Introduction. Surgical treatment of patients with ronchopathy and obstructive sleep apnea syndrome (OSAS) is a topical issue of modern medicine. The velopharyngeal muscle injury of various intensity due to surgical interventions on the soft palate leads to inflammation, tissue necrosis or partial rejection and wound healing with a fibrous scar, muscle hypotrophy and hypotonia, palatal ptosis and, as a consequence of this, disease recurrence.

Aim. To evaluate the effectiveness of laser surgery on the soft palate in patients with ronchopathy and obstructive sleep apnea syndrome.

Materials and methods. The results of examination and treatment of 523 patients with ronchopathy and obstructive sleep apnea syndrome of varying severity aged from 23 to 78 years (men 299, women 224) are presented. Surgical intervention on the soft palate was performed in 352 (67.3%) patients: 309 underwent laser sculptural uvulopalatoplasty, 43 underwent surgery using the Remacl method M. et al. (comparison group).

Results and discussion. A comparative analysis of subjective and objective indicators obtained in the same patients according to monitoring computer pulse oximetry, polysomnography and computer somnography before and at different times after laser sculptural uvulopalatoplasty demonstrates persistent and significant (p ≥ 0.005) positive changes. The data from the study of patients in the comparison group demonstrate a positive trend in the results obtained at different times after Remacl surgery M. et al. only if they have uncomplicated snoring and mild OSA.

Conclusion. Laser sculptural uvulopalatoplasty is a highly effective method of treating patients with ronchopathy, regardless of the presence and degree of obstructive sleep apnea syndrome. With high-quality and adequate selection for surgery, accurate determination of the levels of obstruction, shape and degree of collapse of the soft tissues of the upper respiratory tract, careful consideration of the individual characteristics of the structure of the soft palate and pharynx and minimization of surgical trauma to the palatine curtain, it is possible to achieve a positive effect of surgery in the vast majority of patients.

Introduction. Improving the effectiveness of conservative treatment of secretory otitis media (SOM) in children remains an urgent problem because of the multifactorial etiology of the disease and the continued reliance on surgical intervention. The article presents the collective experience of monitoring the course of SOM after ARI with therapy aimed at various links in the pathogenesis of the disease.

Aim. To evaluate the clinical efficacy of intranasal azoximer bromide (Polyoxidonium ® , Petrovax, Russia) versus combination therapy with a mucoregulator, topical antibacterial agents, and a decongestant for the treatment of secretory otitis media in children after acute respiratory viral infection.

Materials and methods. A randomized, open-label, prospective, comparative clinical study was conducted in 49 children aged 4–7 years with SOM after ARI. The study group included 23 patients who received intranasal azoximer bromide, 3 drops in each nostril three times daily for two weeks. The control group comprised 26 patients who received combination therapy: an intranasal spray containing neomycin, polymyxin, dexamethasone metabenzoate, and phenylephrine (one administration per nostril three times daily for 10 days) plus oral carbocysteine at an age-appropriate dose for two weeks.

Results. During azoximer bromide treatment, the dynamics of intratympanic pressure recovery were not inferior to those with standard therapy, and SOM relapses were less frequent at 3 and 6 months.

Conclusions. Age-related characteristics of local immunity in children aged 4-7 years may underlie chronic catarrhal inflammation of the mucous membrane of the auditory tube and tympanic cavity after acute respiratory viral infection. Intranasal immunocorrection with azoximer bromide resolves catarrhal inflammation of the tympanic cavity and auditory tube during SOM developing after acute respiratory viral infection.

Introduction. Patients with infertility often require the help of assisted reproductive technologies to solve their problem. Two thirds of failures in ART cycles are associated with insufficient endometrial receptivity.

Aim. To evaluate the effectiveness of using estradiol valerate 2 mg (Progynova®) in women with thin endometrium in ART cycles.

Materials and methods. The study included patients with a thin endometrium ≤ 7.0 mm according to the ultrasound examination (US) of the pelvic organs on the 10–14th day of the menstrual cycle (peak of luteinizing hormone (LH) in the blood or on the day of progesterone administration in the hormone replacement therapy cycle). Patients with a thin endometrium (n = 74) were divided into two groups: the first group (n = 43) – patients with chronic endometritis established by histological examination and immunohistochemistry (IHC); group 2 (n=31) – patients with a thin endometrium without chronic endometritis. All patients received estradiol valerate according to one of the following regimens: 4 mg estradiol valerate in a natural cycle from the moment the dominant follicle reached a diameter of 13 mm or 4 mg estradiol valerate from day 3 of the menstrual cycle.

Results. Administration of estradiol valerate statistically significantly increased the endometrial thickness in women with thin endometrium (p < 0.05). The increase in endometrial thickness in patients of group 1 averaged 1.9279 mm, in patients of group 2 – 2.09 mm. The average endometrial thickness before treatment with estradiol valerate was 6.315 (4.7; 7.0) mm, after treatment – 8.311 (5.6; 11.0). 70 of 74 (94.6%) patients had an endometrial thickness of > 7 mm. Pregnancy in an IVF or PE cycle occurred in 44 patients with thin endometrium (62.5%) after treatment with estradiol valerate.

Conclusions. The use of estradiol valerate in IVF and ET cycles increases the thickness of the endometrium and increases the frequency of pregnancy and live birth in patients with a thin endometrium.

Introduction. The choice of medications for the treatment of iron deficiency anemia (IDA) in a pregnant woman is based on therapeutic efficacy and safety, forming a high patient compliance to long-term therapy.

Aim. To evaluate the therapeutic efficacy, clinical tolerance and safety of using a medication based on iron sulfate and ascorbic acid in the treatment of iron deficiency anemia in pregnant women

Materials and methods. The study included 155 women diagnosed with IDA: twenty-four pregnant women in the first trimester (group 1), forty-five pregnant women in the second trimester (group 2), and eighty-six patients in the third trimester (group 3). Antianemic therapy was administered to all pregnant women with Sorbifer Durules (iron sulfate 100 mg of iron sulfate and 60mg of ascorbic acid) 100 mg two times per day for a long time until normalization of hematological parameters and improvement of the clinical symptoms with a transition to 100 mg per day until delivery for the purpose of preventing IDA.

Results. The gestational age included in the observation were10.6 (1.6), 20.2 (2.6) and 30.9 (2.6) weeks. When analyzing hematological parameters changes in 1 month after the start of therapy, there was positive dynamic which revealed the increase in hemoglobin levels by 5.4 g/l and 7.2 g/l in patients of groups 1 and 2, respectively (p < 0.05), with a continuing tendency to increase at 37.1 ± 1.1 weeks by 10.3 g/l and 9.7 g/l (p < 0.05). It was noted that there was a decrease in the number of patients with IDA in group 1to 20.8%, which is 1.5 and 2.1 times lower compared to groups 2 and 3 (p = 0.03). Adverse reactions when taking Sorbifer Durules were registered in 3.2% of pregnant women, there were no clinical situations requiring discontinuation of the medication.

Conclusion. The combination of iron sulfate and ascorbic acid in a prolonged release formula (Sorbifer Durules) is a well-tolerated and effective treatment option of IDA at any stage of pregnancy.