Pathology Of Respiratory Tract Research Articles

Air Pollution as a Problem of the Modern World

Research relevance: the development of diseases and pathological conditions caused by air pollution depends on the types of pollutants, their physical and chemical characteristics, while air pollution increases the incidence of respiratory diseases. Research objectives: to develop a scheme for the pathogenesis of the development of immunological disorders in the body of people living in conditions of exposure to atmospheric air pollutants, to conduct a statistical analysis of factors influencing the development of allergic rhinitis and the development of bronchial asthma. Research materials and methods: a study of the characteristics of atmospheric air was carried out in three places in Kyrgyzstan: in the area of ​​the village Papan, near the village Gulbar, and Aravan district and near the Osh city. The study was an open, prospective, non-interventional, observational study in parallel groups. The study participants included residents of three regions of the Kyrgyz Republic, depending on the degree of air pollution. Research results: the data obtained indicated that people living in different regions of the Kyrgyz Republic with varying degrees of atmospheric pollution exhibit significant differences in indicators indicating pathology of the upper respiratory tract and allergization of the body. Conclusions: The harmful effects of air pollution and climate change on human health can be largely prevented through the timely adoption of the necessary legislation.

Досвід застосування засобу «Біоплазмікс спрей для горла» в комплексному лікуванні гострих вірусних фарингітів у дітей з атопічним фоном

The problem of therapy of acute respiratory infections in children remains relevant. The most common infectious pathology of the upper respiratory tract in both children and adults is acute viral pharyngitis. Irrational prescribing of antibiotics leads to medication-induced side effects and the spread of resistance of microorganisms to antibiotics in society. Topical application of respiratory probiotics may be an important component in the supportive treatment of acute respiratory infections and reducing antibiotic dependence. The use of probiotics in children with an atopic background is of particular importance due to the possible occurrence of adverse reactions. Purpose - to assess the safety and effectiveness of the local application of Bioplasmix throat spray in the complex treatment of acute viral pharyngitis in children with an atopic background. Materials and methods. 45 children aged 6-18 years with acute viral pharyngitis took part in the study. 2 research groups were formed: the Group I - main (n=25) - received protocol treatment + Bioplasmix throat spray locally and the Group II - comparison (n=20) - only protocol treatment. All patients were assessed for the severity of clinical symptoms (fever, headache, sore throat, scratching, cough) and oropharyngoscopy data (hyperemia, swelling of the mucous membrane of the oropharynx, granularity of the back wall of the pharynx) on the 1st, 2nd, 3rd, 4th, 5th and 7th days of using the product. Results. The use of the local application of Bioplasmix throat spray for acute pharyngitis in children ensures a faster reduction in the severity of the main clinical manifestations and signs of inflammation of the oropharynx. In the Group I, compared to the Group II, there were better indicators of a decrease in the severity of cough (1.2±0.91 points vs. 1.76±0.85 points), a scratching (1.12±0.92 points vs. 1.7±0.86 points), sore throat (1.6±0.81 points vs. 2.23±0.76 points) and hyperemia of the pharynx (1.4±0.7 points vs. 2.1±0.9 points) from the 3rd day, swelling of the pharynx (1.22±0.86 points vs. 1.8±1.04 points) from the 4th day. Adverse reactions were not noted during the use of the local application of Bioplasmix throat spray. Conclusions. Local probiotic therapy is an important component of the complex therapy of acute pharyngitis, the use of bacteria of the genus Bacillus in the form of Bioplasmix throat spray shows a positive effect on the course of acute viral pharyngitis in children, which manifests by a faster decrease in the severity of subjective symptoms of pharyngitis and inflammatory signs of the oropharynx. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Dynamic indicators of acute respiratory diseases treatment in children after correction.

Aim: To study the Respiratory pathology of the upper respiratory tract, markers of the inflammatory response of the organism, Oxidative stress, Metabolic adaptation and possibilities of correction. Materials and Methods: The study group (n=111) included school-aged children (10-14 years old). The general group of inflammatory diseases of the respiratory tract (J000-J06) was considered, with a diagnosis of acute respiratory infection (ARI) of viral and bacterial origin and included local inflammationof the upper respiratory tract with presentation of acute pharyngitis (68.0%), acute bronchitis (22,0%), acute tonsillitis (10,0%). Results: Dynamic observation of groups of children who received optimized (group 1, n=60) and basic (group 2, n=51) treatment was carried out. The level of the erythrocyte pool correlated with IL-1 (r=-0,29, p=0,03), IL-4 (r=0,32, p=0,01), TNF-α (r=-0,35 , p=0,006). Creatinine value correlated with IL-10 (r=0,3, p=0,005), γ-IFN (r=0,42, p=0,001), TNF-α (r=0,25, p=0,05). Correlations of ferritin presented positive correlation values with the level of total protein (r=0,26, p=0,04) and TNF-α (r=0,41, p=0,001). Conclusions: After the optimized treatment, there was a significant decrease in the reliable levels of CRP and γ-IFN by 7 and 4,4 times (by groups) and 5,8 and 3,2 times (by groups), respectively. Correlation relationships of urea levels with IL-2,4 were detected. The level of the erythrocyte pool correlated with IL-1,4, TNF-α, Ferritin presented positive correlation values with the level of total protein,TNF-α .

