CLINICAL EVALUATION OF VOICE IN CHILDREN WITH DYSPHONIA

Objective: make a comparative analysis of the voice of the index (VHI) and endoscopic studies in the pathology of the voice of children.Material and Methods: The study involved 87 children, from 6 months to 14 years. The clinical study included fibrorinolaryngoscopy with video fixation (C-MAC, K. Storz, Ø-2,7 mm) and a survey of parents (or guardians) of children at the Uzbek version of the voice handicap index (pVHI), with sub- sections (functional - F, the physical - P and emotional - E).Results: endoscopic diagnosed laryngitis 20,6% (n = 18), functional 16,1% (n = 14) and mutational 9,2% (n = 8), dysphonia, benign larynx (respiratory papillamatosis) - 18.4 % (n = 16), the vocal cords paresis - 5.7% (n = 5), the vocal folds nodules 26.4% (n = 23), throat structure anomalies (acquired) 3,4% (n = 3). The survey revealed pVHI average points total pVHI and its sub-group of patients were as follows: F - 13,94, P - 15.48, E - 12.15 and T - 41.58, which is significantly higher than the group of healthy children and children with functional disorders of voice.Conclusions: Fibrolaryngoscopy with the smallest diameter of the lumen of the laryngoscope with video fixation allowed to quickly ascertain the diagnosis of organic disease of the larynx in children. In addition, the survey pVHI allowed to differentiate the severity of the vocal apparatus, to conduct timely special endoscopic diagnosis of vocal cord diseases.Objective: make a comparative analysis of the voice of the index (VHI) and endoscopic studies in the pathology of the voice of children.Material and Methods: The study involved 87 children, from 6 months to 14 years. The clinical study included fibrorinolaryngoscopy with video fixation (C-MAC, K. Storz, Ø-2,7 mm) and a survey of parents (or guardians) of children at the Uzbek version of the voice handicap index (pVHI), with sub- sections (functional - F, the physical - P and emotional - E).Results: endoscopic diagnosed laryngitis 20,6% (n = 18), functional 16,1% (n = 14) and mutational 9,2% (n = 8), dysphonia, benign larynx (respiratory papillamatosis) - 18.4 % (n = 16), the vocal cords paresis - 5.7% (n = 5), the vocal folds nodules 26.4% (n = 23), throat structure anomalies (acquired) 3,4% (n = 3). The survey revealed pVHI average points total pVHI and its sub-group of patients were as follows: F - 13,94, P - 15.48, E - 12.15 and T - 41.58, which is significantly higher than the group of healthy children and children with functional disorders of voice.Conclusions: Fibrolaryngoscopy with the smallest diameter of the lumen of the laryngoscope with video fixation allowed to quickly ascertain the diagnosis of organic disease of the larynx in children. In addition, the survey pVHI allowed to differentiate the severity of the vocal apparatus, to conduct timely special endoscopic diagnosis of vocal cord diseases

Efficiency of modern correction methods of ovarian hyperandrogenism in puberty

Aim. To evaluate the effectiveness of correction of the ovarian hyperandrogenism (OHA) in girls in puberty. Methods. 38 girls with OHA syndrome were examined. The average age of the girls was 14.39 ± 0.27 years. Ferriman-Gallwey hirsutism score was 19.7 ± 0.47, the hormonal score 18.14 ± 2.43, the indifferent score 2.34 ± 0.13. The comparison group included 20 girls matched by age (14.74 ± 0.15 years) with physiological course of puberty. The study included the evaluation of hirsutism severity by Ferriman-Gallway score, determination of the hormones of hypothalamus-pituitary-adrenal-ovarian system in early follicular phase on day 5-7 of menstrual cycle. Results. The causes of OHA syndrome in the pubertal period were found to be polycystic ovary syndrome in 68.42 % and tumor-like formations (follicular cysts) in 31.58 % of girls. Compared to healthy girls, the girls with OHA syndrome had statistically significantly higher values of luteinizing hormone (LH) - 9.19 ± 0.96 mME/ml, LH/FSH ratio - 1.8 ± 0.15, total testosteron (Ttotal) - 1.3 ± 0.11 ng/ml, estrone (E1) - 109.5 ± 4.88 ng/ml, androstenedione (An) - 4.01 ± 0.12 ng/ml as well as low values of estradiol (E2) - 49.1 ± 2.6 pg/ml and sex hormone-binding globulin (SHBG) - 45.7 ± 2.14 nmol/l. The study demonstrated that correction of ovarian hyperandrogenism, promotes an increase in the level of E2, SHBG and decrease of the level of LH, LH/FSH ratio, Ttotal, An. Conclusion. Complex pathogenetic therapy of OHA syndrome in girls in puberty leads to significant improvement of hormonal status in this group of patients

