Local radiation damage to the mucous membranes. Oropharyngeal candidiasis - thrush affecting the mucous membranes of the mouth and lips

Oropharyngeal candidiasis is medical term, which doctors call thrush in the mouth if it simultaneously affects the palate, throat, tonsils, pharynx, tongue, tender inner surface of the cheeks and lips. It develops in patients of all ages due to increased growth Candida is a microscopic yeast-like fungus. The disease is considered quite widespread and is not dangerous with timely treatment.

Causes of oral thrush

Basically, only children can become infected with this type of candidiasis. But in adults, the pathogen is constantly in the mouth in small quantities. While there is little of it, there is no need to talk about oropharyngeal candidiasis, since it is normal condition mucous membranes. Candida is part of the healthy microflora, being in negligible quantities compared to the predominant type of microbes - lactobacilli, and remain dormant.

Caution: the condition of oropharyngeal candidiasis can cause sepsis.

Regulation of their quantity is achieved through the immune system. In addition, microbes in the microenvironment have their own competitive relationships, in which candida are symbiotic (they coexist harmlessly with a number of beneficial microorganisms). If lactobacilli on the surface of our mucosa are about 95%, then the opportunistic sector occupies only 2% (they also include candidiasis pathogens).

A failure occurs when the immune system suffers at a local or general level. The result of this imbalance is the pathogenic growth of candida. Very quickly there is so much fungus that it begins to form mushroom chains, and then colonies. Colonization of infectious agents is the root cause of oropharyngeal candidiasis. Such colonies are introduced into upper layer epithelium, affecting its cells (the fungus needs them to feed nutrients Having taken away what is needed from the cell, candida releases its toxins, which leads to the death of healthy cells).

The following factors contribute to the development of fungal flora and the onset of candidiasis:

• Immunodeficiency conditions (especially HIV infection);
• Serious chronic diseases;
• Infancy;
• Lack of proper hygiene;
• Hormonal disorders;
• Antibiotic therapy;
• Microtraumas of the mucous membrane;
• Carious, untreated teeth;
• Improper or dishonest care of dentures;
• Smoking;
• Bad habits;
• Intestinal infections.

The presence of one of the list or several similar factors does not necessarily lead to oropharyngeal candidiasis, but significantly increases the risk of developing the disease.

Types of disease

Varieties of the disease are distinguished depending on the location candida infection. It is most convenient to consider them in a table.

There are also differences in the course of the disease. Oropharyngeal candidiasis, like other types of thrush, can occur in the following forms:

• Acute (generalized damage to the oropharyngeal region is more often observed);
• Chronic (in certain areas of the mucous membrane).

Candidiasis can cause changes in morphological type. So, depending on their nature, several types of illness are distinguished:

• Pseudomembranous (typical for children and the elderly);
• Atrophic or erymatous (develops in those who have taken antibiotics or hormones for a long time or incorrectly, and also wear dentures);
• Hyperplastic or candidal leukopathy is a type of oral thrush that is prone to malignant transformation.

Symptoms

Depending on the form of the course, there are differences in the manifestation of characteristic symptoms.

Acute oropharyngeal candidiasis

This candidiasis is very rarely diagnosed in the early stages. At the very beginning of the pathogen’s impact on the oral cavity, slight redness appears in the throat and tonsils. Then white dots appear - single plaques (outwardly they look like grains of semolina). During this period, slight discomfort may be felt. Gradually, the whitish dots grow, merging with each other, and forming a single plaque. It turns yellowish or gray shade. This is a characteristic symptom of oropharyngeal candidiasis.

At first, you can easily remove the plaque with a spatula, but if left untreated, removal becomes difficult. The surface underneath becomes not just swollen and inflamed: a large number of bleeding wounds and erosions are visible on it. The pain is much more pronounced.

Children suffer from the disease with difficulty. They become restless, refuse to breastfeed, and scream. Since the mucous membrane of newborn babies is more tender, the disease develops more rapidly.

In general, the following symptoms of oropharyngeal candidiasis can be distinguished:

• Pain in the mouth, which intensifies during swallowing;
• Burning sensation;
• White plaque (from single to continuous, depending on the degree of infection) sometimes with a gray or yellow tint;
• Redness, rashes resembling small blisters;
• Erosion under plaque;
• Dry mucous membranes;
• Cracks, wounds, erosions;
• Swelling and swelling of the affected surface;
• Feeling of “too much tongue”;
• Sometimes fever;
• Nausea;
• Lack of appetite.

Not all patients exhibit the full range of symptoms. The presence of even a few of them indicates the need for consultation with a competent specialist.

Manifestations of the chronic form of the disease

With such a flow the following are combined:

• Stomatitis;
• Cheilitis;
• Glossitis;
• Pharyngitis.

There are two options for the development of events:

1. Hyperplastic candidiasis chronic type accompanied by whitish plaques against the background of swollen and reddened mucous membranes in the mouth and throat. A protracted process is associated with the formation of adhesions yellow color films. Their mechanical removal ends with the formation of ulcers.
2. Atrophic candidiasis of the chronic type is accompanied by dryness, pain, and burning in a strictly defined area. Those with dentures are especially at risk.

