Bitten wounds of the maxillofacial area in children

The aim of the work is to determine the frequency, structure, features of clinical manifestations and treatment of bitten wounds of the face and neck in children of Poltava region. Materials and methods: It has been analyzed 91 histories of disease of thematic patients undergone treatment at the Surgical Department of Pediatric town clinical hospital of Poltava. Results: In the structure of traumatic injuries of maxillofacial area in children 5.3% were patients with bitten wounds of the face and neck. Among the injured were children of the age 7-12 years old (30.2%). In 74.7% of cases, the bites were complicated by acute inflammatory processes. Urban residents accounted for 71.8% of the total number of cases, while rural residents accounted for 28.2%. Boys were injured by 53.6% and girls by 46.4%. Sharps (74.5%), punctures (19.3%) and lacerations (6.2%) differed in form. The comprehensive treatment of patients with bitten maxillofacial area wounds was carried out according to the protocol of care. Conclusions: The clinical picture and severity of bitten wounds of maxillofacial area in children have individual features, which are largely due to topographic and anatomical localization of injuries. The choice of the optimal variant of primary surgical treatment of wounds and the amount of surgery should be determined individually depending on the severity of the injury, the time of injury. Special attention should be paid to normalization of psycho-emotional state of patients and prevention of scar formation

Clinical-morphological characteristics and peculiarities of treatment of paraururicular fistulas in children

The aim: Determining the frequency of occurrence of paraauricular fistula in children and comparing the results of their own experience regarding their clinical manifestations, treatment principles and morphological features with existing scientific data. Materials and methods: The results of a comprehensive examination and surgical treatment of 25 children with paraauricular fistulas. Results: Most often, para-auricular fistula was observed in infants 22 – (88%). In 18 persons (72%), they were unilateral, in 10 – (40%) hereditary. In 8 – (32%), fistula was diagnosed immediately after birth. In 17 – (68%) the pathology was not clinically manifested, but was an accidental finding during the next medical examination. Morphological research has shown that congenital paraauricular fistula is a formed canal intimately associated with the epithelium and cartilage, and the presence of epithelial lining on the fistula wall with constant support of the inflammatory process makes it impossible to heal even against the background of multicomponent treatment. Conclusions: Due to the topographic-anatomical localization, features of the clinic of the born fistula, surgical treatment does not always allow to achieve the desired results, and requires repeated interventions during recurrence. It is possible to prevent recurrence by the extensive use of additional diagnostic manipu

Peculiarities of antenatal and postnatal periods of child development with inflammatory maxillofacilal localization processes

За 7 років обстежено 537 дітей з гострими гнійними одонтогенними і неодонтогенними процессами щелепно-лицевої ділянки. Встановлено , що в їх структурі превалювали гострий гнійний лімфаденіт (29 %) та аденофлегмона і одонтогенний остеомієліт, на долю яких припадало по 18 %. Аналіз перебігу вагітності засвідчив, що в цей період у матерів обстежених дітей досить часто простежувалися випадки гострих інфекційних захворювань, наявність патологічних станів і це певною мірою відображалося на пологовій діяльності. Характерним є також те, що діти , які знаходилися на штучному та змішаному вигодуванні з місячного та шестимісячного віку частіше хворіли. Така ситуація вказує на необхідність включення цих дітей до групи ризику з метою своєчасно оздоровлення, що може звести нанівець вплив несприятливих чинників, дію яких вони відчували як в анте - так і постнатальному періодах їх розвитку.For the period of 7 years, 537 children with acute purulent odontogenic and non-odontogenic processes of maxillofacial area were examined. Acute purulent lymphadenitis (29 %) and adenoflegmon and odontogenic osteomyelitis, which accounted for 18 %, were found to be predominant in their structure. Noteworthy is the fact that a large number of children and their relatives seek specialized care behind time and are often treated for the wrong diagnosis. There are also certain age differences depending on the nosological form of the disease. Analysis of pregnancy showed that in this period, in the examined children’s mothers cases of acute infectious diseases, the presence of pathological conditions were quite frequently observed, and this has reflected in childbirth. It is also noteworthy that infants who were in artificial and mixed feeding from the age of one month and six months were more likely to fall ill. This situation indicates the need to include these children to the risk group in order to timely recover, which can negate the impact of adverse factors that they have experienced in both the ante- and post-natal periods of their development

Rapid Etiological Classification of Meningitis by NMR Spectroscopy Based on Metabolite Profiles and Host Response

