Respiratory Tract Lesions Research Articles

Incidence of infectious diseases in infants under one year in the Astrakhan region in 2017-2021

The purpose of the study. To analyze the epidemiological situation of “childhood infections” among children under 1 year old for 2017–2021 in the Astrakhan region. Materials and methods. There were analyzed, epidemiological maps of infants with “children’s” infections as well as maps of inpatient sick infants who were treated in an infectious hospital. The results of the study. The main complaints of the majority of patients were fever — 87.8% and exanthema syndrome — 84.6%. In rare cases, patients showed catarrhal phenomena of the upper respiratory tract — 13.2%. Dyspeptic phenomena were observed in 15.9% of children. In rare cases, patients had angina — 0.5% and lymphadenopathy — 8.9%. Conjunctivitis and scleritis were observed in 9.6% of infants, including twelve cases with whooping cough, four with chickenpox and 58 with measles. The phenomena of meningitis were observed in one child — 0.1% with chickenpox. Lesions of the lower respiratory tract in the form of bronchitis — in 18.5% of infants, including two infants with chickenpox, 117 infants with whooping cough and 24 infants with measles. Research limitations. Epidemiological maps of infants with “childhood” infections identified in them were studied, during which data on the structure of the incidence of measles, scarlet fever, whooping cough and chickenpox were analyzed. Conclusions. The leading place in the incidence in infants falls on chickenpox, group outbreaks of which were repeatedly recorded over 2017 and 2018. There is a decrease in the incidence of infections such as scarlet fever and whooping cough among infants under the age of 1 year. During 2020–2021, against the background of general well-being, there is an increase in the number of cases of measles among children of different age groups, including among infants under the age of 1 year. The main complaints were fever and exanthema syndrome.

Unusual onset and course of Crohn’s disease in children

The purpose of the article is to demonstrate a clinical case of Crohn’s disease in an 8-year-old child. Materials and methods: The given clinical example is a case of a non-classical variant of the course of Crohn’s disease in an 8-year-old child who debuted with an upper respiratory tract lesion in combination with abdominal pain against the background of long courses of antibacterial therapy. Conclusion: This clinical case demonstrates the complexity of the diagnostic search, the need for careful history collection and differential diagnosis.

Nosological Pattern of Diseases Accompanied by Chronic Cough in Dogs

Introduction. A practicing veterinarian usually faces difficulties in both diagnosing and treating coughing in dogs. The unsolved problem in diagnosing entails doubts in the efficacy of the prescribed therapy. This is especially relevant for small dog breeds of middle and old age that often suffer from the chronic respiratory diseases and mitral insufficiency due to endocardiosis, and each of these diseases can lead to chronic cough. The aim of the research is to reveal the nosological pattern of the diseases accompanied by chronic cough in dogs.Materials and Methods. The research was based on the analysis of the medical records of 145 dogs with chronic cough that have attended to the network of veterinary clinics “Vita” (Rostov region) in the period from September 1, 2021 to July 31, 2024. The research was carried out using the following equipment: Karl Storz video bronchoscope (PAL colour system, working channel 2.3 mm, gaze direction 0°, aperture angle 120°, up/down deviation 180°/100°, depth of field 3–50 mm, working length 61 cm, outer diameter 6.2 mm); premium ultrasound scanner with improved image quality on the ZST+Mindray Vetus 9 platform; Maxivet 400 veterinary X-ray digital DR system; Poli-Spectrum–8/B computerassisted electrocardiograph; automatic hematology analyzer Idexx ProCyte Dx; automatic biochemistry analyzer Idexx Catalyst One; digital microscope Celestron.Results. The conducted research allowed us to find out the main causes of coughing in dogs. The most common cause of chronic cough found in these animals was chronic bronchitis, including that occurring simultaneously with the collapse of the upper respiratory tract. The rarest revealed cause of chronic cough was endocardiosis.Discussion and Conclusion. Coughing in dogs is not a characteristic sign of endocardiosis: even when the disease was clinically evident, coughing was observed only in the cases of lung congestion and interstitial pulmonary edema. As a rule, dogs with endocardiosis that have a pronounced loud cough intensifying after exertion, have a concomitant disease of the upper respiratory tract. Coughing in dogs with endocardiosis and upper respiratory tract lesion does not go away upon getting merely a specific endocardiosis treatment.