REGRESSION MODELS OF THE AREA OF THE SOFT PALATE AND TONGUE IN YOUNG MEN AND YOUNG WOMEN WITH AN ORTHOGNATHIC BITE WITHOUT AND TAKING INTO ACCOUNT THE TYPE OF FACE DEPENDING ON TELEROENTGENOMETRIC INDICATORS OF THE UPPER RESPIRATORY TRACT

The prevalence of pathologies related to the soft palate and its surrounding structures is a serious challenge for medicine. Sleep apnea and other diseases directly related to this anatomical region pose a threat not only due to the actual cause of deaths, but also complications of concomitant diseases. In this regard, the definition of normative indicators of the upper respiratory tract, in particular the soft palate and its surrounding structures, is a relevant topic for study. The purpose of the work is to build and analyze the regression models of the area of the soft palate and tongue in young men and young women with an orthognathic bite without and taking into account the type of face, depending on the features of teleroentgenometric indicators of the upper respiratory tract. With the help of the licensed medical software OnyxCeph³™, version 3DPro and the diagnostic program “UniqCeph”, a cephalometric analysis of lateral teleroentgenograms of 49 young men and 76 young women with an orthognathic bite and the absence of upper respiratory tract pathology was performed (primary teleroentgenograms were obtained from the database of the Research Center and Department of Pediatric Dentistry, National Pirogov Memorial Medical University, Vinnytsia). Face types in young men and young women were determined using the Garson index. Regression models of the area of the soft palate and tongue depending on teleroentgenometric indicators of the upper respiratory tract were built using the license package “Statistica 6.0”. In Ukrainian young women with an orthognathic bite, regardless of face type, with very wide and wide face types, all possible models of the area of the soft palate and tongue were built depending on teleroentgenometric indicators of the upper respiratory tract with a coefficient of determination (R2) greater than 0.5 (R2= from 0.682 to 0.937, p<0.001), which most often include the thickness of the soft palate and the length of the soft palate (42.9 % each), tongue height and tongue length (30.0% each), the value of the position of the hyoid bone relative to the vertical mandibular plane and the angle of inclination of the soft palate (20.0 % each). In Ukrainian young men with an orthognathic bite without taking into account the type of face and with a wide face type, all possible models of the area of the soft palate and tongue were also built depending on teleroentgenometric indicators of the upper respiratory tract with a coefficient of determination greater than 0.5 (R2= from 0.562 to 0.925, p<0.001), which most often include the thickness of the soft palate and the length of the soft palate (33.3 % each).

Non-specific prevention of respiratory infections during vaccination against COVID-19

The novel coronavirus infection (COVID-19) has a suppressive effect on innate immunity, which is a prerequisite for developing strategies to enhance this non-specific link as a preventive measure to protect against other respiratory infections during the ongoing circulation of mutating strains of the SARS-CoV-2 virus. Despite the currently developed and available preventive measures, it has been noted that in persons who have undergone COVID-19, repeated episodes of both coronavirus infection and diseases caused by other pathogens have been recorded.
 This review analyzes data from the biomedical literature and considers examples of health risks associated with continued infection with pathogens that cause respiratory tract pathologies. It also reflects the ways and approaches of possible preventive measures, the purpose of which is to prevent the development of pathologies of both the respiratory organs and other systems.

The Risk of Developing of Malnutrition and the Principles of Correction of Nutritional Status Disorders in Children with Cystic Fibrosis

Cystic fibrosis is a severe hereditary disease with polysystemic manifestations and progressive course. Malnutrition in cystic fibrosis occurs as a result of exocrine insufficiency of the pancreas, an increase in energy losses in chronic inflammation in the bronchopulmonary system, manifested by increased stress on the respiratory system. The presented literature review highlights the modern principles of prevention and correction of malnutrition in children with cystic fibrosis, identifies the most promising methods for further development that correct nutritional status disorders. The review has shown that an active approach to nutrition at any age, the use of aggressive methods of nutritional support against the background of enzyme replacement therapy, timely and adequate therapy of respiratory tract pathology lead to an improvement in the indicators of nutritional status in cystic fibrosis. The most promising is the further development of targeted therapy, which allows, as a result of exposure to the etiopathogenetic mechanisms of the disease, to reduce the frequency and severity of bronchopulmonary exacerbations, partially restore the exocrine function of the pancreas, which is manifested in patients with cystic fibrosis by an increase in body weight and mass-growth index.