Bacterial meningitis is an acute disease with high mortality that is reduced by early treatment. Identification of the causative microorganism by culture is sensitive but slow. Large volumes of cerebrospinal fluid (CSF) are required to maximise sensitivity and establish a provisional diagnosis. We have utilised nuclear magnetic resonance (NMR) spectroscopy to rapidly characterise the biochemical profile of CSF from normal rats and animals with pneumococcal or cryptococcal meningitis. Use of a miniaturised capillary NMR system overcame limitations caused by small CSF volumes and low metabolite concentrations. The analysis of the complex NMR spectroscopic data by a supervised statistical classification strategy included major, minor and unidentified metabolites. Reproducible spectral profiles were generated within less than three minutes, and revealed differences in the relative amounts of glucose, lactate, citrate, amino acid residues, acetate and polyols in the three groups. Contributions from microbial metabolism and inflammatory cells were evident. The computerised statistical classification strategy is based on both major metabolites and minor, partially unidentified metabolites. This data analysis proved highly specific for diagnosis (100% specificity in the final validation set), provided those with visible blood contamination were excluded from analysis; 6-8% of samples were classified as indeterminate. This proof of principle study suggests that a rapid etiologic diagnosis of meningitis is possible without prior culture. The method can be fully automated and avoids delays due to processing and selective identification of specific pathogens that are inherent in DNA-based techniques

Statistical information about the inflammatory processes of the jaw-facial part in children

Вступ: В структурі хірургічних стоматологічних захворювань у дітей превалюють гострі та хронічні запальні процеси. Слід зауважити, що в хірургічних спеціалізованих відділеннях переважають різні форми лімфаденітів, аденофлегмони та одонтогенный остеомієліт, але без чіткого розуміння статистичної ситуації не можливо вирішити ряд організаційних проблем; Introduction: The acute and chronic inflammatory processes prevail in the structure of the dental surgical diseases in children. Notably, various forms of lymphadenitis, adenophlegmon and odontogenous osteomyelitis dominate in the specialized surgical units; however, it is not possible to resolve a number of organizational problems without clear understanding of the statistical situation. The aim: The paper is aimed at the analysis of the incidence rate of major nosological forms of the acute suppurative inflammations of the maxillofacial area in children for the prospective planning of arrangements to provide them with high-quality specialized care. Materials and methods: The paper involves findings of comprehensive examination and treatment of 537children with acute purulent lymphadenitis, adenophlegmon and odontogenous osteomyelitis that was carried out within 6 years. Results: The resulting clinical data have shown that three abovementioned nosological forms of the disease accounted for 42% of the overall number of the inpatient dental patients and 11% of the total number of children with acute surgical pathology. Out of 537 patients, 240 patients (44.8%) with acute purulent lymphadenitis, 150 (27,9%) patients with adenophlegmon and 147 (27.3%) patients with acute odontogenous osteomyelitis have been observed (318 (59,2%) boys and 219 (40,8%) girls aged from 2 months to 15 years). The study of the past history of the disease has established that in the majority of patients burdened premorbid history and occurrence of concomitant chronic general somatic diseases was presented prior to the onset of acute inflammation. Conclusions: The factors, mentioned above, greatly contributed to increase in protective-adaptive properties of child body and create the prerequisites for the formation of pathological symptomocomplex in children, which can be implemented even in the minimal effect of antigen load on the tissues of maxillofacial area. Such situation requires a balanced multidisciplinary approach to the planning of preventive measures in this category of patients at all stages of the observation; Мета: Вивчити частоту зустрічаємості ведучих нозологічних форм гострих гнійних запальних процесів щелепно-лицевої ділянки у дітей для планування організаційних заходів по наданню їм якісної спеціалізованої допомоги на перспективу. Матеріали та методи: Матеріалом для написання даної наукової роботи слугували результати комплексного обстеження і лікування протягом 6 років 537 дітей з гострим гнійним лімфаденітом, аденофлегмоною та гострим одонтогенним остеомієлітом. Результати: За даними нашої клініки, ці три нозологічні форми захворювання складають 42% від усієї кількості стаціонарних стоматологічних хворих і 11% від загальної кількості дітей з гострою хірургічною патологією. Із 537 пацієнтів з гострим гнійним лімфаденітом спостерігали 240 хворих (44,8%), з аденофлегмоною 150 - (27,9%), з гострим одонтогенним остеомієлітом 147 - (27,3%). Хлопчиків було 318 - (59,2%), дівчаток – 219 (40,8%). Вік хворих від 2 місяців до 15 років. Вивчення анамнезу захворювання дозволило встановити, що виникненню гострого запалення передував обтяжливий преморбідний фон та наявність супутніх хронічних загальносоматичних захворювань у превалюючої більшості хворих. Висновки: Вище згадані фактори в значній мірі призводять до зниження захисно-адапційних можливостей дитячого організму та створюють передумови для формування у дітей патологічного симптомокомплексу, який може реалізуватися навіть при мінімальній дії на тканини щелепно - лицевої ділянки антигенного навантаження. Така ситуація потребує виваженого мультидисциплінарного підходу до планування лікувально-профілактичних заходів у даної категорії хворих на всіх етапах спостереження