编号 11 (2013)

Acute otitis media (AOM) is an acute inflammation in middle ear cavity, which is manifested by ear pain, hearing loss, and fever. The disease is caused by viruses, bacterial and fungal flora, and their associations. Treatment of AOM should be comprehensive and include adequate therapeutic measures, which can be divided into local and general measures. III generation cephalosporins, in particular ceftibuten (Cedax) are effective as antibacterial broad-spectrum drugs in the treatment of AOM. The penetration rate of ceftibuten in middle ear fluid of children is 73 %, clinical response is 88-97 %.

The study, including 10 patients with parodontitis, has evaluated the efficacy of probiotic preparation with bifidobacteria in the surgical treatment; dynamics of the microflora of the mucous membrane in the area of the planned surgery was assessed. It was found that improvement of composition of the mucosal microflora after oral administration of the drug promoted uneventful course of postoperative period with enhancement of epithelization of the operative wound. Against the background of use of this drug, side effects and adverse events were not observed.

Analysis of the morbidity rate in the Russian population shows a significant deterioration in the nation health and the steady trend to weakening the health of children and adolescents. First of all, attention is drawn to the annual increase in the number of patients with various forms of chronic diseases. Such patients suffer infectious diseases much heavier than somatically healthy children, often with complications and worsening of the underlying disease. Therefore, immunoprophylaxis is one of ways of rehabilitation of children with chronic diseases aimed at improving their health and quality of life. This provision is one of the basic principles of the WHO Expanded Programme on Immunization. The main results of theoretical and practical work aimed at improving the safety and efficacy of immunization of children with medical issues conducted at the Federal Centre for Immunoprophylaxis are presented.

The article presents the current data on the pathogenesis of lactase deficiency (LD) in children and adults, methods of diagnosis and clinical manifestations. Particular attention is paid to the treatment of LD and its dietary correction. The features of administration of enzyme preparations and mixtures containing low lactose levels are described. It is emphasized that individual approach to the selection of mixtures is necessary, and allows to eliminate the main clinical manifestations with retaining the possibility of breastfeeding.

The article considers the questions of the pathogenesis and treatment of acute otitis media in children in outpatient and a day hospital settings. Amoxicillin remains the leading drug for empiric systemic antibacterial therapy of AOM in outpatient settings, because it is most active against penicillin-resistant pneumococci.

The proportion of adenovirus infection (ADVI, mono- and mixed-variants) in the etiological structure of acute respiratory diseases was estimated in 6,494 hospitalized children and was 25-30 % in all age groups of patients. A statistically significant increase in the frequency of ADVI was observed in children older than 3 years with bronchitis and pneumonia, in which it was combined with respiratory syncytial virus and mycoplasmal infections. The clinical features of the disease were analyzed in 1,756 children; it was noted that in all cases of ADVI, intoxication, catarrhal syndrome and, therefore, the acute phase of the disease were longer than in flu caused by monoinfection. It is shown that the use of Viferon® (gel and suppositories) in the treatment of children with ADVI promotes more rapid reduction of the catarrhal symptoms in the nose, throat and lungs, intoxication, as well as the elimination of antigens from the body (according to the dynamic determination in the materials from the nasopharynx of patients).

Tics are most common form of hyperkinesis among children and adolescents, and their etiology is not completely clear. The study found a high comorbidity of tic disorders (TD) with epilepsy, which was confirmed by videoEEG -(electroencephalographic) monitoring. Epileptiform activity in patients with TD, even in the absence of epileptic seizures, is a poor prognostic factor. In the initial treatment of tics, the administration of GABA(γ-aminobutyric acid)-ergic drugs (hopantenic acid) is pathogenetically justified. The debut of the disease before the age of 7 years with transient and chronic remittent course and mild TD allows to assign repeated treatment with hopantenic acid without antipsychotics and anticonvulsants.