Pathology Of Respiratory Tract Research Articles

Immunodiagnostics, immunotherapy and immunoprophylaxis in the clinic of otolaryngology. Message 2. Indicators of local immunity in assessment of clinical and laboratory status of patients in inflammatory ENT diseases (Analytical summary)

Topicality: It is considered proven that the state of the immune system determines the development and course of many pathological processes, which are based on inflammation. At the same time, taking into account modern trends in assessing the immunological status, a mandatory component is to determine the state of local immunity in the upper respiratory tract. Aim: to conduct an integral analysis of data to determine the state of local immunity in inflammatory diseases of the upper respiratory tract (URT) to select the optimal necessary informative indicators. Materials and methods: A generalization of the data of immunological studies of 168 people with inflammatory pathology of the upper respiratory tract (VDS) was carried out, of whom 42 had chronic tonsillitis (CT), 36 – chronic rhinitis (HR – catarrhal form), 40 – chronic pharyngitis (CP), 28 – secretory mean otitis media (CO), 22 people made up the control group (C) of practically healthy donors. The age of the surveyed was from 14 to 60 years, the duration of the diseases was from 1 to 5 years, female patients predominated (~ 60%). The examination was carried out at the stage of clinical remission. The material for the research was mixed saliva, in which the content of immunolobulins and citrokines was investigated by the ELISA method: enzyme immunoassay, the following factors of immunity and inflammation in the CGS were determined: - secretory and monomeric form of immunoglobulin A (Hema Medica, RF); - immunoglobulins of classes G, M (Hema Medica, RF); - interleukins – 1β; 4; 8; 10 (Cytokine, RF); - interferons α and γ (Cytokine, RF); - pro- and defensins (Nucalt bioteknology, Netherlands); - macrophage inflammatory protein-Mip-1b (Assauro, USA); - salivary lysozyme (Diagnostik Nord, Germany). Statistical processing was carried out using the methods of Student’s t-criterion and angular transformation “φ” according to Fisher. Results: Integral of all methods for determining various types of immunity in diseases of the upper respiratory tract with a chronic course is the insufficiency of factors of both innate and acquired immunity, especially during the period of clinical remission of the disease. A special role in protective reactions belongs to the humoral component, in which the most stable indicator is the level of class A secretory immunoglobulin; it has been shown that almost all the studied components of the immune response had abnormalities in the presence of a chronic inflammatory process in the upper respiratory tract and they can be presented as a line the degree of decrease in the frequency of deviations: secretory IgA, IgG., pro-inflammatory cytokines (IL1β and IL-8), γ-interferon, lysozyme, defensin-β, Mip-1b. Conclusion: The developed criteria and approaches to assessing systemic immunity in patients with inflammatory diseases of the upper respiratory tract can be used in examining patients and assessing the effectiveness of therapy.

Vitamin D and antimicrobial peptides in congenital pneumonia of premature newborns

Introduction. One of the leading causes of morbidity in newborns is the pathology of the respiratory tract. Among this group of patients, and especially premature newborns, congenital pneumonia takes the leading role among diseases of the respiratory system. The aim of the work was to identify the relationship between the level of vitamin D and endogenous antimicrobial peptides in congenital pneumonia of premature infants. Material and methods. We observed 2 groups of premature newborns: 32 newborns with congenital pneumonia, and the comparison group consisted of 20 "almost healthy" newborns without respiratory tract pathology. Results. In patients with pneumonia, the level of vitamin D was significantly lower (9,57 [6,57-17,25]) when compared with conventionally healthy newborns (21,1 [9,2-32,02]), p<0.01. However, in the group with congenital pneumonia, the levels of cathelicidin LL-37 and HBD-2 were significantly higher (2,87 [2,3-4,43] and 240,4 [132,4-406,7]) compared with another group (1,6 [0,8-2,5] and 156,7 [82,4-208,7]), p<0,01. Moreover, patients with severe congenital pneumonia had significantly lower concentration of vitamin D (7,6 [5,7-13,2]) and higher cathelicidin LL-37 (3,75 [2,8-4,26]) compared with patients with moderate pneumonia (13,7 [9,7-16,5] and 2,5 [2,1-3,7], respectively). But we did not observe such a relationship with HBD-2 (in severe congenital pneumonia, there was a decrease in HBD-2 (220,4 [142,6-401,6] and 278,2 [154,6-378,6], respectively). Conclusion. Lower vitamin D concentrations in serum may be have significant associatiation with congenital pneumonia. Also, vitamin D levels can predict the need for mechanical ventilation and the duration of hospitalization for congenital pneumonia in premature infants.