Damage to the organ of hearing and upper respiratory tract in vasculitis associated with antineutrophil cytoplasmic antibodies

Antineutrophil cytoplasmic antibodies associated vasculitis (ANCA-AV) is a systemic necrotizing granulomatous vasculitis affecting mainly small-caliber vessels. ANCA-AV occupy a special place among systemic vasculitis, which is characterized by a highly active life-threatening course of the disease, requiring rapid differential diagnosis and aggressive immunosuppressive therapy. The ANCA-AV group consists of 3 nosologies: granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis. The “calling card” of ANCA-AV is the lesion of the upper respiratory tract, especially the ENT organs (70–100 % of patients). The nasal cavity and paranasal sinuses are the most common areas of lesion in the head and neck (85–100 %), whereas ear damage occurs in about 35% (range, 19–61 %) of cases. Lesion of the ENT organs is typical for the debut of ANCA-AV, which makes early diagnosis difficult, since diseases of the upper respiratory tract are extremely common in all age groups. Diagnosis verification occurs mainly at the stage of generalized involvement of many organs and systems, causing severe course with the development of pulmonary-cardiac and renal insufficiency, which lead to the death of the patient. The main ENT manifestations of ANCA-AV can be grouped into several groups: sinonasal, otological, tracheobronchial, oral cavity lesions and others. Pseudotumors are often found in ANCA-AV. They are characterized by the appearance of parapharyngeal, parotid, submandibular, paratracheal volumetric formations. As a rule, the appearance of tumor-like formations is observed at an early stage of the disease and is associated with the presence of antibodies to proteinase 3, systemic manifestations of vasculitis. Pseudotumor in the ENT region may be accompanied by secondary neuropathies of cranial nerves, destruction of bone tissue, which requires histological verification of the disease.

Gene editing of pigs to control influenza A virus infections

ABSTRACT Proteolytic activation of the haemagglutinin (HA) glycoprotein by host cellular proteases is pivotal for influenza A virus (IAV) infectivity. Highly pathogenic avian influenza viruses possess the multibasic cleavage site of the HA which is cleaved by ubiquitous proteases, such as furin; in contrast, the monobasic HA motif is recognized and activated by trypsin-like proteases, such as the transmembrane serine protease 2 (TMPRSS2). Here, we aimed to determine the effects of TMPRSS2 on the replication of pandemic H1N1 and H3N2 subtype IAVs in the natural host, the pig. The use of the CRISPR/Cas 9 system led to the establishment of homozygous gene edited (GE) TMPRSS2 knockout (KO) pigs. Delayed IAV replication was demonstrated in primary respiratory cells of KO pigs in vitro. IAV infection in vivo resulted in a significant reduction of virus shedding in the upper respiratory tract, and lower virus titers and pathological lesions in the lower respiratory tract of TMPRSS2 KO pigs as compared to wild-type pigs. Our findings support the commercial use of GE pigs to mitigate influenza A virus infection in pigs, as an alternative approach to prevent zoonotic influenza A transmissions from pigs to humans.

Establishment of a real-time fluorescent quantitative PCR detection method and phylogenetic analysis of BoAHV-1

BackgroundInfectious bovine rhinotracheitis (IBR), caused by Bovine alphaherpesvirus-1 (BoAHV-1), is an acute, highly contagious disease primarily characterized by respiratory tract lesions in infected cattle. Due to its severe pathological damage and extensive transmission, it results in significant economic losses in the cattle industry. Accurate detection of BoAHV-1 is of paramount importance. In this study, we developed a real-time fluorescent quantitative PCR detection method for detecting BoAHV-1 infections. Utilizing this method, we tested clinical samples and successfully identified and isolated a strain of BoAHV-1.1 from positive samples. Subsequently, we conducted a genetic evolution analysis on the isolate strain’s gC, TK, gG, gD, and gE genes.ResultsThe study developed a real-time quantitative PCR detection method using SYBR Green II, achieving a detection limit of 7.8 × 101 DNA copies/μL. Specificity and repeatability analyses demonstrated no cross-reactivity with other related pathogens, highlighting excellent repeatability. Using this method, 15 out of 86 clinical nasal swab samples from cattle were found to be positive (17.44%), which was higher than the results obtained from conventional PCR detection (13.95%, 12/86). The homology analysis and phylogenetic tree analysis of the gC, TK, gG, gD, and gE genes of the isolated strain indicate that the JL5 strain shares high homology with the BoAHV-1.1 reference strains. Amino acid sequence analysis revealed that gC, gE, and gG each had two amino acid mutations, while the TK gene had one synonymous mutation and one H to Y mutation, with no amino acid mutations observed in the gD gene. Phylogenetic tree analysis indicated that the JL5 strain belongs to the BoAHV-1.1 genotype and is closely related to American strains such as C33, C14, and C28.ConclusionsThe established real-time fluorescent quantitative PCR detection method exhibits good repeatability, specificity, and sensitivity. Furthermore, genetic evolution analysis of the isolated BoAHV-1 JL-5 strain indicates that it belongs to the BoAHV-1.1 subtype. These findings provide a foundation and data for the detection, prevention, and control Infectious Bovine Rhinotracheitis.

