Cavity Of Children Research Articles

SKILLS OF INDIVIDUAL ORAL HYGIENE IN CHILDREN WITH ORTHODONTIC PATHOLOGY

Relevance. Orthodontic pathology contributes to the deterioration of the hygienic condition of the oral cavity in children and increases the risk of developing dental caries and inflammatory periodontal diseases. In this regard, rational and effective oral hygiene becomes especially relevant.
 Aim of this study is to analyze the results of a questionnaire of children with orthodontic pathology regarding the skills of individual oral hygiene and oral hygiene products they use.
 Materials and methods. A dental examination of 138 children aged from 14 to 17 years with orthodontic pathology was carried out. Before starting the treatment, the children filled out a specially developed questionnaire that contained 20 questions with suggested answer options. The children were surveyed in the presence of parents; the children answered the questions independently by filling out a Google form, parents were not allowed to intrude into the survey.
 Results. 73 children (52.9%) followed the recommendations to brush their teeth twice a day in the morning and in the evening. 47 (34.1%) children reported about brushing their teeth in the morning only and 6 (4,3%) children brushed their teeth in the evening. 35 (25.4%) children admitted that they did not brush their teeth every day. 76 children (55.1%), i.e. more than half, were fount to spend no more than 1 minute for toothbrushing, another 35 surveyed children (25.4%) indicated that their brushing time, as a rule, did not exceed 2 minutes, and only 25 children (18.1%) followed the recommended time of 3-5 minutes. Among all the participants, 53 children (38.4%) regularly brushed their teeth after meals, 28 (20.3%) – before meals. 57 children (41.3%) reported no established order between meals and oral routine in the morning, some of them said that oral hygiene might depend on food, others paid no attention to the sequence between meal and oral hygiene. 66 (47.8%) children are not interested in the immediate result of the performed cleaning, 42 children (30.4%) received some information about the quality of oral cavity care only at a dentist’s appointment, 30 children (21.7%) monitored the state of oral hygiene by using mirror without the additional dye indicators. The vast majority of children, 57.2%, used a manual toothbrush for oral hygiene, 31 children (22.5%) reported about regular use of an electric toothbrush, and 28 children (20.3%) indicated for periodic alternation regarding the use of toothbrushes of one or another type of teeth. 58 children (42.0%) indicated that the main motivational incentives for choosing brushes were their design and colour, while 33 (23.9%) and 24 (17,4%) children chose brushes based on the advice of their dentists or parents, respectively. 15 children
 (10.9%) chose toothbrushes without attaching any importance to this. Every 2-3 months, 67 children (48.6%) replaced a worn-out toothbrush with a new one, every 4-6 months – 27 children (19.6%), 40 children (29.0%) were not interested in the replacement period. All the participants used toothpaste, but half of them, namely, 70 children (50.7%), were guided by its organoleptic properties, colour, package design, etc. when choosing paste; 49 children (35.5%) followed the recommendations of dentists, while 11 children (8.0%) did not think about what toothpaste to choose. Toothpastes with complex action or anti-caries activity were used by 44 (31.9%) and 40 (29.0%) children, respectively, but 22 children (15.9%) did not pay any attention to toothpaste composition, indications and contraindication. Some children are informed about interdental hygiene products. Thus, 21 children (15.2%) reported about regular use of dental floss for interdental cleaning, 12 children (8.7%) also used it, but only occasionally, 26 children (18.8%) indicated that they used an irrigator, but at the same time 105 children (76.1%) never used dental floss, and 112 (81.2%) used an irrigator.
 Conclusion. According to the results of the questionnaire, the level of awareness of children with orthodontic pathology about rational and effective individual oral hygiene routine and products is far from being completely satisfactory. The development of additional oral hygiene recommendations for children with such problems seems appropriate and necessary.

Hubungan Tingkat Pengetahuan dengan Motivasi Orang Tua dalam Melaksanakan Oral Hygiene pada Anak Usia 7-12 Tahun di Ruang Flamboyant RSUD Dr. Doris Sylvanus Palangka Raya

Oral hygiene is an act of care needed to keep the mouth in good condition. Children aged 7-12 years do not have good self-maintenance behavior, so they need parental supervision, including oral hygiene maintenance. Parental knowledge is very important in supporting oral hygiene in children. This knowledge can be obtained naturally or planned through the educational process. The high knowledge of parents about oral hygiene has a major impact on the health of the oral cavity in children. The purpose of the study was to determine the relationship between the level of knowledge and parents' motivation in carrying out oral hygiene in children aged 7-12 years in the Flamboyant room of RSUD dr. Doris Sylvanus Palangka Raya 2019. This research method is correlated with the sampling method, namely purposive sampling. Respondents took as many as 30 mothers with children aged 7-12 years. Data analysis used the chi-square test, which showed a significant relationship between knowledge and parental motivation in carrying out oral hygiene in children aged 7-12 years, with the study's results showing sufficient knowledge of 80% and motivation of 77%. The analysis results with the chi-square test obtained 0.001, which is sig. (2-tailed) < 0.05. The results of this study are that there is a relationship between the level of knowledge and parents' motivation in carrying out oral hygiene in children aged 7-12. The conclusion is that motivation from the family is needed, especially parents, to always emphasize to children that oral hygiene is important to do every day to avoid the accumulation of food debris so that oral hygiene is maintained.