DDX3X coordinates host defense against influenza virus by activating the NLRP3 inflammasome and type I interferon response

Viruses and hosts have coevolved for millions of years, leading to the development of complex host–pathogen interactions. Influenza A virus (IAV) causes severe pulmonary pathology and is a recurrent threat to human health. Innate immune sensing of IAV triggers a complex chain of host responses. IAV has adapted to evade host defense mechanisms, and the host has coevolved to counteract these evasion strategies. However, the molecular mechanisms governing the balance between host defense and viral immune evasion is poorly understood. Here, we show that the host protein DEAD-box helicase 3 X-linked (DDX3X) is critical to orchestrate a multifaceted antiviral innate response during IAV infection, coordinating the activation of the nucleotide-binding oligomerization domain-like receptor with a pyrin domain 3 (NLRP3) inflammasome, assembly of stress granules, and type I interferon (IFN) responses. DDX3X activated the NLRP3 inflammasome in response to WT IAV, which carries the immune evasive nonstructural protein 1 (NS1). However, in the absence of NS1, DDX3X promoted the formation of stress granules that facilitated efficient activation of type I IFN signaling. Moreover, induction of DDX3X-containing stress granules by external stimuli after IAV infection led to increased type I IFN signaling, suggesting that NS1 actively inhibits stress granule–mediated host responses and DDX3X-mediated NLRP3 activation counteracts this action. Furthermore, the loss of DDX3X expression in myeloid cells caused severe pulmonary pathogenesis and morbidity in IAV-infected mice. Together, our findings show that DDX3X orchestrates alternate modes of innate host defense which are critical to fight against NS1-mediated immune evasion strategies during IAV infection.

Хирургия доброкачественных и опухолеподобных образований гортани с использованием полупроводникового лазера с длиной волны 445 нм

The issues of phonosurgery remain truly relevant today since there is a high prevalence of benign and tumor-like laryngeal formations among the pathology of the upper respiratory tract (up to 55–70%). Nowadays, laser technologies are coming to the fore among the possibilities of laryngological practice. Photoangiolytic lasers, such as the KTP laser, are actively used to coagulate subepithelial vessels without destroying the superficial epithelium. A novelty among laser systems is a laser with a wavelength of 445 nm certified in 2018, which combines high hemostatic and cutting effects without the extensive zone of thermal damage to surrounding tissues. This paper presents two clinical cases where a 445 nm laser is used. The first clinical case describes a patient with an anterior commissure scar after previous surgical interventions. Treatment using a 445 nm laser made it possible to dissect the scar and restore the normal laryngeal anatomy without stent placement. 5 weeks after the operation, the patient underwent phonopedic therapy and was satisfied with the voice quality. The second clinical case describes a patient with a cystic-like neoplasm of the left vocal fold. Dissection and enucleation of the formation using a direct micro laryngoscopy was done, followed by laser coagulation of the incision edges. Within 2 weeks, the patient showed restoration of the laryngeal endoscopic state and a voice improvement with normalization of acoustic parameters. Thus, the 445 nm semiconductor laser has shown in practice highly pronounced photoangiolytic and cutting properties, which proves its effectiveness in phonosurgery.

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 течения круглогодичного аллергического ринита на фоне респираторной внутриклеточной инфекции

As it is known, allergic rhinitis is one of the most pressing issues of modern rhinology. At present, special attention is directed to the study of the problem of year-round allergic rhinitis, since in recent years its incidence in economically developed countries has been steadily growing. Often the only complaint of patients is the constant stuffy nose with mucous discharge, so both patients and doctors often underestimate the importance of timely diagnosis and treatment of the disease. According to research, year-round allergic rhinitis can contribute to the development of pathology of the nasopharynx, middle ear and auditory tube, nasal cavity and paranasal sinuses, which often take on a chronic or recurrent form. The treatment proposed in the clinical recommendations, carried out in three main areas, does not always lead to persistent remission of the atopic process. This article covers the course of ENT diseases against the background of respiratory chlamydia and mycoplasmic intracellular infection. The problem of year-round allergic rhinitis associated with respiratory intracellular infection has not been elucidated to date, but the chronization of the process, long uncontrolled course, and the tendency to complications of this pathology of the upper respiratory tract may be related to it.