The population morbidity with diseases of ear and mastoid and accessibility of otorhinolaryngological care

The article analyses level and dynamics of morbidity of diseases of ear and mastoid in the Sakha Republic (Yakutia) in 2020-2021 and availability of otorhinolaryngological care. The methods of comparative statistics and mathematical analysis were applied to analyze official data provided by the Yakut Republic Medical Information and Analytical Center, the specialized Department of Otorhinolaryngology, the Republic Hospital № 2 - Center for Emergency Medical Care and the Federal State Statistics Service of Russia. The study established increasing trend of increasing morbidity of these diseases in both the adult and child population. In 2021, the growth rate of overall morbidity of adult population reached 17.7% and 8.8% in children, as compared to 2020. The primary morbidity of adults made up to 22.3%, in children - 15.7%. The comparative analysis demonstrated higher rates of general morbidity in the Republic: by 0.5% as compared with the Russian Federation and by 14.1% as compared with the Far Eastern Federal Okrug. The level of primary morbidity was lower than similar indicators of the compared territories by 17.1% and 3.0%, respectively. It is worth noting that analyzed morbidity of diseases of ear and mastoid reflects prevalence of ENT diseases in the region only indirectly, as the statistical data do not allow to estimate separately rate of upper respiratory tract lesions. Meanwhile, respiratory diseases rank first in the structure of population diseases in Yakutia. The growth of disability in children due to diseases of ear and mastoid requires attention. Among children of 0-17 years old, the indicator of primary disability increased from 0.38 to 0.8 per 10,000 of children population (increase of 110.5%); in children 0-3 years old - from 0.9 to 2.3 per 10,000 of the child population (an increase of 155.6%). The analysis of the number of beds in otorhinolaryngology wards established that that the bed capacity per 10,000 population was 0.6 that is significantly lower than the established standards. The article emphasizes need to adjust the Federal standards for hospital bed capacity, taking into account climatic and geographical conditions of the region, which contribute to spread and chronization of ENT diseases.

Detection and typization of HPV genotypes in subjects with oral and upper respiratory tract lesions, Milan, Italy

Background Oral human papillomavirus (HPV) is common among healthy individuals but causes and implications of persistent infections are under evaluation in the pathogenesis of head and neck neoplasms. Methods This was a retrospective study evaluating the prevalence of high-risk (HR), probable HR and low-risk (LR) HPV types in patients reporting signs/symptoms of oral and upper respiratory tract lesions. Individuals attending between 2019 and 2022 a University Hospital in Milan, Italy, with risk factors for HPV (unprotected oral sex and/or previous documentation of HPV infection in oral and upper respiratory tract and/or another anatomical site) were included. Results Fourteen out of 110 (12.7%) individuals tested positive for HPV DNA. The prevalence of HR-HPV and LR-HPV was 3.6% (4/110) and 9.1% (10/110), respectively. No probable/possible HR-HPV was detected. Specifically, 10/110 (9.1%) were diagnosed with 1 LR-HPV genotype, 3/110 (2.7%) were infected with 1 HR-HPV and 1/110 had 3 concomitant HR-HPV types. HPV 16 (2.7%, 3/110) and 6 (4.5%, 5/110) were the most common HR and LR types, respectively. One patient positive for HPV 16, 33 and 35 was diagnosed with cancer at the base of the tongue. Two individuals among those who tested positive for HPV DNA reported previous HPV vaccination. Conclusions Our data, in line with observations from previous prevalence studies, support the potential role of HPV in head and neck neoplasms. HPV DNA testing should be performed in patients presenting lesions in oral/respiratory tracts and risk factors for HPV. Improvement in HPV vaccination coverage is warranted.

