No abstract

The article presents a description and scientific substantiation of cytological aspects of confirmation of stages of otitis media with effusion (OME). The pathophysiological mechanisms leading to the formation of exudate in the middle ear cavity are presented. The nature of the cellular landscape in accordance with the current stage of the disease is substantiated. Based on the study, cytograms were analyzed that reflect a specific stage of the disease. Each type of cytogram allows you to reliably assess the degree of degenerative changes in the mucous membrane of the tympanic cavity. The proposed cytological study of exudate in OME makes it possible to clearly determine the type of inflammatory process in the tympanic cavity, and also contributes to the final establishment of the stage of the process from the position of morphological and functional classification by N.S. Dmitriev and al. (1996), classification M. Tos (1976). Currently, there is no cytological classification of exudate in OME depending on the stage of the disease, which complicates the clinical and instrumental diagnosis of the features of the disease. The ability to assess the state of local immunity (cytological study of the secret of the middle ear) allows to predict the clinical course of the disease, followed by the optimal choice of personalized tactics of therapeutic measures in hospital and outpatient treatment.

The research of effective methods of treatment of broncho-obstructive diseases is one of the most important questions of the pediatric pulmonology. General clinical manifestations are characterized by attacks of breathlessness, prolonged exhalation, unproductive cough, whistling and noisy breathing sometimes with a help of auxiliary muscles. Often this disease leads to bronchial asthma, obstructive bronchitis, and malformations of the lung and bronchus. In the pathogenesis of bronchial obstruction whilst respiratory infections the main factors are inflammatory infiltration of the bronchial mucosa, its swelling, hypersecretion of viscous mucus and bronchospasm due to hyperactivity of the bronchi of the inflammatory nature. To diagnose this disease it is important to establish the presence or absence of the effectiveness of the protective mechanisms of the body at different hierarchic levels. To protect the respiratory tract from exposure to adverse environmental factors in the process of ontogenesis pro-tective mechanisms formed. The first stage of purification of the bronchial system is mucociliary clearance carried out by the cells of the ciliated epithelial cells and glands that produce bronchial secret. If the cause of the disease is established, the etiotropic and pathogenetic treatment of the underlying disease should be carried out. Of special interest in pediatric pulmonology is the experience of the combined drug Kashnol. It simultaneously affects almost all parts of the pathogenesis of acute and chronic broncho-pulmonary diseases.

A review article is devoted to diagnostical etiopathogenetic criteria of hepatoblastoma in pediatric patients. There is a distinguished cytogenetic analysis that detects only a limited amount of structural and numerical anomalies in hepatoblastomas; histopathological assessment of liver bioptats which facilitates treatment tactics. Distinctive laboratory findings in pediatric hepatoblastoma are microcytic anaemia, reactive thrombocytosis, and elevated alpha-fetoprotein. The immunohistochemical analysis allows the assessment of the nuclear expression of INI1 (SMARCB1) and the exclusion of malignant rhabdoid liver tumours. There is recommended hepatic doppler ultrasonography, as well as a three-dimensional assessment of primary tumour sizes and tumour volume to reveal the extent of hepatoblastoma according to the PRETEXT system. Radiography and computed tomography of the chest organs are advised to determine hepatoblastoma’s metastases.

The article presents a case report of a variant of leukodystrophy: Krabbe disease. The disease was aggravated by concomitant hepatitis, hepatocellular insufficiency grade 3. The authors analyse the clinical course of the disease and possible outcomes in case of its early diagnosis. Key words: Krabbe disease, children, leukodystrophy