[The value of herbal medicine in the treatment of acute tonsillopharyngitis of non-streptococcal genesis]. / Znachenie fitoterapii v lechenii ostorogo tonzillofaringita nestreptokokkovogo geneza.

The purpose of the study. To establish the effectiveness of symptom reduction and preventive action of the herbal drug Tonsilgon N (HD) as monotherapy for exacerbations of chronic tonsillitis/pharyngitis in adult patients. MATERIAL AND METHODS: The study included 60 adult male and female patients aged 18 to 60 years with an established diagnosis of acute tonsillopharyngitis. In total, each patient underwent 5 visits. Visit 1 - enrollment in the study and beginning of HD monotherapy, Visit 2 - on Day 7, Visit 3 - on Day 14 and completion of HD monotherapy, Visit 4 - on Day 60 and Visit 5 - on Day 180. The diagnosis of the disease and the examination of the patient was carried out on the basis of anamnesis, general clinical and ENT examination, palpation of regional lymph nodes. The severity of the clinical signs was evaluated on the basis of the symptom score. The general condition of the patient was also evaluated using a visual analogue scale (VAS) and the number of exacerbations of tonsillopharyngitis during the observation period. RESULTS: The number of exacerbations of chronic tonsillitis and episodes of ATP for 6 months after the end of treatment decreased 4.8 times compared to the previous period. During the course of treatment (14 days), complaints of patients with ATP (general health and/or fatigue, pain when swallowing, headache, cough, burning sensation, a lump in the throat, hoarseness, pain and dryness in the throat, difficulty swallowing) had a pronounced tendency to regression. Improvement was also noted on examination and clinical evaluation. According to the results of the analysis of the evaluation of general condition according to the VAS (according to the standard technique in cm), there was a significant improvement both during the treatment period by 2.2 times, and during the observation period (180 days) from the period of Visit 2 to Visit 4 by 31.3 times. CONCLUSION: The use of HD as monotherapy for non-streptococcal ATP has shown its high efficiency. The possibility of using Tonsilgon N was shown as a prophylactic agent that reduces the number of exacerbations of inflammatory diseases in the pharynx during the period after the treatment course.

[Microflora of the nasal mucosa in allergic perennial and infectious rhinitis]. / Mikroflora slizistoi nosa pri allergicheskom kruglogodichnom i infektsionnom rinitakh.

The microbiological study of 69 patients with allergic annual rhinitis (AAR) and infectious rhinitis (IR) was carried out. In AAR the isolated representatives of 15 genera and 40 species were distributed in 2 to 7 component; in IR the isolated representatives of 16 genera and 25 species were grouped in 2 to 4-component associations. In AAR Staphylococcus aureus was found to belong to the main species and in IR, S. aureus and S. epidermidis, while the number of species regarded as occasional in AAR was 7 (S. auricularis, S. cohnii, S. hominis, S. haemolyticus, S. warneri, S. apitis, S. schleiferi). Differences in the distribution of Neisseria, nonfermenting Gram negative bacteria, Streptococcus in associations in cases of AAR and IR were established. In AAR Corynebacterium pseudodiphthericum and in IR C. pseudotuberculosis were the dominant species.

Antimicrobial susceptibility of nasopharyngeal isolates of Haemophilus influenzae from healthy children in day-care centres: results of multicentre study in Russia.

Resistance of Haemophilus influenzae from clinical isolates can be predicted on the basis of results of antimicrobial susceptibility of nasopharyngeal isolates. The carriage rate and the antimicrobial susceptibility of H. influenzae isolated in healthy children attending day-care centres in Moscow, Smolensk and Yartsevo was studied. The susceptibility of ampicillin, amoxycillin/clavulanate, cefaclor, erythromycin, roxithromycin, clarithromycin and trimethoprim-sulphamethoxazole were determined by the E-test. The mean carriage rate of H. influenzae was 44%. Resistance of H. influenzae to ampicillin was 2.3%, to amoxycillin/clavulanate 0.7%, to cefaclor 0.7%, to clarithromycin 18.7% and to trimethoprim-sulphamethoxazole 21%. These included strains that showed intermediate-resistance. The antimicrobial resistance profiles varied in different centres. The clinical use of trimethoprim-sulphamethoxazole should be restricted because of the high resistance of H. influenzae to antifolate compounds.

[Aspects of nasopharyngeal microflora and middle ear function in children]. / Osobennosti mikroflory nosoglotki i funktsional'noe sostoianie srednego ukha u detei.

Exudative otitis media (EOM) was detected in 13 (14.8%) children out of 88 preschool children at audiological investigation. In their nasopharynx, these children carried pneumococci and hemophylic bacilli. The latter were identified 1.7 times more often in children with EOM than in those free of it. Both pathogens were encountered in EOM children 2.6 times more frequently. It is suggested that the above pathogens may support development and maintenance of EOM.

Antimicrobial resistance of Streptococcus pneumoniae isolated from healthy children in day-care centers: results of a multicenter study in Russia.