Clinical Manifestations of COVID-19 in Different Periods of the Pandemic in Persons from Occupational Risk Groups of Infection

Relevance. One of the most affected by the new coronavirus infection (COVID-19) groups of the population were medical workers who have high risks of infection in the performance of professional dutiesAim. Analysis the clinical manifestations of COVID–19 in different periods of the pandemic in medical organizations, taking into account the genetic variability of circulating strains of SARSCoV- 2 and vaccination status.Materials and methods. To study the clinical manifestations of coronavirus infection, an online survey of medical workers in a large industrial region was conducted in March 2022 using a specially designed anonymous questionnaire. The total number of respondents was 3,078. Clinical manifestations were analyzed during five epidemic rises in the incidence of COVID-19 from March 2020 to March 2022. To assess the SARS-CoV-2 virus strains circulating in the region, data from the GISAID database (the first and second waves of the pandemic, n = 298) and the results of PCR studies in the laboratory of UMMC-Health LLC (third - fifth waves, n = 349) were used.Results and discussion. In the first and second epidemic rises of morbidity associated with SARS-CoV-2 strains B.1. and B.1.1, the structure of clinical forms did not significantly differ: 3.6% and 3.9% were asymptomatic forms, 61.3% – variants of acute respiratory infection (AR I) and 35.1% and 34.8% - pneumonia, accordingly. In the third epidemic upsurge caused by the Delta variant (V.1.617.2), the structure of clinical forms did not undergo significant changes. In the fourth epidemic rise in morbidity, also associated with the spread of the Delta variant, the share of ARI in the structure of clinical forms increased to 77.0%, and pneumonia decreased to 21.3%.In the fifth wave of the pandemic caused by the Omicron gene variant (B.1.1.529), there was an increase to 91.3% of the proportion of mild clinical forms and a decrease to 7.1% of forms with lung damage. The frequency of detection of general infectious symptoms, upper respiratory tract lesions and neurological manifestations of COVID-19 had statistically significant differences in different periods of the pandemic. Whereas the frequency of gastrointestinal disorders did not significantly differ. The high clinical efficacy of vaccination has been shown – in ter ms of a 3.6-fold reduction in the chances of developing moderate and severe forms of the disease.Conclusion. Based on the results of the study, new data were obtained on the features of the clinical manifestations of COVID-19 in different periods of the pandemic with the change of genetic variants of the pathogen and the role of vaccination in preventing the development of moderate and severe clinical forms of infection was shown.

КЛИНИЧЕСКАЯ, ЭПИДЕМИОЛОГИЧЕСКАЯ И ЛАБОРАТОРНАЯ СПЕЦИФИКА НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИИ У ДЕТЕЙ

Background. COVID-19 is characterized by high contagiousness in all population groups, however, children are more likely to carry the infection both asymptomatically and in a mild form. The characteristics of COVID-19 in children require analysis and a search for a risk factors for severe course. Objective. To study the clinical, epidemiological, and laboratory specifics of the new coronavirus infection in children permanently resident in Bronnitsy, Moscow region, to conduct a comparative analysis of the occurrence of the main factors affecting the severity of COVID-19, including the level of body supply with vitamin D and iron. Methods. Among the patients examined, school age children predominated (61.3%). The disease was predominantly mild and infection in 89.1% of cases in family centers as a result of close contact with sick family members. The symptoms of the disease were nonspecific in nature of upper respiratory tract lesions (fever, cough, symptoms of nasopharyngitis). Patients with moderate COVID-19 had lower hemoglobin, erythrocytes, lymphocytes, platelets, and ESR (p<0.05). A decrease in iron and 25(OH) levels was revealed in the blood serum of children with COVID-19. Results. School-age children predominated among the examined patients (61.3%). The disease was predominantly mild and infection in 89.1% of cases in family centers as a result of close contact with sick family members. The disease was predominantly mild and the symptoms were nonspecific in nature, catarrhal inflammation of the upper respiratory tract (fever, cough and signs of nasopharyngitis). Patients with moderate COVID-19 had lower hemoglobin, erythrocytes, lymphocytes, platelets, and ESR (p<0.05). A decrease in serum iron and 25(OH)D concentration indices was revealed in children who had undergone COVID-19. Conclusions. Among those infected with COVID-19, school-age children with asymptomatic and mild disease prevailed. The infection clinic presented with catarrhal symptoms, including fever, cough, and signs of nasopharyngitis. In the moderate course of COVID-19, the chances of anemia in children increased (OR= 2.56), as well as the indicators of iron availability and VD status decreased, which requires further study.

