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The purpose of the research was to analyze the effectiveness of the therapy SynflorixTM” vaccine in the conservative complex treatment of chronic tonsillitis in children. Material and method. The clinical study included 68 children with uncomplicated chronic tonsillitis who were divided into two groups: 1-34 children undergoing treatment with the vaccine „SynflorixTM” concomitantly with standard therapy; Lot 2 - 34 children receiving standard therapy (tonsil gaps washing with antiseptic solution sprinkling tonsils Lugol solution). Immunological investigations were carried out before and after three months of treatment, which included: the functional activity of T cells and specific sensitivity of cells; CD16 lymphocyte content; phagocytic ability of neutrophils; the level of circulating immune complexes (CIC); Complement hemolytic activity (AHTC); titer content cytokines IL-8, IL-1β, TNF-α, IL-4. Results. CIC levels really decreased after treatment only in children from group 1 (p<0.01, to treatment - 290 ± 27; after - 187 ± 16.2), in group 2 was observed only a downward trend. In children from the first group, the increase phagocytic activity of neutrophils was more robust (p<0.001, up - 4.2 ± 0.14 after - 5.2 ± 0.19) compared with children from Lot 2 (p <0.05 by - 4.7 ± 0.27; after - 5.3 ± 0.18). Dynamic content in CD-16 treatment was really increased only in children from the first group (p <0.01, up -14.6 ± 0.28 ± 0.23 after -15.8). Post-treatment, the AHTC remained truthful highest in children from Lot 1, compared with children from Lot 2 (p <0.05, 60.4 ± 1.36; 55.8 ± 1.42). The functional activity of T lymphocytes in dynamics conclusive treatment increased more in children of group 1 (p<0.001, 65.9 ± 0.70, 68.4 ± 0.65), than those from group 2 (p<0, 05 66.8 ± 0.79, 69.2 ± 0.67). The titer of Streptococcus antigens and T lymphocytes increased after treatment only in children from group 1 (p<0.05, 3.5 ± 0.30, 4.2 ± 0.16). Proinflammatory cytokine, TNF-α, reduced after treatment more significantly in group 1 (p<0.001, 1.5 ± 0.1, 0.7 ± 0.08) compared with group 2 (p<0.05, 1.5 ± 0.13, 1.0 ± 0.16). The levels of IL-8 and IL-1β cytokine tended to decrease after treatment in both groups. The titres of anti-inflammatory cytokine IL-4 were higher after treatment in children from group 1, than those from group 2 (p<0.05, 21 ± 1.19; 15.8 ± 2.17). The number of acute upper respiratory tract infection really decreased over 2 years in group 2 (p<0.001 by the treatment - 5.7 ± 0.18 by - 1.3 ± 0.42). In group 1, the decrease was less significant (6.4 ± 0.30, 2.8 ± 0.32). Post-treatment, the number of antibiotic therapy prescriptions dropped more truthful in children of group1. Conclusion. The vaccine „SynflorixTM” normalizes the immune reactivity of children with chronic tonsillitis and has a positive clinical effect at a high level. [ABSTRACT FROM AUTHOR]

The Goal. The study of the special features of the electroencephalographic response and auditory evoked potentials limits of the trunk of the brain in the diagnosis of sensorineural hearing loss in children with perinatal pathology of the central nervous system. Materials and methods. Audiological examination by the recording of the auditory evoked potentials test of the trunk of the brain has been carried out in the center of the Audiology IMSP IMsiC. The study group included 110 children (the main group) with various neurological disorders and sensorineural hearing loss and 30 children (the control group) with normal hearing, the age of the children being between 1-36 months. In accordance with the degree of hearing loss, the children from the main group have been divided in: 29 children with moderate hearing loss, 51 with severe hearing loss and 30 with deep hearing loss. Recording evoked potential has been conducted in accordance with the conditions and the parameters required, the children being in a state of physiological sleep or on medication. Results and discussions. The value of the auditory threshold determined on the basis of wave V of the potential hearing aids in group of children with moderate hearing loss was 61.69 dB±1.09 dB; in children with severe hearing loss was 76.92±0.64 dB; in the group of children with profound hearing loss this was 97.69±0.96 dB. In the main group the auditory evoked potential have been determined by a pathological trend, determined by the lack of all the components of the times the waves I, III and V deleted, irreproducible. The wave I in cases of moderate hearing loss has been detectable 84.03%, in cases of severe hearing loss was absent in 16.67% and absent in 53.33% in the group with profound hearing loss. The comparative analysis of the results obtained reveals a prolongation of the latency of the waves I, III, V and the interval I to V from the control group. We