Chronic tonsillitis in adolescents: clinical features and the role of ultrasound diagnosis in the northern region of Ukraine

Background. Chronic tonsillitis is the most common disease among children and adolescents in the structure of pathology of the ENT organs. Untimely diagnosis and irrational treatment lead to decompensation of chronic tonsillitis and the development of lesions of many organs and systems of the child’s body of tonsillogenic origin. The aim of the work was to study the clinical features and ultrasound changes of the palatine tonsils in adolescents with chronic tonsillitis. Materials and methods. We have examined 47 children aged 13 to 17 years suffering from chronic tonsillitis: group I — 27 patients with compensated chronic tonsillitis, group II — 20 patients suffering from decompensated chronic tonsillitis. The control group consisted of 16 practically healthy children, representative in terms of age and gender. We used clinical methods, ultrasonography of the palatine tonsils, and statistical methods. The study was approved by the Institutional Bioethics Committee and it conforms to the principles outlined in the Declaration of Helsinki. Results. According to the results of an ultrasound examination of the palatine tonsils in children with chronic tonsillitis, the main changes were an increase in their transverse dimensions by more than 15 mm, deepening of lacunae, thickening of the capsule, fibrous changes. In addition, in patients with tonsillogenic lesions of the cardiovascular system and a decompensated form of chronic tonsillitis, the pathological signs of the disease according to ultrasound were more significant and were manifested by unclear contours, increased echogenicity, heterogeneous hyperechoic structure, diffuse fibrous and cystic changes of the palatine tonsils. Conclusions. Ultrasonography of the palatine tonsils is a non-invasive, painless, accessible and informative method for studying the structure of the tonsils in normal and pathological conditions. It allows for a more thorough assessment of their changes in compensated and decompensated forms of chronic tonsillitis

Quantum switch based on coupled waveguides

PACS. 72.10.-d Theory of electronic transport; scattering mechanisms – 73.23.Ad Ballistic transport – 02.00 Mathematical methods in physics,

Risk factors of the fungal urinary tract infections

The role of fungi as causative agents of infections is growing. In in-patients, especially at intensive care units, fungal infections might cause serious problems. Studies conducted over recent years shows an increase of fungi detection in urine in in-patients from 5,01 up to 10,63%. Most often, the appearance of fungi in the urine connected with contamination or colonization of the urinary tract. However, in immunocompromised patients, this could be the part of urinary tract infection and even of disseminated fungal process. Candida is the most common cause of fungal urinary tract infections. At the same time, the presence of Candida in urine (candiduria) not always comes with clinical signs of urethritis, cystitis and pyelonephritis. Detection of no-Candida albicans agents in urine is increasing, new Candida species revealed are resistant to antifungal drugs so risk of complications is increasing. Recent researches reveal new mechanisms of how Candida interacts with the bacteria that cause urinary infections. The main mechanisms of Candida virulence factors are dimorphism, adhesion proteins — Als1-7,9 and Gls, invasion enzymes — phospholipase, Als3 and Ssa1, as well as enzymes that neutralize reactive oxygen species. The most significant risk factors of fungal urinary tract infection are the presence of a urinary catheter, diabetes mellitus, immunosuppression and previous antibiotic intake. The study of the formation process of the cellular and immune response to Candida makes it possible to identify the main links in the pathogenesis of urinary tract candidiasis, as well as the main role of immunosuppression in the development of the disease. © 2020, Remedium Group Ltd. All rights reserved

Fungal urinary tract infection in outpatient practice: approaches to diagnosis and treatment

Introduction. In recent years, the role of fungal infection in inpatient and outpatient patients has been increasing. At the same time, there are currently no recommendations on the duration of treatment of outpatient patients with fungal urinary tract infection (UTI). Aim of the study. Optimization of methods of diagnosis and treatment of outpatient patients with fungal UTI. Materials and methods. To detect fungi in urine, the E. Koneman et al. (1997) method was improved. 56 patients with fungal UTI were examined. The efficacy of fluconazole in the treatment of fungal UTI was studied in 53 patients. Results. Candida albicans was detected in 37% of cases of fungal UTI in outpatient patients. Risk factors for fungal UTI in outpatient patients include: antibacterial therapy, infravesical obstruction, type 2 diabetes mellitus and the presence of urinary drain-age. The microbiological efficacy of fluconazole therapy for 7, 10 and 14 days was 83.0%, 94.3% and 96.2%, respectively. The growth of fungi in the urine a month after treatment was absent in 86.7% of patients. In outpatient patients with fungal UTI without type 2 diabetes mellitus, the efficacy of fluconazole at a dose of 150 mg per day for 7 days was 94.9%. In patients with type 2 diabetes mellitus after 7 days of therapy, the efficacy was 50.0%. Conclusions. The most common causative agent of fungal UTI in outpatient patients is Candida albicans. To detect fungi in urine, samples should be seeded on selective media, while increasing the seeding volume to 0.1 ml and extending the incubation time to 96 hours. Fluconazole is a highly effective treatment for fungal UTI at a dose of 150 mg per day for 7 days, however, in patients with diabetes mellitus, therapy should last at least 10 days. © 2021, Remedium Group Ltd. All rights reserved