Human parechovirus infections in children: modern concepts

This article is a review of modern ideas about human parechovirus infection in children. At this time human parechoviruses are a common cause of infectious diseases in childhood with clinical presentation of acute gastroenteritis, upper respiratory tract pathology, fever, and rash. Severe forms damaging the central nervous system or the development of sepsis are possible in newborns and infants and are almost exclusively associated with parechovirus A type 3 (HPeV-A3). The infection is transmitted mainly via food and droplet routes. The main method of infection diagnosis is the detection of viral RNA by real-time PCR in cerebrospinal fluid, blood, and feces. No treatment for the parechovirus infection has been developed so far.

MORPHOFUNCTIONAL CHANGES OF CEREBRAL CORTEX CELLS UNDER PARTIAL TRACHEAL STENOSIS IN EXPERIMENTAL ANIMALS

Introduction. To date, there are limited opportunities to study the effects of congenital airway pathology in the experiment. To study the damage to body tissues in case of impaired airway ventilation, the author's version of artificial narrowing of the tracheal lumen by applying ligatures was used. The study of morphofunctional reactions and structural changes in organs and tissues of the body made it possible to identify and study pathogenetic and target tissue targets in order to develop tactics for the treatment of this pathology in newborns. Objective: to investigate the peculiarities of ultrastructural changes in the cells of the sensorimotor cortex of the cerebral hemispheres of experimental immature animals after modelling partial tracheal stenosis. Materials and methods. Ligature was applied to young rats at the level of the upper third of the trachea, which limited the tracheal lumen by about 25-30%. After modelling the pathology of the upper respiratory tract, the appearance of characteristic wheezing sounds was noted, this allowed us to consider the experimental intervention as an analogue of the stridor model in newborns. On day 7 and day 21 of the experiment, after surgery and removal of the previously applied ligature, the ultrastructure of the sensorimotor cortex of young animals was studied and, on this basis, variants of pharmacological protective and therapeutic effects and acceleration of cerebral rehabilitation in experimental animals were proposed. Results. The development of neurodystrophic processes and damage to cell ultrastructures and blood-brain barrier functions were established. After removal of the ligature from the trachea and elimination of the artificial compression effect of this factor on the airways of animals, the observed dynamics of pathological ultrastructural changes remained virtually unchanged, even after repeated surgical procedures. This indicates the need for the use of pharmacological agents and medical technologies to restore cytomembranes in cells of the central nervous system of different types under the influence of chronic hypoxia. Conclusions. Partial tracheal stenosis causes damage to the nerve cells of the cerebrocortex, and the removal of the ligature on day 7 of the stenosis modelling experiment did not affect any ultrastructural changes compared to the results obtained in the group of animals with chronic tracheal stenosis. The restoration of lung ventilation and the nature of the data revealed indicate the absence of significant recovery changes in the nerve and vascular cells of the brain. They indicate the need for urgent therapeutic and rehabilitation measures to accelerate the restoration of the structure and functions of cerebrocortical cells in the posthypoxic period.

Real-time PCR for indication of representatives of <i>Chlamydiales</i> order: needs for development and main analytical characteristics of the method

Respiratory diseases occupy a dominant position in the structure of morbidity, often the etiology of which remains unclear. This situation is largely due to the lack of knowledge of the entire spectrum of pathogens that cause respiratory diseases, as well as the lack of approaches to their indication and identification. Thanks to constant progress of molecular biology, a number of bacteria related to chlamydia have been identified, some of which are associated with human respiratory diseases, including chlamydia-like microorganisms. The role of atypical pathogens such as chlamydia-like microorganisms Parachlamydia acanthamoebae, and Simkania negevensis in the pathology of the human respiratory tract is still not fully understood. A real-time PCR-based method has been developed and optimized. It is capable of detecting the DNA of both chlamydia and chlamydia-like microorganisms (Parachlamydia acanthamoebae and Simkania negevensis). The method is characterized by high specificity and reproducibility, as well as by analytical sensitivity at a level of 8.7∙103 GE/ml. Its use will make it possible to assess the contribution of these atypical pathogens to the etiological structure of infectious diseases of the respiratory tract.

