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The objective of the present study was to improve the effectiveness of early diagnostics and prophylaxis of hearing disturbances in the children presenting with various chronic diseases. As is known, there are several dozens of neurologic disorders associated with hearing disorders. By way of example, there is a group of nephropathologies responsible for the loss of hearing in the children. Specifically, hearing impairment can be one of the symptoms of diabetes mellitus. The patients presenting with mucopolysaccharidosis make up a group at risk of hearing impairment. Sensorineural loss of hearing is widespread among the children presenting with coeliac disease. The protocols for the treatment of certain pathologies envisage the application of certain medications possessed of the cytotoxic activity, such as preparations for chemo- and radiotherapy or cytostatic agents that suppress cell proliferation when applied for the management of some autoimmune diseases. It is concluded that cooperation between health providers representing different medical disciplines may be instrumental in the organization of efficacious screening for the detection of children with severe chronic pathology.Цель работы - повысить эффективность ранней диагностики и профилактики тугоухости у детей с различной хронической патологией. Врачи детской практики разных специальностей должны быть осведомлены о многообразных причинах развития тугоухости. Неврологических заболеваний, ассоциированных с нарушением слуха, насчитывается до нескольких десятков. Известна группа нефрологической патологии, при которой у детей возможно развитие тугоухости. Сахaрный диабет может проявляться снижением слуха. Лучевая терапия и химиотерапия приводят к осложнениям со стороны органа слуха. Пациенты с мукополисахаридозом составляют группу риска по развитию тугоухости. Среди детей с целиакией высоко распространена сенсоневральная тугоухость. В схемах лечения ряда болезней присутствуют ототоксичные препараты. Кооперация медицинских специалистов разных профилей позволит эффективно осуществлять аудиологический скрининг детей с тяжелой хронической патологией.

Cardiac rhythm and its structure are indicators of the state of heart regulatory systems. Estimation of heart rhythm variability (HRV) makes it possible to detect cardiac autonomic regulatory impairments and to estimate their magnitude, by providing additional possibilities to examine autonomic disorders and to search for new differential diagnostic distinctions between Levy body dementia (LBD) and Parkinson's disease (PD). Objective: to analyze autonomic provision of cardiac performance in patients with LBD versus PD patients with and without dementia (PD+D and PD-D). Subjects and methods. The study enrolled 21 patients with probable LBD and 31 patients with PD (24 patients with PD-D and 7 with PD+D), who were matched for gender and age. Results and discussion. Resting heart rhythm analysis revealed no normal age-related abnormalities in patients with LBD as compared to those with PD+D who had a marked reduction in HRV. An orthostatic test in both patients with LBD and those with PD (mainly that with dementia) showed inadequate sympathetic effects on heart rhythm, which is suggestive of cardiac sympathetic dysregulation and favors the development of orthostatic hypotension. During the orthostatic test, the patients with LBD were found to have supraventricular premature contractions with the pulse being fixed, which were probably caused by the hypersensitivity of denervated receptors to humoral factors. As the denervation process became longer, receptor sensitivity was decreased, hence supraventricular premature beats and arterial hypertension were absent in the horizontal position in long ill patients with PD+D, in whom the adaptive properties were considerably lower.