Diagnostics

Any symptoms that resemble oropharyngeal candidiasis require testing by a doctor. It needs to be differentiated from other diseases in this area.

The most reliable way to diagnose the disease is a biopsy - taking a piece of tissue affected by the pathogen. In this biomaterial, you can not only detect the presence of candida, but also determine their number. Ordinary washes from the surface of the nasopharynx are also used.

Treatment of oropharyngeal candidiasis

To set a course, it is best to take several factors into account:

• External manifestations of candidiasis;
• State of immune mechanisms;
• Concurrent diseases;
• Presence of contraindications;
• Age.

Treatment can be carried out locally and systemically. If the situation is not advanced, then good external medications are quite enough. They will quickly relieve the symptoms of thrush, significantly alleviating the patient’s condition. They have no contraindications (with rare exceptions), so there is minimal harm to the body.

The course of treatment for oropharyngeal candidiasis lasts about three weeks. The disappearance of obvious symptoms clearly does not indicate the fact that medications should not be used. To defeat candida, you should methodically reach the end, otherwise the thrush will quickly return.

Local remedies are not always effective enough, so they can be supplemented with systemic ones. Tablets are more toxic, but sometimes you can’t do without them. If oropharyngeal candidiasis manifests itself in a generalized manner, then, most likely, you will have to use tablets. If you use them according to the scheme, you can be cured quickly.

Based on Fluconazole, Ketoconazole, Clotrimazole, Nystatin. They are produced in convenient forms: tablets for further resorption, sprays, rinsing solutions, tablets for oral administration. Therapy can be supplemented with aniline dyes and nystatin ointment. Doctors, as a rule, describe in detail the rules for using medications. They must be observed very strictly so as not to provoke another progression of fungal flora.

Inflammatory process accepts severe form in the presence of the following circumstances:

• Low levels of immune response;
• Large area of ​​damaged areas;
• Early age;
• The presence of a generalized form.

But medications have different ways introduction. For oropharyngeal candidiasis:

• Oral;
• Inhalation;
• Parenteral.

Which one to choose is a question for the doctor, since different features body and each clinical case should be taken into account when selecting a methodology.

ethnoscience

Of course, the treatment methods used by our grandmothers can help. You just have to remember that you shouldn’t rely completely on them in treating fungus. It is more correct to supplement medications with such methods. So, the following can be used as bases for solutions for further rinsing:

• Soda solution

Regular baking soda always saved from thrush. It is diluted in water and a couple of drops of iodine are dropped into a glass. The finished product changes the acidity: its indicator decreases significantly, alkaline is not favorable for candida, therefore they cannot reproduce in the same volume.

• Herbal decoctions or infusions

Herbs are also good in moderation. The oral cavity is rinsed with products based on them. Chamomile, calendula, juniper, hawthorn, verbena, jasmine, St. John's wort and other plants are successfully used as disinfectants and antifungals. Some of them are suitable for preparing healing herbal tea. A specialist will advise you on how to use them correctly. He will also talk about the advisability of combining them with mainstream medicine.

• Garlic

It has been used to fight candida and other fungi for a very long time. It also helps restore immunity and disinfects the affected surface. Oropharyngeal candidiasis is also afraid of this product, so it is certainly included in the diet. You can also prepare a garlic infusion for rinsing.

Attention: ethnoscience does not replace the classical one, but is of an auxiliary nature.

Features of treatment in childhood

Babies are a special category of patients; they need delicate and effective therapy. This is especially true for infants. Many babies develop plaque soon after birth. They refuse breasts, pacifiers, and bottles because of the pain. This is mainly due to infection from the mother during or after childbirth, but other adults can also carry candidiasis.

During treatment, you need to follow the recommendations of the pediatrician who is caring for the baby. For early stages Soda treatment is suitable, but later soft solutions, drops and ointments are prescribed. At the same time, all objects that may come into contact with the oral cavity of the sick child are treated.

If the mother has candidiasis on her nipples, then it is treated with the same remedy as her child’s thrush. From breastfeeding don't refuse.

Complications

A relatively safe disease in the absence of a qualified medical approach can lead to very undesirable consequences for any patient:

• Chronic form

It is extremely undesirable because it is difficult to treat. Such patients may experience frequent relapses of the disease. Acute candidiasis inflammatory process quickly turns into a recurrent form.

• Spread of infection

Oropharyngeal candidiasis can cause candidal lesions in other organs. Most often, the fungus begins to progress in the intestines, nose, and ears.

• Incorporation of third-party infectious agents

The affected mucous membrane becomes a target for all sorts of microbes. Its microenvironment is weak and disharmonious, so it cannot protect itself. The situation is further complicated by the fact that other bacterial infections are treated with antibiotics. They lead to even greater disharmony in the microflora. Candida only progresses from this.

