Vol 4, No 4 (2013)

The results of treatment of acute hematogenous osteomyeLitis (CSO) were analyzed into two groups. For general group (142 children) was used laser osteoperforation with diode lasers with wave length of 0.8, 1.64, 1.9 microns. In the comparison group (93 children) was performed the mechanical osteoperforation by electric drill. The Laser osteoperforation was performed into both walls of the medullary chanal in the affected metaepiphysis and the adjacent part of the bone shaft with the formation of 8 to 20 holes. For ekstramedullar phase additionly was used small incisions for opening purulent streaks. The proposed method let to reduce frequency of complications for children with CSOs up 16.1 % to 7.0 %. The stable remission was observed for 96.3 % of children after usage laser technology, after traditional surgery it was observed in 91.4 %. The transition to the chronic phase of the disease in the general group was marked two times less than after traditional operations. The advantages of the method of Laser osteoperforation are fewer frequency of complications, faster recovery period, good tolerance and good functional results.

In the research the results of the study of sensitivity of Escherichia clinical strains (E. coli n 110) to antibiotics, antiseptics are presented. The Escherichia were isolated from ill children. According to the data of the research, we found high sensitivity of E. coli to combined penicillin antibiotics (amoxicillin/clavulanate, piperacyllin/tazobactam), cefalosporines (ceftriaxone, cefepime); meropenem; fluoroquilones (gatifloxacine, levofloxacine). The Escherichia had low sensitivity to amoxicillin/sulbactam, streptomycine, kanamycine, cefazoline, cefamandol, cefuroxime. High antimicrobial activity of decasan, miramistin with superiority of decasan according to E. coli, was proven.

In recent years the non-alcoholic fatty liver disease (NAFLD) has become one of the most common liver disease in children and adolescents. This phenomenon is explained by the sharp rise in obesity among the population worldwide, including children, and increased co-morbidities associated with obesity. There is sufficient evidence that age and gender are important determinants of the risk for the development of fatty liver disease in children. There is reason to believe that an important role in the pathogenesis of NAFLD in children may play a hormonal profile in adolescents, family history, the state of insulin sensitivity and the level of adipocytokines. However, these studies are still limited to a small number of observations. Liver biopsy remains the standard for the diagnosis and staging of NAFLD. At the same time, children in some cases observed morphological pattern, which is not typical for adults. There is a need for the development of alternative non-invasive methods of diagnosis of NAFLD and imaging of hepatic steatosis . Clinically, the disease occurs in children is diverse and can be malignant, but the natural history and prognosis are still to be determined. Also the necessary lifestyle changes in NAFLD in children are not determined reliably, and a multi-center randomized clinical trials on the drug therapy are not compleated.

Autoimmune pancreatitis (AP) is not well-known disorder, it hasn’t been described in children yet. Current data about epidemiology, mechanisms of development, pathological and clinical signs of AP are descripted in the article, including international criterions of its diagnosis. Among 57 children with confirmed diagnosis of chronic pancreatitis 4 correspond to criteria of AP. 2 from 4 children had primary AP, the rest 2 - secondary AP, associated with inflammatory bowel disease. Primary AP had prominent clinical manifestation and immunological markers of AP: high level of IgG4, anti-lactoferrin antibodies, prednisolone treatment reduced flare. Prolong remission support became possible only in case of using azathioprine and pancreatic enzyme Creon.

The purpose of the research was a complex clinical-instrumental examination of structural and functional artery condition of patients with metabolic syndrome, autoimmune thyroiditis -euthyreose and subclinical hypotheriosis at the background of substitution therapy. Three groups were made during the research: 1 group (23 women) with metabolic syndrome without pathology of thyroid gland, 2 group (14 people) with autoimmune thyroiditis - euthyreose, 3 group (14 woman) with subclinical hypotheriosis. The instrumental examination included assessment of endothelial function and artery hardness, intima-media complex by ultrasound method. The results showed that first two groups of patients ware characterized by the increase of artery hardness with endothelium dysfunction, having normal indices of endothelium-independent vasodilatation (EIVD). The prescription of substitution therapy led to the improvement of the indices of EDVD and to the decrease of the progressing of vascular hardness.

Diffuse toxic goiter (DTG) is an autoimmune disease, to which there is a genetic predisposition. In children DTG is less common than in adults. Manifestation of graves‘ disease in childhood has a number of peculiarities. During the DTG in children is usually manifested thyrotoxicosis, requiring long-term treatment to achieve euthyroid, tendency to relapse and more frequently than adults, accompanied by ophthalmopathy and the large size of goiter. Diagnosis of graves‘ disease is based on the clinical picture of thyrotoxicosis, the existence of which is confirmed by the level of thyroid hormones and TSH in the blood. There are three types of treatment of patients DTG: medical, radioactive iodine therapy and surgery. There is no а single glance at the choice of the volume of operations in children.

The review article is addressed to general pediatricians. It considers common approaches, technical principles and applications of DNA polymerase chain reaction (PCR) usage in clinical microbiology. Comparative significance of immunological (antigen-based) and PCR/nucleic acid based diagnostics for detection of various viral, protozoan and bacterial infections is discussed. PCR applications are considered for diagnostics of different infectious diseases, e. g., viral hepatitis, sexually transmitted diseases, some zoonotic infections.

A. Burns described thyroid cancer in 1811. History of surgical treatment of thyroid cancer is presented in the article. N. I. Pirogov was the first in the world who performed thyroid resection under general anesthesia in 1847. A. A. Bobrov was the first who started to perform thyroid operations under recurrent nerves visual control since 1893. V. I. Razumovsky was the first who described anaplastic and medullary thyroid carcinomas in 1903. Tactics in thyroid cancer treatment in different country are presented.

Studying of ways of identification of “group of risk” and prevention of formation of addiсtive behavior at teenagers by means of psychopreventive and psychocorrectional actions in connection with growth of number of minors with addiсtive behavior. Psychological work with group of risk can be divided into some stages: diagnostic, psychopreventive, psychocorrectional, finishing