[The structure of childhood diseases in the patients presenting with hospital-acquired ENT pathology estimated based on the results of monitoring children's hospitals in Moscow]. / Struktura zabolevaemosti deteĭ s gospital'noĭ patologieĭ LOR-organov po rezul'tatam monitoringa detskikh statsionarov Moskvy.

The objective of the present work was to study the structure of childhood diseases in the patients presenting with hospital-acquired ENT pathology based at the results of analysis of the annual reports presented by the heads of departments of otorhinolaryngology of Moscow children's hospitals for the period from 2011 till 2013. It was shown that pharyngeal pathologies predominate among the children amounting to 43.9% of the total ENT morbidity. These conditions are followed by nose and paranasal sinus pathologies (29.2%), ear diseases (22.5%), laryngeal, bronchial and tracheal pathologies (4.4%). The analysis of the internal structure of different classes of diseases was made separately for the ear, throat, and nose (ICD-10). The results of the study give evidence of the tendency toward the higher incidence of selected forms of acute inflammatory diseases and chronic ENT pathologies in the childhood.

[The concept of the development of the otorhinolaryngological service in Moscow under conditions of modernization of the healthcare system and single-channel funding].

This paper highlights the complex of organizational and socio-economic measures designed to modify the healthcare system in the city of Moscow, improve the quality of medical aid, and ensure its availability for the urban population. The proposed methods were developed based on the results of analysis of the data obtained in the course of checking the work of the otorhinolaryngological services of the city, analysis of effectiveness of using the hospital stock in the therapeutic and prophylactic facilities of Moscow.

[Peculiarities of epidemiology of chronic tonsillitis under current conditions of providing specialized aid to the patients presenting with ENT diseases].

The objective of he present works was to analyse epidemiological parameters characterizing the prevalence of chronic tonsillitis morbidity and specific features of its local and systemic complications (the former included paratonsillar abscess, PA, while the latter acute rheumatic fever, ARF, and acute post-streptococcal glomerulonephritis, APSGN). The data subjected to the analysis comprised information collected by the Statistical Department of the Clinical Infectious Hospital No 1 for the past 10 years about the number of hospitalized patients having the diagnosis of tonsillitis in combination with PA and the data on the number of peritonsillar abscess drainage procedures performed between 2008 and 2010 (Statistical Department of S.P. Botkin City Clinical Hospital), the number of tonsillectomies, the prevalence of ARF and APSGN during the last 10 years (Medical Statistics Bureau of the Moscow Health Department), and the results of monitoring regular medical check-ups of the patients presenting with the above pathologies. The number of the patients hospitalized at the Clinical Infectious Hospital No 1 for the diagnosis of tonsillitis in combination with PA was shown to increase as well as the number of autopsies of the patients with PA performed at S.P. Botkin City Clinical Hospital. Simultaneously, the number of tonsillectomies in the clinics of Moscow Health Department decreased whereas the prevalence of ARF and APSGN and the number of the patients with chronic tonsillitis under dispensary observation for over 2 years increased. It is concluded that otorhinolaryngologists working in outpatient facilities must promptly identify indications for radical surgical sanitation of the pockets of chronic infection by means of bilateral tonsillectomy.

[The incidence of chronic purulent otitis media and the treatment of this pathology in Moscow].

Analysis of medical appealability of adult subjects in outpatient clinics of Moscow during the last 5 years (2003-2008) has demonstrated a tendency toward the increased incidence of ear diseases and mastoid process lesions as well as the concomitant decrease of the incidence and prevalence of chronic purulent otitis media (CPOM). Accordingly, the surgical activity in specialized otorhinolaryngological facilities has grown up to 8.9%. Treatment of chronic purulent otitis media accounts for 47.5% of this value. 26.4% of the patients presenting with CPOM undergo hearing-saving operation on the middle ear and sometimes classical radical surgery. Patients with CPOM account for 41.1% of their total number in surdological departments. Treatment by hearing-preserving surgery on the middle ear is given in surdological departments to only 13% of the patients presenting with CPOM. In the departments for urgent otorhinolaryngological aid, patients with chronic purulent otitis media constitute 4.4% of the total and 45% of them undergo sanitizing hearing-preserving surgery on the middle ear (including extensive interventions in the cases developing complications).

[Relevance of the chronic tonsillitis problem].

This study was designed to analyse dynamic characteristics of planned and emergency surgical care provided to patients with chronic tonsillitis (CT) in 3 large hospital of Moscow during the period between 2002 to 2006. The number of planed surgical interventions for the treatment of chronic tonsillitis performed during 5 years decreased almost two-fold. In contrast, the total number of urgent operations for surgical drainage of paratonisillar abscess in all clinics of the city during the last 10 years increased by a factor of 2. Results of bacteriological studies of species composition of microflora in patients with CT suggest the relationship between the incidence of this pathology and acute rheumatic fever. Analysis of activities aimed at the prevention of chronic tonsillitis (based in the first place at specialized dispensary facilities) has demonstrated that the number of patients involved in relevant monitoring programs is rather small and those in need of radical sanation of inflammatory CT foci are not referred for surgical treatment at the early stages of the disease as required by the current diagnostic and therapeutic algorithm for the management of chronic tonsillitis.

[Analysis of delayed consequences of lowered surgical activity for children with chronic tonsillitis].

Materials for the analysis of medical histories of the patients admitted for planned tonsillectomy and those in need of emergency surgical treatment for paratonsillar abscess were collected in the Department of Otorhinolaryngology, G.N. Speransky City Children's Clinical Hospital No 9 during the periods from 1990 to 2007. Simultaneously, analysis of the work of the Departments of Cardiorheumatology and Nephrology of the same hospital was undertaken. It was shown that the reduction in the number of surgical interventions for the treatment of different forms of chronic tonsillitis in the last years resulted in the increased frequency of local complications and concomitant morbidity.

[The prevalence, causes and specific features of voice disturbances in teachers]. / Rasprostranennost', prichiny i osobennosti narushenii golosa u pedagogov.

The paper analyzes voice disturbances, their causes and specific features in teachers based on the questionnaires filled by 934 general educational school teachers. The teachers have been found to associate voice disturbances not only with changes in the voice timbre, but with different subjective feelings that make their professional activity difficult. The major factors that cause voice disturbances are the voice overloads that differ in teachers of different specialities, their inability to use the voice, psychoemotional stresses, and frequent colds, as well as a combination of several factors. The incidence of vocal apparatus diseases does not tend to decrease, which makes it necessary to implement combined medical and pedagogical prophylactic measures to prevent dysphonia.