Preventive measures

Of course the best medicine is timely prevention. In order to avoid encountering this type of thrush, it is enough to follow simple rules:

• Eat right (balanced diet, quality healthy food, less sweets and baked goods);
• Do not smoke or drink alcohol;
• Keep your mouth clean;
• Treat chronic illnesses in a timely manner;
• Visit the dental office regularly;
• Take proper and timely care of dentures;
• Monitor the level of hormone secretion;
• Pay attention to metabolism;
• Take antibiotics only when necessary, combining them with drugs to normalize the flora.

If oropharyngeal candidiasis appears even with the observance of preventive measures, do not despair. Hurry to the doctor, carefully follow his recommendations and soon the problem will be solved. If you can’t cope with the disease, share your story with our experts: they will help you.

Oropharyngeal candidiasis is a type of thrush caused by the fungus Candida. The disease affects the oral mucosa, tongue, cheeks, gums, and pharynx. Treatment of oropharyngeal candidiasis often carried out with candles.

Symptoms of oropharyngeal candidiasis

This type of candidiasis occurs in a third of cancer patients who have undergone chemotherapy. In addition, oropharyngeal candidiasis affects up to 90% of people with AIDS. In this regard, it has been proven that candidiasis of this type is a clear indicator of weak immune system.

Characteristic symptoms oropharyngeal candidiasis:

• whitish coating on the cheeks,
• sky,
• language,
• gums,
• as well as cracks in the corners of the mouth.

White dotted formations, often of a curdled nature, can merge, forming large foci of fungal infection. At first, such formations are easily removed mechanically. But already three months after the start of the fungal proliferation process, the plaque thickens, and when rejected, forms small ulcers and erosions.

Symptoms of chronic oropharyngeal candidiasis

At chronic diseases on the mucous membrane inner surface flat grayish-white keratinization may appear on the cheeks. The corners of the mouth become inflamed and there is a burning sensation in the throat. Most patients with candidiasis feel discomfort and sometimes pain when eating.

Symptoms of oropharyngeal candidiasis different forms

The following types of candidiasis of this type are distinguished:

Cheilitis is a lesion of areas of the lips on which dense scales and deep cracks form.

Oropharyngeal candidiasis of the angular cheilitis variety (or jams) is erosion of the corners of the mouth of a reddish hue with a white coating.

Gingivitis is a lesion of the gums in the form of a gray-yellow film that causes inflammation and sometimes bleeding.

Glossitis as a type of oropharyngeal candidiasis is a lesion of the oropharynx.

Stomatitis is a consequence of the proliferation of candida, which can be characterized by either a slight plaque on the palate, cheeks and tongue, or the formation of extensive ulcers and erosions throughout the oral cavity.

Oropharyngeal candidiasis, a type of tonsillitis, is a disease accompanying stomatitis and glossitis, which is characterized by the formation of white cheesy deposits on the tonsils.

Pharyngitis is a lesion of the pharynx.

Treatment of oropharyngeal candidiasis

Note that, despite the causative agent - candida, medications for each type of thrush will be different. Therefore, it is not worth treating oropharyngeal candidiasis. An appointment with a doctor and the course of treatment he prescribes is the most reliable way get rid of this disease.

The doctor prescribes an antifungal drug to the patient, as well as a special ointment (gel) to treat the affected areas.

Treatment of oropharyngeal candidiasis with suppositories

Oropharyngeal candidiasis is considered one of the most unpleasant and intrusive: the fungus Cfndida, called yeast-like, becomes extremely dangerous forms when a person’s immunity decreases. This gives the fungus a chance to literally take over the entire body. And the best way to counteract such a disease can be suppositories for candidiasis.

Today, the pharmaceutical industry has an arsenal of suppositories that relieve (or at least remove) the peak pain with a diagnosis of oropharyngeal candidiasis. And considering that almost anyone can carry out a course of treatment with suppositories when diagnosed with oropharyngeal candidiasis (as opposed to injections), many people suffering from candidiasis prefer this method of treatment - with suppositories. Here are some of them below common name"vaginal".

Treatment of oropharyngeal candidiasis with Coltrimazole

If we briefly characterize the suppositories, and there are also creams containing coltrimazole, you should definitely start with the broad spectrum of action of this antifungal drug. It “works” very effectively locally in the treatment of oropharyngeal candidiasis, primarily on a specific area of ​​the mucous membrane, which signaled the disease with itching and burning. But at the same time, some amount of coltrimazole can be absorbed into the blood, causing side effects. This is why you should not self-medicate or self-prescribe suppositories for oropharyngeal candidiasis - consultation with a doctor is necessary.

But there are two starting positions in which, even without consulting a doctor, you should refuse to use suppositories with Coltrimazole: first, if this is a pregnant woman diagnosed with oropharyngeal candidiasis; second - if it is a nursing mother. Everyone else also needs to keep in mind that suppositories for candidiasis are inserted once a day (preferably at night) into the vagina. The minimum course of treatment is a week. By the way, suppositories for the diagnosis of oropharyngeal candidiasis can be given by taking drugs or injections in parallel.