Prior SARS-CoV-2 Infection Prevents Acute Disease and Lung Pathology in Reinfected Syrian Hamsters but not Virus Replication in the Upper Respiratory Tract

Human cases of SARS-CoV-2 reinfection have been documented throughout the pandemic but are likely underreported. In the current study, we used the Syrian hamster SARS-CoV-2 model to assess reinfection with homologous (Washington WA1) and heterologous (United Kingdom B.1.1.7 (alpha) and South Africa B.1.351 (beta)) SARS-CoV-2 variants over time. Upon primary infection with SARS-CoV-2 WA1, hamsters rapidly developed a strong and long-lasting humoral immune response. Following reinfection with homologous and heterologous SARS-CoV-2 variants, this immune response protected hamsters from clinical disease, virus replication in the lower respiratory tract and acute lung pathology. However, reinfection led to SARS-CoV-2 replication in the upper respiratory tract with the potential for virus shedding. Our findings indicate that reinfection results in restricted SARS-CoV-2 replication despite substantial levels of humoral immunity, denoting the potential for transmission through reinfected asymptomatic individuals.Funding: This study was funded by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH). Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: Work with infectious SARS-CoV-2 was approved by the Institutional Biosafety Committee (IBC) and performed in the high biocontainment facilities at Rocky Mountain Laboratories (RML), NIAID, NIH. Sample removal from high biocontainment followed IBC-approved Standard Operating Protocols (44). Animal work was approved by the Institutional Animal Care and Use Committee and performed by certified staff in an Association for Assessment and Accreditation of Laboratory Animal Care International accredited facility. Work followed the institution’s guidelines for animal use, the guidelines and basic principles in the NIH Guide for the Care and Use of Laboratory Animals, the Animal Welfare Act, United States Department of Agriculture and the United States Public Health Service Policy on Humane Care and Use of Laboratory Animals.

Скрининговый способ диагностики фаринголарингеального рефлюкса

Pharyngolaryngeal reflux (PLR) can cause the upper respiratory tract pathology. To diagnose PLR based on complaints is rather difficult, due to the absence of typical manifestations of reflux syndrome in some cases of the disease. The use of daily impedance pH monitoring of the esophagus is not always possible due to the invasiveness and unavailability of the method. The aim of the study was to develop an affordable non-invasive method for diagnosing PLR. The study group consisted of 48 patients with PLR proven by the results of impedance pH-monitoring. The control group consisted of 20 healthy patients. The “Pharyngolaryngeal reflux index” questionnaire was developed based on the analysis of patient complaints. The questionnaire was assessed using ROC analysis. Patients who scored 5.5 points according to the results of the questionnaire with a probability of 93.2% have PLR. Thus, a method for the diagnosis of PLR has been developed, including the simultaneous comparison of the laryngoscopic signs of PLR with the highest diagnostic sensitivity (hyperemia, edema, maceration of the interarytenoid mucosa) and “Pharyngolaryngeal reflux index” questionnaire results, which allows diagnosing of PLR.

Does CT help in reducing RT-PCR false negative rate for COVID-19?

