Vol 17, No 2 (2020)

The review addresses the main issues related to the rational pharmacotherapy of urinary tract infection (UTI). UTIs are a common and important clinical problem in children. Among UTI causative agents in children are dominated by gram-negative bacteria, E. coli. According to modern clinical guidelines, the leading direction in the treatment of UTI in children is antibiotic therapy, which should be prescribed taking into account the sensitivity of microorganisms. Drugs of choice for UTI in children: cephalosporins or protected aminopenicillins

Infantile hemangioma is one of the common benign vascular tumors found in infants. This tumor can undergo reverse development after the initial proliferation, so many doctors consider pharmacotherapy in this case impractical. It should be noted that some hemangiomas are accompanied by functional disorders, scars and painful on palpation. Therefore, it is important for the Clinician to understand the etiopathogenetic factors contributing to the development of tumors, morphological features, stages of development of this pathology when choosing methods and means of pharmacotherapy. This paper describes a clinical case of infantile hemangioma in a three-month-old child in the suborbital and posterior regions. Despite its benign nature, hemangiomas had features of a clinically malignant course. Despite the possibility of self-healing and stopping the growth of hemangioma with subsequent involution, its further course still remains unpredictable, which justifies the need for dispensary observation of the patient.

The article presents a clinical case selfharm the child. It describes the difficulties of making a clinical diagnosis, finding the cause, and the importance of a detailed study of the history of psychological comfort in the family.

The article is devoted to the study of the prevalence of ankyloglossia in children from 5 to 13 years of age, taking into account the anatomical and physiological characteristics of the maxillofacial region. Functional tests are proposed for the study of language motility and their assessment is carried out on a 4-point system. The studies were carried out after obtaining the written consent of the parents, taking into account the recommendations of the Ethics Committee. It is established that the prevalence of ankyloglossia is (6,96 ± 0,053) % of the number of examined children in Volgograd. It was noted that almost all the examined had impaired motor function of the tongue, requiring surgical treatment.

With the using a binary logistic regression analysis, a representative model it was constructed that allows in 80,7 % of cases to predict the risk of developing bronchial asthma in children of early and preschool age with recurrent wheezing and an initially low Asthma Predictive Index (API) in school age with a high discriminatory ability (AUC = 0,901).

Analysis of 830 cases of psychological assistance to victims of emergency situations from 2013 to 2018 in the Volgograd region showed the effectiveness of its organization and activities.

Preeclampsia remains a formidable disease in the second half of pregnancy. Therefore, the search for new drugs for the treatment and prevention of preeclampsia is an urgent task of modern pharmacology. Materials and methods. The experiment was performed on female Wistar rats. The studied drugs were administered from 10 to 21 days of pregnancy. Functional tests were performed on the 21st day of pregnancy. Results. The use of a peptide that imitates erythropoietin а-helix B in experimental preeclampsia leads to a pronounced correction of pathological changes: blood pressure decreased, microcirculation in the placenta increased, and the morphological picture in the placenta improved. Resume. The results indicate the promise of the use of a peptide imitating а-helix B erythropoietin in experimental preeclampsia.

The article considers a particular model of the glycation reaction, called glycoxidation and characterized by a significant involvement of oxidative reactions and the participation of transition metals. The enhancement of oxidative processes, which makes it possible to identify the reaction as glyoxidation, was realized by introducing copper (II) cations (CuSO4 * 5H2O) into the reaction medium in a form accessible for interaction with the reaction participants. The main reagents in the glycoxidation reaction, in addition to CuSO4*5H2O are bovine serum albumin (1 g/l), glucose (0,5 M), HEPES buffer solution (24 g/l) dissolved in deionized water. The conditions have been selected under which the glycoxidation reaction linearly depends on the concentration of copper (II), which makes the cation activity a sensitive target when monitoring the reaction. The dependence of the reaction on the concentration of CuSO4 * 5H2O under the presented experimental conditions has been confirmed experimentally and mathematically. An analytical range of concentrations of CuSO4*5H2O has been established, in which a linear dependence of AGE formation on concentration is observed. For the concentration of CuSO4*5H2O, which produces the greatest potentiating effect on the AGE formation (10 mg/l), the procedure was validated by the indices of internal laboratory reproducibility and convergence. The technique is of interest for investigation of the antiglycoxidative activity of novel compounds