Treatment of oropharyngeal candidiasis with Ciclopirox

Doctors call these suppositories an alternative to coltrimazole in the treatment of candidiasis: providing therapeutic effect on the skin and mucous membrane affected by fungal infection, they act less irritatingly and are compatible with almost all patients. Those. absent by-effect.

And yet, it is impossible to force the treatment of oropharyngeal candidiasis with cyclopyroxome suppositories: once a day. And the duration of the course depends on the severity of candidiasis - for some, three days is enough, but for more advanced disease you will need a two-week course. The warning is almost the same as in the case of Coltrimazole suppositories: prohibited for pregnant and breastfeeding women. Plus - children diagnosed with oropharyngeal candidiasis under ten years of age and those who are allergic to Ciclopirox.

Oropharyngeal candidiasis is a disease. None of her “acquaintances” who have first-hand experience would argue with this. Therefore, you need to go to the doctor with the disease. Self-medication of the disease in this case will more likely harm than help - this is the case. And secondly, be careful when buying the candles prescribed for you: they must be sterilely packaged and, also important, not produced in the last century.

Edema, focal and confluent epitheliitis, salivation disorders (xerostomia), pain when swallowing and passing food through the esophagus, and when the larynx is irradiated - laryngitis.

The threshold dose for the development of radiation oropharyngeal syndrome is considered to be 5-7 Gy. Later
4-8 hours after irradiation, a transient vascular reaction of the mucous membranes of the oropharynx can be detected, manifested in the form of redness, swelling, opalescence, and the appearance of tooth marks.
When irradiated at doses of about 10 Gy or higher, after a latent period, lesions of the mucous membranes of the oropharynx of varying severity develop.
^ For oropharyngeal syndrome of I severity the peak period begins 2 weeks after irradiation. It manifests itself in the form of congestive hyperemia with a bluish-bluish tint, swelling and small single erosions on the mucous membrane soft palate and palatine arches.
Normalization of the mucous membranes occurs within 2 weeks.
Main manifestations oropharyngeal syndrome II severity arise after 1-
2 weeks, when numerous, sometimes with hemorrhages, erosions of the buccal mucosa, soft palate, and sublingual area appear, usually complicated by secondary infection and regional lymphadenitis. The process takes about 3 weeks and is completed full restoration mucous membranes, although erosions can occur repeatedly, followed by complete repair.
^ For oropharyngeal syndrome of III severity The latent period lasts about 1 week. During the peak period, quite large multiple ulcers and erosions, covered with necrotic plaque, appear in all areas of the oral mucosa. The erosive-ulcerative process is accompanied by a very pronounced pain syndrome, is recurrent in nature and, as a rule, is complicated by bacterial-fungal and viral (most often herpetic) infection. Its duration is more than 1 month, and after regeneration of the mucous membranes, scars remain at the sites of former deep ulcers.
^ For extremely severe (IV) degree of oropharyngeal syndrome after some weakening of the primary hyperemia for 4-6 days, it recurs again: the mucous membrane becomes bluish, with white deposits, and swells. Soon, extensive ulcerative-necrotic lesions develop, spreading to the submucosal layer and deeper, the ulcers become infected, local hemorrhages occur, and pronounced pain syndrome.
The course of the process is very long (about 1.5 months) and often recurrent. Complete repair of the mucous membranes does not occur: the mucous membrane remains thinned, dry, with multiple easily vulnerable scars.
After irradiation of the oropharyngeal area at doses of more than 15 Gy, in almost half of the cases, oropharyngeal syndrome can be a direct cause fatal outcome.
35.Features of ARS during neutron irradiation.

, lie:

- lower penetrating power compared to x-rays and gamma rays;

These factors act in opposite directions. As a result of this factor, the intestinal epithelium is more strongly affected by neutron exposure, the radioresistance of which, in comparison with hematopoietic tissue, is largely associated with a greater ability to repair sublethal cell damage. The hematopoietic system is affected less than with a corresponding absorbed dose of an electromagnetic radiation source: this is due to the acceleration of the process of restoration of hematopoietic tissue due to the migration of cells from its less irradiated areas.
For the same reasons, serious damage small intestine develop even with non-lethal doses of neutron irradiation of the body. the presence of intestinal syndrome is not always an unfavorable prognostic sign; its treatment can lead to further recovery.
Main features of ARS from neutron exposure:
-high severity of the primary reaction to radiation and RPN syndrome
(early transient disability);
- great depth of lymphopenia during the primary reaction to radiation;
- signs of more severe damage to organs and tissues on the side of the body facing the radiation source;
- more pronounced bleeding as a result direct damage neutrons from the walls of blood vessels.
The listed features must be taken into account when the body is exposed to penetrating radiation from a nuclear explosion, when the ratio of the contribution of neutrons and gamma rays to the radiation dose depends on the power, type of nuclear weapon and distance to the center of the explosion.
36. Features of injuries caused by exposure to neutrons. With uneven irradiation.
The basis of the differences inherent in ARS when exposed to neutrons , lie:
- less reparable neutron lesions on cellular level;