Background:Early detection is the key to contain the ongoing pandemic. The current gold standard to detect SARS CoV2 is RT-PCR. However, it has a high false negative rate and long turnaround time.Purpose:In view of the high sensitivity of CT in detection of lower respiratory tract pathologies, a study of 2581 patients comparing RT-PCR status with CT findings was undertaken to see if it augments the diagnostic performance.Materials and Methods:A multi centre prospective study of consecutive cases was conducted. All CT studies suggestive of COVID 19 pneumonia were collated and evaluated independently by three Radiologists to confirm the imaging diagnosis of COVID-19 pneumonia. The RT-PCR values were retrospectively obtained, based on the RT-PCR values, CT studies were categorised into three subgroups, positive, negative and unknown. CT features from all three groups were compared to evaluate any communality or discordance.Results:Out of the 2581 patients with positive CT findings for COVID pneumonia, 825 were females and 1,756 were males in a wide age group of 28-90 years. Predominant CT features observed in all the subgroups were Ground glass densities 94.8%, in mixed distribution (peripheral and central) (59.12%), posterior segments in 92% and multilobar involvement in 70.9%. The CT features across the three subgroups were statistically significant with a P value <0.001.Conclusion:There was a communality of CT findings regardless of RT-PCR status. In a pandemic setting ground glass densities in a subpleural, posterior and basal distribution are indicative of COVID 19. Thus CT chest in conjunction to RT PCR augments the diagnosis of COVID 19 pneumonia; utilization of CT chest may just be the missing link in closing this pandemic.

Abstract 13869: Inflammatory Changes in the Lungs of Rats Exposed to E-cigarettes Without Marijuana, Vitamin E Oil, or Nicotine

Background: Recently, the clinical entity of EVALI (E-cigarette or vaping product use associated lung injury) was described and has similarities to COVID -19 pneumonia. We determined in a quantitative manner the inflammatory changes in the lungs associated with EVALI in a rodent model that does not include use of marijuana, vitamin E oil, or nicotine, which had been implicated as a cause. Methods: Adult Sprague Dawley rats were exposed to either pure air (n=5) or electronic cigarette (eC) vapor (propylene glycol/vegetable glycerin, tobacco flavoring) using a device with a nickel-chromium alloy (NC) heating element at 70 Watts (n=6) for 2 hours. The e-liquid did not contain nicotine, marijuana, or Vitamin E oil. Rats were euthanized within a few days of exposure and H&amp;E-stained lung sections were assessed. Inflammatory cells were counted from 10 random areas per section at 20х magnification. Results: Alveolar structure appeared normal in the air group (Figure, panel C); the eC group using the NC heating element showed alveolar inflammation (D). The numbers of inflammatory cells per high power field in the lung parenchyma were significantly greater in the rats exposed to eC using NC heating element (67.5 ± 44.5) compared to the air group (6.7 ± 0.3; P &lt; 0.001, Kruskal-Wallis test). The predominant cell type was mononuclear and secondary were neutrophils. Other features included accumulation of fibrin and inflammatory cells in the lumen of the trachea (A); thickened alveolar walls; and red blood cell congestion (D). Inflammation of the nasal passages was also observed (B). Exposure of rats to e cigarettes using a stainless steel heating element did not result in EVALI, and the amount of inflammatory cells was closer to air exposed rats (7.2± 0.4). Conclusion: Vaping using a nichrome heating element at high power leads to respiratory tract pathology and a significant increase in the number of inflammatory cells in the alveoli. EVALI occurred without marijuana, vitamin E oil or nicotine.

Several studies on the problem of management patients with chronic tonsillitis during periods of remission and exacerbation

Increase in the number of acute and chronic diseases is a global trend. On the one hand, the emergence of new types of viruses, their active mutation, an increase in antibiotic-resistant bacterial strains, a high frequency of immunodeficiency and allergic diseases contribute to this. On the other hand is inadequate treatment of inflammatory diseases of the upper respiratory tract, widespread use of systemic antibiotics without indications. The use of bioregulatory medicines with proven efficacy in the complex treatment can reduce the drug load on the body, reduce the bacterial complications and side effects. Traumeel®S joins the physiological course of inflammation and activates pro-resolving mediators, contributes to its faster completion and tissue repair. The efficacy and safety of Traumeel®S has been confirmed in many randomized clinical trials. The drug has proven its value in almost any inflammatory pathology of the upper respiratory tract and ear. The drug Lymphomyosot®, a multicomponent agent with lymphatic drainage action, has proven itself perfectly in the complex therapy of chronic tonsillitis. In November 2019, the Council of Experts of the National Medical Association of Otorhinolaryngologists on the problems of pathology of the lympharyngeal ring was held. It is recommended to use the multicomponent bioregulatory preparation Traumeel®S to correct the inflammatory process, which has shown in studies a modulating effect on inflammatory mediators without suppressing COX-2 (prostaglandins). With exacerbation of chronic tonsillitis and lymphadenitis of nonspecific etiology, it is possible to use the multicomponent preparation Lymphomyosot®, which helps to improve the drainage and detoxification function of the lymphatic system.