INVESTIGATION OF MECHANICAL PROPERTIES AND CORROSION RESISTANCE OF TUBING WITH FERRITO-PERLITE STRUCTURE

Проведены исследования механических свойств и стойкости к углекислотной коррозии образцов насосно-компрессорных труб из стали 35ХГФ с феррито-перлитной структурой. Определены границы применения стали с феррито-перлитной структурой в зависимости от агрессивности среды.The carried out researches of mechanical properties and resistance to carbon dioxide corrosion of samples of tubing from steel with ferrite-pearlitic mine. The boundaries of the use of steel with a ferrite-pearlite operation are determined depending on the aggressiveness of the medium

Empirical evaluation of state support measures for the agricultural industry in modern practice

The article presents the results of the study of the effectiveness of the state program “Development of Agriculture” in the Kaliningrad region; econometric analysis of the dependence of the results of the economic activity of agricultural enterprises on the amount of state subsidy is proposed as a research method; on the basis of the econometric models the regression-correlation analysis of the effectiveness of financial resources distribution on the main directions of the state agricultural program is conducted

Pulmonary embolism and atrial fibrillation: analysis of data from the SIRENA Russian registry

Aim. To present the clinical characteristics and in-hospital prognosis in patients with pulmonary embolism (PE) and atrial fibrillation (AF).Material and methods. On the initiative of a working group of physicians, the basic principles of an observational prospective study (SIRENA registry) have been developed.Results. Among the 660 patients included in the registry, AF was diagnosed in almost every fourth patient — in 22,9% of cases (n=151), which reflects its high incidence in relation to PE. The prevalence of AF corresponded to such conditions as heart failure (HF) (23,2%; n=153), diabetes (15,6%; n=103), and hypertension (HTN) (65,7% n=400). The diagnosis of AF in most patients is based on the history data (n=144; 95,4%), while the first registered AF episode was verified in 7 patients (4,6%). Patients with AF were characterized by older age, significantly higher prevalence of HF (51,2%), HTN (80,8%), chronic kidney disease (18,5%), stroke or transient ischemic attack (23,2%). It is important to note the low prevalence of anticoagulant therapy (15,3%) in the group of patients with previously diagnosed AF (n=144). The prevalence of thrombolytic therapy in patients with AF was significantly lower than among patients without AF (13,9 vs 25,8% (p=0,026)), which is due to contraindications and underdiagnosis of PE. Given the predominantly senile age, high comorbidity rate in patients with AF, as well as the absence of outpatient anticoagulant therapy, in-hospital mortality in patients with PE and AF was 31,1%, and significantly differed from that in those without AF 12,6% (p=0,001). In the general group, post-mortem diagnosis of PE was noted in 7,7% of cases (n=51), of which the proportion of patients with AF was 54,9% (n=28). A possible explanation for the underestimation of PE in AF patients was an erroneous explanation of its manifestations (tachypnea, tachycardia, lower limb edema) due to concomitant HF.Conclusion. Suspicion for PE in elderly patients with AF and manifestations of HF decompensation, as well as the timely administration of anticoagulant therapy, will prevent both arterial and venous embolism

Immediate and late follow-up results of auto- and alloplastic operations in inguinal hernias