The number of dental implants performed at the dental reception is steadily increasing. Along with this increased and the frequency of occurrence postprostatectomy complications in dental implantation. One of the main tasks of a dentist is early detection of the initial signs of inflammation of the parotid tissue, leading to mucositis. If you do not act on the site of inflammation in a timely manner, the destruction of bone tissue around the implant will begin with the development of peri-implantitis. In this work, we conducted a retrospective analysis of the frequency of occurrence of mucositis and periimplantitis. An algorithm for diagnostic measures has been developed. The patients were determined by the hygienic index, the iodine number of Svrakov, the degree of bleeding, and the depth of probing of the dental sulcus. The implant stabilization was determined using amplitude-frequency analysis. A detailed periodontal screening was performed to assess the condition of the gums and identify pathological processes occurring in the tissue surrounding the implants. The condition of the cortical plate and parotid bone tissue was evaluated radiologically. The developed algorithm for diagnostic examination of patients with postprotetic complications during dental implantation helps to detect inflammation in an early period, which in turn allows to preserve the integrity of the tooth.

The retrospective analysis of nearest results of laparoscopic surgery for cardiospasm was provided according to the materials of the department of thoracic surgery of the «Volgograd Regional clinical Hospital №1» for 2018-2020. The research included 32 laparoscopic surgical treatment cases of cardiospasm II-III stage with Heller's method with Nissen's fundoplication or partial fundoplication after Tupa (270 °С). Analysis of the nearest results of laparoscopic surgery for cardiospasm rated the advantages of the laparoscopic method in perfoming exstramucosal esophagocardiomyotomy are assessed. The traumatism and time of the operation decreasewas marked, it was reduced the patients hospital stay and postoperation rehabilitation was also redused in patients with II-III stage of the disease.

The outcomes of pregnancy and childbirth, which ended with a cesarean section, were studied in accordance with Robson's classification in order to find ways to reduce the frequency of surgical delivery in a level 3 hospital. The mechanisms to reduce the frequency of cesarean section in an obstetric hospital are defined: pregravid preparation in risk groups for preterm delivery and assessment of perinatal risk factors, a personalized approach to methods of pre-induction of parturition in high-risk patients, especially in full-term pregnancy, rational management of parturition, prevention of the first cesarean section, an increase in delivery through the natural birth canal in pregnant women with a scar on the uterus.

A comprehensive study of the state of the spincter muscle complex in children after surgical correction of anorectal malformations was carried out,including MRI of the structure of the spincter muscle complex,fecal continence on the Rintala scale, manometric studies of the anal function.The poor development of the spincter muscle complexwas characterized by a decrease (p < 0,05) of the average values of the relative width of the puborectal muscle (PRWR) to 0,14 ± 0,03, for the relative width of the external anal sphincter (EASWR) to 0,12 ± 0,02, which turned out to be 2,4 times lower than patients with excellent and good results. Values of PRWR <0,18 and EASWR <0,15 in 63 % of cases corresponded to an unsatisfactory result on the Rintala scale and was accompanied by fecal incontinence. A good function of anal function was observed in 58 % of patients with PRWR >0,18 and EAsWr >0,15.

Atrial Fibrillation is a complex and dangerous disease. Methods of remote electrocardiography for examination of patients were used in outpatient units with different territorial remoteness of two medical institutions. ECG records on the Internet were sent to the cloud storage, where it was sent to the personal office of the doctor of functional diagnostics to control the automatic conclusion of the devices. Medical ECG reports were returned to the device to the doctor/paramedic for future work with the patient. Atrial Fibrillation was detected in 137 patients: in 40 cases (29,1 %) for the first time in life. A high risk of brain complications (2 or more points) was installed in 114 people (83,2 %) according to the CHA2DS2-VASc. The standard of treatment was not met by all patients. Electrocardiography with remote transmission revealed arrhythmia at the level of the doctor «first contact». Electrocardiography with remote transmission showed arrhythmia at the level of the doctor «first contact».