Prospects of application of cone beam computed tomography for analyzing upper respiratory tract pathologies in patients with dentition system diseases

The goal of the study was to analyze the upper respiratory tract condition indicators obtained by means of сone beam computed tomography (CBCT) for patients with dentition system diseases and obstructive sleep apnoea syndrome. Patients were divided into 3 study groups. The control group (the 1st study group) included the CBCT data obtained for 33 healthy patients. The 2nd study group included the CBCT data obtained for 136 patients with dentition system diseases (partial secondary edentia combined with chronic generalized periodontitis) without sleep disorder signs. The 3rd study group included the CBCT data obtained for 70 patients with partial secondary edentia combined with deep distal occlusion and obstructive sleep apnoea syndrome (OSAS). The CBCT method using the proposed diagnosis criteria made it possible to identify not only dentition system diseases, but also the dysfunction of the upper respiratory tract, in particular the OSAS causes. It was found with confidence that the reduction of the upper respiratory tract diagnostic indicators by 40 % or more, as compared to the regulatory indicators of healthy patients, led to the dysfunction of the respiratory tract and the apnoea development. Deep distal occlusion and secondary edentia conditioned the presence of the upper respiratory tract concave configuration and the localization of the minimum cross-sectional area below the occlusion plane, which increases the probability of development and progression of the obstructive sleep apnoea syndrome.

The effects of labor on airway outcomes with Supreme\u2122 laryngeal mask in women undergoing cesarean delivery under general anesthesia: a cohort study

BackgroundPregnancy is associated with higher incidence of failed endotracheal intubation and is exacerbated by labor. However, the influence of labor on airway outcomes with laryngeal mask airway (LMA) for cesarean delivery is unknown.MethodsThis is a secondary analysis of a prospective cohort study on LMA use during cesarean delivery. Healthy parturients who fasted > 4 h undergoing Category 2 or 3 cesarean delivery with Supreme™ LMA (sLMA) under general anesthesia were included. We excluded parturients with BMI > 35 kg/m2, gastroesophageal reflux disease, or potentially difficult airway (Mallampati score of 4, upper respiratory tract or neck pathology). Anesthesia and airway management reflected clinical standard at the study center. After rapid sequence induction and cricoid pressure, sLMA was inserted as per manufacturer’s recommendations. Our primary outcome was time to effective ventilation (time from when sLMA was picked up until appearance of end-tidal carbon dioxide capnography), and secondary outcomes include first-attempt insertion failure, oxygen saturation, ventilation parameters, mucosal trauma, pulmonary aspiration, and Apgar scores. Differences between labor status were tested using Student’s t-test, Mann-Whitney U test, or Fisher’s exact test, as appropriate. Quantitative associations between labor status and outcomes were determined using univariate logistic regression analysis.ResultsData from 584 parturients were analyzed, with 37.8% in labor. Labor did not significantly affect time to effective ventilation (mean (SD) for labor: 16.0 (5.75) seconds; no labor: 15.3 (3.35); mean difference: -0.65 (95%CI: − 1.49 to 0.18); p = 0.1262). However, labor was associated with increased first-attempt insertion failure and blood on sLMA surface. No reduction in oxygen saturation or pulmonary aspiration was noted.ConclusionsAlthough no significant increase in time to effective ventilation was noted, labor may increase the number of insertion attempts and oropharyngeal trauma with sLMA use for cesarean delivery in parturients at low risk of difficult airway. Future studies should investigate the effects of labor on LMA use in high risk parturients.Trial registrationThe study was prospectively registered at clinicaltrials.gov (NCT02026882) on 3 January 2014.