Evaluation of the diagnostic yield of lung cancer on various Bronchoscopic modalities

Background: The application of cytological techniques in identifying malignant respiratory tract lesions has been widely praised as a significant achievement. Flexible fiberoptic bronchoscopy has greatly transformed respiratory cytology, making procedures such as bronchial brushings, broncho-alveolar lavage, and bronchial forceps biopsy more convenient, accessible, and popular. Methodology: All the suspected cases of lung cancer from 1st Jan, 2020 - 31st Dec, 2022 fulfilling inclusion criteria who have undergone flexible bronchoscopy in our center have been analyzed and enrolled in the study. Results: Out of 90 patients, 85 were found to be malignant. Squamous cell carcinoma was the most common carcinoma (31.1%) followed by adenocarcinoma (26.7%), non-small Cell Lung Carcinoma (17.8%) and small cell carcinoma (12.2%), majority of the cases were of 6-7th decade of life and were smoker. Sensitivities of Bronchoalveolar Lavage (BAL), Bronchial brush, Endobronchial forceps Biopsy (EBB), Transbronchial Lung Biopsy (TBLB) and Transbronchial Needle Aspiration (TBNA) were found to be 32%, 87%, 83%, 55% and 69% respectively. Diagnostic accuracy of BAL, bronchial brush, EBB, TBLB and TBNA were found to be 36%, 87%, 83%, 55% and 61% respectively. Conclusion: With a greater sensitivity (87%) and diagnostic accuracy (87%), bronchial brushing shows great promise as a convenient cytological technique suitable for screening ambiguous cases and early detection of lung cancer, as it saves the time required for processing biopsy samples.

Avian colibacillosis – current aspects

Colibacillosis is a bacterial disease of humans, animals and birds caused by Escherichia coli, pathogenic gram-negative bacillus. Despite its secondary nature, colibacillosis widely affects poultry farms and causes significant economic losses. The disease spread is closely associated with antibiotic resistance problem because a diseased carrier bird may be a reservoir of antibiotic-resistant Escherichia coli strains. In addition, genes of virulence and resistance have been proven to be transferred from avian Escherichia strains toextra intestinal pathogenic strains that are dangerous to humans. Colibacillosis is transmitted aerogenically, alimentally, rarely transovarially, with droppings, mucus, feed, water, handling tools and operating personnel. Birds are most susceptible attheage of1–14days and at the onset of laying period. The disease may present asacute, subacute and chronic forms and is most often manifested by catarrhal hemorrhagic enteritis with profuse foamy diarrhea, respiratory tract lesions, fibrinous peritonitis and polyserositis, as well as a significant decrease in weight gains, stunting, egg laying decrease or complete cessation. Colibacillosis is diagnosed comprehensively taking into account the epizootic situation, findings of clinical examination and postmortem examination of dead or emergency-slaughtered poultry as well as laboratory test and bioassay results. Bacteriological, serological and molecular genetic methods are used for the disease diagnosis. Colibacillosis prevention includes improvement of poultry keeping practice (control of feed and water quality, disinfection, pest control, microclimate control) as well as timely complex vaccination of all poultry. The disease shall be treated taking into account primary etiological factors and bacteria sensitivity to antimicrobials.