PECULIARITIES OF HARD CARIES OF TEMPORARY TEETH IN CARE IN CHILDREN 4-5 YEARS OLD WITH ADENOID VEGETATIONS

Nowadays, the high prevalence of caries in the population of Ukraine is not surprising. Unfortunately, in some areas especially those with low fluoride rate in potable water, the incidence of caries can reach 100%. The polyetiological concept of dental caries progression creates obstacles in effective treatment and prevention, which would reduce caries rates. Children under the age of 6 are in the risk group for dental caries.
 The somatic state directly and indirectly contributes to the development of cariogenic situation in preschool children. Adenoid hypertrophy is a quite common disease among this group of children; it ranks one of the leading places in the structure of the peadiatric diseases and its prevalence makes up 60%. Diseases of the pharyngeal tonsils have been found out to impact on the quantitative and qualitative indicators of oral fluid, promote insemination of the oral cavity with acid-producing bacteria, reduce the resistance of hard tissues of deciduous teeth.
 In order to solve this problem, 103 children aged from 3 to 5 with adenoid hypertrophy were surveyed. Children from Poltava (Ukraine) had no difference in social statue and living conditions. The presence of adenoid hypertrophy was confirmed by patients` medical records, which also contained the information about the duration of concomitant pathology (less than a year, more than a year). All children were checked for the dental caries intensity, the DEF indices (t) (D – decayed deciduous teeth, E – extracted deciduous teeth due to caries complications, F – filled deciduous teeth) and def (s) (d – surfaces of carious deciduous teeth, e – extracted deciduous teeth, f – filled surfaces of deciduous teeth) were determined, the hygienic condition of the oral cavity was assessed using the Fedorov-Volodkina’s index (1971). The study of the caries intensity of temporary teeth (DEF (t)) was based on assessing caries activity by Vinogradova in accordance with the average intensity in each age group of Poltava. The significance was established as p≤0.05.
 Depending on the degree of caries intensity determined with the above mentioned indices, the research groups of 3 – 5 year old children with adenoid hypertrophy were formed. Thus, 51.5% of the children had I stage (compensated) dental caries intensity, 36.9% of children had II stage (subcompensated) caries intensity and 11.7% had III stage (decompensated) of caries intensity. The study of caries in deciduous teeth revealed a significant difference between the observation groups (p≤0.05).
 The analysis of the obtained results revealed the existence of a direct average correlation between the indicators of the state of oral hygiene in children with adenoid hypertrophy and the intensity of caries according to DEF (t) index (r = “+ “0,6)
 The study results indicate a more intense caries in deciduous teeth in the children with more than a yearlong adenoid hypertrophy in the medical history. Mainly the oral type of respiration in children with the diseases of pharyngeal tonsils creates the grounds for the development of cariogenic situation.
 Poor oral hygiene in children with adenoid hypertrophy can be explained by xerostomia due to oral or mixed breathing as well as opportunistic microflora presence and pH shift towards more acidic.
 The obtained results provide a background for further research and improvement of preventive complexes targeting at elimination of mechanisms that contribute to the cariogenic situation in the oral cavity of children, considering the presence of somatic disease.

Oral fluid immunological characteristics in children with congenital cleft palate and a postoperative defect

Relevance. The lack of anatomical differentiation between the oral cavity and the nasal cavity in children with congenital cleft palate leads to the deterioration of saliva characteristics affecting dental and periodontal disease progression. The oral fluid immunological profile may provide information about the nature of the inflammatory processes and changes in the reaction to the ongoing therapy.Material and methods. The article presents the results of the oral fluid enzyme immunoassay in 109 children aged 6-12 years with congenital cleft palate and a postoperative defect and in 50 practically healthy children of the same age. The study determined the levels of pro-inflammatory (IL-1β, IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) cytokines and secretory immunoglobulin sIgA in the oral fluid by enzyme-linked immunosorbent assay.Results. The study of children aged 6-12 years with congenital cleft palate and a postoperative defect revealed hyperstimulation of oral fluid pro-inflammatory (IL-1β, IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) cytokines and a decrease in secretory immunoglobulin sIgA mean level.Conclusion. The oral fluid immunological complexes imbalance in children with congenital cleft palate and a postoperative residual defect is a progressive factor for the development and chronicity of oral inflammatory diseases.The received data evidence the local inflammatory process and a decrease in the oral fluid local protective factors, which one must consider to develop methods for improving the condition of organs and tissues of the oral cavity in children with congenital cleft palate during preparation for surgery to eliminate the residual defect.

