Background. Mycoplasma pneumoniae is included in the group of atypical pathogens of acute respiratory diseases. Mycoplasma pneumoniae is characterized by a tendency to prolonged course with progressive changes in the lungs. Main value in the confirmation of mycoplasma infection has microbiome in biosubstrates selection and serological diagnostics: the determination of specific immunoglobulins IgM or IgG in the dynamics to M. pneumoniae. Antibacterial therapy of mycoplasma pneumonia is prescribed based on the sensitivity of the pathogen to them. The duration of antibiotic treatment of mycoplasma pneumonia is determined by the dynamics of clinical and radiological data. Materials and methods. The article describes the features of the clinical course of mycoplasma pneumonia in a patient with tubinfection proceeding with bronchoadenitis and obstruction of the bronchus, which necessitated a differential diagnosis with tuberculosis of the intrathoracic lymph nodes and the appointment of repeated courses of antibiotic treatment.Results. In the described clinical case, the duration of Mycoplasma infection exceeded 3.5 months, during which time the patient received several courses of antibiotics. Mycoplasma pneumonia had a prolonged course, accompanied by bronchoadenitis.Conclusion. Our observations show the need to study the effectiveness of extended courses of antibiotics from the azalid group in the treatment of prolonged and complicated forms of Mycoplasma pneumonia.

No abstract

The substitutive enzymatic therapy is vital in cystic fibrosis patients with pancreatic insufficiency. Usually patients are given enzymes at every meal. If it is necessary to replace one enzymatic remedy to another, the replacement should be done gradually (for 12-14 days). A comparative study of encapsulated enzyme preparations Creon 10 000 IU/25 000 IU and Pangrol 10 000 IU/25 000 IU safety, efficacy and tolerability was done in 20 patients with cystic fibrosis at the age of 11 months - 16 years. 13 people have got the doses in the calculation of the lipase up to 100 TU; and more than 100 TU - 7 people. Different drug doses effectiveness was determined according to faeces parameters and coprogram indicators. Numerical evaluation of the clinical efficacy and tolerability of both drugs was conducted through a questionnaire survey of patients and specialists. All patients completed the study. The effectiveness of the treatment according to coprogram was the same in both groups. In most cases, the process of transferring patients from Creon on Pangrol passed without the appearance of negative symptoms. It has been shown that encapsulated, mini-tablet pancreatin Pangrol well tolerated by patients. This allowed to 60 % of patients with cystic fibrosis change the treatment from Creon on Pangrol. Adverse events (10 %), detected in the process of transferring patients from one drug to another, were rare and short-term. The majority of physicians and patients prefer to continue therapy with Creon, according to their previous successful experience. Step-by-step scheme of replacing one enzymatic remedy on another is shown in this paper.

Background The aim of our study was to investigate the rate of developmental dysplasia of the hip (DDH), and the association between the risk factors for DDH and the results of the hip ultrasound (US) findings among healthy infants Methods The study group consisted of healthy infants who admitted to the outpatient Healthy Child Clinics of Istanbul University, Cerrahpasa Medical Faculty for their routine control between December 2014 and May 2015. Files of the patients who were followed up at least 1 year of age were reviewed with regard to risk factors (sex, birth weight and lenght, type of delivery, order of birth, type of presentation, maternal age, history of oligohydramnios, multiple pregnancy, swaddling history, family history of DDH) and hip US findings. All infants had their hip US performed at 4 to 6 weeks of age in the Radiology Department of Istanbul University. Results A total of 300 infants (175/125:male/female) with a birth weight and length of 3137.03±557.23 gr and 49.69 ±2.68 cm, respectively were enrolled. Fifteen infants had a history of maternal oligohidramnios (5%), 70 (23.3%) were born vaginaly, 27 (9%) were born as twins and 2 (0.7%) had a breech presentation. Family history of DHH was present in 17 infants (5.7%) and 28 (9.3%) had a swaddling history. US finding of immature hip was detected in 52.9% of those with a family history of DHH and 13.6% of those with a swaddling history. There was a statistically significant association between family history of DHH and swaddling, and finding of immature hip on US (p=0.0001). In those with findings of immature hip, left hip was affected in 28 (56%) and right hip was affected in 13 (26%) infants. Involvement of left hip was significantly more frequent in case of an immature hip on US (p=0,04). Only one infant had a finding of DDH (Type 2b) on US.Conclusions The rate of DHH in this study was 0.3%. while the rate of immature hip was 16.7%. Positive family history and swaddling were found to have a strong association with immature hip on US with a significantly more frequent involvement of the left hip. We want to emphasize that family history of DHH should be sought during evaluation of an infant with regard to DHH. We realized that swaddling was still a common practice in Turkey for which the parents should be warned about its associated risk for DHH.Case 1 In a 7-year-old boy with right inguinal pain, limp, fever and CRP of 288 mg/l, X-rays and ultrasound of both hips showed normal findings. On day 3 of treatment with ibuprofen and intravenous ceftriaxon MRI of pelvis and hips was performed, showing widening and increased signal of the inferior ramus of the right pubis with oedema of the surrounding obturator muscles. The antibiotics were changed to clindamycin. Skeletal scintigraphy was performed on day 7 with the finding of changes in the right pubis. Within 15 days of treatment, laboratory findings normalised. Clinical symptoms disappeared within 3 weeks. The antibiotic treatment was continued for 6 weeks altogether. The last MRI performed after ...