[Hearing in children of the Central Federal Region].

A cohort trial of hypoacusis was made in three districts of the Central Federal Region for three years. 11.6% of all hypoacusis and deafness were children under 14 years of age: under 1 year -- 6.3%, 1-3 years -- 9.4%, 4-7 years -- 39.8%, 8-14 years -- 44.4%. Hearing problems were detected in 4% of children under 1 year. In 1-3-year-olds hypoacusis was detected in 13.3%, in 4-7-year-olds -- in 43.2%, in 8-14-year-olds -- in 39.5%. It was established that only in 33.6% junior children hearing defects were related to ENT pathology. 30.4% of hearing lesions in children arise due to pathological pregnancy and labor, 12.5% -- after infectious diseases.

[Clinico-immunological effects of cryosurgery in chronic hypertrophic pharyngitis]. / Kliniko-immunologicheskii éffekt kriokhirurgicheskogo lecheniia bol'nykh khronicheskim gipertroficheskim faringitom.

The authors observed a clinico-immunological effect of cryosurgical treatment for chronic hypertrophic pharyngitis resistant to previous conservative therapy. Cryosurgery results in the patients' recovery with normalization of basic indices of local and systemic immune defense to day 30. Thus, cryosurgical treatment of patients with chronic hypertrophic pharyngitis has both clinical and immunological advantages over conservative treatment.

[Serological assessment of destructive processes in the pharynx in conservative and cryosurgical treatment of patients with chronic hypertrophic laryngitis]. / Serologicheskaia otsenka destruktivnykh protsessov v glotke pri konservativnom i kriokhirurgicheskom lechenii bol'nykh khronicheskim gipertroficheskim faringitom.

The examination of 29 patients with chronic pharyngitis before the treatment, 10 and 30 days after treatment and 18 controls without ENT pathology revealed that the patients' blood and oral fluid contained the antigen inherent for pharyngeal tissue in 24.1 and 89.6% cases, respectively. This antigen was not found in the controls. The appearance of the tissue antigen in the blood and oral fluid may result from destruction of the inflammed tissue and may entail autoimmune reaction. 10 days after conservative anti-inflammatory treatment 12 patients exhibited a temporary clinical and serological effect--improvement of general condition, attenuation of destructive processes, blood and oral levels of the autoantigen and humoral autoimmune reaction to the tissue antigen. 20 days after the treatment clinical and laboratory manifestations renewed. 10 days after cryosurgery antigenemia and autoimmune reaction persisted but 30 days after the treatment the antigen was found neither in the blood nor in the oral fluid, autoimmune reaction declined. This indicates termination of the inflammation and correlates with clinical results.

[Autoimmune reactions in chronic hypertrophic pharyngitis]. / Autoimmunnye reaktsii pri khronicheskom gipertroficheskom faringite.

The aim of the study was to examine blood serum and oral liquid of patients with chronic pharyngitis (CF) for autoimmune reaction, i.e. the presence of pharynx-specific antigen (FSA), antibodies to it and complexes antigen-antibody. A total of 29 CF patients were examined and 18 healthy controls. Before the treatment, FSA was detected in the blood and oral liquid in 24.1 and 89.6%, respectively. The indices of the blood and oral liquid correlated. 30 days after conservative treatment the rate of the antigen detection was not less, while after cryosurgical treatment the antigen was not found. Autoantibodies to FSA occurred in the blood of the patients in 86.2%, in the oral liquid in 34.5%. Conservative treatment failed to reduce the antibodies frequency though cryosurgical treatment lowered this frequency to 5.9 and 17.6%, respectively. Immune complexes in the blood of CF patients were registered before the treatment in 10.3%, after conservative treatment in 9.1%, after cryosurgical treatment they were not found. The emergence of autoantibodies and immune complexes may be a normal reaction to introduction of tissue antigen of the affected organ. Detection of the antigen in the blood and oral liquid indicates destruction of the tissue and the test can be used for assessment of the destruction degree.

[Combined premedication at adenectomy in children]. / Kombinirovannaia premedikatsiia pri adenotomii u detei.

Adenoid vegetation is a frequent pathology in children, and adenotomy (AT) is the only method of its treatment. The problem of anesthesia at AT has always remained an acute one: the risk of general anesthesia exceeds manifold the risk of intervention itself. At the same time, the local anesthesia is not always an method, therefore, the authors put the goal to improve it through potentiating. A total of 180 children, aged 3 to 14, were divided into several groups; anesthesia at AT was implemented according to the below described methods and with regard for the age-related doses of preparations: Group 1--a 2% lydocain solution administered endonasally (e/n); Group 2--lydocain plus diazepam solution administered e/n; Group 3--same preparations and 50% metamizol solution administered e/n; Group 4--lydocain, metamizol e/n, and diazepam administered transbuccally, i.e. chewing gum; Group 5--a 4% articain solution and metamizol e/n plus diazepam administered transbuccally; Group 6--the same technique after a preliminary administration of lydocain; Group 7--clonidine, administered transbuccally, was added. The adequacy of anesthesia was evaluated by using the parameters of the vegetative nervous system and hemodynamics. It was demonstrated that the administration of lydocain alone leads to a sharp activation of the sympathoadrenal system; metamizol and diazepam, especially when administered transbuccally, contribute to an enhanced efficiency of anesthesia, while the endonasal administration of articain and metamizol, after a preliminary introduction of lydocain, combined with the transbuccal administration of diazepam and clonidine is the most optimal variant, however, this method can not be acknowledged as an ideal one and needs further improvement.

[Comparative clinical efficacy and tolerance of cefuroxime axetil (zinnat) and ceftibuten (cedex) in patients with acute sinusitis]. / Sravnitel'naia otsenka klinicheskoi éffektivnosti i perenosimosti tsefuroksim aksetila (zinnata) i tseftibutena (tsedeksa) u patsientov s ostrym sinusitom.

The aim of the study was to substantiate clinically and microbiologically administration of such oral cephalosporins as cefuroxime axetil and ceftibuten in acute sinusitis. The spectrum of causative agents of acute sinusitis was determined, most common pathogens were identified and their sensitivity to antibiotics was tested. The conclusion is made that cephalosporins of the II-III generation meet the requirements to antibacterial drugs for treatment of acute sinusitis.

[Potentiation of local anesthesia in endonasal surgery]. / Potentsirovanie mestnoi anestezii pri éndonazal'nykh operatsiiakh.

An original method of buccal administration of the drugs (by means of chewing gum) was tried in 30 patients aged 18-33 years. The drugs (ketrodol--0.5 mg/kg, diazepam--0.15 mg/kg, clofelin--1 microg/kg) were used to potentiate local anesthesia in operation--submucosal resection of the nasal septum under novocain solution anesthesia. Control 15 patients were operated under local anesthesia with morphine premedication (dose 10 mg). Adequacy of anesthesia was assessed by parameters of central and peripheral hemodynamics. Local anesthesia with morphine significantly activated sympathoadrenal system. Hyperdynamia was secured at the expense of accelerated cardiac rhythm with relatively low myocardial performance. Premedication with the chewing gum allowed to avoid pressor responses to the trauma in moderate hyperdynamia with adequate cardiac performance and minimal shifts in myocardial contractility.