Acute otitis media is one of the urgent problems of pediatric otolaryngology. Its relevance is predetermined by the wide spread of the disease, especially among young children, the frequency of prescribing antibiotic therapy and the potential threat of severe complications. Pneumococcus is the most frequent causative agent of acute otitis media. Having introduced pneumococcal vaccination the incidence of acute otitis media has significantly decreased in many countries. The aim of the study was a retrospective analysis of the incidence of acute otitis media according to the Rostov ENT clinic for the period from 2012 to 2018. There is a significant annual increase in the number of children with moderate and severe forms of the disease. In 2018 the proportion of children under 3 years hospitalized with acute otitis media tended to reduce, that fact cannot be regarded as a result of vaccination, since the incidence of acute otitis media is subject to significant spontaneous fluctuations and depends on the epidemiological characteristics of viral respiratory infections.
Введение. Перинатальное поражение центральной нервной системы (ЦНС) является одним из наиболее частых заболеваний в нозологической структуре неонатального периода, что делает особенно актуальным изучение патогенетических механизмов его развития, а также полисистемных взаимодействий данной патологии у детей различного гестационного возраста. Цель. Установить характер поражения центральной нервной системы у недоношенных новорожденных и определить взаимосвязь с функциональными нарушениями желудочно-кишечного тракта для последующей оптимизации программы комплексной терапии. Материалы и методы. Проведена сравнительная оценка неврологического, гастроинтестинального статуса, результатов нейросонографического исследования и ультразвукового исследования желудочно-кишечного тракта с использованием аппарата Voluson 730 General Electric и датчиков с частотой 3,5–5,5 МГц у 75 недоношенных детей различного гестационного возраста. Результаты. Выявлено, что у детей с гестационным возрастом до 32 недель имеют место наиболее тяжелые формы поражения ЦНС гипоксического и/или геморрагического характера. Во всех группах установлена сильная прямая корреляционная взаимосвязь между перинатальной патологией ЦНС и функциональными нарушениями желудочно-кишечного тракта. Максимальная корреляция неврологической и гастроинтестинальной патологии имела место у детей с гестационным возрастом менее 32 недель. Заключение. Тяжесть поражения ЦНС у недоношенных детей нарастает по мере снижения гестационного возраста и коррелирует с функциональными нарушениями желудочно-кишечного тракта, что требует комплексного подхода в диагностике и лечении пациентов данной категории. Introduction. Perinatal involvement of the central nervous system (CNS) is one of the most frequent diseases in the nosological structure of the neonatal period, making study of its pathogenetic mechanisms as well as polysystemic interactions of this pathology in children of various gestational ages particularly relevant. Purpose. To establish the nature of central nervous system involvement in preterm newborns and to determine its relationship with functional gastrointestinal disorders for subsequent optimization of integrated therapy program. Materials and methods. A comparative assessment of neurological and gastrointestinal status, as well as findings of gastrointestinal neurosonography and ultrasound examination was carried out using a Voluson 730 General Electric device and sensors with a frequency of 3.5–5.5 MHz in 75 premature infants of various gestational ages. Results. Children with gestational age up to 32 weeks were found to have the most severe forms of CNS lesions of hypoxic and/or hemorrhagic nature. In all groups, a strong direct correlation was established between perinatal CNS pathology and functional disorders of the gastrointestinal tract. Maximum correlation of neurological and gastrointestinal pathology occurred in children with gestational age less than 32 weeks. Conclusion. The severity of CNS damage in premature infants increases with decreasing in gestational age and correlates with functional disorders of the gastrointestinal tract, requiring an integrated approach to diagnostics and treatment of this category of patients.
In order to improve the diagnosis and treatment of bacterial vulvovaginitis (VV) in preschool children with urinary tract diseases, we conducted the prospective controlled study of 86 patients aged 3–6 years, of which: group 1 (n = 21) – VV; group 2 (n = 20) – VV against the background of chronic pyelonephritis with exacerbation; group 3 (n = 20) – VV against the background of acute pyelonephritis; group 4 (n = 25) – VV with dismetabolic nephropathy. Depending on the method of correction, the patients were divided into those that received standard treatment and those that received combined treatment with the use of a bacteriophage complex. It was revealed that chronic forms of VV prevailed in all groups, but when combined with urinary tract diseases (groups 2, 3, 4), the incidence of synechia of the labia minora was significantly increased. It was established that the number of relapses of VV after the combined treatment is significantly lower than after the standard treatment.Inflammatory urogenital diseases in girls are characterized by a high rate of relapse. The combination therapy of VV, including the use of a bacteriophage complex, improves the condition of the vaginal biotope, prevents the persistence of the infection.
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