BACKGROUND: It has been previously shown that study of susceptibility of nasopharyngeal isolates in healthy carriers can predict resistance in clinical isolates. The purpose of this multicenter study was to determine the carriage rate of Streptococcus pneumoniae in healthy children attending day-care centers in Moscow, Smolensk and Yartsevo, Russia, and in vitro activity of penicillin G, amoxicillin/clavulanate, cefaclor, erythromycin, roxithromycin, clarithromycin and trimethoprim-sulfamethoxazole (TMP-SMX) against representative isolates. METHODS: Included in this study were 305 pneumococcal isolates from 733 children attending 9 day-care centers in Moscow, Smolensk and Yartsevo. All children enrolled in this study were <7 years of age. MICs of selected antimicrobials were determined by Etest. Serotyping of selected pneumococcal isolates was done with pool and type antisera. RESULTS: The carriage rate of S. pneumoniae in the 3 centers varied from 44.9% to 66.0% (mean, 55.9%). Susceptibility testing was performed with 305 (74.4%) of 410 isolates. Only 23 (7.5%) of 305 pneumococcal isolates were penicillin-intermediate (range, 2.8 to 12.8%) with no penicillin-resistant strains. All tested pneumococci were susceptible to amoxicillin/clavulanate. Macrolides possessed comparable activity against S. pneumoniae, at 4.6% resistant strains for both erythromycin (range, 1.1 to 17.1%) and clarithromycin (range, 1.7 to 17.1%). The highest level of resistance was observed with TMP-SMX, 53.4% (range, 43.8 to 70.9%). Of 23 strains 20 (87.0%) with intermediate resistance to penicillin were serotyped. The most prevalent serotype was 14 (5 isolates), followed by serogroups 19 (4) and 23 (4). CONCLUSIONS: Resistance to penicillin, other beta-lactams and macrolides does not seem to be a problem for Russia now. The high level of resistance to TMP-SMX considerably restricts its usage for the treatment of pneumococcal infections.

[Risk factors in the development of otitis media with effusion in children]. / Faktory riska razvitiia ékssudativnogo srednego otita u detei.

The data of the genealogical and perinatal anamnesis, neurological examination of patients with exudative otitis media (EOM) suggest that they are at high risk of hypoacusis. Early comprehensive neurological examination of children from the risk group helps detection of hypoacusis in childhood. EOM children need neurological rehabilitation and correction of vegetative status.

[A clinico-morphological rationale for the use of heparin in nasal polyps occurring with rhinosinusitis in children]. / Kliniko-morfologicheskoe obosnovanie ispol'zovaniia geparina pri polipoznom rinosinusite u detei.

Clinicomorphological study of polypous rhinocinusitis in children gave evidence for functional disorders in local immunity and autonomic nervous system, i.e. adaptation system. It is supposed that correction of these disorders should be made by including in the treatment complex of medicines activating local immunity and vegetotropic drugs. Heparin ointment in the postoperative period was beneficial.

[Health status of children with speech disorders]. / Sostoianie zdorov'ia detei s patologiei rechi.

Preschool children with speech defects often have unfavourable history of family and perinatal diseases. Their health status is not satisfactory. Therefore, a special conditioning program should be developed and applied to children with speech defects.

[Experience in the use of eucalymine in acute inflammatory ENT diseases in children]. / Opyt primeneniia évkalimina pri ostrykh vospalitel'nykh zabolevaniiakh LOR-organov u detei.

Eucalyptus-based drug eucalymine made in Russia has been tried in children with acute maxillary sinusitis, exacerbation of chronic purulent maxillary sinusitis and peritonsillar abscess. The findings indicate a good antiinflammatory effect of eucalymine which can be used as a treatment of choice in children with ENT diseases.

[Acoustic impedance measurement in the diagnosis of hypoacusis in children]. / Akusticheskaia impedansometriia v diagnostike tugoukhosti u detei.

In 1986-1988, we examined 1105 children no older than 15 years with various forms of hypoacusis. It was found that measurement of acoustic impedance can help topical diagnosis at any age, especially in children younger than 3 years. In 1988, we examined 350 children with conductive hypoacusis. The specific features of tympanography and acoustic reflexes allow early and accurate diagnosis of middle ear abnormalities. It is stressed that measurement of acoustic impedance may play an important role in examinations of patients with middle ear pathologies.

[Organization of deafness services to children in Moscow]. / Organizatsiia surdologicheskoi pomoshchi detiam v Moskve.

In recent years the percentage of patients with neurosensory hypoacusis among those with chronic hearing diseases has substantially increased. This fact makes important improvement of surdological aid to children in Moscow. The major goals of the city surdological department are: detection of children with hearing pathologies, their treatment and rehabilitation, manufacture of hearing aids. Rehabilitation is performed in dedicated kindergartens and schools. At the present time the basic purpose of the personnel is to detect children with hearing problems in high risk groups.