Objective. To conduct a scientific investigation for comparative investigation of results of auto- and allohernioplastic operations. Materials and methods. The investigation was based on analysis of postoperative results in 400 patients, ageing 16 - 85 yrs old, to whom in Scientific Surgical Centre named after Acad. M. A. Topchibashev and the City of Shirvan Central Hospital in 2009-2019 yrs period surgical treatment for inguinal hernia was conducted. Depending on the procedure of hernioplasty applied, the patients were divided into two Groups. In a control one (n=200) the operations were performed, using open autohernioplasty only. In the main Group (n=200) open procedure and laparoscopic allohernioplasty, using different synthetic nets, were applied. Results. Comparative analysis of intraoperative, postoperative immediate and late follow-up results in the patients after auto- and allohernioplasty was done. In accordance to criteria of the intraoperative and immediate postoperative morbidity rate the statistically meaningful differences between two groups of patients were absent. Good late results of allohernioplasty were noted in (71.8 ± 3.41)%, satisfactory - in (17.2 ± 2.86)%, poor - in (11 ± 2.36)% patients (p<0.05); allohernioplasties - accordingly, in (80.2 ± 2.91)%, (16 ± 2.68)% and (3.8 ± 1.39)% patients (p<0.05). Comparative analysis done have shown the statistically much better results of allohernioplasty. Recurrences after allohernioplasty were observed in 3 times less frequently - 3.8%, and after autohernioplasty this index have constituted 11% (p < 0.05). Сomparative analysis of late follow-up results of various autohernioplastic methods have shown good results of Postemskyi method in (76.7 ± 7.72)% patients, and of Postempskyi method in our modification - in (88.9 ± 7.41)% patients. Good results of autoplasty in other methods were noted merely in equal quantity of the patients - in up to 70%, and statistically significant difference was absent. Conclusion. Basing on own results obtained, we recommend to perform autohernioplasty of the inguinal channel anterior wall in accordance to Girard-Sposokukotskyi method with Kimbarovskyi suture for oblique inguinal hernias, while in direct inguinal hernias, for strengthening of posterior wall, - Postempskyi method in our modification. In large and recurrent hernias in patients of middle and senile age it is expedient to apply a Lichtenstein plasty in our modification. Total extraperitoneal or transabdominal preperitoneal plasty is recommended if technical installments needed and the physician’n laparoscopic skills are available

Взаимосвязь маркеров эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита на фоне обтурационной желтухи

Цель. Изучение взаимосвязи маркеров эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита на фоне обтурационной желтухи, выявление его раннего перехода в цирроз печени и оптимизация тактики лечения в до- и послеоперационном периоде с оценкой показателей исследуемых лабораторных тестов. Материалы и методы. Исследование проведено в отношении 15 больных с гнойным холангитом, из них у 9 больных был хронический гепатит, у 6 больных хронического гепатита не было. Из 9 больных с хроническим гепатитом 4 больным противовирусную терапию не проводили, 5 - проводили. Результаты. Непосредственные результаты проведенного лечебно-диагностического исследования свидетельствуют о сходных проявлениях эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита. Всем больным с гнойным холангитом выполняли декомпрессию желчных протоков, устраняли причины обтурации, проводили дезинтоксикационную терапию. По данным корреляционного анализа показателей функционального состояния эндотелия у больных с хроническим гепатитом, получавших противовирусную терапию, улучшение отметили на 10-е сут, через 1 мес оно было более выраженным, чем у больных, не получавших противовирусную терапию. У 6 больных с гнойным холангитом без хронического гепатита своевременное хирургическое, дезинтоксикационное лечение совместно с озонотерапией привело к улучшению показателей функционального состояния эндотелия на 10-е сут, через 1 мес они приблизились к норме. Выводы. Своевременное выявление эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита способствует раннему прогнозированию его перехода в стадию цирроза печени и правильному выбору тактики лечения в до- и послеоперационном периоде. Подытожив полученные данные, можно сделать вывод о том, что при гнойном холангите у больных с хроническим гепатитом целесообразно проведение противовирусной терапии до и после операции