The Effectiveness of Anchovy as Antibacterial Agent for Children Oral Health

Background: Caries Several pathogenic microorganisms cause this infectious disease in the oral cavity. These pathogenic microorganisms can be inhibited by using drugs and natural materials all around us. One of the natural ingredients that we can use to treat infections in children's teeth is anchovy extract (Stolephorussp) which we often encounter in Indonesian marine waters. Stolephorussp contains a lot of high fluoride and calcium. The fluoride content is 15.7-38.33ppm, especially in CaF2 compounds. Aim: Providing information about the effectiveness of anchovy extract (Stolephorussp), on the condition of the oral cavity of children, the author wants to compare the level of effectiveness of a natural ingredient stolephorussp an antibacterial agent in the oral cavity of children. Mini-Review: The Fluoride in bacteria works as bacteriostatic to prevent cell proliferation by inhibiting nucleic acid synthesis, which is vital for cell development. Anchovy contains fluoride, protein, calcium, and minerals Literature review was carried out until December 2021 using PubMed, and Google Scholar. In writing this SR, it is hoped that Stolephorusinsularis is an antibacterial alternative to treat infections in children's teeth. Conclusion: The use of natural ingredients for anchovies (Stolephorusinsularis) is expected to provide benefits to children's teeth, especially overcoming their dental infections.

Оптимизация хирургического лечения переломов нижней стенки глазницы у детей с использованием комбинированного доступа

Purpose.. To optimize surgical treatment of fractures of the lower orbital wall in children using combined access. Material and methods. The analysis of the results of surgical treatment of fractures of the lower wall of the orbit in 63 children using combined access performed at the Morozovskaya Children’s hospital in the period from 2018-to 2021 was carried out. Results. The use of the combined approach in surgical treatment of fractures of the lower wall of the orbit in children, including transconjunctival and transnasal access under endoscopic control with installation of a sinus catheter and a membrane of highly purified xenocollagen type 1, makes surgical intervention less traumatic, improves the postoperative period, allows to achieve complete restoration of the eyeball motility and no signs of diplopia. Conclusion. The method makes it possible to restore the integrity of the lower wall of the eye cavity in children aged from one to 18 years without violating the physiological growth of the facial skeleton. Key words: fracture of the lower orbital cavity wall, combined access, endoscopic control

Evaluating Knowledge, Attitudes and Practices of Pakistani Dental Professionals Regarding Silver Diamine Fluoride

Objective: The objective of this study was to evaluate the knowledge and attitude regarding Silver Diamine Fluoride (SDF) among Pakistani Dental Professionals worked at various institutes of Karachi.
 Methodology: This cross-sectional survey-based study was conducted among the house surgeons, general dental practitioners and specialists worked at various institutes of Karachi. Questionnaire was distributed among 375 participants through social media. Questionnaire was kept on google forum and link was sent to all participants through social media including Facebook, WhatsApp by non-probability consecutive sampling. Questionnaire was composed of two portions. Questions in first portion were related to demographic data and in second portion of Questionnaire had 13 closed ended questions regarding Knowledge and Approach towards Silver Diamine Fluoride. Statistical package for social sciences SPSS-25 was used for data entry and analysis with descriptive statistic, which used frequency, percentage, mean, and standard deviation.
 Results: Out of the total 375 participants, 160(43%) were male and 215 (57%) female. Mean age of participants was 33 + 11.8 years. 191(51%) heard about SDF and only 108(29%) attended lectures/discussions about SDF. 189(50.40%) responded that SDF is used in enamel lesion. 251(67%) participants responded that SDF is used in both anterior and posterior teeth. Only 160(42.66%) of participants responded that SDF is used for both dentitions. 122(32.53%) were agreed that SDF is an alternative to removing dental lesion by a dental drill, while only 118 (31.47%) agreed that many patients would not accept treatment of dental caries with SDF due to the permanent black staining of the carious lesion. 240 (64%) of participants were disagree about the SDF require the use of local anesthesia and more than half of participants responded that the silver is an antimicrobial ingredient in SDF. 237(63.2%) of participants responded that SDF is indicated in Children with High caries rate and most of them responded that black staining of tooth is main disadvantage and barrier to the use of SDF. Majority of participants did not know about reapplication interval for use of SDF.
 Conclusion: SDF is an appropriate alternative for restoring dental cavities in children. As it doesn’t require local anesthesia, it is the safest way to limit the progression of lesion in patient with high caries index. But there are some barriers related to the use of SDF in their regular dental practice is that, SDF causes permanent staining of tooth and also practitioners had little knowledge about their application protocols and recall or reapplication intervals.