Less penetrating power compared to X-rays and gamma rays;
- less uniform dose distribution throughout the body.
These factors act in opposite directions. As a result of this factor, the intestinal epithelium is more strongly affected by neutron exposure, the radioresistance of which, in comparison with hematopoietic tissue, is largely associated with a greater ability to repair sublethal cell damage. The hematopoietic system is affected less than with a corresponding absorbed dose of an electromagnetic radiation source: this is due to the acceleration of the process of restoration of hematopoietic tissue due to the migration of cells from its less irradiated areas. For the same reasons, serious damage to the small intestine develops even with non-lethal doses of neutron irradiation of the body. the presence of intestinal syndrome is not always an unfavorable prognostic sign; its treatment can lead to further recovery.
The following are distinguished: kinds uneven irradiation:
- general uneven irradiation;
- subtotal irradiation;
- local irradiation.
With uneven irradiation general patterns the course of ARS (cyclicality, hypoplasia of hematopoietic tissue) may be slightly modified or less clearly expressed. This is due to the fact that in shielded parts of the body some radiosensitive tissues remain intact or are slightly damaged.
(bone marrow, intestines). During the recovery period, this contributes to more rapid recovery and normalization of functions. As a result, recovery is possible even for people exposed to the effect. ionizing radiation in doses that, under conditions of uniform irradiation, inevitably cause death.
The locality of irradiation often leads to the fact that in the clinical picture of ARS, local damage to organs and systems comes to the fore. This may be the immediate cause severe complications and death of those affected. Therefore, predicting the outcome of uneven radiation damage is much more difficult.
Under these conditions, great prognostic value acquire criteria for biological dosimetry.
When irradiating primarily the head and neck a pronounced primary reaction is observed: “gushing”
vomiting, severe headaches, vasomotor disorders. If the radiation dose exceeds 4–5 Gy, hyperemia and swelling of the face appear, followed by epilation of eyebrows and eyelashes. At a dose of 10 Gy or more,

cerebral edema with pronounced neurological manifestations, as well as ulcerative-necrotic damage to the mucous membranes of the mouth and nasopharynx (oropharyngeal syndrome). In peripheral blood and sternal punctate there are no clear signs of suppression of hematopoiesis.
Irradiation of the thoracic segment of the body occurs with minimal manifestations of the primary reaction; in the first two days are observed discomfort in the heart area up to angina pain, various disorders cardiac rhythm and corresponding changes on the ECG. In the sternal punctate there is inhibition of hematopoiesis. In peripheral blood - no changes due to increased hematopoiesis in other parts of the bone marrow tissue.
Irradiation of the abdominal segment of the body due to the presence of a large reflex zone manifested by a pronounced primary reaction and symptoms of damage to the abdominal organs. The features of the clinical picture of the disease are determined by clinical and morphological changes in these organs, primarily the intestines (segmental radiation colitis, enteritis, etc.), which are characterized by the greatest radiodamage.
Significant changes in the kidneys and Bladder. In the blood: devastation bone marrow observed in those bones that have been irradiated. In case of uneven irradiation, for an objective assessment of hematopoietic function, it is necessary to examine bone marrow punctate from different bones.
For local irradiation of the extremities the outcome of diseases depends on the severity of local radiation injury (the severity and extent of radiation damage to the skin and subcutaneous tissues).
Local radiation injuries characterized by the occurrence of radiation burns, clinical picture which is determined both by the absorbed dose, energy and type of radiation, and individual characteristics body, the area of ​​the burn and its location. The skin of the hands, feet, groin and armpits is especially radiosensitive.
37.Classification and purpose technical means respiratory protection.
The principle of protective
Combined arms
Special

Filtering
Small gas mask
PMG Small-sized gas mask PMG-2
Gas mask boxed mask PMK Gas mask boxed mask PMK-2
Gas mask boxed mask PMK-3 Respirator
R-2 Combined arms universal respirator ROU
Universal gas mask for missile forces PRV-U Modernized gas mask for missile forces
PRV-M Filtering gas mask for flight personnel PFL
Marine respirator RM-2
Additional cartridge kit
KDP
Insulating
Self-contained breathing apparatus IP-4
Self-contained breathing apparatus IP-4M
Self-contained breathing apparatus IP-5
Marine self-contained breathing apparatus Pffl-6 Portable breathing apparatus GGDA-3
Hose breathing apparatus ShCA
38. Purpose, composition and operating rules of the respirator.
Respirators designed to protect the respiratory system from aerosols of radioactive substances and biological agents. Respirators do not protect against HVAC vapors and gases and do not enrich the inhaled air with oxygen, and therefore they can only be used in an atmosphere free of HVAC and containing at least 17% oxygen.
Respirators are a filtering half mask equipped with inhalation and exhalation valves. The half mask is attached to the head using a headband, and the nose clip ensures a more tight fit of the half mask in the nose area. Modern respirators are made on the basis of filter material proposed in 1955 by academician I.V. Petryanov-Sokolov. Petryanov filters are a hydrophobic polymer made of ultra-thin fibers of polyvinyl chloride, polystyrene or methyl methacrylate fabric. This fabric has a large and persistent electrostatic charge that attracts aerosol particles. As the aerosol flow rate increases due to increased friction, the fabric charge increases, which contributes to better particle retention on the filters. At proper storage and use, the electrostatic charge on Petryanov filters can be retained for ten years. The respirator is stored in a plastic bag, since when the respirator gets wet, its filtering ability and, consequently, its protective properties are significantly reduced. The leakage coefficient in respirators does not exceed 0.1%.