Особливості сучасного перебігу гранулематозу з поліангіїтом (гранулематозу Вегенера) у дітей на прикладі клінічного випадку в пацієнта підліткового віку

The article introduces readers to a rare disease from the group of systemic vasculitis - Wegener’s granulomatosis. The prevalence of this disease in European countries ranges from 4.9 to 10.5 cases per 1 million adult population. A feature of the disease is the pathology of the upper respiratory tract at the beginning of the inflammatory process, which leads to long and difficult treatment of patients by otolaryngologists, as a result of which the correct diagnosis is delayed and the prognosis of the disease worsens. The disease is especially rare among children. Purpose - to share the experience of diagnosis and treatment of a teenager with this extremely rare pathology. Complications of drug therapy and ways to solve them are considered in detail. The conclusion of this experience is an understanding of the severity of the course of the disease and the need to use aggressive therapy already in its early stages in order to save the patient’s life. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent of the parents and the child was obtained for the study. No conflict of interests was declared by the authors.

Diseases of the upper respiratory tract and their pathogenetic mechanisms in children living under conditions of chronic exposure to aldehydes and aromatic hydrocarbons

Introduction. The problem of diseases of the respiratory system in children in regions with technogenic atmospheric pollution by chemical agents is relevant. 
 The aim of the study was to study the features of the formation of the pathology of the upper respiratory tract, their pathogenetic mechanisms, and causal relationships of clinical, instrumental, and immunological disorders with toxic load in children living under conditions of chronic exposure to phenols and aromatic hydrocarbons of the industrial origin. 
 Materials and methods. one thousand one hundred fifty one 4–13 years children were examined, 883 people made up the observation group and lived in the territory with excess of hygienic standards in the air of phenol, formaldehyde, acrolein, o-xylene. The comparison group consisted of 268 children living in the territory of ecological well-being. The prevalence of pathology of the upper respiratory tract (URT), rhinomanometry, laboratory parameters were assessed, correlation-regression relationships of clinical and laboratory parameters and the concentration of chemicals in the blood were determined. 
 Results. The study established for the first time the relationship between the concentration of chemical compounds in the blood, laboratory and instrumental indicators in children with URT pathology, living in the territory with excess levels of phenol, formaldehyde, acrolein. The total nasal airflow in the observation group was 10-15% lower than in the comparison group and inversely related to the blood concentration of acrolein, o-xylene, phenol, formaldehyde, and the content of IgG specific to phenol, myelopyroxidase, total number of lymphocytes, subpopulations of CD3+CD25+ and CD3+CD95+, integral index of proliferation and frequency of cells with apoptotic bodies and circular notches of the nucleus. 
 Limitations. The results of the study can be extrapolated to 4-13 years children, boys and girls. The study did not include young children or adults. 
 Conclusion. Characteristic features of the pathology of the upper respiratory tract associated with increased levels of acrolein, o-xylene, phenol and formaldehyde in the blood are a decrease in nasal airflow against the background of specific immune-dependent and non-specific inflammation. To reduce the incidence of URT in children, it is necessary to develop programs that include measures aimed at improving the quality of the environment, therapeutic and preventive measures that increase adaptive capacity.

Analysis of clinical and paraclinical findings in children with community-acquired pneumonia and comorbid chronic tonsillitis

Background. Respiratory morbidity is the most frequent cause for children consulting a doctor, accounting for about one-quarter of primary care consultations. The current research aimed to analyze the clinical and paraclinical features of community-acquired pneumonia (CAP) with comorbid chronic tonsillitis in children and to assess the prognostic value of the proposed diagnostic procedures to optimize the management of patients. Materials and methods. The study was conducted at the Pulmonology and Allergology and Infectious Department of the Municipal Medical Establishment “Chernivtsi Regional Children’s Clinical Hospital”, Ukraine. Clinical group I included 20 children (mean age 9.40 ± 1.56 years) with uncomplicated community-acquired pneumonia and concomitant chronic tonsillitis, and the clinical group II consisted of 16 patients (mean age 9.60 ± 1.13 years) with CAP without concomitant pathology of the upper respiratory tract. Results. Community-acquired pneumonia in children with comorbid chronic tonsillitis is characterized by an intense proinflammatory response in the airways, which manifests itself in fever (odds ratio (OR) 6.0), malaise and fatigue (OR 14.3), persistent cough and dyspnea (OR 3.7), leukocytosis (OR 2.0), high levels of acute phase proteins (OR 4.5), activation of the oxidative protein modification according to the exhaled breath condensate examination (OR 6.0–30.0), and more frequent fungal-bacterial association according to the microbiological examination of sputum and oropharyngeal swab (OR 11.1). The obtained data suggest that parenteral antibiotic therapy was used in 20 % of patients from group I and 12.5 % from group II, while 6.3 % of children from group II received only oral antibiotics. In children with CAP and chronic tonsillitis versus comparison group, the ОR of receiving parenteral antibiotic therapy for longer than 7 days reached 10.0, and the OR of oral antibiotic therapy for longer than 5 days reached 4.0. Conclusions. The results obtained from the study show that children with CAP and comorbid chronic tonsillitis have more pronounced clinical symptoms, accompanied by paraclinical signs of inflammation that last longer during hospital treatment and require comprehensive therapy (OR 3.3) of longer duration (OR 4.0–10.0).