Rapid Maxillary Expansion Has a Beneficial Effect on the Ventilation in Children With Nasal Septal Deviation: A Computational Fluid Dynamics Study.

Nasal septal deviation (NSD) is one of the most common nasal diseases. Different from common clinical examination methods, computational fluid dynamics (CFD) can provide visual flow information of the nasal cavity. The dimension and volume of the nasal cavity are easily affected by rapid maxillary expansion (RME). The purpose of this study was to use CFD to evaluate the effect of RME on the aerodynamics of the nasal cavity in children with maxillary transverse deficiency and NSD. Computational fluid dynamics was implemented after 3D reconstruction based on the CBCT of 15 children who have completed RME treatment. After treatment, the volume increases in the nasal cavity, nasopharynx, oropharynx, and pharynx were not statistically significant. The wall shear stress of the nasal cavity after RME, 1.749 ± 0.673 Pa, was significantly lower than that before RME, 2.684 ± 0.919 Pa. Meanwhile, the maximal negative pressure in the pharyngeal airway during inspiration was smaller after RME (−31.058 Pa) than before (−48.204 Pa). This study suggests that RME has a beneficial effect on nasal ventilation. The nasal airflow became more symmetrical in the bilateral nasal cavity after RME. Pharyngeal resistance decreased with the reduction in nasal resistance and the increase in the volume of oropharynx after RME.

Safe Renal Transplantation to the Extraperitoneal Cavity in Children Weighing Less Than 15 kg

Pediatric renal transplantation is associated with various surgical complications due to the complexity of the technique and the often-fragile condition of patients with end-stage renal disease. We evaluated the surgical complications associated with renal transplantation via the extraperitoneal approach in pediatric recipients. This retrospective study enrolled 280 patients younger than 16 years old who underwent renal transplantation via the extraperitoneal approach: 216 patients underwent transplant placement in the iliac fossa like in adults, and 64 underwent transplant placement in the distal part of the original renal lower pole (the extraperitoneal cavity). On the basis of the Clavien-Dindo classification, 30 patients (10.7%) showed grade 2 complications and 12 patients (4.3%) showed grade 3 or higher complications. None of the patients showed gastrointestinal complications. In a Cox regression analysis, grade 2 or higher complications were significantly associated with weight less than 15 kg (P=.027) and operative times longer than 245 minutes (P=.029). Among the 49 patients weighing less than 15 kg with an allograft placed in a distal portion of the original renal lower pole, only 3 patients (6.1%) developed surgical complications. Thus, allograft placement in the extraperitoneal cavity can be performed safely in children weighing less than 15 kg.

Relationship of morphometric parameters of the liver and abdominal cavity of children and adolescents according to the data of computer tomography

Relationship of morphometric parameters of the liver and abdominal cavity of children and adolescents according to the data of computer tomography

Динамічна оцінка поширеності та глікемічного контролю цукрового діабету I типу в дитячій популяції