Respirator R-2 consists of a filter half mask and a head cap. The filtering half mask is made of three layers of materials. Outer layer- polyurethane foam of a protective color, the inner one is an airtight polyethylene film with two built-in inhalation valves, and between the polyurethane foam and the film there is a layer of filter material made of polymer fibers of Petryanov-Sokolov fabric. The exhalation valve is located in the front part of the half mask and is closed from the outside with a screen.
Marine respirator RM-2 is a modification of the R-2 respirator. It is designed to protect the respiratory system from radioactive aerosols, as well as from exposure to vapors radioactive iodine and polonium. RM-2 consists of half masks with a headrest on which a filter box with inhalation and exhalation valves and an intercom are placed.
General purpose respirator The ROU consists of a front part in the form of a filtering-absorbing mask with a spectacle unit, which simultaneously performs the functions of the front part and the filtering-absorbing element. Unlike the respirator R-
2 ROU respirator is also designed to protect the eyes from the light radiation of a nuclear explosion and the respiratory system from vapors of toxic substances.
39. Purpose, composition and operating rules of a filter gas mask.
Filtering gas masks are designed to protect the respiratory organs, vision and facial skin of personnel from toxic and highly toxic substances (HTS), radioactive substances (RS) and biological agents (BS), as well as to reduce the intensity of damage from light radiation nuclear explosions. The protective effect of filter gas masks is based on the fact that the air used for breathing is pre-cleaned of harmful impurities as a result of the processes of adsorption, chemisorption, catalysis and filtration through granular absorbers.
A filter gas mask consists of a filter-absorbing system, made in the form of a filter-absorbing box or filter-absorbing element, a front part and a gas mask bag. If there is a threat of carbon monoxide poisoning, the filter-absorbing system is made in the form of a filter-absorbing box and a set of additional cartridges. In the filter-absorbing system, an anti-aerosol filter is placed first in the air flow, and then a special absorber (charge) created on the basis activated carbon with various chemical additives

The front part of the gas mask is made in the form of a helmet-mask or a mask, the structural elements of which are goggles, fairings to protect the glasses from fogging, a valve-distribution box and a head mounting system. A correctly selected front part should fit tightly with the edges to the head, provide the necessary sealing without causing pain. To maintain normal speech volume, the gas mask has front parts that contain a membrane intercom, and a special configuration of the glasses in the gas masks allows you to work with

optical instruments. In addition, the front part of a number of gas masks is equipped with a liner, a seal and a system for receiving liquid.
(KDP), which includes a connecting tube, a DP-2 cartridge, which is a cylindrical box equipped with a desiccant, hopcalite and a catalyst, an anti-aerosol filter and a bag. Passing through the additional cartridge DP-2, the air with carbon monoxide in the desiccant layer is freed from moisture, and then, interacting with the hopcalite mixture, turns into carbon dioxide. The additional cartridge kit is effective in a wide temperature range: from - 40°C to + 40°C. At positive temperatures, time protective action set of additional cartridge is up to 400 min, at minus temperature


A filter gas mask consists of a filter-absorbing system made in the form of a filter-absorbing box or filter-absorbing element, a front part and a gas mask bag. If there is a threat of carbon monoxide poisoning, the filter-absorbing system is made in the form of a filter-absorbing box and a set of additional cartridges. In the filter-absorbing system, an anti-aerosol filter is placed first in the air flow, and then a special absorber (charge) created on the basis of activated carbon with various chemical additives
(degassers, catalysts, etc.).
The front part of the gas mask is made in the form of a helmet-mask or a mask, the structural elements of which are goggles, fairings to protect the glasses from fogging, a valve-distribution box and a head mounting system. A correctly selected front part should fit tightly with the edges to the head, provide the necessary sealing without causing pain. To maintain normal speech volume, the gas mask has front parts that contain a membrane intercom, and a special configuration of the glasses in gas masks allows you to work with optical instruments. In addition, the front part of a number of gas masks is equipped with a liner, a seal and a system for receiving liquid.
It must be remembered that, due to their design features filter and absorption boxes of modern gas masks are not capable of neutralizing carbon monoxide

(carbon monoxide). In this regard, to protect against harmful effects carbon monoxide applied additional cartridge kit(KDP), which includes a connecting tube, a DP-2 cartridge, which is a cylindrical box equipped with a desiccant, hopcalite and a catalyst, an anti-aerosol filter and a bag. Passing through the additional cartridge DP-2, the air with carbon monoxide in the desiccant layer is freed from moisture, and then, interacting with the hopcalite mixture, turns into carbon dioxide. The additional cartridge kit is effective in a wide temperature range: from - 40°C to + 40°C. At positive temperatures, the protective action time of the additional cartridge kit is up to 400 minutes, at minus temperatures
40°C and the presence of hydrogen - about 70 minutes. High air humidity has virtually no effect on the operation of the device.
It should be remembered that when the concentration of carbon monoxide is over 1%, when there is a lack of oxygen in the air (concentration less than 17%) and during fires in enclosed spaces, the additional device kit is ineffective. In these cases, it is necessary to use self-contained breathing apparatus (insulated gas masks).

