In the pathogenesis of acute widespread peritonitis and accompanying diabetes, a vital link is an endogenous intoxication caused by the translocation of microorganisms and their toxins from the intestine into the blood, metabolic changes, and immunological reactivity of the body. Our work aimed to investigate the microbial composition in the parietal intestinal biotope and the features of the blood cytokine profile in animals with acute disseminated peritonitis on the background of streptozotocininduced diabetes. The study was conducted on 56 sexually mature non-linear white male rats. Diabetes mellitus was modeled by a single intraperitoneal injection of streptozotocin (60 mg/kg). On the 14th day of the development of streptozotocin-induced diabetes mellitus, a 10% filtered fecal suspension (0.5 mL) was injected into the abdominal cavity of animals, and acute generalized peritonitis was initiated. Sowing on nutrient media was carried out for bacteriological research to isolate a pure culture of microorganisms and their identification. The concentration of TNF-α, IL-1β, and IL-6 was studied by solid-phase enzyme immunoassay.
The research results demonstrate an imbalance of cytokines in the dynamics of experimental acute disseminated peritonitis against the background of diabetes and quantitative and qualitative changes in the microbiota of the parietal intestinal biotope. A decrease in the number of Escherichia coli strains isolated in monoculture and an increase in the number of twocomponent and three-component microbial associations were revealed, among which Enterobacter aerogenes, Escherichia coli, Bacteroides spp., Proteus mirabilis, Klebsiella spp. and Candida species prevailed.

Modern aspects of the pathogenesis of acute inflammation of the peritoneum that is concurrent with diabetes involves analysis of metabolic mechanisms, in particular peroxidaton of proteins – antioxidant defense. Therefore, the objective of our study was to examine the interrelation between the processes of free-radical oxidation of proteins and antioxidant system in the dynamics of development of acute generalized peritonitis against the background of streptozotocin-induced diabetes. The study was performed on 56 non-linear white mature male rats. Diabetes mellitus was modeled by a single intraperitoneal injection of streptozotocin (60 mg/kg). On the 14th day of the development of streptozotocin-induced diabetes, we injected 10% filtrated faeces suspension (0.5 mL) into the abdominal cavity, thus initiating acute generalized peritonitis. Oxidative modification of proteins in blood serum was studied using the I. F. Meshchyshen’s method and the condition of antioxidant protection was monitored according to the activities of superoxide dismutase, catalase, content of reduced glutathione, and the level of ceruloplasmin.
The study of the parameters of free-radical oxidation of proteins and study of the condition of antioxidant system in
blood of the rats with experimental acute generalized peritonitis against the background of streptozotocin-induced diabetes demonstrated that oxidative protein modification grew, while the parameters of the activity of antioxidant system were being inhibited, depending on the stage of acute inflammation of the peritoneum. We determined inverse correlation relationships between the products of free-radical oxidation of proteins and parameters of antioxidant system on the third and on the seventh days of modelling of combined pathology. Manifestation of acute generalized peritonitis concurring with streptozotocin-induced diabetes was accompanied by a gradual accumulation of the products of free-radical oxidation of proteins and exhaustion of the antioxidant defense during all stages of the development of acute inflammation of the peritoneum, peaking on the seventh day after administration of faecal suspension (terminal stage of peritonitis). The observed inverse correlations between the levels of oxidative modification of proteins and the activity of superoxide dismutase, catalase, reduced glutathione, and ceruloplasmin on
the third and on the seventh days of modelling of combined pathology indicate a predictive role of the processes of free-radical oxidation of proteins in exhaustion of antioxidant-defense resources.