Correlations of cephalometric parameters of the upper respiratory tract in Ukrainian young men and young women with a wide face type

Annotation. Changes in the size of the upper respiratory tract can lead to the emergence or aggravation, complications of already existing pathologies. In this regard, there is a need to study their sizes both in normal and pathological conditions. Cephalometric analysis is one of the important tools that allows you to assess the location of the structures of the upper respiratory tract and their parameters. The purpose of the study is to establish the peculiarities of correlations between cephalometric parameters of the upper respiratory tract in Ukrainian young men and young women with an orthognathic bite with a wide face type. On primary lateral radiographs of Ukrainian young men (aged 17 to 21 years) and young women (aged 16 to 20 years) with a wide facial type, orthognathic bite and absence of upper respiratory tract pathology, using the licensed medical software OnyxCeph³™, version 3DPro (company Image Instruments GmbH, Germany) and the diagnostic program “UniqCeph” carried out a cephalometric analysis of the upper respiratory tract, soft palate, hyoid bone and tongue. Correlations were evaluated using the Statistica 6.0 license package using Spearman's non-parametric statistics. In young men and young women with a wide face type, multiple, mostly straight, medium-strength reliable (r= from 0.42 to 0.56) and strong (r= from 0.62 to 0.82) correlations were established between most of the cephalometric characteristics of the upper respiratory tract itself, and only in young women – multiple straight correlations of average strength reliable (r=0.44 and r=0.53) relationships between most of the cephalometric characteristics of the hyoid bone. In addition, in young men with a wide face type, multiple straight correlations of mostly medium strength, reliable (r= from 0.47 to 0.52) and unreliable (r= from 0.30 to 0.41) relationships of the AH-CV, AH-MP or VT distances and most of the cephalometric characteristics of the upper respiratory tract itself, mainly the inverse of the average strength of reliable (r=-0.44 in both cases) and unreliable (r=-0.32 and r=-0.38) correlations of the value of most of the cephalometric characteristics of the soft palate (with the exception of the PM-U distance) and the tongue, as well as mostly straight correlations of medium strength unreliable (r= from 0.34 to 0.38) relationships between the values of most of the cephalometric characteristics of the hyoid bone (with the exception of the AH-CV distance) and the tongue; and in young women, there are direct, reliable, medium-strength (r=0.45 and r=0.53) and strong (r=0.63 in both cases) relationships between the value of the AH-CV distance and almost all cephalometric characteristics of the upper respiratory tract itself, as well as mainly direct unreliable average strength (r= from 0.37 to 0.38) correlations between the size of the PM-U or AH-FH distance and most of the characteristics of the tongue. Thus, the most pronounced manifestations of sexual dimorphism correlations are established between the cephalometric characteristics of the upper respiratory tract itself and the hyoid bone or tongue, as well as between the cephalometric characteristics of the soft palate and the tongue.

Peculiarities of correlations of upper respiratory tract cephalometric parameters in Ukrainian young men and young women regardless of face type