Glycated hemoglobin (HbAc1) remains one of the most valuable methods of glycemic control among patients with diabetes mellitus (DM). Its target level in children and adolescents is ≤7% according to the recommendations of ISPAD (2018) and ≤7.5% – ADA (2020), but the presence of complications and labile course of type I diabetes mellitus (T1DM) in children and adolescents requires an individual approach to achieve optimal glycemic control. The level of glycated hemoglobin determines the risk of concomitant purulent-inflammatory diseases (PID) and the restoration of systemic homeostasis after the surgery. High HbAc1 levels during the last 90 days before the surgery significantly increase the length of hospital stay among adult patients. Currently, there are no published data on the level of glycemic control in children with T1DM in Vinnytsia region, which is extremely important in assessing the risk of complications and treatment outcomes of this population in a surgical department. Purpose – to analysis and assessment of the prevalence of T1DM and glycemic control among children with T1DM in Vinnytsia region in 2013, 2016 and 2017. Materials and methods. We carried a retrospective study to assess the prevalence of T1DM among the pediatric population of Vinnytsia region through the period from 2013 to 2017 by analyzing the reports of the Vinnytsia Regional Clinical Endocrinology Center and demographic data of the Main Department of Statistics in Vinnytsia Region, case histories of patients treated at Vinnytsia Regional Children’s Hospital. Number of patients with T1DM in 2013 was – 321, in 2016–358, in 2017–399 patients. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from parents to conduct the research. HbAc1 was used to assess glycemic control. The value of HbAc1 ≤7.5% was considered as optimal, >7.5–9.0% – suboptimal, >9.1% – poor. Patients with no HbAc1 available were excluded from further study. Fisher’s exact test was used to compare the groups. P-value ˂0.05 was considered statistically significant. Results. During the study period, there was an increase in the prevalence of T1DM in the pediatric population. Particularly, in 2013 this indicator was equal to – 1.08‰, in 2016 – 1.23‰, and in 2017 – 1.37‰ (p=0.1266; p=0.0015, compared to 2017, respectively), which corresponds to the estimated global trends. The primary incidence of T1DM in Vinnytsia region was: 0.017% in 2013, 0.015% in 2016, 0.022% in 2017, with the peak of the manifestation at the age of 6 and 10. Average indicators of glycemic control based on HbA1c were at the level of 8.73±1.82% in 2013, 8.60±1.52% in 2016, 8.85±1.88% in 2017, respectively. In 2013 glycemic control was assessed as optimal in 27.5% (88/319) of children, suboptimal – 37.5% (120/319), poor – 35% (111/319). In 2016 the number of patients with optimal HbAc1 decreased to 25% (83/336), suboptimal level was found in 41% (139/336), poor – in 34% (114/336), respectively. In 2017 the optimal level of HbAc1 was recorded in only 21% (68/329), suboptimal – in 41% (135/329), poor – in 38% (126/329), respectively. There is an increase in the number of patients with poor glycemic control and HbA1c exceeding 11% in 2017 (42/329) compared to the corresponding indicator in 2016 (24/336), p=0.0191. Clinical manifestations of poor glycemic control in the study population were acute complications (ketosis, ketoacidosis), which were accompanied by abdominal pain, nausea and vomiting and required treatment in the intensive care unit. Purulent-inflammatory diseases (PID) of the abdominal cavity in children with T1DM were accompanied by a combination of clinical and laboratory data of decompensation of T1DM, a significant increase in WBC and diffuse abdominal pain. Macroscopic and pathomorphological characteristics of the appendix and peritoneum corresponded to destructive forms of PID in the presence of a short period from the disease onset. The course of the postoperative period in children with PID of the abdominal cavity in the setting of T1DM was labile and required insulin correction. Conclusions. The prevalence of T1DM among children in Vinnytsia region is growing (1.08‰ – in 2013, in 1.37‰ – in 2017; p=0.0015). Glycemic control in this population is within suboptimal limits (>7.5–9.0%) during the period from 2013 to 2017. As of 2017, more than a third of pediatric patients (38%) have poor glycemic control. The number of patients with HbA1c >11% significantly increased in 2017 compared to 2016 (p=0.0191). The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: type I diabetes mellitus, glycemic control, glycated hemoglobin, children.

The treatment of patients with posthemorrhagic hydrocephalus

The article discusses the possible causes of polycystic posthemorrhagic ventriculomegaly in infants, as well as predictors of this pathological process. When choosing a treatment method the doctor shall take into account not only the etiology of the disease, but also age parameters, concomitant pathology. An important aspect in the approach to the treatment of polycystic posthemorrhagic multilevel hydrocephalus includes the determination of the biomechanical properties of the craniospinal system, especially the compliance of the brain and resorption of cerebrospinal fluid. Particular attention is paid to the timely correction of complications, including the analysis of inflammatory changes markers in the craniospinal system, which serve as predictors of the outcome of cerebrospinal fluid resorption. The authors also noted that the violation of the cerebrospinal fluid outflow from the cranial cavity in children may depend on a large number of «extracerebral» factors. They consider the stages of neurosurgical care to patients in this group on a clinical example. This example and literature data demonstrate that children with age develop changes not only in the craniospinal segment, which is responsible for the transformation of free fluid, but also in the extracranial cavities. Thus, we are able to recommend an integrated approach for the management of newborns with intracranial hemorrhage, complicated by posthemorrhagic hyporesorbent and occlusive hydrocephalus, with the justification of the optimal neurosurgical tactics for managing drainage-dependent patients, the course of the disease in which is accompanied by a multicomponent inflammatory syndrome.

Foreign bodies in the nasal cavity in children

Foreign bodies in the nasal cavity in children are a fairly common reason for contacting an otorhinolaryngologist. Most foreign bodies can be removed quite easily. However, some cases are associated with significant difficulties in their searching and removing and require the use of special technical methods and general anesthesia. We present two cases of unusual foreign bodies in the nasal cavity in children.

