points in detail.
Maintaining the health and revitalization of local immunity.
This way to prevent SARS - the most, perhaps, important and most effective. In its basis - ensuring the normal functioning of the mucous membranes of the respiratory tract, control of the state rheology of sputum.
Fluid mucus (saliva, snot, phlegm) - the main weapon of the local immunity. Dry mouth or nose - local immunity "shut down": it means that all the conditions to get sick.
What determines the state of the mucous membranes and the rheology of mucus in a healthy child? The answer to this question, we already know very well: first, the parameters of the air he breathes, and secondly, from the "system" mode of dressing and drink - propotel, time did not drink - that's mouth was dry, and thirdly, from the diet - it's hard to "work" of local immunity, if the mouth is constantly some kind of food, and fourthly, by inhalation of any dust and chemical hazards, which increase the burden on local immunity.
From the foregoing, it is logical to follow specific, practical recommendations:
· Maintain optimal temperature and humidity of indoor air. And not only where you live! Take an interest in the kindergarten at the school - whether the administration knows what should be the humidity, whether in the garden at least one humidity sensor, at least one moisturizer, what mode of ventilation of premises, how often and what wash floors. Try to reach consensus. After all your hard earned money is much more productive to invest in a moisturizer than a pharmacy. And it may be wise to encourage cleaner Aunt Pasha, so she washed the floors are not 1 times with bleach (in the bedroom of a kindergarten !!!), and 3 times, but ordinary water;
· Fresh air. Often, at any time of year. Proper Dress, possibly limiting sweating. If, after running dry in the mouth and the child asks for something to drink - be sure to take a walk drinks. Ensure that the child drank a lot while playing sports;
· Restriction on feeding in the intervals between feedings: remember that saliva has a pronounced antiviral activity. Permanent Food - decrease in activity of saliva. It is clear that when the food in your mouth so saliva "deals" are not viruses, and food;
· Cleanliness in rooms, dust removal, restraint in the use of household chemicals;
· Always be careful that the child draws in her mouth! There is nothing surprising in the fact that after the child pogryzet felt-tip pen out of toxic plastics from him (the child, of course) will drop local immunity;
· Control the process of cleaning teeth: if after the procedure, the child notes a dry mouth - Change your toothpaste. Do not use toothpaste without direct medical guidance of a dentist;
• In situations where humidify the air in a residential installation Viagra is suitable whether you fails, use to moisten the mucous membranes brine.
All of the above - well we know the parameters of lifestyle. And all this is a direct illustration of the fact that effective prevention of SARS, based on maintaining the health of local immunity - is not one-off event, it is a direct fulfillment of older people of their debt - a parent, vospitatelskogo, teacher. Debt, was not only to give birth, raise and teach, but also to create for our children normal conditions of existence ...
Thus, normal conditions, we, as far as they could, provided. But not everyone can live in a country house, and negotiate with the head of a kindergarten - it is mostly a pipe dream. And not because it is a head without understanding this. Just her but you still have to agree with the sanitary station, which requires cleaning floors with disinfectant solutions, monitors the temperature of the air, but it is not interested in humidity and how much time takes a walk. This is just some examples illustrating the fact that even knowing - that local immunity is good and what is bad, we do not always have the opportunity to do the right thing.
Therefore, constant efforts to improve, enhance local immunity by certain medications. And these drugs - stimulants local immunity - there.
Immediately, we note that local and general immunity are so closely intertwined that clearly distinguish them almost impossible. Any tool that stimulates local immunity, in varying degrees affects the total. Therefore, with respect to the names of drugs, correct to say "immune stimulators with a predominantly local action" - but essentially it does not change.
Modern local immune stimulants are fragments of bacterial cells, which, after ingestion or application to mucous membranes significantly increase the concentration of protective substances (immunoglobulins, lysozyme, etc.) in the mucus and phlegm. Drugs in this group demonstrated their effectiveness as a prophylactic against SARS, and in relation to the bacterial ARD. Another important plus - prevention of bacterial complications of SARS.
Bacterial stimulators of local immunity is deservedly popular among doctors and patients. They are safe, effective enough. At the same time never forget that the concentration of protective substances in the mucus and phlegm is significant only when this mucus and this mucus liquid. No even the most expensive and best stimulant of local immunity could not show their medicinal properties, if not previously be optimized parameters of air, if not protected from drying out mucous membranes.
