CC BY
90
Section 7. Medical science
References:
1. Budchanova N. U., Delyagin V. M., Khondkaryan G. S. Prevalence and peculiarities of clinical manifestations of primary headaches in school children. Rasprostranyonnost I osobennosti klinicheskikh proyavleniy pervichnikh golovnikh boley u shkolnikov. [Pediatrics]. 2008. № 87 (5). P. 138-140. (in Russian).
2. Zavadenko N. N. Hyperactivity and attention deficit in childhood. - M., 2005. P. 256 (in Russian).
3. Barkley R. A. Attention-deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 3rd ed. N. Y., 2005. 770 p.
4. Behavioral and Temperamental Characteristics of Children and Adolescents Suffering from Primary Headache/L. Mazzone, B. Vitiello,
G. Incorpora, D. Mazzone//Cephalalgia. 2006. - № 26 (2). P. 194-201.
5. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. (DSM-V). Washington, 2013. 947 p.
6. Kröner-Herwig B., Heinrich M., Morris L. Headache in German Children and Adolescents: a Population-based Epidemiological Study//Cephalalgia. 2007. - № 27 (6). P. 519-527.
7. Pennington B. F. Diagnosing Learning Disorders: A Neuropsychological Framework. N. Y.; L., 2009. 355 p.
8. Prevalence and Clinical Characteristics of Primary Headaches among School Children in South Korea: a Nationwide Survey/Y. I. Rho,
H. J. Chung, K. H. Lee et al.//Headache. 2012. - № 52 (4). P. 592-599.
9. Prevalence of Headache and Migraine in Children and Adolescents: a Systematic Review of Population-based Studies/I. Abu-Arafeh, S. Razak, B. Sivaraman, C. Graham//Dev. Med. Child Neurol. 2010. - № 52 (12). P. 1088-1097.
10. Primary Headaches, Attention Deficit Disorder and Learning Disabilities in Children and Adolescents/J. Genizi, S. Gordon, N. C. Kerem et al.//The J. of Headache and Pain. 2013. - № 14. P. 54.
11. The Associations among Childhood Headaches, Emotional and Behavioral Difficulties, and Health Care Use/T. W. Strine, C. A. Okoro, L. C. McGuire, L. S. Balluz//Pediatrics. 2006. - № 117 (5). P. 1728-1735.
Salakhiddinov Kamoliddin, Andijan State Medical Institute, assistant professor, of faculty and hospital surgery, Uzbekistan E-mail: kamaliddin@mail.ru
Modern view in treatment of burn wounds
Abstract: The authors studied 65 patients with burn wounds upper and lower extremities with the use of chelating agent in the treatment of regional lymph and antibiotic biosynthetic wound Parapran coatings. Showed a positive result of the application of lymphatic therapy can reduce wound complications.
Keywords: burns, lymphatic therapy, wound dressings, wound complications.
Introduction
It is important to notice that any combustions, especially extensive, irrespective of their localization, are followed by inflammatory process and the expressed external lymphorrhea (plasmorrhea) with which, the organism is left by the vital elements, proteins, electrolytes and etc.
Do not forget about the often accompanying the process of burn wound infections [1].
Plasma loss at deep combustions it is shown not only wound loss, but also formation of an edema in surrounding a burn wound of a tissue.
At the disorders of microcirculation resulting in massive stagnation of a blood in vessels the local compensatory augmentation of a limfoproduktion takes place. During this period the lymphatic bed can be one of the main drainage links of an interstitial [2; 3].
Lymphatic system is not only a derivative ofvenous system, but also highly provides communication of an interstition with other departments of the blood course [3; 4].
Important circumstance of lymphatic system, the factor of accumulating of the damaged cages, microorganisms and toxins with the subsequent neutralization and removal is in their natural way.
Washing away or so-called capture, happens lymphatic capillaries, but not blood microvessels since the wall of the first, without possessing on the histologically structure a basal membrane, is capable to pass through itself the microbial bodies and other corpuscular particles having big molecular weight [2; 3; 4].
Research purpose: to estimate clinical efficiency of application of regional lymphatic therapy in treatment ofburn wounds, various localization.
Materials and methods.
We studied 65 patients with combustions of III And the Art., various localization. From them 30 it is groups sick with a basis by which the complex of medical actions included a regional lymphatic antibi-oticotherapia (RLAT) and a wound covering «Parapran». 35 patients made control group which received traditional treatment. All studied patients were mainly with combustions of the top or lower extremities.
The clinical assessment of results of treatment was carried out on the basis of a current of a wound process, terms of depression of an edema, cuticularization terms from an initiation of treatment, bacteriological and cytologic researches, by wound pyeses. At patients in dynamics studied changes of the main clinical laboratory indicators.
Results of researches:
Comparing clinical and datas of laboratory of the compared groups we received the following: against complex treatment of RLAT at 16 (53.3%) patients already by the beginning of 2 days it was noted appreciable and places and full depression of an edema and refocal inflammation, in control group these indicators were shown in later terms for 3-4 days.