Oral Mucocele of Lower Lip - A Case Report

Aim: This paper reports a case of mucocele in the left side of the lower lip treated by conventional surgical excision of the lesion.Background: Mucoceles are most frequently occurring benign salivary gland lesion.The most common site of occurrence of mucocelein the oral cavity is the lower lip. Extravasation type is most frequently occurring lesion because of the extravasation of mucus secretion into the fibrous connective tissue that result from an alterationof minor salivary glands and ducts. The main etiological factors are trauma or lip biting habit. Because of its pathognomonic presentation, the diagnosis is mainly clinical. Histopathogical investigation is also necessary to rule out other salivary lesions or tumours.Case Report: In this report, a mucocele developed in the fourteen old year female patient is described. Surgical excision of the lesion was planned followed by the gentle dissection of the lesion. Histopathological examinationrevealed the presence of cystic cavity surrounded by the underlining connective tissue stroma, which consist of numerous salivary gland tissues lined by inflammatory cell infiltration suggestive of mucous extravasation cyst.Conclusion:Out of various treatment modalities, Simple surgical excision is the treatment of choice, alleviating patient’s distress and discomfort.Clinical significance: Oral mucocele is the most common benign lesionoccuring in the oral cavity in children. Thus clinical knowledge about the diagnosis and treatment of oral mucocele is necessary to avoid further complications in children.

Діагностика та лікування інфільтратів черевної порожнини в дітей

Мета дослідження — покращити результати лікування дітей з інфільтратами черевної порожнини за рахунок удосконалення діагностичних заходів, хірургічних технологій і післяопераційної реабілітації. Матеріали та методи. За 22 роки в Чернігівській області виконано 27 325 операцій на органах черевної порожнини в дітей, із них у 19 842 (72,6 %) — із причини різних форм апендикулярного відростка. Ускладнення у вигляді інфільтратів та абсцесів черевної порожнини встановлено у 285 (100,0 %) хворих дітей, з яких інфільтрати діагностовано в 78 (27,4 %) та абсцеси — у 207 (72,6 %). Хворі розподілені на дві підгрупи: групу дослідження (I; 2005–2015 рр.) — 29 дітей (37,2 %) і групу порівняння (II; 1994–2004 рр.) — 49 (62,8 %). Первинні інфільтрати черевної порожнини (ПІЧП) установлено в 51 хворого (65,4 %), з яких у I групі — у 27 (34,6 %), у II — у 24 (30,8 %). Вторинні інфільтрати черевної порожнини (ВІЧП) встановлено у 27 хворих (34,6 %), з яких у I групі — у 2 (2,6 %), у II — у 25 (32,0 %). Усім хворим проводилися загальноклінічне, лабораторне, а в групі дослідження — ультразвукове дослідження черевної порожнини з кольоровим допплерівським картуванням та комп’ютерна томографія органів черевної порожнини. Результати. Проведені дослідження показали, що термін госпіталізації дітей із первинними інфільтратами в I групі становив 11,75 ± 0,23 доби, а в II — 13 ± 1 доба, із вторинними інфільтратами — 13,65 ± 1,65 доби, серед дітей у I групі — 19 ± 9 діб, у II — 12,52 ± 1,71 доби. Клінічна картини у хворих із ПІЧП була такою: лихоманка — у 86,3 % випадків, симптоми дисфункції шлунково-кишкового тракту — у 41,1 %, нудота — у 29,4 %, біль у животі — у 62,4 %. Дані симптоми вказували на атиповість перебігу захворювання, що спричинило помилки на діагностичному етапі. Причинами несвоєчасної діагностики ПІЧП були: самолікування — у 43,1 % випадків, пізнє звернення за медичною допомогою — у 37,2 %, несвоєчасна амбулаторна діагностика — у 19,6 %. Променеві методи дослідження (оглядова рентгенографія черевної порожнини та комп’ютерна томографія): у II групі в 6 дітей (11,7 %) проти 18 (35,3 %) — у I. Клінічна картина з ВІЧП: лихоманка — у 100,0 % дітей, нудота — у 63 %, блювання — у 37 %, здуття черевної порожнини — у 55,6 % дітей, що була більш специфічною для ранніх післяопераційних інфільтратів — у 10 хворих (37 %). При об’єктивному обстеженні визначалися біль у животі — у 81,4 % дітей, симптоми подразнення очеревини — у 96,3 %, симптом «пухлини, що пальпується» — у 63 %. Променеві методи дослідження: у II групі в 5 дітей (18,5 %) проти 2 (100 %) — у I. З метою покращання результатів лікування нами була розроблена шкала бальної оцінки. Пацієнтам, які згідно з діагностичною шкалою мали 26–36 балів, було показане консервативне лікування. У хворих, які мали 37–45 балів, застосовували хірургічне лікування недуги через місцевий доступ. У хворих, які мали 46–72 бали, застосовували хірургічне лікування недуги через серединну лапаротомію. У 7 (9 %) хворих із ПІЧП при обстеженні згідно з діагностичною шкалою було встановлено 26–36 балів — показане консервативне лікування, з яких у І групі — у 3 (3,9 %), у ІІ — у 4 (5,1 %). У 35 дітей (44,9 %) було 37–45 балів — застосовували хірургічне лікування через місцевий доступ, з яких у І групі — у 18 (23,1 %), у ІІ — у 17 (21,8 %). У 9 дітей (11,5 %) було 46–72 бали, у них застосовували хірургічне лікування через серединну лапаротомію, з яких у І групі — у 6 (7,6 %), у ІІ — у 3 (3,9 %). Таким чином, у 44 хворих із ПІЧП проведено оперативне лікування. У 26 (33,4 %) хворих із ВІЧП згідно з діагностичною шкалою було встановлено 26–36 балів та показано консервативне лікування, з яких у І групі — у 2 (2,6 %), у ІІ — у 24 (30,8 %). В 1 дитини (1,2 %; хворий із ІІ групи) було встановлено 37–45 балів, застосовували хірургічне лікування з місцевого доступу. Висновки. Установлено, що клінічний перебіг інфільтратів черевної порожнини у хворих у 12,5–18,9 % випадків характеризується атиповою клінічною симптоматикою, що здебільшого призводить до запізнілого звернення до дитячого хірургічного стаціонару. Впровадження шкали бальної оцінки недуги черевної порожнини дозволило досягти покращання результатів лікування як у близькому, так і віддаленому періодах. У дослідженнях встановлено, що найбільш вразливими до розвитку інфільтратів черевної порожнини є діти віком від 7 до 12 років, які мають атипову локалізацію апендикулярного відростка в 62,3 % спостережень.