The effect of selective perioperative intestinal decontamination in patients with acute sigmoid diverticulitis complicated by covered perforation on the number of postoperative complications was described. A prospective and partially retrospective study of the results of complex treatment of 196 patients with acute diverticulitis localized in the sigmoid colon, complicated by covered perforation, divided into group А - 66 patients with perioperative selective intestinal decontamination and group B -130 patients without decontamination. Rectal resection by open, laparoscopic and robot-assisted methods with the formation of primary colorectal anastomoses was performed in all cases. Of the 196 patients included in our study, 122 (62,2 %) underwent surgery without complications. Abdominal postoperative complications directly caused by surgical interventions and related, according to the classification of Clavien-Dindo surgical complications (C-D) to grades I, IIIb and IV, were noted in 9 (13,6 %) patients of group A and 36 (27,6 %) patients of group B, and extraabdominal (C-D I, IV), which included: pneumonia, acute renal failure, pyelonephritis, urosepsis, postoperative delirium and transient ischemic attack - in 8 (12,1 %) and 21 (16,1 %) patients of the corresponding groups. In group A, there was a significantly lower number of general abdominal and wound complications, as well as the total number of all postoperative complications (p = 0,03, p = 0,04 and p = 0,0111 respectively). There were no fatalities. The used scheme of oral antibiotic therapy, along with orthograde intestinal sanitation with osmolar solutions, significantly reduced the frequency of surgical and non-surgical complications.

Morphometric indices of the depth of the maxillary basal arches of the mesocranial, brachiocranal and dolichocranial types of the skull were studied. The work was performed on 187 preparations of skulls of people of both sexes of the first and second periods of adulthood with physiological occlusion of teeth. As a result of the study, the minimum and maximum limits of basal arches depth indices at the level of canines, premolars and molars were determined. It was found that at the level of premolars the depth of basal arcs in men of mesocranial skulls statistically significantly exceeded the depth of basal arches in women. In each craniotype, the depth of basal arches at the level of canines and molars in men and women was not statistically significant.

The dependence of heart rate variability in patients with chronic heart failure (CHF) and type 2 diabetes on the severity of diabetic autonomic cardiac neuropathy (DACN) is described. 60 patients with Functional Class II-III CHF and type 2 diabetes, 30 of them had signs of DACN of varying severity were examined. The temporary values of heart rate variability, spectral characteristics were estimated, as well as the ratio of sympathetic and parasympathetic influences. It was revealed that patients with CHF and type 2 diabetes complicated by DACN had significant disturbance of autonomic regulation and the prevalence of adverse types of autonomic reactivity. At the same time, the severity of autonomic disorders increased with the aggravation of autonomic dysfunction.

The goal of investigation was to evaluate the effect of speleoclimate on the psycho-emotional state, the frequency of occurrence of buccal epithelial cells with core aberrations and the level of а-amylase activity in the oral cavity of students. Second-year students of VSMU named N. N. Burdenko were selected as subjects. The collection of psychological parameters, buccal epithelium, to assess genetic stability, and oral fluid, for evaluation of the activity of а-amylase was carried out in the first, fourth, eighth, eleventh day visit speleochamber and four days after a course of speleoclimate. The psycho-emotional state of the subjects was assessed using the SAN questionnaire and the scale of C.D. Spielberger and Y.L. Khanin. The state of genetic homeostasis of students was evaluated using a micronucleus test in the buccal epithelium. The level of activity of а-amylase was carried out by the method of solid-phase enzyme immunoassay. Comparison of the studied indicators was carried out using the nonparametric Van-der-Warden criterion. The relationship between the dynamics of а-amylase activity and cytological parameters was revealed using the Spearman correlation coefficient (rs). The results obtained indicate a positive effect of speleoclimate on the psychological and genetic stability of a person. Subjects with low а-amylase activity showed a higher level of cells with abnormal nuclei. A negative correlation was found between the dynamics of the frequency of abnormal nuclei in buccal epithelial cells and the activity of а-amylase in the group with initially low activity (rs= - 0,8; P < 0,05). Speleoclimatotherapy can be recommended as a method of non-medicamental correction of the effects of stress influence on health of students.