From burn wounds prior to treatment of control and main groups strains of P.aeruginosa of 20% of S.aureus, in other cases of S.epideridis were sowed in
State of neuro-humoral regulation in congenital heart defects in children
Through 2 days after an initiation of treatment patients of control group had a microorganisms that as before treatment, the microbial contamination didn't change, and was even in certain cases enlarged. In the main group with use of RLAT the microbial contamination decreased with 105,4 to 103,6 on КОЕ cm2 of a wound surface, the vysevayemost of P. aeruginasa and S. aureus decreased. Against treatment of RLAT by 5 th days microorganisms were allocated only at 2 patients, from them at 1-P. Aeruginasa, 1 Acinetobacter spp.
Depression oflevel of a microbial contamination ofburn wounds against complex treatment with 103,6 to 101,2 on КОЕ™2 of a wound surface became perceptible. In group of comparison in 2 cases against traditional treatment by 5th days allocation of microorganisms from burn wounds is noted. In 3 cases the two-component association is received (S. aureus with P. aeruginasa). The microbial contamination of burn wounds against traditional treatment decreased with 105,5 to 103,4 on KOEcm2 of a wound surface.
Prior to treatment all patients of the main and control groups had the following cytologic picture: types of cytograms prevailed inflammatory (75%) and inflammatory and regenerator (25%). Against treatment for the 5th days in control, the cytogram type at 25 patients was replaced with regenerator and inflammatory, remaining inflam-
matory and regenerator at 8 (22,8%) and inflammatory at 2 (2,5%) patients. At the same time in group of comparison against RLAT the inflammatory and regenerator type of the cytogram is noted at 2 (6,6%) the patient, at 10 (33,3%) — regenerator and inflammatory and at 18 (60%) regenerator and inflammatory with an autoimmune component.
For the 4th days at 23 (76.6%) the patients who received a regional lymphatic antibioticotherapia the expressed active cuticular-ization opposite to 15 (42.8%) control became perceptible.
Suppuration of wounds was observed in 2 (6.5%) primary and 5 (14.2%) of the control groups.
Thus, the regional lymphatic antibioticotherapia in complex treatment of victims of combustions referred on prophylaxis and treatments of complications burn wounds significantly influences the current and the result of inflammatory process in a wound, a bacterial contamination, reduces the frequency of complications. As a result of use of RLAT depression of an edema, refocal inflammation becomes perceptible, terms of restoration of an integument decrease. Besides RLAT it: a possibility of more aim administration of medicines to the lesion center (achievement of high concentration of antibiotics), ease and a possibility of use at all stages of treatment, economic efficiency.
References:
1. Alekseev A. A., Krutikov M. G., Yakovlev V. P. Burn infection. Etiology, pathogenesis, diagnostics, prophylaxis and treatment. - the Monograph - M. Vuzovskaya the book, 2010-416 p.
2. Borodin Yu. I., Sapin M. R., Etingen L. E. and other//General anatomy of lymphatic system. Novosibirsk.: nauka of Sib.otd.1990, 243 p.
3. Nechepelenko G. V.//Segmentary theory of lymphatic system. - M.: khimiya, 1990, 160 p.
4. Sapin M. R., Borzyak E. I.//Extra organ ways of transport of a lymph. - M of a.: meditsin, 1982, 264 p.
5. Kaye ET. Curr Clin Top Infect Dis. 2000; 20: 43-62.
6. Pruitt BA. In: Infection and the surgical patient. Polk HC. (Ed.) Churchill Livingstone. 1982; 4: 113.
Navruzova Shakar Istamovna, MD, Associate Professor, Head of Department of Childhood Diseases and Neonatology of the Bukhara State Medical Institute, Bukhara, Uzbekistan.
Sa'dulloeva Iroda Kurbonovna, Senior scientific employee-researcher, Assistent of Department of Childhood Diseases and Neonatology of the Bukhara State Medical Institute, Bukhara, Uzbekistan.
E-mail: ss-1961@mail.ru
State of neuro-humoral regulation in congenital heart defects in children
Abstract: Authors examined 160 patients of children with congenital heart disease (CHD). We studied the cellular and humoral immunity, cytokine, and thyroid status in patients with corticoid children with congenital heart disease in the periods before and after surgery. The authors argue that the state of neuro-humoral regulation (NHR) of the body determines the course of CHD. Natural and after operating for CHD accompanied by dysfunction of the endocrine glands. Operational correction CHD partial or complete removal of the thymus further reduces the innate.
Keywords: congenital heart disease, immune system, timic-cortical status, neuro-hu-moral regulation.
Congenital heart defects (CHD) — one of the most common congenital anomalies in children. In recent years there has been an increase in the frequency of CHD due, probably, the use of more
advanced methods of functional diagnosis and the increased interest in the issue of the CHD other physicians [1-3].
According to various authors, in the United States are born each year to 30-35 thousand children with CHD, in the Russia 20-22 thousand Children [14; 15].
Natural mortality for all CHD is about 40%, and most patients die in the first year of life and 70% of them — in the first month of life [15]. In the age structure of mortality from CHD and anomalies of the great vessels 91% were children of the first year of life. Among them, about 50% — children up to 28 days of life (neonatal period) [6-9].
According to research L. A. Bokeria and collaborators (2010), children with CHD and low concentrations of total immunoglobulin