The treatment of oropharyngeal candidiasis is carried out (depending on the location of the source of infection) by an otolaryngologist or dentist.

Treatment tactics depend on many factors: the patient’s age, concomitant diseases, method of infection, state of immunity. Therapy can be local and general.

Methods of general therapy

General treatment is carried out with medications that have a systemic effect on the body. Antifungal drugs divided into 2 groups: polyene antibiotics (Levorin, Nystatin, Amphotericin) and imidazoles (Clotrimazole, Econazole).

Polyene antibiotics are taken from 2 to 6 times a day for about 2 weeks, imidazoles - up to 100 mg per day for 1-3 weeks.

Local impact

Local treatment for oropharyngeal candidiasis is performed with drugs that are not absorbed into the bloodstream. Medicines in the form of sprays, solutions, tablets (Fluconazole, Ketoconazole, Natamycin) are effective.

When lips are wiped with aniline dyes. Nystatin, dekamin ointments, and iodine preparations are also used ().

Lysozyme and Lizak have a bactericidal effect. Good result observed from frequent (up to 6 times a day) rinsing the mouth with solutions of boron, boric acid, and sodium bicarbonate. If the tonsils or sinuses are infected, physiotherapy (inhalations, quartz treatment) may be prescribed.

The course of treatment lasts 1-2 weeks. After completion of therapy, it is necessary to take preventative medications recommended by a specialist for another 6-7 days.

In order to strengthen the immune system, vitamin and mineral complexes are prescribed. Calcium gluconate may be recommended. You need to take it for about a month. To eliminate signs of allergies caused by Candida fungi, Fenkarol, Suprastin, Pipolfen are prescribed.

The diet is limited to easily digestible carbohydrates.

Possible complications and prevention

If oropharyngeal candidiasis is not treated, the disease becomes chronic and manifests itself in acute form with decreased immunity.

A secondary infection with the formation of abscesses is possible. In this case you will need combination therapy(antimycotic with antibiotic), as well as the prescription of immunostimulants.

The sad result of thrush in the oropharyngeal area can be meningitis, nephritis, endocarditis, and rheumatic changes in the joints. Dysphagia and cachexia are sometimes observed. However, in patients with good immune status (subject to timely treatment) the risk of complications is minimal.

To prevent the infectious process, it is necessary to refuse bad habits, observe, visit the dentist annually, balance the diet, reduce the consumption of easily digestible carbohydrates (baked goods and sweets), treat chronic diseases.

Oropharyngeal candidiasis, due to the specific location, can cause significant discomfort and worsen the quality of life. Running process dangerous with serious complications. However, timely treatment begins to relieve the disease, and lifestyle correction minimizes relapses.

Oropharyngeal candidiasis is a thrush of the oral cavity, which manifests itself in the form of a white cheesy coating on the tongue, gums, tonsils and lips. In complicated cases, yeast-like microflora also affects the pharynx. The inflammatory process can affect the entire oral mucosa at the same time, which in medicine is called the diffuse form of the disease. What to do with oropharyngeal candidiasis? How to recognize this disease and take timely measures to eliminate it.

Smoking can trigger oropharyngeal candidiasis

Oropharyngeal candidiasis develops mainly in children. The protective functions of the adult body are able to cope with the causative agent of the disease, suppressing its activity. Please note that every person, without exception, has a fungus of the genus Candida on the oral mucosa. This is why children can become infected with thrush from their parents if basic preventive measures are not followed.

The oropharyngeal form of thrush in children can develop under the influence of a number of predisposing factors:

• Taking antibacterial drugs.
• Hormonal imbalance.
• Failure to comply with hygiene rules.
• Presence of chronic diseases.
• Injury to the mucous membrane.
• Intestinal infections.

In an adult, this disease develops extremely rarely. Most often this happens when immunodeficiency states and reception hormonal drugs. Smoking can provoke the growth of yeast-like microflora in the oral cavity.

Symptoms

The manifestations of a fungal disease are related to the exact form in which it occurs. Each of them is characterized by certain symptoms.

Acute form

Dryness of the oral mucosa and cracks in oropharyngeal candidiasis

It is characterized by the appearance of redness of the mucous membrane in the area of ​​the tonsils and throat. Over time, small white spots appear that look like grains of semolina. This is accompanied by discomfort. Next, the white spots combine until the oral mucosa is covered with a dense cheesy coating, which acquires a grayish-yellow tint.

