Pathology Of Upper Respiratory Tract Research Articles

Ефективність алергенспецифічної імунотерапії пилковими алергенами в дітей із позиції молекулярної алергології

Мета роботи — встановити можливі причини неефективності алергенспецифічної імунотерапії (АСІТ) пилковими алергенами (бур’янів) у дітей із сезонним алергічним ринітом і/або бронхіальною астмою на підставі вивчення гіперчутливості до алергенів, аналізу анамнестичних даних. Матеріали та методи. Проведено алерготестування 192 дітей. 52 пацієнтам проведене анамнестичне опитування з акцентом на перехресну алергію та супутню патологію верхніх дихальних шляхів, а також на ефективність АСІТ. Статистична обробка результатів проведена в програмі Statistica for Windows 6.0. Результати. Серед хворих на поліноз переважала гіперчутливість до амброзії (56 %), циклахени (46 %) та соняшника (58 %). До злакових рослин (райграс, грястиця, вівсяниця) чутливі 10—20 % пацієнтів. 23 % дітей мають сенсибілізацію до 5 та більше алергенів (в середньому до 3,3 ± 0,4). 52 % дітей мають супутню харчову алергію, 15 % — синдром оральної алергії, третина дітей — аденоїдні вегетації, гіпертрофію глоткових мигдалин, у 13 % алергічний риніт ускладнювався синуситом. Незадовільний клінічний ефект АСІТ пилковими алергенами асоціювався з наявністю поєднаної пилково-грибкової сенсибілізації, перехресної харчової та пилкової алергії, із сенсибілізацією до 4 та більше пилкових алергенів, з полівалентною алергією, а також спостерігався при поєднанні алергічного риніту із синуситом (р < 0,05). Висновки. Перед початком АСІТ дітям із полінозами необхідно визначити групу ризику стосовно можливої неефективності цього методу терапії та рекомендувати їм визначення специфічних імуноглобулінів класу Е до мажорних та мінорних алергенів для прогнозування ефективності АСІТ.

Коррекция носовой перегородки у детей с хирургической патологией околоносовых пазух (обзор литературы)

Diseases of a nose and paranasal sinuses are in the lead among pathology of upper respiratory tract. The incidence of chronic sinusitis in children ranges from 16 to 34%. Deviation of a nasal septum is detected in 74% of children at the age of 14 years. There are researches proving efficiency of one-stage performing septoplasty and FESS operations at adult patients. At the same time, data on efficiency and safety of carrying out onestage septum-operation and FESS at children’s age aren’t enough. Improvement of nasal breathing and providing broad access to the surgical area is a result of such interventions. It is also possible to refer decrease anesthesiology load of the child and readmission number. Carrying out low-invasive operations on structures of nose and paranasal sinuses under endoscopic control allows to reduce traumatization of a mucous membrane and improves visibility of the surgery field for the operator. Simultaneous surgical treatment of paranasal sinuses and a nasal septum deviation using methods of FESS in children is a perspective and safe method of treatment. Such surgery demands good practical skills, up-to-date equipment, correct algorithm of performing surgical intervention and also thorough observation of the patient in preoperative and postoperative periods.

Особенности биоценоза слизистой оболочки глотки и носа у больных с хронической патологией ЛОР-органов, ассоциированной с хламидийной инфекцией

Objective: to study the characteristics of microbiocenosis of throat and nose mucosa in patients with chronic pathology of upper respiratory tract associated with Chlamydia infection. In order to verify Chlamydia we implemented the methods of direct and indirect identification of infection Chlamydia trachomatis and Chlamydophila pneumonia. Laboratory study for microflora involved bacteriological tests for the material and determination of enzyme activity of expressed staphylococcus. We have studied microflora obtained from throat and nose mucosa in 84 patients with chronic ENT pathology. The main group was represented by 35 patients with verified Chlamydia, the rest of the subjects (49 participants) composed control cohort. The results of the research showed the peculiarities of quantitative and qualitative content of microbiocenosis of throat and nose mucosa in the group of patients with identified Chlamydia infection as well as the strengthening of pathogenic factors in staphylococcus isolated strains in Chlamydia infected cohort.

КЛИНИКО-ГЕМАТОЛОГИЧЕСКИЕ ОСОБЕННОСТИ ПРИ ЧАСТЫХ И РЕЦИДИВИРУЮЩИХ ЗАБОЛЕВАНИЯХ У ДЕТЕЙ

Изучены некоторые клинико-гематологические особенности у 267 часто и длительно болеющих детей в возрасте от 1 года до 15 лет включительно.Установлено, что дети раннего, дошкольного и младшего школьного возраста болели приблизительно одинаково и составили 82,8%. Часто болеющие дети с хронической патологией верхних дыхательных путей имели, преимущественно, хронический тонзиллит и аденоидит (81,1%) с проявлениями воспалительного процесса бактериального генеза и требуют реабилитации.