Поражения глаз при гранулематозе Вегенера

Wegener's granulomatosis, also called granulomatosis with polyangiitis, is a primary systemic necrotizing vasculitis of small and medium-sized vessels with the formation of granulomatous inflammation. This is a severe, progressive disease, presumably of autoimmune nature, which without basic treatment – immunosuppressive therapy (suppression of disease activity, remission maintenance and episodic therapy) can lead to the death of the patient. Upper respiratory tract, eye, lung and kidney lesions prevail in the clinical picture of Wegener's granulomatosis. Ocular manifestations often appear at early stages of the disease and are associated with upper respiratory tract and/or middle ear inflammation. Wegener's granulomatosis can affect any segment of the eye, most often the anterior segment and much less often the posterior, and can present in the form of minor and moderate ocular inflammation (scleritis, keratitis, etc.) or severe disorders of all structures and orbits (pseudotumour) leading to low vision and even blindness. Difficulties in the diagnosis of Wegener's granulomatosis arise from a variety of forms and ways of clinical progression at early stages of the disease, when ophthalmic changes are not very specific. In order to establish the correct diagnosis, it is necessary to compare biopsy results (characterized by granulomatous inflammation and vasculitis of small vessels, areas of necrosis) with clinical laboratory assessments. The refractory course of pathological process in the orbit, eye and its appendages, especially if the patient has some atypically occurring pathological processes in the upper respiratory tract and/or sinuses and lungs, should be a warning sign for a doctor to use an interdisciplinary approach for the diagnosis and treatment. Key words: Wegener's granulomatosis, granulomatosis with polyangiitis, systemic necrotizing vasculitis, eye disorder, scleritis, orbital pseudotumour

A case of laryngeal tuberculosis mimicking supraglottic carcinoma in a pregnant patient and literature review

Tuberculosis (TB) is the most common granulomatous disease, but laryngeal involvement is rare. The risk of developing this clinical form is higher in immunocompromised patients due to primary infection or reactivation of latent TB. Laryngeal TB can be misdiagnosed as laryngeal cancer since they have similar macroscopic lesions, and both cause dysphonia. We present a case of laryngeal TB in a 37-week pregnant patient who complained of dysphonia, odynophagia, and dysphagia. A mass with supraglottic carcinoma findings was discovered during a laryngoscopic examination. The reason for presenting this case is to emphasize the necessity for a high degree of suspicion for laryngeal TB involvement in patients with upper respiratory tract lesions in regions with high TB prevalence, to achieve early diagnosis and treatment.

Use of Saccharomyces boulardii to Prevent Antibiotic-associated Diarrhea in Children with Pneumonia and Bronchitis

In recent years, an increase in the prevalence of antibiotic-associated diarrhea (AAD) in children has been registered. In modern conditions, there are changes in the microbial spectrum of AAD pathogens and their sensitivity to antimicrobial drugs. This indicates the need for further research on the effectiveness and safety of the use of antidiarrheal drugs, in particular Saccharomyces boulardii (SB), in clinical practice. The objective: to analyze the clinical effectiveness and safety of the use of SB in the prevention of AAD manifestations in children. Materials and methods. The results of examination and treatment of 84 children aged 1 to 16 years with pneumonia (n=50) and acute bronchitis of bacterial etiology (n=34) were analyzed. Patients comparable in age, gender, etiology and clinical form of acute respiratory disease were divided into two research groups: I (main) group – 44 children who received SB for a course of 10–12 days in complex treatment (antibacterial and symptomatic therapy) and II (control) group – 40 patients who received only antibiotic therapy and did not take probiotic drugs. During the study, the condition of the digestive tract (appetite, presence of nausea and vomiting, frequency and severity of diarrhea), skin (dryness, drowsiness), nervous system (sleep disturbances, restlessness) was assessed. Results. At the beginning of the study there was no statistical difference between the frequency of pathological symptoms in the research groups. In the course of treatment, positive dynamics of clinical manifestations of respiratory tract lesions were observed in children in the groups. In the patients of the I group who received SB, on the 10th day all patients had formed stools, while in the II group, on the 10th day diarrhea was detected in 12 (30%) of 40 children (p<0.01). In the dynamics of treatment on the 10th–12th day, the decrease in the number of bifidobacteria (<1010) was found in 2 (6.7%) of 30 children of the I group and in 15 (60%) of the 25 children of the II group (р<0.01). A decrease in the number of lactobacilli (<107) was found in 1 (3.3%) of 30 children of group I and in 9 (36.0%) of 25 patients of group II (p<0.05). On the 10th–12th day, it was possible to achieve complete normalization of intestinal function in almost all children of the I group. There were no side effects during the use of the drug. Conclusions. The use of SB simultaneously with antibacterial therapy made it possible to reliably reduce flatulence and intestinal colic in 86.4–88.6% of children on the 5th day of complex treatment. In the main group the frequency and consistency of bowel movements quickly normalized. Such dynamics of clinical symptoms was not observed in the comparison group.