Analysis of the Microorganism’s Sensitivity in Patients with Chronic Adenoiditis to Pharmacotherapy with Antibacterial Drugs

Introduction: The prevalence of chronic pathology of the pharyngeal lymphatic system in preschool children reaches 45% and is mainly manifested by hypertrophy of adenoid vegetations, which in half of cases are combined with chronic inflammation, which, with repeated periods of exacerbation, leads to the development of severe chronic pathology of the upper respiratory tract. The role of microorganisms toleranceto pharmacological agents is widely proven in formation of chronic inflammatory disorders and demand correction of therapeutic schemes. Research tasks: The aim of this research was to study the microbial landscape of oropharynx in children who received surgical for adenoiditis and determine the sensitivity of the identified microorganisms to the pharmacotherapy with antibiotics. Material and Methods: We conducted a study of 1577 children aged from 1 year to 17 years and 11 months who received inpatient treatment at the otorhinolaryngological Department of the OO “Scientific and clinical multidisciplinary center named after Z. I. Kruglaya” in the city of Oryol in the period from 2015 to 2017 for hypertrophy of adenoid vegetations. The patients were divided into three groups based on the years of the study. The study of the oropharyngeal microbial association was performed by preparing a smear followed by Gram staining and bacterioscopy. Determination of the sensitivity of microorganisms to antibacterial drugs was performed by discdiffusion method. Results: We found in patients oropharynx microbial landscape with hypertrophy of chronic vegetation in dynamics over the period from 2015 to 2017, an increase in the number of opportunistic saprophytic flora was detected, which was observed against the background of a clear increase in the number of patients with this pathology an increase in the number of cases associated with saprophytic MRCA flora, represented mainly by Staphylococcus aureus, leads to a decrease in the effectiveness of conservative treatment of chronic adenoiditis, which is expressed in an increase in the number of adenotomies. Conclusion: The study revealed negative consequences of uncontrolled use of antibiotic therapy at the pre-hospital stage and irrational schemes of chemotherapy in hospital units, which is manifested in the growing resistance of microorganisms to both “old” antibacterial drugs and a decrease in sensitivity to pharmacotherapy with the latest generation of antibiotics and requires active revision of the schemes of antibiotic therapy and prevention.

Immunodiagnostics, immunotherapy and immunoprophylaxis in the department of otolaryngology. Message 1. Optimal indicators of systemic immunity in assessing the clinical and laboratory status of patients with inflammatory diseases of the upper respiratory tract (analytical generalization)

Introduction: It is considered proven that the state of the immune system determines the development and course of many pathological processes, which are based on inflammation. At the same time, taking into account current trends in assessing the immunological status, conditional variants of deviation from the norm, a decrease in the number of cells from the average statistical norm of the region and control parameters in the performing laboratory by 1.5 or 2 times were adopted, since deviations are within 30-60 % are borderline and quite easily compensated by the body. The aim of the work was to conduct an integrated analysis of data to determine the state of systemic immunity in inflammatory diseases of the upper respiratory tract (URT) to select the optimal informa-tional indicators. Materials and methods: Immunological methods were used to examine 260 people with inflammatory pa-thology of the upper respiratory tract, of which 82 had chronic tonsillitis, 76 with chronic rhinitis, 70 with chronic pharyngitis and 32 people made up a control group of healthy donors. The age of the subjects ranged from 16 to 60 years, the duration of the disease from 1 year to 5 years, female patients predominated (≈60%). Examinations were conducted in the clinical remission stage. When assessing systemic immunity, the number of T-lymphocytes (CD 3, 4, 8), B-lymphocytes (CD22), NK (CD56), monocytes (CD14), concentration of immunoglobulins of classes M, G, A, E, cytokines with regulatory properties, interferon-γ-IL4 were determined. Functional tests in assessing systemic immunity are presented by determining the cytolytic activity of blood mononuclear cells in relation to avian xenogenic red blood cells and the activity of phagocytic blood cells in relation to latex particles at the absorption stage. Statistical processing was performed using the angular transfor-mation method "φ" according to Fisher and the "one-sided" criterion "U" Wilcoxon. Results: Based on a wide range of immunological studies in patients with chronic diseases of the upper respiratory tract, it seems most appropriate to use the following laboratory tests to assess systemic immunity to determine the characteristic deviations in the immune status of patients: High diagnostic value: - decreased serum IgA concentration (&lt;0.5 g/l); - low level of activity of ECC of blood (&lt;20% for xenoerythrocytes); - increased level of interleukin-1β (&gt; 25 pg/ml); Relative diagnostic value: - determination of the degree of dysimmunoglobulinemia in serum; - increased titers of antibodies to streptolysin-O, other microbial antigens; - increased serum IgM. Conclusion: The developed criteria and approaches in assessing systemic immunity in patients with in-flammatory diseases of the upper respiratory tract can be used to examine patients and assess the effectiveness of the treatment.