The study of the parameters of the upper respiratory tract has become one of the leading directions of medical research, due to the connection of this structure with the occurrence and course of many diseases of both childhood and adulthood. The study of normative indicators of this structure and its relationship with craniometric indicators should be the first step before further research of samples with pathologies. The purpose of the study is to establish correlations of cephalometric parameters of the upper respiratory tract in Ukrainian young men and young women with an orthognathic bite, regardless of the type of face. Primary lateral radiographs of 49 Ukrainian young men (aged 17 to 21 years) and 76 Ukrainian young women (aged 16 to 20 years) with an orthognathic bite and the absence of upper respiratory tract pathology taken from the database of the research center and the Department of Pediatric Dentistry age of National Pirogov Memorial Medical University, Vinnytsia, with the help of the licensed medical software OnyxCeph3™, version 3DPro (Image Instruments GmbH, Germany) and the diagnostic program “UniqCeph”, a cephalometric analysis of the upper respiratory tract was performed. In the “Statistica 6.0” license package, correlations between cephalometric indicators of the upper respiratory tract were assessed using non-parametric Spearman statistics. In Ukrainian young men, multiple, mostly direct, medium-strength (r= from 0.32 to 0.48) and strong (r= from 0.65 to 0.83) correlations were established between most of the characteristics of the upper respiratory tract or tongue; in young women, there are also predominantly direct, medium-strength (r= from 0.33 to 0.57) and strong (r= from 0.62 to 0.85) correlations between most of the characteristics of the upper respiratory tract or tongue, as well as medium-strength inverse (r= -0.30 and -0.40) and direct (r= 0.45 and 0.85) correlations between most characteristics of the soft palate. In addition, in Ukrainian young men, multiple inverse correlations of mainly medium strength (r= from -0.33 to -0.49) were established between the value of the PASmin distance and the UAA section with the value of the SPT distance and the SPA section, and between the value of the NL/PM-U angle and most of the characteristics the tongue, as well as multiple direct, mostly medium strength (r= from 0.30 to 0.55), connections between the characteristics of the upper respiratory tract itself and the hyoid bone or tongue and between the characteristics of the hyoid bone and the tongue; in young women, there are mainly straight lines of medium strength (r= from 0.33 to 0.55) between the value of the AH-CV distance and most of the characteristics of the upper respiratory tract itself, between the value of the AH-FH distance and all characteristics of the tongue, and between the value of the PM-U distance and by the distance VT and the section TA. Thus, the most pronounced manifestations of sexual dimorphism of connections are established between the characteristics of the soft palate, between the characteristics of the upper respiratory tract itself and the soft palate or tongue, as well as between the characteristics of the soft palate and the hyoid bone.

Оптимизация ранней диагностики развития и прогрессирования ретинопатии недоношенных

Purpose. To develop easy-to-use methods for early diagnosis of the development and progression of retinopathy of prematurity (ROP). Мaterial and methods. The extracellular peroxidase activity (EPA) of blood serum was studied by spectrophotometry in 93 premature newborns aged 3–4 weeks of life and the thickness of the retinal neuroepithelium (NES) of the paramacular zone by measuring it at a distance of 500 μm from the border of the foveola in 82 premature infants (162 eyes ) using optical coherence tomography (OCT) of the retina on the RetinaScan — 3000 device (NIDEK) in the Macula Multi Cross mode. Results. Determination in premature newborns at 3–4 weeks of life of the level of blood serum VPA less than 1887.1 c.u. allows predicting the development of ROP in 76.4 % of cases. At the same time, there is an inverse correlation (R = –0.94; p < 0.05) between the value of the VPA and the pathology of the upper respiratory tract (respiratory distress syndrome, respiratory failure, asphyxia). The study of the thickness of the paramacular zone of NES showed an increase in its values, regardless of the stage and form of ROP. At the same time, the average thickness index was higher by 39.0 μm in infants with ADHD compared with stage I of the classical form, by 39.3 μm — by stage II, by 35.8 μm — by stage III (p < 0.05). Stabilization of the pathological process was accompanied by a decrease in the NES thickness index (p < 0.05). Conclusion. Examination of the values of extracellular peroxidase activity in the blood serum at 3–4 weeks of life of a premature newborn, as well as monitoring the thickness of the retinal neuroepithelium in the paramacular zone, allow timely diagnosis of retinopathy of prematurity. Keywords: retinopathy of prematurity, diagnostics, extracellular peroxidase activity, retinal neuroepithelial thickness

Structure of fungal-bacterial association in pulmonary mycetoma of mute swan

Pathologies of the respiratory system are accompanied by the formation of a multicomponent microbiocenosis. Microorganisms isolated from the respiratory tract have different degrees of priority in the development of pathological processes. In waterfowl, from pathologies of fungal etiology, visceral aspergillosis with localization of the pathological focus in the respiratory tract is more common. Aspergillosis is characterized by a chronic course with various forms that can pass into one another and be supplemented by bacterioses. The aim of the work is to determine the spectrum of microbial agents in the fungal-bacterial association isolated from the lungs of a swan. The object of the study was the corpse of a hissing swan. In the course of the work, such methods as autosection, histological, microscopic, mycological, bacteriological were used. Macroscopically revealed signs characteristic of bronchopneumonia complicated by aerosacculitis. There are two types of limited foci in the lungs and air-carrying bags with a diameter from 3 cm to˂0.2 mm. Four groups of prokaryotes Pseudomonas aeruginosa, Proteus mirabilis, Echerichia coli, Staphilococcus aureus, and the microscopic fungus Aspergillus fumigatus were isolated from the lungs. The leading pathogen in the development of pathological changes in the lungs of a swan is smoking aspergillus. The isolation of representatives of enterobacteria from the lung tissue may indicate contamination of the studied material post mortem, and not the etiological significance of these bacteria. However, any negative effect causing suppression of immune defense mechanisms can stimulate the activity of microorganisms that, isolated or only in combination, can cause a pathological process in the respiratory tract. In this regard, the influence of microflora and the role of isolated microbial associates in the development of respiratory tract pathologies should not be underestimated.