Features of COVID-19 in teenagers. Clinical cases

Coronavirus infection in childhood is a common disease and has a number of features of the clinical course. There remain quite a lot of problems related to the variety of clinical symptoms, the severity of the course and treatment tactics in different age categories. Purpose - to study the epidemiological and clinical features of the coronavirus disease COVID-19 in adolescents compared to the younger age group in order to predict the severity of the course and determine treatment tactics. Materials and methods. A single-center retrospective open cohort study of 188 patients under the age of 18 hospitalized in the infectious disease department of the Chernivtsi Regional Children’s Clinical Hospital with a confirmed respiratory infection caused by SARS-CоV-2 was conducted. This cohort of patients is divided into 2 clinical groups. The Group I consisted of children aged 12 to 18 years (43 children), the Group II included children aged 0 to 11 years (145 patients). Results. Epidemiologically, extrafamilial sources of infection prevail in adolescence in the range of 44.2% (n=19), which is explained by greater social activity compared to children from birth to 11 years of age. For the 1st observation group, symptoms of damage to the lower respiratory tract are more characteristic, in particular, cough 81.4% (n=23), shortness of breath 51.1% (n=22), hypoxemia 14.2% (n=6) and symptoms of associated with intoxication syndrome (general weakness, asthenia 97.6% (n=42), decreased appetite, refusal to eat 74.4% (n=32), myalgia 11.6% (n=5), headache 14,2% (n=6)). The severity of the course of the coronavirus infection in adolescence is due to the dominance of lower respiratory tract lesions with the development of pneumonia in 58.2% (n=25) of cases, which required longer and more intensive treatment. Conclusions. The share of adolescents hospitalized due to COVID-19 was 22.9% (n=43), among them with a severe degree of impairment of the general condition - 16.4% (n=7), which is due to the predominance of damage to the lower respiratory tract with the development of pneumonia in 58.2% (n=25) of cases. This cohort of patients is characterized by a longer intoxication syndrome, the epidemiological role of family contacts with regard to COVID-19 decreases, and the value of unidentified non-familial sources of infection increases - 44.2% (n=19). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research. No conflict of interests was declared by the authors.

Viral Conjunctivitis: Findings, Therapy, and Prophylaxis

Viral conjunctivitis is one of the most common acute eye diseases. The fall and winter months are known to be the main season for viral infections which is also reflected in the ophthalmological outpatient clinics. Viral conjunctivitis is often accompanied by symptoms of the upper and lower respiratory tract, fever, chills, arthralgia or skin lesions. The spectrum of pathogens comprises DNA viruses such as Adeno-, Herpes simplex and Molluscum contagiosum as well as RNA viruses. Symptoms caused by pandemic pathogens such as SARS-CoV-2 and mpox viruses can also cause ocular manifestation. Viral conjunctivitis is often self-limiting leaving no residual symptoms, however an ophthalmologist should be consulted if there are inflammatory symptoms of the anterior eye accompanied by visual disturbance. It is particularly important to recognize the affection of corneal or even intraocular structures early to initiate an adequate and effective therapy. Affection of the cornea, vitreus or retina can result in temporary or permanent impairment of the field of vision and visual acuity. The diagnosis is usually made without further tests on the basis of the typical clinical presentation. Rapid tests or PCR diagnostics are also available for confirmation. In most patients the treatment is symptomatically with artificial tears and antibiotic eye drops in cases accompanied by secondary bacterial infections, not prophylactically. If the cornea or other ocular structures are affected by certain viruses, local as well as systemic virostatic therapy is initiated. The most important prophylactic measure is meticulous and consistent hygiene.

