The aim of the study was to determine efficiency of Glutoxim, aimed for correction of immune disorders. The drug was administered to the patients with chronic cerebral ischemia (CCI, Stage I and II) complicated by arterial hypertension. Increased contents of pro-and anti-inflammatory cytokines, IFNγ, IL-2, G-CSF, and activation of the complement system have been revealed for these conditions, at both functional stages of the disease. The patients with stage II CCI showed elevated markers of oxygen-dependent activity in polymorphonuclear leukocytes (increased levels of spontaneous and stimulated nitroblue tetrazolium (NBT) reduction tests, phagocytic capacity and stimulation index of neutrophils). Stage I of chronic cerebral ischemia was characterized by normal values of NBT reduction tests and functional reserve of neutrophils, along with decreased stimulation index of neutrophils. Among 26 parameters of immune status, 73.1% and 80.8% of indices proved to be changed, respectively, in the patients with stage I and II CCI. 66.7% of immune indices appeared similar in magnitude and direction of changes, whereas the resting 33% are identical in orientation. Usage of Cereton and Actovegin in treatment of the stage I CCI caused normalization of 5.3% immune parameters, with partial normalization of 26.3% tests, and 68.4% of the indexes remaining unchanged or increased posttreatment. Inclusion of Glutoxim into the combined pharmacotherapy proved to be more effective since it totally normalized 52.6% of the indexes, along with partial normalization of 21.1%, while 26.3% of the indicators were not affected by the therapy. Administration of Cereton and Actovegin at the second stage of chronic brain ischemia was followed by partial normalization for 47,6% of the tests, while leaving unchanged or increased 52.4% of the indicators. Glutoxim Use fully normalize 19.0% and partially normalizes 57.1% of immune parameters.

Цель исследования-оценка уровня цитокинов и активность системы комплемента в плазме крови и в смыве из десневого кармана у детей с хроническим генерализованным катаральным гингивитом в подросковом возрасте на фоне использования дополнительно к стандартному лечению геля пародонтоцида. Под постоянным наблюдением находилось 42 подростка в возрасте от 14 до 17 лет с верифицированным диагнозом: хронический катаральный генерализованный гингивит, которые были разделены на 2 группы: пациенты 1-й группы получали базисное лечение, а пациенты 2-й группы дополнительно в составе базисного лечения получали гель пародонтоцида. До начала лечения и через 2 недели определяли уровень фактора некроза опухолей альфа (TNFα), IL-2, IL-1α, IL-6, IL-18, интерферона-α (IFα), IL-8, IL-4, IL-10, рецепторного антагониста интерлейкина-1 (IL-1Ra), компонентов системы комплемента (С3, С3а, С4, С5, С5а, фактор H, С 1-ингибитора) и секреторного IgA. Применение только стандартного лечения у подростков с хроническим генерализованным катаральным гингивитом не оказывает необходимого иммунокорригирующего эффекта в отношении показателей системы комплемента и цитокинового звена иммунитета, а требует использования дополнительных средств фармакологической коррекции, в этом отношении эффективным является препарат «Пародонтоцид» в виде геля. Ключевые слова: хронический катаральный гингивит, препубертантный период, пародонтоцид, цитокины, система комплемента.

Crohn’s disease (CD) is nonspecific granulomatous inflammatory disease of all layers of the intestinal wall, characterized by a variety of clinical forms, heterogeneity of age groups of children and extraintestinal manifestations.  The diagnosis of the disease is difficult due to the presence of many  symptoms specific to a number of other surgical diseases of the abdominal cavity organs. This diagnosis is often made intraoperatively. In this study we report a case of treatment of a teenage girl who was admitted with complaints of a mass in the right iliac region extruding above the skin surface, instability of body weight, an increase in body temperature to 37.2° C for one month. As a result of laboratory and instrumental examination, the etiology was not established. Laparoscopy revealed abdominal infiltrate, consisting of the cecum, the distal ileum and a part of the greater omentum, tightly fixed to the anterior abdominal wall, which led to the destruction ofthe peritoneum, muscle tissue and aponeurosis with further infiltration into the sub-cutaneous fat. Appendectomy and separation of the infiltrate were performed. After that, the girl was discharged due to the categorical refusal of the parents of the further treatment.Twelve days later the patient had abdominal pain again, the dynamics of the pain syndrome intensified, the body temperature was febrile. After examination and detection of signs of peritonitis, emergency laparotomy, subtotal resection of the greater omentum, separation of the abdominal infiltrate (repeated), sanitation and drainage of the abdominal cavity were performed. During the surgery, the access to the abdominal cavity was performed with technical difficulties due to the fact that a conglomerate of intestinal loops and omentum was fixed to the anterior abdominal wall from the interior. The conglomerate was separated from the anterior abdominal wall by blunt dissection. The size of the conglomerate was up to 12–15 cm, formed by the transverse colon, the ileum and the greater omentum. The walls of the transverse colon and ileum in the area of the conglomerate had the cartilaginous density. For the purpose of further examination and determination of tactics for further treatment, the child was transferred to the Gastroenterology Department with a diagnosis of “Terminal ileitis. Purulent omentitis. Serous peritonitis. Mild normochromic anemia of mixed origin. Crohn’s disease?” After the additional examination in a specialized hospital, the diagnosis of CD was confirmed.

Background. Rib osteomyelitis is extremely rare in childhood. This localization of purulent focus represents only 1% of all osteomyelitis cases. The typical manifestations of ribs osteomyelitis are fever, chest or back pain. However, these clinical signs are not always present, and the disease can manifest in other way.Clinical Case Description. Mother with 14 years old child K. have applied to the regional children's hospital admission department. The child had complains of right upper quadrant abdominal pain and in right part of the chest, difficulty in breathing. The disease began 2 days before admission with fatigue, weakness, and pyretic fever (39 °C). Complaints remained over time. The patient was hospitalized with the diagnosis: “Chest impact injury with severe pain syndrome? Right lung contusion?". The ultrasound examination of pleural cavities and the right anterior chest surface has revealed osteomyelitic phlegmon in VII intercostal space on the 3rd day of hospitalization. It was lanced and drained under general anesthesia, about 7 ml of liquid pus were obtained. The child received treatment according to clinical guidelines for the management of patients with such nosology. The final diagnosis was: «Acute hematogenous osteomyelitis of the VII rib, local form. Osteomyelitic phlegmon of VII intercostal space. Right pneumonitis. Bilateral mild hydrothorax». The boy was discharged on the 10th day since surgery in satisfactory condition.Conclusion. The described clinical case is interesting for pediatric surgeons, traumatologists, infectious disease specialist. Particular attention should be paid to the clinical features of the disease and anamnestic information in such unclear clinical cases. It will allow to exclude traumatic injuries and assume the local inflammatory process.