General symptoms of oropharyngeal candidiasis:

1. Pain while eating.
2. Burning and itching, forcing you to put your hands in your mouth.
3. A white coating that is difficult to remove and leaves ulcers on the mucous membrane.
4. Rashes and redness on the mucous membrane, resembling fluid-filled papules.
5. Dryness of the mucous membrane and the appearance of deep cracks and wounds.
6. Swelling and swelling of areas affected by the fungus.
7. Swelling of the tongue and cracking of the lips.

In the absence of timely treatment, intoxication of the body occurs. This condition is characterized by increased body temperature, decreased appetite and nausea. If therapeutic measures will not be accepted, then the symptoms of the disease subside, because thrush becomes chronic, requiring long-term treatment using systemic drugs.

Chronic form

In this case, thrush is combined with stomatitis, glossitis, pharyngitis and cheilitis. Chronic oropharyngeal candidiasis develops as follows:

At chronic form candidiasis spreads to the mucous membrane of the throat

• Hyperplastic candidiasis progresses, which is characterized by the appearance of white plaques and swelling of the mucous membrane of the mouth and pharynx. Long course the disease is fraught with development adhesive process: the appearance of a dense yellow film.
• Accompanied by the development of atrophic thrush, which is manifested by pain, dryness and burning in the area affected by the fungus. More often this form Candidiasis develops in older people who use dentures.

Only a doctor can determine the degree of development and form of the disease. Self-diagnosis, as a rule, does not make it possible to make the right conclusion and select effective treatment.

Establishing diagnosis

If primary symptoms of a disease such as oropharyngeal candidiasis appear, it is recommended to immediately go to see a therapist, dentist or otolaryngologist. Diagnosis is carried out taking into account the medical history and the results of laboratory and specific studies.

To detect the type of fungus and determine the quantity pathogenic microflora in the body, the following diagnostic procedures are performed:

1. Polymerase chain reaction (PCR).
2. Oral swab for flora.
3. Blood sugar test.

IN mandatory held differential diagnosis from leukoplakia, lichen, seizures, glossitis, herpes and eczema.

Therapeutic measures

Oropharyngeal candidiasis requires timely diagnosis and treatment. The sooner measures are taken, the greater the chances of a quick recovery and eliminating the likelihood of complications. To eliminate the cause of the disease, additional consultation with specialists such as a mycologist, infectious disease specialist or periodontist is often required.

General drug therapy

Oropharyngeal candidiasis is treated with medicines with systemic effects. Such drugs suppress the activity of yeast-like microorganisms throughout the body at the same time, which eliminates the likelihood of complications and relapses of the disease.

Antifungal systemic drugs are divided into two main groups:

• Polyene antibacterial (levorin and nystatin). Prescribed 3-5 pieces per day for 1-2 weeks. The tablets are intended for resorption and oral use, which allows them to act on the causative agent of the disease locally and systemically. The symptoms of thrush are suppressed already on days 5-7 from the start of treatment, despite this, drug therapy must be completed. If the therapy is ineffective, it becomes necessary to administer amphotericin B or use amphoglucamine in tablet form.
• Imidazole (econazole, clotrimazole, miconazole and diflucan). The drugs have wide range actions and can cause the development adverse reactions. It is recommended to take strictly as prescribed by a specialist.

For the treatment of oropharyngeal candidiasis, in addition to antifungal drugs, drugs are widely used, the effectiveness of which is aimed at increasing protective functions body. The patient is required to be prescribed vitamins PP, B and C. In some cases, there is a need to take calcium supplements and antiallergic drugs.

Local impact

Local antifungal therapy is based on the use of drugs that are not absorbed into the bloodstream, but act purely locally. They must be applied to areas of the mucous membrane affected by the fungus in the dosage recommended by a specialist.

The following drugs are widely used for local treatment of thrush:

1. Iodine preparations (Lugol).
2. Aniline dyes.
3. Antibacterial lozenges.
4. Levorin or nystatin ointment.
5. Mouth rinse solutions (Iodinol, boric acid or sodium bicarbonate).

Traditional therapy

For improvement general well-being and stop the progression of thrush, you can use the remedies that are offered to us Alternative medicine. Among the most effective aids the following can be distinguished:

In order to eliminate the possibility of progression of thrush in the mouth, it is recommended to limit the intake of sweet and spicy foods. This allows you to increase the effectiveness of the treatment.

To strengthen the body's protective functions, you should include daily menu onions, garlic, fruits and vegetables, nuts and dairy products. Medicinal properties has anti-candidiasis properties tea mushroom, kvass, yogurt. These products contain substances that help restore the natural microflora of the oral cavity.

Violations in the treatment of oropharyngeal candidiasis lead to the fact that the disease begins to progress. For achievement positive result It is not recommended to deviate from the recommendations given by the specialist from the treatment being carried out. Should not be used folk remedies without medications. Such measures may not be effective enough, which can have serious consequences.