Comprehensive approach in treatment of locally disseminated oropharyngeal cancer

The article contains information about current trends of treatment of the locally advanced oropharynx cancer. We analyzed the results of chemoradiation treatment, and surgery treatment of patients with rudimentary tumors after the chemoradiation therapy, taking into account the tumor margin, which gives capacity to perform an adequate operation with good oncological results

RESEARCH OF METHODOLOGICAL APPROACHES TO THE DEVELOPMENT OF PROGRAMS FOR SOCIALIZATION OF CHILDREN AND ADOLESCENTS IN THE CONTEMPORARY INFORMATION SOCIETY

The priority task of the Russian Federation in the upbringing of the younger generation is the development of a highly moral person who shares Russian traditional spiritual values, has relevant knowledge and skills, and is able to realize his potential. The modern information society is characterized, on the one hand, by the growth of the electronic educational environment and distance technologies, which make it possible to bring education to a new level of opportunities for the development of children and adolescents, on the other hand, by additional risks of increased aggressiveness in the adolescent environment, peer bullying and other antisocial manifestations. The upbringing of children and adolescents in a family and an educational organization is a strategic nationwide priority that requires the consolidation of the efforts of various civil society institutions and departments at the federal, regional and municipal levels (the Upbringing Development Strategy in the Russian Federation for the period through to 2025). The preprint presented contains materials of research work carried out by the Center for Strategy, Design and Legal Support of RANEPA FIRO in 2021. The object of the described research is the process of socialization of children and adolescents in the modern information space. This preprint contains most of the research done. To achieve the goal of the study, the authors analyzed the literature on the issue and prepared a substantiation of scientific and methodological approaches in the development of programs for the socialization of children and adolescents in the information analysis societies. The subject of the analysis was the study of the psychological well-being of children and adolescents in the course of socialization in the educational space and communication in social networks (based on materials from foreign and domestic studies). In the course of solving scientific problems, the researchers identified the factors influencing the psychological well-being of children and adolescents in the modern educational space, and developed a system for assessing the subjective well-being of the Russian schoolchildren&rsquo;s families based on the results of research on the psychological well-being of children and adolescents in the modern educational space and in social networks. As a scientific and practical development, the researchers offer one of the research results, an original program for the socialization of children and adolescents in a modern information society, which has been tested in 11 regions of the Russian Federation. Additionally, the preprint contains materials that will be useful for practical application by educational psychologists - a set of methods for assessing the psychological well-being of children and adolescents in the modern educational space and in social network

Integrated solution for very high cardiovascular risk patients. Rationale and design of a pilot study

Coronary artery disease (CAD) is the most common cardiovascular disease and the leading cause of morbidity and mortality. Acute coronary syndrome (ACS) as an abrupt destabilization of CAD, multiplies the risk of cardiovascular events. To reduce the incidence of recurrent cardiovascular events, timely tackling potentially reversible risk factors such as hypertension and/or hyperglycemia is imperative. However, a solid basis for a secondary prevention lies in the treatment of dyslipidemia and begins in the first hours of hospital admission. Despite considerable evidence regarding the efficacy and safety of lipid-lowering therapy, averagely only one third of patients maintain control of lipids. The main challenges are low adherence, poor continuity of medical care, and the lack of an ambulatory routine follow-up. Telehealth solutions are believed to address these barriers and may be considered as an add-on to in-person patient care. Telemonitoring of vital and laboratory parameters, remote patient counseling can be introduced into routine care delivery. Telemedicine shows promise for fostering better clinical effect, and provides health-related quality of life improvement.It is planned to conduct a pilot observational study aimed to create and to test an integrated solution, i.e. telemonitoring and remote counseling in patients of very high cardiovascular risk with ACS followed by myocardial revascularization. The goal is to determine the clinical effectiveness, i.e achievement of target values of blood pressure, lipid profile and glycemia, and patient-centeredness of this approach