BACKGROUND: Cellulitis is a common infectious disease with typical feature – the tendency for recurrence. AIM: The aim of the study was to define comorbidities, clinical, and laboratory – biochemical factors associated with longer length of stay (LOS) in patients with recurrent cellulitis in the lower legs. MATERIALS AND METHODS: The study is a retrospective-cohort study conducted at the Department of Dermatovenerology at General Hospital in Skopje, from January 2016 to August 2019. In the study, we included and analyzed only hospitalized patients admitted for recurrent cellulitis on the lower legs. Inclusion in the study recorded the following variables – comorbid conditions in the patients – present in the medical records or obtained from the interview of the patient and initial values of laboratory assays on admission. RESULTS: The study included hospitalized 205 patients, admitted for recurrent cellulitis. The most significant comorbid conditions and laboratory parameters which correlate with increased LOS are as follows: Type 2 diabetes mellitus – insulin dependent (p < 0.001), chronic renal failure (p = 0.003), ischemic heart disease (p = 0.006), peripheral arterial disease (p = 0.007), fever ≥38.0°C (p < 0.001), hypoalbuminemia ˂34 g/L (p < 0.001), elevated value of C-reactive protein >10 mg/L (p < 0.001), and leukocytosis >109 L (p = 0.009). CONCLUSION: Cellulitis is potential medical emergency event. Recurrence is the most significant complication of cellulitis and lower legs cellulitis is associated with a risk for long-term morbidity. The study has identified several independent factors that are significantly associated with an increased LOS. This independent factors present on admission can stratify the patient with the highest risk of mortality, can improve patient care for better outcomes, and decrease the number of relapses and hospital readmissions.

Introduction. The article presents a comparative study of the postoperative period after laparoscopic appendectomy for destructive appendicitis in children with and without application of decimetric-wave therapy (DMWT). Material and methods. The study included 299 children aged from 3 to 17 years, the average age of children accounted for 10.7 ± 3.3 years. Patients were operated on for various forms of destructive appendicitis. The patients observed included 201 boys (67.3%) and 98 girls (32.7%), Destructive appendicitis (DA) was diagnosed in 129 (43.1%) children, appendicular peritonitis (AP) - in (56.9%). Patients of the main group received DMWT, starting from the 1st day after surgery. Patients in the comparison group did not receive physiotherapy. To assess the effectiveness of the use of UHF-therapy in the postoperative period, the following groups were taken into account: 1) intestinal insufficiency syndrome (ISS) and systemic inflammatory response syndrome (SSRS); 2) postoperative complications; 3) abdominal ultrasound data; 4) the dynamics of common laboratory indices 4) the duration of the inpatient stay. Results. In DA cases without peritonitis, ISS and SSRS in the main group were observed by 15.7 and 12.8 times less than in the comparison group, with the duration of ISS decreased by 2.13 times, SSRS by 3.3 times. In AP patients the frequency of ISS decreased by 1.68 times, SSRS - by 1.97 times. By the 5th day of the postoperative period in the main group, both in DA and AP cases, there was a significant increase in the incidence of patients with both leukocytes and lymphocytes count normal for the age, LII, CRP. The inpatient stay in the main group decreased by 1.0±0.7 days in DA patients, in AP cases - by 3.3±0.7 days. Conclusion. Evaluation of the postoperative period, as well as traditional laboratory indices, confirm the effectiveness of DMWTin the postoperative period in DA cases YES, in that the local and systemic anti-inflammatory effect is more pronounced in with AP patients.

Introduction. The article assessed the effectiveness of decimeter wave therapy (DWT) in the postoperative period after laparoscopic appendectomy for destructive appendicitis in children. Authors relate positive clinical effects with the activation of mitochondrial energy metabolism. Material and methods. The study included 132 patients (46 destructive appendicitis cases, 86 h appendicular peritonitis patients). Among them, there were 75 (56.8 percent) boys and 57 (43.2 percent) girls aged of from 3 to 17 years (mean age of 10.7 ± 3.07 years). Patients of the main group received DWT procedures with the use of the apparatus DMV-02 “Solnyshko” starting from the 1st day after the surgery. Patients from the reference group received no physiotherapy treatment. The activity of dehydrogenases of lymphocytes (succinic dehydrogenase (SDH) and NADH-dehydrogenase) in patients from the main group and the comparison group were determined by means of cytomorphological method with the use a hardware-software visualization complex “Videotest” and the “Morphology 5.2” (Russia), at the 1st, 3rd and 5th day of the postoperative period. Results. Under the influence of DWT in the postoperative period the frequency of intestinal insufficiency syndrome, systemic inflammatory response syndrome, infiltrative adhesions was established to decline. There was noted a gain in the activity of mitochondrial enzymes, reflecting the first and second stages of the respiratory chain (SDH and NADH-dehydrogenase). In children with destructive appendicitis against the background of DWT, the normalization of the activity of LDH in moderate activation of NADH-dehydrogenase, and in appendicular peritonitis cases - the significant elevation in LDH activity of lymphocytes and activation of NADH-dehydrogenase occurs. In patients from the main group, the absolute number of peripheral blood lymphocytes normalized Conclusion. Under the influence of DWT there was noted the activation of enzymes of mitochondria that provides a mild course of the postoperative period.