Infantile hypertrophic pyloric stenosis (IHPS) remains the most often cause of projectile non-bilious vomiting in infants during first month of life. IHPS typically manifests between 2 and 6 weeks of age where the pyloric channel became narrowing, resulting in gastric outlet obstruction [1, 2]. The exact etiology of IHPS remains unknown. The failure of pyloric muscle relaxation has been attributed to inadequate innervation, defect of nitric oxide metabolism [3], hyperacidity in the stomach [4], and various environmental and genetics factors [5, 6] have been implicated as risk factors for IHPS occurrence. Despite the identification of these factors, conservative therapies to reverse the muscle hypertrophy have still not been established in most European clinics and if implemented have shown poor outcomes, leaving surgical management as the only option to alleviate this pathology. The medical management is usually reserved for patients who are deemed unfit to undergo general anesthesia due to severe medical co-morbidities [1]. Extramucosal pyloromyotomy for the treatment of pyloric stenosis was first described by Ramstedt in 1912 and during many years this method remains the «gold standard» of the treatment [7]. The open approach is effective at providing excellent exposure of the pylorus but results in an abdominal scar that grows with the patient and may becomes quite significant with time. In 1991, Alain et al. described the laparoscopic approach [8] and this surgical modality gradually accepted by pediatric surgeons [2, 9]. There are still contradictory results in the literature with regard to the benefits and disadvantages of laparoscopic compared to the open procedure to treat infants with IHPS. Some authors claimed that laparoscopic pyloromyotomy associated by a shorter hospital stay, shorter postoperative recovery, and less postoperative pain [10-12], however these advantages were not confirmed [9, 13, 14]. Besides that, some authors have questioned the safety of laparoscopy because of increased frequency of surgical complications compared with open pyloromyotomy [15, 16].

Meckel diverticulum (MD) is one of the most common congenital anomalies of the small intestine [1]. MD results from an incomplete obliteration of the vitelline (omphalomesenteric) duct, which connects the midgut to the yolk sac in the fetus, usually between the fifth and sixth weeks of gestation as the bowel settles into normal anatomical position [2]. Some authors characterized MD by the rule of “twos”: frequency of 2%, 2 times more predominate in males, diagnosed most in children below of 2 years old, located within 2 feet (60 cm) of the ileocecal valve, commonly 2 cm in diam[1]eter, 2 inch (5 cm) of length, and may content of 2 types of ectopic mucosa (gastric and pancreatic) [3-6]. Being in most cases remains asymptomatic [6-8], but in some cases, MD may provoke life-threating complications, such as intestinal obstruction, intestinal bleeding, intraabdominal infection, and umbilical anomalies [4, 5, 9]. The lifetime risk for an MD[1]related complication varies from 4% to 34% [10, 11], and this risk decreases with age [12]. The clear preoperative diagnosis of MD in patients with acute abdominal pain or signs of intestinal obstruction is challenging, despite the availability of modern imaging. Due to that, the lot cases of MD diagnosed intraoperatively [13, 14]. Symptomatic MD always required its removing [7, 15], whereas in cases of incidentally discovered MD there is controversy regarding surgical resection [11, 16, 17]. Traditionally operative management of MD involves laparotomy with diverticulectomy with or without small bowel resection [15, 18]. With the advent of laparoscopic surgery, the intracorporeal diverticulectomy with the laparoscopic stappling devices or laparoscopic-assisted excision, is becoming increasingly popular [19, 20]. However, questions about what type of surgery should be chosen in children with the different types of MD still under debate. The aim of this study was summarized own experience in the management of MD in children.

 Opioid analgesics due to their strong analgesic effect are widely used in modern medical practice [7]. It is important, that the duration of opioid analgesic use should be as short as possible to avoid mental and physical addiction, as well as the development of drug tolerance and the risk of overdose. [5,7]. According to the professional medical literature, long-term use of opioids leads to evidential changes in the organism [12], where the pathology of the oral cavity, paradental tissues occupy a leading place in individuals, who abuse with narcotic substances [3]. Dental status in drug addicted people is overloaded by numerous pathological conditions of the tissues of the tooth and mucous membranes of the oral cavity, what complicates the differential diagnosis and treatment [3,4,15]. In addition, despite the improvement in dental health indexes in many countries, the prevalence of paradentitis remains extremely high, there is no standard treatment regimen today [2,14]. Taking into account the fact that the problem of drug addiction is constantly growing, in dentistry, data on the condition of the oral cavity organs, the structural components of the paradentium under the influence of opioid agents, both in clinical and morphological aspects, are extremely necessary. [13]. In this regard, the introduction of etiopathogenetic treatment of paradental diseases of various origins, including drug addiction is an urgent problem of today [3,4,6,8-10]. Paying attention that the issues of pathomorphogenesis and adequate treatment of dystrophic and inflammatory processes that develop in the paradentium under the action of opioid agents are still relevant, there is originated a necessity to develop in experiment an optimal scheme of pathogenetic complex treatment in such conditions.The aim of the research is to study the features of microscopic reorganization of paradental tissues under six weeks of exposure to the opioid analgesic nalbuphine, its four-week withdrawal and medicinal correction using pentoxifylline and ceftriaxone in the experiment.