Teleroentgenometric parameters of the soft palate in young men and young women with an orthognathic bite without and taking into account the type of face

The study of the features of the upper respiratory tract and the relationship of their parameters with other anatomical formations and structures of the human body is one of the promising areas of modern science. Since numerous anatomical components are involved in the functioning of the respiratory tract, their detailed study should be carried out separately. One of these components that is of direct interest to science and practice is the soft palate. The purpose of the study is to establish the peculiarities of the teleroentgenometric parameters of the soft palate in Ukrainian young men and young women without pathology of the upper respiratory tract with an orthognathic bite without and taking into account the type of face. Determination of teleroentgenometric parameters of the soft palate was carried out in 72 young women and 46 young men with no pathology of the upper respiratory tract with an orthognathic bite (primary lateral teleroentgenograms were taken from the database of the research center and the Department of Pediatric Dentistry of the National Pirogov Memorial Medical University, Vinnytsya). For all young men and young women face type was determined using Garson's morphological index. The analysis of the obtained results was carried out in the statistical package “Statistica 6.0” using non-parametric estimation methods. As a result of the conducted research, pronounced gender differences were found (significantly greater, or a tendency to greater values in young men): the value of the PM-U distance in representatives without taking into account the type of face by 7.1 %, with very wide – by 9.2 %, with wide – by 8.4 % and with narrow – by 7.4 % face types; values of the SPT distance in representatives without taking into account the face type by 10.3 %, with very wide – by 16.4 % and with narrow – by 23.1 % face types; the values of the NL/PM-U angle in representatives without taking into account the face type by 7.6 % and by 11.5 % with wide face types; the size of the SPA area in representatives without taking into account the type of face by 17.2 %, with very wide – by 24.4 %, with wide – by 13.4 % and with narrow – by 32.2 % of face types. When analyzing the value of teleradiographic parameters of the soft palate in young men between different types of faces, it was established that significantly higher values or trends towards higher values in representatives with a narrow face of the SPT distance and SPA area than in young men with a very wide (respectively by 8.9 % and 13.0 %) and average (by 13.9 % and 22.2 %), respectively, face types, and in young men, regardless of face type, there is a tendency for greater values of the PM-U distance than in representatives with an average face (by 4.2 %). In young women with a narrow face, only a tendency to greater values of the NL/PM-U angle was established than in young women with a wide face (by 6.2 %). The results of the study are an integral element of determining the normative values of various parameters of the upper respiratory tract, which enables practicing doctors to more correctly distinguish the norm from pathology.

Клінічна оцінка використання інгаляцій 6% N-ацетилцистеїну у 3% розчині NaCL (ФЛУ-АЦИЛ бронхо) в лікуванні дітей з гострим бронхітом

Purpose - to propose an optimization of treatment of acute bronchitis in children by introducing inhalation of FLU-ACIL broncho before therapy. Materials and methods. An open, prospective, multicenter, non-interventional, comparative (with active control) study with two therapeutic groups was conducted. The experience of therapy of 45 children with moderate acute bronchitis aged 2-12 years old was summarized. The main group included 30 children who received inhalation of Flu-Acyl Broncho in the complex treatment: 5 ml 2 times a day 3-4 hours before bedtime for 7-10 days; the comparison group included 15 children who received oral acetylcysteine/ambroxol for 7-12 days. If it is necessary, antipyretic therapy with ibuprofen or paracetamol was used. The period from the onset of the disease to participation in the study was about 2-4 days. The study did not include children with concomitant acute middle ear diseases, acute sinusitis, acute allergic diseases and children with symptoms of obstruction. The results of examination and treatment of patients were analyzed using the software package «Statistica 6.0 for Windows». Results and conclusions. Comprehensive treatment of acute bronchitis in children with the administration of the inhalation Flu-Acyl Broncho, sterile solution for nebulizer and instillation, has a positive clinical effect, leads to faster relief (p<0.01) and disappearance (p<0.05) of cough compared to oral mucolytics. The additional anti-inflammatory and mucolytic effect of the inhalation route of administration of Flu-Acyl Broncho on the nasopharyngeal mucosa improves the results of treatment of children with concomitant acute respiratory pathology of the upper respiratory tract. This is manifested in faster, compared to oral mucolytics, elimination of rhinitis (p<0.001) and sore throat (p<0.05). All studies were performed in accordance with the ethical principles adopted by the Declaration of Helsinki and Good Clinical Practice (GCP) for medical research conducted on human subjects. Approval was obtained from the ethics committee of the Children’s Clinical Hospital No. 5 of Sviatoshynskyi district of Kyiv. No conflict of interests was declared by the authors.