FEATURES OF CLINICAL MANIFESTATIONS OF COVID-19 IN CHILDREN OF THE FIRST YEAR OF LIFE

During the 3 years of the COVID-19 pandemic, the proportion of children, including children of the first year of life, increased in the structure of cases. The aim of the study is to study the features of COVID-19 in children of the first year of life during the period of active involvement of children of this age in the epidemic process. The article presents a comparative analysis of the clinical and laboratory features of COVID-19 in two observation groups: 49 children aged 1 month to one year and 61 children aged one to 10 years. Clinical symptoms of COVID-19 in infants in most cases are characterized by moderate catarrhal manifestations, normal or subfebrile temperature, absence of clinical signs of lower respiratory tract lesions and respiratory failure. According to CT scans of the chest organs, almost half of the children have lung tissue damage (mainly CT-1). According to the results of laboratory examination, the majority of patients (51-82%) have an increase and long-term preservation of pathological parameters of intracellular enzymes (ASAT, CPK, especially LDH) up to 2-3 norms, blood lactate, D-dimer. Thus, there is a discrepancy between the clinical manifestations of the disease and the detected laboratory parameters.

In-feed nutritional additive probiotic Saccharomyces boulardii RC009 can substitute for prophylactic antibiotics and improve the production and health of weaning pigs.

Non-therapeutic antibiotic use is associated with the current decrease in antibiotic therapeutic efficiency and the emergence of a wide range of resistant strains, which constitutes a public health risk. This study aimed to evaluate the use of Saccharomyces cerevisiae var. boulardii RC009 as a nutritional feed additive to substitute the prophylactic use of antibiotics and improve the productive performance and health of post-weaning piglets. Four regular nutritional phases were prepared. Post-weaning pigs (21-70 days old) received one of two dietary treatments: T1-basal diet (BD-control group) with in-feed antibiotics as a prophylactic medication (one pulse of Tiamulin in P3 and one pulse of Amoxicillin in P4); and T2-BD without in-feed antibiotics but with Saccharomyces boulardii RC009 (1 × 1012 colony forming unit/T feed). The feed conversion ratio (FCR), total weight gain (TWG-kg), and daily weight gain (DWG-kg) were determined. A post-weaning growth index (GI) was calculated and animals (160 days old) from each treatment were analyzed at the abattoir after sacrifice for carcass weight and respiratory tract lesions. Pigs consuming probiotics had higher TWG and DWG than the control group. The group of animals with low body weight obtained the same results. Saccharomyces boulardii administration decreased diarrhea, and FCR reduction was related to a GI improvement. A significant increase in carcass weight and muscle thickness reduction was observed in animals received the probiotic post-weaning. Saccharomyces boulardii RC009, a probiotic additive, was found to improve the production parameters of pigs post-weaning and enhance their health status, indicating that it may be a promising alternative to prophylactic antibiotics.

Primary ciliary dyskinesia in a young woman: case report with challenged transition from pediatrics to adult network

Primary ciliary dyskinesia (PCD) is a rare genetic autosomal recessive disease associated with a defect in the ultrastructure of epithelial cilia. Currently, there is no standard method for diagnosing PCD, so the diagnosis is based on the clinical picture and the results of tests, such as DNA diagnostics, nasal nitric oxide measurements, ciliary beat frequency in a nasal biopsy, ciliary ultrastructure, etc. Diagnosis of PCD can be difficult due to secondary damage to the respiratory epithelium, which often results in undiagnosed or false positive cases. Differential diagnosis with diseases forming widespread bronchiectasis (BE) and upper respiratory tract lesions, especially with cystic fibrosis (CF), is necessary.The aim of this paper is to introduce the difficulties of diagnosis, the appropriate level of detail of the clinical, laboratory and instrumental characteristics over a long period of time, and the organization of care for a patient with PCD. This article describes a clinical case of PCD in a young woman, diagnosed at the age of 17, presents the difficulties and typical mistakes in the management of such patients, and the lack of succession of pediatrician-pulmonologist care.Conclusion. The presented clinical case demonstrates how difficult the diagnosis of PCD is. Such patients need a complex examination, a thorough differential diagnosis to exclude other diseases with a similar clinical picture. Long-term follow-up is carried out by a multidisciplinary team with mandatory microbiological monitoring. The organized care for patients should begin in early childhood and continue in adulthood with proper succession of care and follow-up by of pulmonologist, preferably in specialized centers.