Innate immunity gene expression by epithelial cells of upper respiratory tract in children with adenoid hypertrophy

BackgroundA major role of the innate immunity in the defence of mucosal tissue is well established. However, a balance between the main components of the immunity such as toll-like receptors (TLRs) and defensins in the pathology of upper respiratory tract in children has not been addressed yet. Our aim was to investigate the gene expression of some TLRs as well as alpha and beta-defensins in children suffered from adenoid hyperthrophy in comparison with healthy children. MethodsSamples (nasal epithelium and adenoids) from patients with hypertrophic adenoids (n = 77) and control group (n = 33) were investigated. Quantification of HBD-1 and 2 mRNA, alpha-defensin-HNP1 and toll-like receptors (TLR) 2, 4 and 9 mRNA expression was performed by real-time polymerase chain reaction (PCR). The detection of TLR4 and TLR9 was performed by immunohistochemistry. ResultsThe main finding of the study is a dramatic up-regulation of TLR2 and TLR4 expression (but down-regulation of TLR9) along with a significant reduction in the expression of the defensins in children with adenoid hyperthrophy. ConclusionThe data suggest that one of the mechanisms of mucosal involvement in the pathogenesis of upper respiratory tract infection might by a disbalance between TLRs and defensins revealed in our study.

Особенности состояния внутриносовых структур у детей, больных сахарным диабетом 1 типа

Objective: To examine particular qualities of the intranasal structures state in children and adolescent patients with type 1 diabetes (T1D). Patients and methods. During the period of 2013–2015 161 patients with type 1 were examined having been treated at the endocrinology department of the National Children's Specialized Hospital OKHMATDET and Children's Hospital №6 (Kyiv). The study group included 138 (85.7%) patients with type-1 with the changes of intranasal structures, the control group — 23 (14.3%) patients with type-1 with no pathology of upper respiratory tract. Among children of the main group — 92 (66.67%) boys and 46 (33.33%) girls aged 6–17. All children received clinical and laboratory examination in accordance with the protocols, as well as endoscopy of the nasal cavity, nasopharynx, paranasal sinus computed tomography (if necessary). Results. The most pronounced changes of intranasal structures in children with T1D in the study group were identified in the form of the curvature of the nasal septum (IEF). Endoscopic examination of the nasal cavity and nasopharynx in children of the main group diagnosed the hypertrophy of the inferior turbinate in 54% of patients, acute rhinosinusitis — 12%, chronic adenoids, adenoid vegetations in 10%, polyps — 2%. Microcirculatory disorders according to the nail bed capillaroscopy in patients of the main group were observed 3 times more often than the control group. As a result of bulbar microscopy for children with T1D and IEF vascular changes in a single non-niformity of the caliber of vessels were identified in — 75%, unit sakkulyation venules — 50% maendricus tortuosity of the capillaries — 75%, as well as single-venular anastomoses arteriolo — 37.5%. Intra- and extravascular changes in this group of patients have not been identified. Conclusions. The results of studies in children with T1D indicate the need for timely early diagnosis of the state of intranasal structures and microcirculation to select appropriate methods of correction and treatment. Key words: nose, endoscopy, type 1 diabetes, children, adolescents.

The helth condition of middle aged school children examined in one of gymnasium in Kyiv.

Since the development of a network of gymnasium schools and an increase of psycho-emotional load of students of specialized schools, we studied the health status, physical development, and adaptive capacities of the cardiovascular system in 107 children grades 5-6 of one of the gymnasium schools in Kyiv. It was found that the structure of morbidity in 97.2% of children prevailed changes of the musculoskeletal system (mainly a combination): scoliosis and incorrect posture - at 33.6% and 36.4%, respectively; flat feet - 49%, chest deformity and residual effects of rickets - at 24.5%, the pathology of the foot arch - 49%, malocclusion, dental caries - in 11.5% of children. Gastrointestinal disease, predominantly of a functional nature, was observed in 41.1% of children. Pathology of upper respiratory tract and pathology of vision were observed in 33.7% and 24.0%, respectively.In assessing the physical development it was found out that 70.7% of gymnasium school students have an average level of physical development, while 13.3% - have higher than the average, high, or very high level of physical development; disharmonious development was detected in 21.3% of children, half of them children with 1 degree of obesity. For the development of individual recommendations as to physical activities, the adaptive capacity of the cardiovascular system was assessed by the Ruffier index. Only 10.6% of students had high or above average levels of physical health; 21.4% of students had average levels (able to attend a preparatory group). The majority (68.0%) of children registered functional reserve of the cardiovascular system as below average, i.e. according to the order of the Ministry of Health ofUkraine№518/674, they may only attend a specialized Physical Education group. Our results indicate a low level of adaptive capabilities of the cardiovascular system, the presence of combined systemic disease on the background of relatively satisfactory parameters of physical development. This requires the development of individualized rehabilitation and training programs of gymnasium school students in order to enhance their ability to meet the academic load.

Bronchial diseases and pathology of upper respiratory tract; clinical aspects and therapeutic conclusions.

Bronchial diseases and pathology of upper respiratory tract; clinical aspects and therapeutic conclusions.