Possibilities of phytopreparations in treatment of patients with pharyngeal pathology

Patients with infectious- inflammatory diseases of the pharynx make up a significant percentage on the intake of otorhinolaryngologists and therapists. Most pharyngeal diseases have pronounced clinical signs, have a significant impact on the performance and quality of life of patients, and have a fairly high risk of a complicated course. It is important for such patients to therapeutically provide relief of pain syndrome and stop inflammatory changes. Pharyngeal diseases and their consequences place a pronounced economic burden on the health system and society as a whole. Timely and correctly selected treatment contributes to a favorable resolution of the pathological process, against the background of preserving the protective functions of the pharyngeal mucosa and is economically feasible. Herbal preparations are effective drugs for this purpose. Phytopreparations have long been actively used in clinical practice due to their effectiveness, safety and accessibility. According to the literature, the administration of herbal preparations as monotherapy in patients with acute infectious and inflammatory pharyngeal diseases was found to be a highly effective way of treatment. The active ingredients, chamomile, marshmallow and horsetail contribute to the improvement of the body’s nonspecific defences due to enhancement of phagocytic activity of macrophages and granulocytes. Polysaccharides, essential oils and bioflavonoids of chamomile, marshmallow and yarrow have an anti-inflammatory effect and reduce oedema of the respiratory tract mucous membrane. In addition to antimicrobial and anti-inflammatory effects, herbal preparations have an immunomodulatory effect, which is particularly important because infectious inflammation, trauma, chronic stress entail a secondary immunodeficiency condition. Unnecessary prescriptions of antibacterial drugs, deterioration of the ecological situation contribute to the development of this condition. The immunomodulating effect of phytopreparations is promising not only in the treatment of upper respiratory tract pathology, but also in the secondary prophylaxis and the prevention of chronization of inflammation processes.

Cephalometric characteristics of the upper respiratory tract in Ukrainian young men and young women with an orthognathic bite without and with the type of face taken into account

The upper respiratory tract is a component of the respiratory system, which ensures the performance of several key human functions at once. The variability of cephalometric indicators of this structure of the human body, depending on the peculiarities of body structure, nationality, sex, and other factors, is one of the current topics of discussion among modern scientists. The purpose of the study is to establish the peculiarities of the cephalometric characteristics of the upper respiratory tract in young people without pathology of the upper respiratory tract with an orthognathic bite without and taking into account the type of face. For 72 Ukrainian young women and 46 young men with an orthognathic bite and the absence of pathology of the upper respiratory tract, taken from the database of the research center and the pediatric dentistry department of National Pirogov Memorial Medical University, Vinnytsya, determination of cephalometric parameters of the upper respiratory tract itself was carried out. The face type of young women and young men was determined using Garson's morphological index. The statistical analysis of the obtained results was carried out in the licensed statistical package “Statistica 6.0” using non-parametric estimation methods. In Ukrainian young women and young men without and taking into account the type of face, the percentile range of cephalometric parameters of the upper respiratory tract proper was established (distance PASmin – the size of the retroglossal oropharyngeal airway space, distance PM-UPW – the size of the nasopharyngeal airway space, distance U-MPW – the size of the retropalatal oropharyngeal airway space, distance V-LPW – the size of the hypopharyngeal airway space, area UAA – the size of the upper airway area). Sex differences (significantly greater, or a tendency towards greater values in young men) of distance V-LPW values were found in representatives without taking into account the face type by 13.8 %, with a wide face type – by 11.6 % and with a narrow face type – by 15.9 %; as well as the size of the UAA area in representatives without taking into account the face type by 20.6%, with a very wide face type – by 21.2 %, with a wide face type – by 21.6 % and with an average face type – by 23.1 %. Both in young women and in young men, no reliable differences or trends in the magnitude of the cephalometric parameters of the upper respiratory tract between representatives with different types of faces were established.