Alternative methods for controlling nasal obstruction in children

Currently, rhinitis accompanied by nasal obstruction is one of the most common diseases in children and adolescents. Regardless of the cause of its occurrence - an infectious or non-infectious (allergic) process, each time there is a vascular (vasomotor) reaction. In children of preschool and primary school age, the most common is infectious rhinitis, which develops with viral and bacterial infections. The group of non-allergic rhinitis, which develops more often in adolescents, is united by the term idiopathic (vasomotor) rhinitis.Purpose of the study. Evaluation of the effectiveness of the use of a complex preparation containing calendula, witch hazel, esculus, menthol and zinc oxide in the treatment of vasomotor rhinitis in children.Materials and methods. The study included 40 patients of childhood and adolescence, of both sexes (23 girls and 17 boys) aged 6 to 14 years with an established diagnosis of vasomotor (idiopathic) rhinitis, without concomitant pathology, not registered with specialists, without constant admission The study drug was used to lubricate the mucous membrane of the nasal cavity or put turundas with ointment for 3-5 minutes 2-3 times a day. The course of treatment was 7-10 days. The effectiveness of treatment was assessed by the dynamics of clinical data and the severity of the subjective symptoms of the disease.Results. A comparisons of these scores for re-assessing the status of patients relative to the timing of the study drug use showed a uniform positive trend in terms of the clinical picture and subjective complaints of patients.Conclusions. The inclusion in the complex therapy of pediatric patients with idiopathic (vasomotor) rhinitis of the drug Fleming’s Ointment, or monotherapy with this agent, contributes to a  rapid and pronounced weakening of  the  clinical manifestations of the disease, allowing you to quickly achieve positive treatment results in the form of relief of nasal obstruction, rhinorrhea, edema of the mucous membrane of the cavity nose, sneezing. There is a positive trend in the state of the mucous membrane itself

Postoperative cognitive dysfunction: etiology, clinical features, diagnosis

Introduction. The present study analyzed the possibility of using neuropsychological tests to assess postoperative cognitive dysfunction. New data were obtained: in the postoperative period, hippocampal memory impairments predominate in patients, which makes it expedient to use methods for diagnosing primary modal-nonspecific memory disorders in patients who are to undergo neurosurgical intervention on the spinal cord.The aim of the study to evaluate the influence of surgery with anesthesia on the cognitive functions of middle-age patients.Materials and methods. The study included 20 middle-aged patients. All patients had to undergo spinal surgery. Patients received total intravenous anesthesia with propofol induction (4–12 mg/kg/hr). Cognitive functions before and after the operation were made with the use of the MoCA, TMT A and B, FCSRT, state-trait anxiety inventory test (STAI).Results. The development of POCD was noted in 15% of cases. The patients showed a decrease in the FCSRT prompt index (1st day = 87 ± 9.0; 2nd day = 83 ± 15; p = 0,0005), while the overall severity of cognitive impairments (total score of MoCA) did not change significantly (standard deviation according to MoCA: 24.25 ± 2.86 on day 1 and 24 ± 3.24 on the second day, p = 0.61). The RT level decreased by day 2: 44.65 ± 7.4 versus 41.1 ± 8.2 (p = 0.001). Correlation analysis did not show the relationship between the age of patients, education level, comorbidity and development of POCD; however, the duration of anesthesia was associated with a decrease in MoCA scores (Pearson’s correlation coefficient r = –0.44; p = 0.050).Conclusion. Thus, our study shows that the study of hippocampal memory impairments is important in patients with POCD. These data differ from the data of researchers presented earlier, where the most important clinical manifestations of POCD are considered to be a decrease in attention and speed of mental processes. Of course, the small sample size dictates the need for additional research

Differential diagnosis of chronic tonsillitis in frequently ill children

Chronic tonsillitis is one of the most common pathologies of the lymphoepithelial pharyngeal ring. The main pathogen in chronic tonsillitis and its complications is group a β-hemolytic Streptococcus A (BGSA). This pathogen is detected in 30–60% of patients. At the present stage, the role of latent viral infections (Epstein – Barr virus (EBV), cytomegalovirus (CMV)) in the formation of chronic tonsillitis in children has been proven. Treatment of frequently ill children with pathology of the pharyngeal lymphoid ring remains an urgent and widely discussed issue. Depending on the etiology and clinical form of chronic tonsillitis (simple, toxicallergic form (TAF I or II), the choice is between conservative methods and radical surgical treatment. Surgical treatment of chronic tonsillitis in children is recommended only if there are absolute indications. To standard methods of conservative treatment, such as sanation of lacunae of the tonsils with antiseptic solutions, the appointment of physiotherapy, funds for the correction of systemic and local immunity are actively used. In Pediatrics, the safe and optimal complex of effects of the herbal medicinal product Tonsilgon N is widely used. Based on the analysis of clinical observations of frequently ill children with chronic tonsillitis, the effectiveness of the herbal medicine Tonsilgon H (in monotherapy mode) was revealed. As a result, the expediency of using the drug Tonsilgon H in the treatment of compensated forms of chronic tonsillitis in frequently and long-term ill children was established. There was a significant decrease in the frequency of acute respiratory infections and, consequently, the risk of transition to a decompensated form of chronic tonsillitis

The foundation of treatment of otitis media in children on the modern stage

The pathological inflammatory process in the Eustachian tube, as well as the catarrhal stage of acute otitis media, are the most common conditions in the practice of a pediatric otolaryngologist. The article presents literature data on acute pathology of the middle ear, epidemiology, etiology and standard conservative therapy. The fact of the influence of persistence of herpes virus infection on the development of hyperplastic processes in the lymphoid ring of the pharynx in children is described. It was noted that there are few data on the conduct of etiotropic and pathogenetic therapy in patients with acute middle ear pathology infected with pathogens of latent infections in the literature. The article presents a clinical case of successful treatment of the patient with acute otitis media and timely identified markers of an active infection process. Also the determination of clear indications and the timing of the specific conservative treatment of acute otitis media in children, based on an analysis of the etiological aspects of the development of this disease, the duration and somatic condition of the patient allowed to reduce the percentage of complications and relapses in the development of acute otitis media. When selecting adequate therapy for acute otitis media in children, it is necessary to consider the etiology of the disease in each individual patient. In the presence of acute lymphoproliferative syndrome in combination with middle ear inflammation, it is necessary to verify the causative factor with a laboratory examination (diagnosis by polymerase chain reaction and enzyme-linked immunosorbent assay with antibody detection) for herpes virus infection (Epstein-Barr virus, cytomegalavirus, herpes simplex virus 6 type), with further selection of specific therapy and observation of an otolaryngologist and infectious disease specialist

Prevalence of cognitive impairments in neurological diseases: Analysis of the activities of a specialized outpatient reception office

The paper gives the data obtained from the preliminary analysis of the activities of RussiaХs first Memory Impairment Laboratory. The findings allowed the authors to estimate the approximate prevalence of cognitive impairments (CIs) in patients with various pathological processes. The authors made a differential analysis of the causes of the varying severity of CIs. The causes of the latter in patients of varying age were shown to be different. There were preliminary data on the association of cognitive with other neuropsychological impairments. The ongoing studies make it possible to make a more in-depth analysis of the mechanisms of the development of these or those CIs in a Russian population, to define diagnostic approaches in detail, and to improve the quality and timeliness of medical care given to these patients