8 Other acute infections of the upper respiratory tract of multiple localization. J06.8 Other acute infections of the upper respiratory tract, multiple sites Meaning in medical language f 06.8

Supportive care includes analgesia, hydration, and bed rest. Penicillin V (Penicillin V) is considered the drug of choice in the treatment of tonsillopharyngitis caused by group A hemolytic streptococcus; the dose is 250 mg orally 2 times a day for 10 days for patients with body weight< 27 кг и 500 мг при массе тела >27 kg. If a liquid form is required, amoxicillin is effective and more palatable. If compliance is a problem, a single intramuscular injection of benzathine penicillin at a dose of 1.2 million units (600,000 units for children weighing 27 kg) is effective. Other oral medications include macrolides for patients allergic to penicillin, 1st generation cephalosporins, and clindamycin.
Treatment is started immediately or delayed until culture results are available. If treatment is hypothetically initiated, it should be discontinued if cultures are negative. Repeated cultures from the pharynx are usually not performed. They are used in patients with frequent recurrences of tonsillopharyngitis caused by group A hemolytic streptococcus, or in cases of pharyngitis of close home or school contacts.
The question of tonsillectomy is considered when frequent relapses tonsillitis caused by group A hemolytic streptococcus (> 6 episodes per year, > 4 episodes per year for 2 years, > 3 episodes per year for 3 years), or severe and persistent acute infection despite antibiotic therapy. Other indications for tonsillectomy include obstructive sleep apnea, recurrent peritonsillar abscess, and suspected cancer.
Various effective surgical methods used to perform tonsillectomy, including electrocaustics, microdebrider with one-stage high-frequency ablation and sharp dissection (sharp dissection). Severe intra-operative or post-operative bleeding occurs in less than 2% of patients, usually within 24 hours after surgery or 7 days after the eschar falls off. Patients with bleeding should be taken to the hospital. If bleeding continues on arrival, patients are usually examined in the operating room and hemostasis is performed. If the thrombus is in the tonsil fossa, patients are observed for 24 hours. Postoperative intravenous rehydration therapy is needed in 3% of patients, and possibly even fewer patients with optimal preoperative fluid therapy, preoperative administration of antibiotics, analgesics and glucocorticoids. Postoperative obstruction respiratory tract most often occurs in children under 2 years of age with previous obstructive sleep apnea and in patients with morbid obesity, neurological diseases, craniofacial pathology and with severe preoperative obstructive sleep apnea. In adults, complications are much more frequent and usually more severe.

Organic emotionally labile disorder is a mental disorder that occurs after complications of pregnancy or childbirth, severe infection or organic brain disease (trauma, tumor, stroke). Characteristic pronounced emotional restlessness and lability (instability, rapid change) of a person’s mood.

The diagnosis and treatment of this disorder should be carried out jointly by a psychiatrist (or psychotherapist) and a neurologist.

The disorder is also called asthenic (from the Greek asthenia - weakness, impotence). In addition to constant and severe mood swings, patients are characterized by general weakness, fast fatiguability, headache, dizziness. A person can get tired after 2-3 hours of work, not withstand a full day of work, several times a day there is a need to lie down to rest.

According to international classification diseases ICD-10 is coded as F06.68 - "Organic emotionally labile asthenic disorder due to mixed diseases." To his most common reasons include:

• head injury
• pregnancy and childbirth of the mother, which proceeded with complications (toxicosis, the threat of miscarriage, eclampsia)
• serious condition of the child after birth (for example, the baby was given mechanical ventilation), severe illnesses/infections in early childhood
• vascular diseases of the brain (atherosclerosis, hypertension, disorders cerebral circulation- strokes)
• epilepsy
• brain tumors
• HIV infection
• neurosyphilis and other neuroinfections, encephalitis (inflammation in the brain)
• drug intoxication, alcohol
• effects of anesthesia

Symptoms of organic asthenic disorder

People with the disorder are characterized by tearfulness, emotional irascibility, frequent and pronounced mood swings, a storm of emotions, often for a minor reason. All reactions are spontaneous (occur without a serious reason, reason) and uncontrollable.

A person painfully reacts even to minor events, emotions, as a rule, are negative (anger, irritation, resentment).

Trouble perceives as "the end of the world", constantly outbursts of anger and irritability at loved ones, surrounding people.

Diagnosis of an organic emotionally labile disorder is an examination by a psychiatrist and a neurologist. Additionally, the attending physician may prescribe a pathopsychological examination, blood tests and instrumental methods(EEG, CT, MRI).

A person complains of regular and severe headache, dizziness, decreased or impaired vision, increased blood pressure, noise in ears. These complaints indicate a brain disease that led to an organic emotionally labile disorder. They prevent a person from living and working, because of them he goes to the doctor.

Characterized by hypersensitivity pain sensitivity in response to a weak touch on the skin, excessive auditory or photosensitivity, when sounds of ordinary strength are perceived as very loud (up to the development of pain), and sunlight causes severe tearing and pain in the eyes.

General weakness, fatigue, decreased performance, a feeling of powerlessness - all these are integral companions of organic asthenic disorder.

Organic emotionally labile asthenic disorder in children occurs due to severe pregnancy of the mother (toxicosis, threatened miscarriage, eclampsia), complications in childbirth or serious illnesses early childhood.

An experienced psychiatrist can make a diagnosis already at the first examination. The main manifestations of asthenic disorder include excessive capriciousness, frequent tearfulness, disobedience, irritability, inability to concentrate for a long time. Such children may experience sudden lethargy, lack of initiative. It is necessary to differentiate an emotionally labile disorder from character traits and age-related changes.

The prognosis in adults and children is favorable, subject to the recommendations of the attending physician.

Treatment of organic emotionally labile personality disorder

Treatment should be complex and strictly individual. With the correct diagnosis and adequate treatment, the symptoms of asthenic disorder may weaken or go away completely.

Organic emotionally labile asthenic disorder is treated with drug and non-drug methods. Medicines include the following groups of pharmaceuticals:

• vaso-vegetotropic- normalize the work of the autonomic nervous system
• nootropics- improve metabolic processes in the brain tissue
• sedatives- have a calming effect by balancing the processes of excitation and inhibition of the nervous system
• antipsychotics- relieve excitement
• antidepressants- remove anxiety, normalize mood

Non-pharmacological methods include:

1. individual psychotherapy- a psychiatrist-psychotherapist teaches a person to control behavior, to relax. It helps to build priorities (to achieve success at work, live in love and harmony with loved ones) and stick to them.
2. biofeedback therapy — modern method treatment mental disorders. A specialist using sensors and a computer measures physiological parameters - respiratory rate, heartbeat, blood pressure. As soon as a person managed to bring these indicators back to normal (following the instructions of a specialist), the computer reports success. The patient learns relaxation skills and can then use them in emotionally stressful situations to pull themselves together.

Diagnosis F06.6 Organic emotionally labile asthenic disorder often remains untreated - the people around and the person himself believe that he has a "severe character." But this is wrong. The symptoms of the disorder can be relieved by modern drugs and non-drug methods and return to a full life.

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