Once again, in other words. You gave the child the medicine, and number of protective immunoglobulins in the mucus increased by 100 times. If the mucus is dry, so the number will not make any difference: in the dry mucus immunoglobulins simply do not work. "
Creation of specific immunity through vaccination
This is, by and large, a dream: that's to be done for vaccination against SARS and forget it! But since SARS - a few hundred a wide variety of viruses, vaccination is not. You can not protect against all, but you can create a vaccine against any one, specific virus.
A typical example of such protection is a flu vaccination.
Readers who have carefully studied Chapter 6.2, dedicated to the flu, can be skeptical smile, because an effective vaccine appears at first glance, unlikely. And really: if the virus is constantly changing, if at the same time may circulate several viruses, so what kind of vaccine may be a question?
Thus, skepticism and distrust grounded in two quite specific problems:
- The virus is changeable, so even getting immunity this year, we will be defenseless in the next, because the virus has come from an entirely different antigenic composition.
- Who knows what virus will come this year? From any virus should be vaccinated?
Nevertheless, on both issues have a specific algorithm is completely rational decision.
As soon as the virus is variable, so therefore should be vaccinated annually. Unpleasant, expensive, inconvenient, but there is no alternative. Want to not get the flu? Not "never sick", but "this year will not get sick? Do you? So, this is the year and should be vaccinated.
Well. We agree. But oppressed by doubts. Where is the guarantee that we will be grafted from the very virus that will cause an epidemic in the winter it this year? After all, look what happens. We decided as a family planting in November, because in January, is expected flu epidemic - so, at least, "said Smart's uncle on TV.
The vaccine is. Already have! But it had to cook, but it's certainly a few months. And then deliver to the pharmacy. And then sell it. That is, it turns out that the vaccine did, probably in the summer, and the virus is expected in January! Are they witches, wizards, to know in July how the virus will be in January!
And it really is not clear how such miracles are possible. Nevertheless, possible, but of no magic are not talking. And it requires an explanation.
As early as 1948, WHO created a special program that focuses on fighting the flu. This program today includes four specialized international center (in Atlanta, London, Melbourne and Tokyo) and more than 120 virological laboratories located throughout the world. Lab monitor the circulation of the virus and are constantly exchanging information with each other about what strains of virus are found in a region where they move. All results obtained are flocking to the international centers. In February of each year, the WHO Expert Committee announces the outlook on what antigenic variants of influenza virus will circulate in the coming season. Over the past 15 years, forecast accuracy was 92%. In March, the WHO laboratories carry out seed virus and send out material to vaccine manufacturers. The composition of each vaccine contains, as a rule, three types of viral antigens: two type A and one type C. From April to July is in the process of production - growing, blending, testing, testing. In August, the vaccine is packed, in September, she gets into the pharmacy, in October-December vaccination.
Current influenza vaccines are in most cases well tolerated and highly effective prevention.
Theoretically, influenza vaccination is shown to everyone who has a real chance to get sick. And any resident of the city, any child attending a children's team, the chances of ill enough. Again, it is fundamentally important that moment that if someone has a family member gets sick the flu, so everyone else a chance to survive is small.
In view of the described, vaccination against influenza - it's not so much a matter of expediency, as the question of material capabilities. But if you compare the cost of the vaccine to the cost of a two-week illness, so a definite conclusion is automatic.
Nevertheless, there are categories of people who are vaccinated against influenza clearly shown - shown at any price. These are the people (adults, children - does not matter) for which the flu - a disease not only dangerous, but deadly - it is about those who already have some kind of disease that may escalate against influenza: chronic diseases of the respiratory and cardiovascular system , renal failure, diabetes, immunodeficiency ... vaccine is very (!), we need all those over 65 years - regardless of health status.
You can argue about whether to vaccinate minors (malomesyachnoe) child who does not visit children's team, but definitely worth instill all those adults who can bring the flu into the house. One can argue whether or not to vaccinate pregnant women, but grafted on the eve of planned pregnancy, or to instill all pregnant members of the family - is quite reasonable.
A few words about what vaccines are.
Live vaccines containing live attenuated influenza virus.