Oral cavity tumors in children. Diagnostic approach

Although the majority of lesions reported in children and adolescents are benign, it should be recognized that oral malignant tumors do occur in children. The incidence of childhood malignancy is greatest in the 1st year of life, with the second peak to be found at 2–3 years of age. Many clinicians do believe that oral cancer is particularly aggressive in young patients, and is associated with poorer survival compared to adults. Numerous early reports of oral cancer in young adults concluded that the disease was more aggressive, and prognosis was poorer than in older adults. Purpose of this study is to make a literature review on the diagnostic methods of the tumors of oral cavity in children. Conclusion. Despite the progress in technology and medicine paraclinical examination methods in determining tumors of the oral cavity in children haven’t been developed and studied enough, thourder studies have to be done in order to create diagnostic protocols for the pediatric population.

Superabsorbent polymer balls as foreign bodies in the nasal cavities of children: our clinical experience

ObjectiveTo summarize the clinical diagnosis and treatment of superabsorbent polymer balls as nasal foreign bodies in children.MethodsWe retrospectively analysed the clinical data concerning 12 cases of superabsorbent polymer balls as nasal foreign bodies in children and summarized the corresponding clinical features, methods of diagnoses and treatment, and prognoses.ResultsTwelve children with superabsorbent polymer balls as foreign bodies in their nasal cavities presented with relatively severe symptoms, such as congestion, runny nose, and nasal swelling. When such foreign bodies stay in the nasal cavity for a prolonged period, patients may suffer from general discomfort, such as agitation, poor appetite and high fever. Most of the children had to undergo nasal endoscopy under general anaesthesia to have the foreign bodies completely removed. An intraoperative examination revealed significant mucosal injury within the nasal cavity. With regular follow-up visits and adequate interventions, all the patients recovered.ConclusionThe longer superabsorbent polymer balls remain in the nasal cavity, the more damaged the nasal mucosa will be. It is challenging to remove such foreign bodies in the outpatient setting. Transnasal endoscopy under general anaesthesia appears to be safer and more effective in such cases. Since the nasal mucosa is injured to varying degrees, postoperative follow-up and treatment are equally important for preventing the occurrence of complications.

КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ ИЗМЕНЕНИЙ МИКРОБИОМА ПОЛОСТИ НОСА У ДЕТЕЙ СО ЗЛОКАЧЕСТВЕННЫМИ ОПУХОЛЯМИ ПАРАМЕНИНГЕАЛЬНОЙ ЛОКАЛИЗАЦИИ ВО ВРЕМЯ ХИМИОЛУЧЕВОЙ ТЕРАПИИ

Malignant tumors of parameningeal localization are various morphological neoplasms located in the nasal cavity, nasopharynx, paranasal sinuses and middle ear. As a result of tumor growth, conditions are created for the development of chronic inflammation. Studies of the microbiome of the upper respiratory tract in children with malignant tumors were practically not conducted. Objective of the research: to identify changes in the microbiome of the nasal cavity in children with malignant tumors of parameningeal localization during chemoradiotherapy. Materials and methods: the study included 29 patients with parameningeal tumors, 2–17 years old. Among the included in the study there were 18 boys (62%) and 11 girls (37%). Morphologically, the following were verified: embryonic rhabdomyosarcoma (ERMS) – 17 (58%), alveolar rhabdomyosarcoma (arms) – 3 (10%), other sarcomas – 4 (13%), nasopharyngeal cancer – 5 (17%). All patients received induction chemotherapy. Simultaneous radiotherapy (LT) and chemotherapy (CT) – in 24 (82%) cases. After completing the chemoradiotherapy stage, consolidation therapy continued in 20 (70%) patients. Results: before the start of LT (after the induction stage of chemotherapy), a variety of microflora was observed in the nasal secretions, gram-positive and gram-negative bacteria were isolated in an equal ratio. The absence of growth of microorganisms was determined in 4 (13%) cases before the start of LT. Methicillin-resistant Staphylococcus epidermidis and Staphylococcus haemolyticus were more frequently detected after LT. Colonization of the nasal cavity of Candida albicans occurred before the start of LT in 4 (13%) and persisted after irradiation in 5 (17%) patients. In the delayed period, there was an increase in the percentage of patients who ridiculed gram-negative microorganisms – Pseudomonas aeruginosa in 4 (13%) cases. After 12 months, 3 (10%) patients showed a return of nosocomial flora (S. epidermidis MRSE and S. haemolyticus MRS), a decrease in colonization of P. aeruginosa and the preservation of C. albicans. Conclusion: at different stages of chemoradiotherapy, the nasal mucosa is colonized by various microorganisms that differ in their properties and pathogenicity. The continuation of this study will clarify the clinical significance of certain types of opportunistic microorganisms in the pathogenesis of inflammatory diseases of the upper respiratory tract in children with malignant tumors.

Low-Grade Myofibroblastic Sarcoma of the Oral Cavity: A Report of Three Cases Illustrating an Emerging Disease in Children

Low-grade myofibroblastic sarcoma (LGMS) is a mesenchymal tumor of myofibroblasts that occurs more frequently in adults. A series of three cases is presented to illustrate that LGMS may also occur within the oral cavity in children and adolescents. The first case (Case 1) occurred intra-osseously in the mandible, while the remaining two presented as gingival swellings and were purely restricted to soft tissue (Cases 2 and 3). The intra-osseous lesion arose in a 7-year-old girl, whereas the gingival lesions were observed in a 12-year-old girl (Case 2) and a 13-year-old boy (Case 3). Histopathologically, all cases were composed of spindle shaped cells arranged into long fascicles showing mild to moderate degree of nuclear atypia. Ki-67 (MIB-1) proliferation activity was relatively low, amounting to 3–5% in all cases. Immunohistochemically, all cases showed smooth muscle actin (SMA) positivity in spindle cells, while desmin, beta catenin, cytokeratin, and CD34 were negative, resulting in a diagnosis of LGMS. In conclusion, current series of three cases of LGMSs that occurred in the oral cavity in a child and two adolescent patients is presented to highlight an emerging disease that requires additional data for further characterization.

Oral microbiota in children with type 1 diabetes mellitus.

The oral cavity is aunique ecosystem in which the microbiome is formed by the colonization of billions of bacteria, viruses, and fungi. Aim of the study was to assess the quality and quantity of bacterial microbiota of the oral cavity in children with type 1 diabetes in comparison to healthy children. The study group consisted of 50 randomly selected type 1 diabetic children aged 10-18 years divided into 2groups (25 people each) according to the level of diabetes control: well-controlled group (WC) - HbA1c ≤ 7.5%) and poorly-controlled group (PC) - HbA1c>7.5%. The control group (GC) consisted of 25 randomly selected children with no systemic diseases. The material for microbiological tests was collected as two swabs: one from the bottom of the oral cavity and the other one from the posterior part of the dorsum of the tongue). The statistical analysis revealed statistically significant differences in the total number of isolated microorganisms between PC and GC (post hoc test p=0.003) and WC and GC (post hoc test p<0.001). There were no statistically significant differences in the number of isolated microorganisms between PC and WC (p=0.195). Oral microbiome in type 1 diabetic children is significantly quantitatively different in comparison to healthy children. There are also visible qualitative differences in the profile of oral microbiota in type 1 diabetic children and healthy children.