[OUTPATIENT ANTIMICROBIAL TREATMENT FOR ACUTE TONSILLOPHARYNGITIS].

UNLABELLED: One of the most significant problems in antimicrobial therapy (AMT) is widespread administration of antimicrobial agents without relevant medical conditions. The aim of the research was the analysis of antimicrobial agent prescribing practices for outpatient treatment of acute tonsillopharyngitis at the Karaganda Polyclinic №1 and Polyclinic №2. The analysis of antimicrobial agents prescribing practices for outpatient treatment of acute tonsillopharyngitis was conducted; medical records of outpatients with acute tonsillopharyngitis treated in 2014 at Polyclinics №1 and №2 were analyzed. INCLUSION CRITERIA: patients ranging in age from18 to 44, verified diagnosis - acute tonsillopharyngitis. It was found that in all cases antimicrobial agents have been prescribed speculatively, without previous bacteriological study or method of express diagnostics of Group A beta-hemolytic streptococcus (GABHS). In a majority of cases ß-lactams were prescribed. Flemoxin Solutab was the most commonly prescribed ß-lactam in Polyclinic №1; Amoxicillin was the most commonly prescribed ß-lactam at Polyclinic №2; it associated with personal experience of administration of these agents rather than data of evidentiary medicine. Study of actual medicine administration showed that in half of the cases dosage regimen, rout of administration, dosage and treatment session duration have not been followed. For the development of clinical guidelines for rational treatment of acute tonsillopharyngitis is necessary to study the local spectrum of the major pathogens and their antimicribial resistance.

THE IMPORTANCE OF IMMUNOHISTOCHEMICAL STUDIES IN THE DIAGNOSIS OF CANCER OF UNKNOWN PRIMARY ORIGIN.

The purpose of the research is to give a comparative diagnostic characteristic to tumors of unknown primary origin by admission diagnosis and morphological diagnosis. 162 treated cases with tumors of unknown primary at Oncologic Dispensary for 5 years were analyzed in details. Besides clinical, instrumental, cytological, morphological methods, immunnohistochemical research of tumors was carried out by avidin-biotin-peroxydase tecnics. The cases with poorly differentiated carcinoma (33,3±4,3%) and lymphoproliferative disorders (27,2±3,5%) prevailed among the cases with tumors of unknown primary by histological research. High degree of noncoincidence of cytologic and histological diagnoses (χ2=515, р=0,00001), histological and immunohistochemical diagnoses (χ2=378, р=0,00001), cytologic and immunohistochemical diagnoses (χ2=556, р=0,00001) were revealed. Cytologic overdiagnosis of undifferentiated carcinoma by 13,6% (р<0,05) and hypodiagnosis of benign diseases by 4,4% (р<0,05) and histological overdiagnosis of poorly differentiated carcinoma by 11,1% (р<0,05) and hypodiagnostics of tumors of nerve tissue by 8,0% (р<0,05) are marked, that points to the necessity of making immunohistochemical research in the cases of given pathology. Statistically significant connection of mean degree between diagnoses of poorly differentiated tumors made by cytologic, histological and immunohistochemical investigation is revealed.