[Evaluation of the possibility of diagnosing purulent-septic rhinogenic complications of the orbit and eyelids in children based on the analysis of clinical and laboratory data]. / Otsenka vozmozhnosti diagnostiki gnoino-septicheskikh rinogennykh oslozhnenii orbity i vek u detei na osnove analiza kliniko-laboratornykh dannykh.

OBJECTIVE: To study the features of clinical and laboratory parameters of rhinogenic complications of the orbit (RCO) and eyelids depending on the blood leukocyte shift index (LSI) to create a predictive model in pediatric patients. MATERIAL AND METHODS: The study included 50 patients who were treated at the Regional Clinical Hospital No. 2 of Tyumen with inflammatory pathology of the paranasal sinuses. Group I with RCO - reactive edema of the eyelids and orbital tissue included 29 (58.0%) patients (of which 16 (32.0%) were boys, 13 (26.0%) were girls). In group 2 with ROC, purulent-septic complications of the eyelids and orbit included 21 (42.0%) patients (of which 10 (20.0%) were boys, 11 (22.0%) were girls). RESULTS: LSI values in the general age group (n=50) from 1 to 17 years old were: 1.61 [1.40; 1.82] in patients of group 1; 3.45 [2.96; 3.94] in patients of group 2 (p≤0.05). With an index of LSI from 1.36 to 1.96, the development of reactive edema of the eyelids and orbital tissue is predicted, from 3.14 to 4.72 - the development of purulent-septic complications of the eyelids and orbit in patients of preschool and primary school age. CONCLUSION: The marker of clinical and laboratory parameters of the severity of the disease is the LSI indicator, taking into account the age of the child, which can be used in the early diagnosis of purulent-septic rhinogenic complications of the orbit and eyelids in children.

[The combination of recurrent otitis media and adenotomy in early childhood as diagnostic marker of mucopolysaccharidosis type II (Hunter syndrome)]. / Sochetanie retsidiviruyushchego srednego otita i adenotomii v rannem detskom vozraste kak diagnosticheskii marker mukopolisakharidoza II tipa (sindroma Khantera).

Mucopolysaccharidoses are a group of rare lysosomal accumulation diseases caused by a deficiency of the lysosomal enzyme and the accumulation of mucopolysaccharides in various organs and tissues. Children with mucopolysaccharidosis type II (Hunter syndrome) develop multisystem dysfunction, including severe airway obstruction. At the same time, 34% of patients already at an early age (2-3 years) undergo surgical manipulations related to ENT organs (tonsillectomy, adenotomy). The article describes a clinical case of diagnosis of type II mucopolysaccharidosis by a pediatric otorhinolaryngologist. The main manifestations of the disease are discussed in detail, including the presence of indications for adenotomy at the age of 2 years, episodes of otitis media, which served as diagnostic markers for suspected orphan disease mucopolysaccharidosis type II. The leading role of the pediatric otorhinolaryngologist in the early diagnosis of the rare disease mucopolysaccharidosis type II is substantiated.

[A rare case of thalassemia concomitant with chronic decompensated tonsillitis].

The present paper reports a rare combination of Cooley's disease (thalassemia B) and the decompensated variant of chronic tonsillitis in a 14-year old girl. The patient presented with the severe form of hypochromic anemia and degenerative changes of erythrocytes. She was treated by means of bilateral tonsillectomy associated with the high risk of postoperative hemorrhage. In the preoperative period, the child received drop intravenous infusion of tranexam at a dose of 15 mg/kg body weight together with hemostatic agents. Hemorrhage during the surgical intervention was stopped by pressing tampons impregnated with tranexamic acid known to exert local and systemic hemostatic and antifibrinolytic action. The patient was discharged from the hospital for the further treatment of the primary disease.