The analysis of the assortment of nasal drugs permitted for use on the territory of the Russian Federation was carried out. The relevance of the development and introduction of systemic nasal medicines into domestic medical practice, including on the basis of fundamentally new pharmacologically active substances, has been revealed. It also shows the feasibility of conducting research in the field of creating domestic nasal medicines for pediatrics, studying the possibility of using new dosage forms for nasal medicines that meet all modern efficacy and safety requirements for high demand in the domestic and foreign pharmaceutical markets.

In recent years, the concept of cardiovascular risk factors, one of which is the process of vascular aging, has been of great interest. 30 patients with stage 2-3 of arterial hypertension and type 2 diabetes mellitus aged 45 to 65 years were included, including 23 women and 7 men. Patients after the washout period a fixed combination of perindopril with amlodipine (the original drug Prestans, AO Servier) in the form of tablets (perindopril arginine / amlodipine bezilat) were prescribed for 12 weeks, 1 time per day. Vascular age and 5-year risk of developing cardiovascular complications were calculated on the calculator app for smartphones ADVANTAGE AGE (Les laboratories Servier version 2, 2015). After 12-week therapy with a fixed combination of perindopril and amlodipine, the achievement of target blood pressure values was noted in 100 % of patients. The average passport age of the patients included in the study was (61,9 ± 4,4) [45; 65] years. In assessment vascular age, there was a statistically significant initial increase in vascular age above the passport age - (69,3 ± 8,5) [55; 89] years. 46,7 % of patients have an average risk of developing cardiovascular complications and 53,3 % of patients have a high risk of cardiovascular accidents. After 12 weeks of therapy with arginine perindopril and amlodipine bezilate, there was a significant decrease of vascular age to 63,1 ± 5,6 [51; 73] years, a decrease in the percentage of patients with high risk of cardiovascular complications to 23,4 % (p < 0,05), due to patients with average risk (53,3 %, at p < 0,05), and the appearance of patients (3,3 %) with a low risk of cardiovascular accidents within 5 years. In patients with arterial hypertension and diabetes millitus type 2, vascular age significantly increases in comparison with the passport age. The use of a fixed combination of perindopril arginine / amlodipine bezilate for 12 weeks in this category of patients significantly reduces the vascular age of patients and reduces the frequency of detection of patients with high and medium risk of cardiovascular accidents.

1800 pre-made cone beam computed tomograms (CBCT) were examined, of which 202 CBCT were selected. It was revealed that a prevalence of three-rooted mandibular first molar was 2,5 %, second molars - 4,5 %. First molar supernumerary root was always distolingual root (radix entomolaris). Second molar supernumerary root was distolingual root in 2,5 % (radix entomolaris), in 2 % mesialbuccal root (radix paramolaris)., The prevalence of double-root in the mandibular first premolar was 2 %, in the second premolar was 1 %, in the mandibular canines was 5 %, the bifurcation was located in the apical and middle third root canals of canine and premolar, which makes endodontic treatment of such teeth as difficult as possible.

The article discusses comorbid diseases that occur in chronic obstructive pulmonary disease, which are considered in the context of «comorbid pathology». The pathogenesis of associated diseases and its relationship with the underlying disease is shown.

We have to state that «adult» diseases are increasingly common in children. In the article, the team of authors describes the clinical cases of thrombosis in children: the difficulties of verifying the diagnosis, justifying the therapy, and the tactics of the doctor's action.