studied the auditory evoked potentials in the dynamics to 43 children with hearing loss, 9 of them with moderate hearing loss, 22 with severe hearing loss and 12 with profound hearing loss, in all cases after the neurological treatment. It has been found an improvement in the shape of the wave form that allowed the identification of the waves I and III, in several cases in relation to the initial examination. If in the group with moderate hearing loss wavelength III to the initial examination has not been possible to identify only in 25% of cases, then the lengthwise examination in 50%, the group of children with severe hearing loss in 35.71% from 16.67% at the initial inspection and 41.67% from 16.67% in the group of children with profound hearing loss. During the longitudinal control it was noted an improvement in the identification of the waves and the waveform in its entirety. So if at the time of the initial examination in the group with severe hearing loss the auditory evoked potentials have been absent in 22.73% of cases where the examination in the dynamics their lack was found only to 4.55%. In the group with profound hearing loss of the 75% of the cases for which the first examination has recorded the absence of the auditory evoked potentials, at the repeated examination it has been confirmed the absence in just 8.33% of cases. These results confirm the sensitivity of the auditory evoked potentials the turmoil at the level of the central nervous system. Conclusions. The auditory evoked potential test of the trunk of the stroke is an objective method, reliable, in the diagnosis of hearing loss in children with perinatal pathology of the central nervous system remains a the reference method in the complex audiological exam. [ABSTRACT FROM AUTHOR]

The etiological diagnosis with maximum accuracy has a major importance in the problem of sensorineural hearing loss in children. Many researches have allowed to identify a series of factors acting at different stages of ante-, intra-, or postnatal period that would contribute to the installation of hearing loss in children. The goal. The discriminant statistical analysis of the risk factors, in the periods ante-, intra-, or postnatal for identification and forecasting of sensorineural hearing loss in children, based on their. Materials and methods. In 110 children aged between 0-36 months, with different forms of sensorineural hearing loss, have been studied 57 risk factors; children with a history of deafness within the family (genetic forms) were excluded from the study group. The distribution by age was: 0-12 months - 21 children (19.09%); 13-36 months - 89 children (80.91%). The distribution in accordance with the degree of hearing loss was: children with moderate form - 29 (26.36%), severe - 51 (46.36%), deep - 30 (27.28%). Results. The single factor discriminat analysis under F-criterion has allowed the demonstration of the following factors, in the antepartum period: harmful professional conditions of mother 17.43% (p<0.05), chronic somatic disease of the mother 18.35% (p<0.05), the intragenitale diseases 37.61% (p<0.01), CMV 24.77% (p<0.001), the administration of ototoxic drugs 92.61% (p<0.05), the intranatal period - palogical extended birth (EBRD) 40.91% (p<0.01), accelerated delivery 28.18% (p<0.001), asphyxia 64.55% (p<0.001), prematurity 16.36% (p<0.05), hipotrophy 20% (p<0.05), hemolytic jaundice 13.64% (p<0.05); the postnatal period - meningitis 20% (p<0.05), craniocerebral trauma 22.73% (p<0.05), the administration of ototoxic drugs 47.27% (p<0.001). For forecasting the installation of hearing loss in children on the basis of the risk factors, we appeal to the multifactorial analysis and the interconnection of factors. The discriminating analysis “step-by-step” highlighted the 9 factors of the ante- and intranatal periods: pathological birth (F=56.715), asphyxia at birth (F=5.371), low Apgar score ≤7 (F=12.154); prematurity (F=20.322), forceps (F=4.455), circular umbilical cord (F=3.510), hemolytic jaundice of the newborn (F=2.622), IVA during the pregnancy (F=5.359), pyelonephritis at the mother (F=2.824). The discriminating analysis “step-by-step” highlighted the 7 factors of the postnatal period: the administration of ototoxic drugs (F=26.512), craniocerebral trauma (F=12.388), meningitis (F=5.645), cytomegalovirus (F=9.492), acute viral infection with high fever (F=4.196), neuroinfections (F=3.184), complications after vaccination (F=2.622). The discriminating analysis using these variables allows the forecasting of the sensoroneural hearing loss in children in 84.40% of cases. Conclusions. Highlighting the factors with the major contribution in the outbreak of deafness and the principle of forecast allow the development of measures to prophylaxis and etiologic diagnosis of sensorineural hearing loss in children. [ABSTRACT FROM AUTHOR]