Inactivated vaccine tselnovirionnye - in their composition inactivated (killed) viruses. The word "tselnovirionny" means that the virus is present entirely - it does not break down, do not share.
Split (split) vaccines contain virus particles are destroyed, its surface and internal proteins.
Subunit vaccines contain only the surface proteins - hemagglutinin and neuraminidase.
Each vaccine has its own specific list of indications and contraindications, their risk factors, their side effects, their methods of administration and dosing principles, which are connected not only with the patient's age, but also to how this vaccine - the primary (ie, the child is instilled against influenza for the first time in my life) or repeated.
Fortunately, the choice of influenza vaccines are so great that when indicated, desires, opportunities, and a doctor who will explain and advise plant can be almost anyone.
Nevertheless, it is important to be vaccinated promptly, precisely, in advance - for immunity, depending on the type of vaccine will require 7 to 20 days.
At the end of a conversation about the specific immunity of some words that immunity may not only be active (created by vaccination), but also passive - ie, formed as a result of the introduction into the body of ready-specific antibodies. In practice this is accomplished through the use of immunoglobulin - preparations obtained from blood donors. A typical example - influenza immunoglobulin that contains antibodies to influenza virus. Advantages of immunoglobulins - high efficiency, not only preventive but also curative; drawbacks - cost, the need for injections of production, the risk of "blood" of infections: after all, the basis of medicine - human blood.
Application immunotropic funds
Theoretically, everything looks quite specifically. Was done on a carefree summer. Approaching season SARS. We know that the frequency and probability of disease depends on the state of the immune system. There is more than reasonable desire to swallow some medicine, strengthen immunity. We are even willing to swallow the medicine every day, throughout the dangerous period - would be good.
Since the desire to improve immunity - an ambition Biochemical hooliganism that mass, so there is nothing unusual in the fact that demand creates supply. To meet the wishes of parents, pharmaceutical industry produces a huge amount of drugs specifically targeted prophylactic use - drugs that can affect the immune system: exercise its correction, stimulation, normalization, improvement, etc. It is not surprising that we have used an umbrella term "immunotropic tools ", implying all drugs related to effects on immunity.
There are many classifications immunotropic agents, but even the experts-immunologists have not yet agreed to the final - who and how to call. Nevertheless, the advertising of medicines is replete with clever names "immunomodulator", "immune", "immunocorrector 1, but we emphasize once more: a clear scientific distinction and specific conventional clarify the meaning of these words so far does not exist.
Specific parent, by and large, deeply care about which group of medicine is and how it operates. Main thing - that was a good judge. Give medicine - the child is not sick. Do not give a - ill.
***
Now a question for you, dear mom and dad. Very important question! After reading everything in this book was written, you admit that they can come in a kindergarten, where 10 children are running around with a runny nose, play with them all day and not get sick because you gave dityu some golden tablets?
You can imagine how sick with SARS dad came home from work, kissed, hugged the children, but they did not get sick because my mother gave them magical droplets, increasing the immunity?
The author has high hopes: savvy readers are not so naive as to believe in magic golden tablets and drops!
The child is not sick, if you do not meet with the virus.
The child is not sick, if there is to this virus-specific immunity, produced after diseases or due to vaccination.
The child has the chance not to get sick if he has a full-fledged local immunity, the effectiveness of which is determined by the parameters of the lifestyle.
There is a virus, there is no specific immunity, there is no normal way of life - a child gets sick, even if you feed him a hundred of the most-presamyh immunotropic drugs.
Immune system surprisingly complex, but surprisingly appropriate. Already studied hundreds (!) Immune processes, and hundreds of variety of substances involved in immune reactions. Mechanisms of many processes are not clear so far. Purpose of the set of immune factors is unclear so far.
One should be very presumptuous to assume a right to interfere in the immune system when no such interference can be circumvented.
Since the state of immunity to 99% by the way of life, and only at a very nominal 1% may be associated with medication, it is impossible to organize a scientific study on the preventive efficacy of whatever the drug. Impossible because no way will create an identical 99% to assess the effect of 1%.
Not surprisingly, the drug with proven efficacy for SARS prevention does not exist. But the drugs that are recommended for the prevention of SARS - a lot. And readers of this difference, I hope to grasp.
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