Criterion characteristics of professional risk of the formation of pathology of the upper respiratory tracts

The influence of dust influence on the change of the mucous membrane of the upper respiratory tract was determined. The criteria of occupational risk of pathology of the upper respiratory tract in workers of «dust-hazardous» industries are established.

Middle ear functional state in case of pathological changes of nose and throat

Objectives -to compare the functional state of middle ear in adults in case of various pathology of nasal cavity, paranasal sinuses and throat. Material and methods. In 2018-2019 period, 151 patient, aged from 16 to 70 years, was examined by acoustic impedancemetry. The patients reported the subjective satisfactory state of the acoustic organ, but had a pathology of the upper respiratory tract. Results. In the groups, there were no significant differences associated with gender. Most of the patients were of working age. In all study groups, the impaired function of the auditory tube, with various intensity, was registered, although the patients had no hearing complaints. At the same time, the acumetry and tonal threshold audiometry data indicated the normal acuity of hearing. Conclusion. Acute and chronic sinusitis was the most frequent risk factor for middle ear ventilation disorder. A quarter of patients with acute sinusitis, without otological complaints, had type B and C tympanograms. 93.7% of patients, who had undergone the surgical correction of the deviated nasal septum, did not have a middle ear ventilation disorder. Surgical intervention in the nasal cavity and oropharynx leads to a transient dysfunction of the auditory tube, but does not require special treatment due to self-recovery.

Использование компьютерной навигационной системы при риносинусохирургии

According to world statistics, of ENT pathology (throat, ear and nose) is among the most common diseases. About 30% of the world’s population constantly suffers from ENT pathology, which leads to a deterioration in the quality of life and disability. One of the most common pathologies of the upper respiratory tract is diseases of the paranasal sinuses (PNS). To date, maximum functionality and minimal trauma to the surgical treatment of ENT diseases, can achieve a functional minimally invasive surgery (Functional Endosocopic Sinus Surgery, FESS), in which the restoration of the natural ventilation and drainage pathways occurs with minimal trauma to the mucous membrane and the anatomy of the structures of the nose and PNS with local surgeries under constant endoscopic control. Endoscopic sinus surgery is a widely used method of surgical treatment of diseases of the nose and paranasal sinuses.The article analyzes the various methods of endoscopic surgery of the paranasal sinuses, describes their positive and negative sides, including the use of a computer navigation system. Data search was carried out in the database PubMed, CRD, Cochrane etc. by keywords. The search for modern solutions of endoscopic sinus surgery determines the relevance of the navigation system in sinus surgery.

Факторы, влияющие на течение раннего послеоперационного периода при кохлеарной имплантации

Persistence of viral infections ((Epstein–Barr virus (EBV), cytomegalovirus (CMV)) contributes to the development of inflammatory pathology of the upper respiratory tract, as well as dystrophic processes in hepatocytes. The impact of this fact on the early postoperative period during cochlear implantation remains poorly understood. A clinical and audiological examination of 100 children with high-grade sensorineural hearing loss was performed. Within the framework of the work, a serological and molecular genetic examination of patients for herpesvirus infections (Epstein–Barr virus, cytomegalovirus) was performed. Two comparison groups are highlighted. The first group included 58 patients with detected latent infections. In the second group 42 patients did not have serological and molecular genetic markers of infection with herpesvirus infection. There is evidence in the literature that surgical trauma combined with general anesthesia can cause reactivation of persistent herpesvirus infection. In 4% (n = 4), markers of an active infectious process were detected. The analysis of the course of the postoperative period in children in two study groups after cochlear implantation was performed. In the hemostatic system, hypocoagulation disorders were found in a number of children. Persistent herpesvirus infection can be a trigger for the development of both inflammatory and non-inflammatory complications after surgical treatment.

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.