Biologist spoke about the deadly danger of children swimming with dolphins

Dolphin therapy: what is it?

The unique properties of these animals, their affection and playfulness are used by humans as one of the types of animal therapy, i.e.
animal-assisted treatment. Dolphin therapy is a method of medical and psychological rehabilitation based on the interaction between a mammal and a person.
This type of therapy is used to correct psychological problems, mental pathologies, and is perfectly combined with drug treatment and other psychotherapeutic methods.

Dolphin therapy is a specially organized process, one of the types of alternative medicine. The process involves specialists of various profiles - zoologists, veterinarians, psychologists, teachers.

Animals involved in dolphin therapy undergo careful selection and examination. The most affectionate, sociable and hardworking individuals are attracted to communicate with people.

Scientists explain the positive effect on the human psyche by the ultrasound emitted by dolphins, which spreads through the sonar (fat pad on the head). The presence of sonar allows dolphins to recognize words spoken by humans.

It is assumed that animal ultrasound heals the human nervous system at the cellular level. Dolphins can recognize subtle vibrations of the internal organs of people, distinguish pathology and influence it.

Hydroxychloroquine and mefloquine

Doctors have been using drugs based on chloroquine for more than 70 years to treat malaria and autoimmune diseases (for example, systemic lupus erythematosus). Scientists have found that the active substance is also effective against the SARS-CoV-2 virus. In March, the Chinese holding Shanghai Pharmaceuticals provided Russia with the drug hydroxychloroquine (a derivative of chloroquine) for the treatment of COVID-19. The Ministry of Health did not identify any contraindications and allowed its use, donating more than 68 thousand packages to hospitals, despite the fact that hydroxychloroquine is not registered in Russia.

Scientists are still arguing about the validity of using hydroxychloroquine. Research by French infectious disease specialist Didier Raoult showed positive results. But the Associated Press published data from American studies. An analysis of medical records of patients treated with the drug showed that hydroxychloroquine was less effective than standard treatments.

In April, the Federal Medical and Biological Agency of the Russian Federation conducted clinical trials of mefloquine (an analogue of hydroxychloroquine approved in Russia). Scientists found out how effective and safe this antimalarial drug is. According to preliminary data from a study involving 347 patients, after using mefloquine, positive dynamics were noted in 78% of cases. The FMBA will provide its final conclusions at the end of May.

Who is dolphin therapy indicated for?

Dolphin therapy is used to stabilize the emotional sphere and mental illness.

Adult patients are accepted for rehabilitation in the presence of such borderline conditions as:

• neuroses of all typologies;
• emotional burnout;
• chronic fatigue;
• post-traumatic syndrome;
• obsessive states, increased anxiety, fears, phobias.

Dolphin therapy is especially effective for correcting diseases in childhood.

Indications for communication with these unique animals are such childhood diseases as:

• genetic pathology, including Down syndrome;
• increased activity in attention deficit disorder;
• Cerebral palsy (cerebral palsy);
• mental retardation in the early stages;
• hearing loss of sensorineural origin;
• autism;
• functional disorders of the nervous system.

Like other types of treatment, dolphin therapy has contraindications, including:

• infections in the acute period;
• epileptic seizures;
• oncology.

In any case, before undergoing the procedures, you should consult with the accompanying child or an adult doctor.

Types of dolphin therapy

Depending on the state of health, dolphin therapy can solve a variety of problems, from minor psychological correction to restoration of lost functions, attention, memory, etc.

For these purposes, various types of activities with animals are used.:

Free interaction with dolphins

The essence of the method is that the patient communicates with the bottlenose dolphin in any form. He is in the same pool with the animal, he can swim, dive, climb on horseback, throw a ball, i.e. performs the actions that he wants. This type of rehabilitation is more suitable for adult patients without obvious mental disorders.

The task of the instructor accompanying the process is to prevent the dolphin from causing harm to humans and vice versa, i.e. security.

Controlled interactions with animals

With this method, the patient interacts with the animal through a specialist who organizes the process, gives special commands, and determines the sequence of actions of the patient and the dolphin.

In this case, the psychotherapist conducts an independent treatment session, and cute creatures act as his assistants, creating a comfortable and favorable background. This method is recommended for the treatment of young children, as well as adults with psychopathologies. Control is established to ensure that patients do not cause harm to themselves or the animal.

Depending on the number of people taking part in a dolphin therapy session, it can be individual (one person) or group (several people).

Ribavirin

It is quite difficult to assess the effectiveness and safety of ribavirin. On the one hand, this drug inhibits the reproduction of the vast majority of viruses, on the other, the mechanism of action of ribavirin is not fully understood. At the end of January, the Ministry of Health recommended the use of this antiviral drug to treat coronavirus. It is prescribed to children for respiratory syncytial infection (a rare type of acute respiratory viral infection), which causes severe lung damage. The drug is used for severe influenza, for measles in children with immunodeficiency, and in combination with interferon ribavirin to treat viral hepatitis C.

However, Academician of the Russian Academy of Sciences Alexander Chuchalin criticized the recommendations of the Ministry of Health. When prescribing the drug to adults, it is necessary to take into account its teratogenicity (threat of disruption of embryonic development), therefore ribavirin is strictly contraindicated during pregnancy. Despite the fact that the drug inhibits the reproduction of many viruses, it is very toxic and causes many side effects.

At the end of March, the Ministry of Health excluded ribavirin from the list of recommended drugs for the treatment of COVID-19.

Positive effects of dolphins on humans

The positive impact of dolphins on humans lies, first of all, in the normalization of the emotional and mental sphere: endorphins (hormones of happiness) are produced, a state of peace and tranquility comes, the mind is cleared of worries and fears.

In addition, it has been proven that communication with animals activates the immune system of patients, and accordingly, increases resistance to diseases.

As an experiment, human encephalograms were conducted before and after a dolphin therapy session.

Here's what was installed:

• the activity of the left and right hemispheres of the brain is synchronized;
• nervous overexcitation disappears;
• brain rhythms slow down.

Similar effects occur when using methods such as hypnosis or holotropic breathing.

In terms of correction of the psycho-emotional state, the following results of dolphin therapy are observed::

• the ability to leave self-isolation (relevant for childhood autism);
• satisfying the need for emotional contacts;
• acquiring adaptation skills in society;
• feeling a “taste for life”, getting out of depression.

A person breaks out of the vicious circle of his own thoughts and experiences. He begins to notice the surrounding reality, and from the positive side. This stimulates further development and self-improvement, and a way out of a depressed emotional state.

Benefits of dolphin therapy for children

Dolphin therapy is especially effective in treating physical and psychological problems of children and adolescents. Without calling for the abandonment of drug treatment, you should try dolphin therapy as a type of additional treatment that brings real benefits to the baby.

The child always associates treatment with bitter pills or “painful” injections. Many children, when communicating with people in white coats or at the sight of a hospital, experience fear, discomfort, and tension.

The big advantage of communicating with animals is that nothing special is required from the baby, he just plays. The child is psychologically liberated, does not worry, he is funny and interested. This emotional state in itself has a powerful therapeutic effect.

Excellent results are observed when autistic children undergo dolphin therapy. The main problem of such guys is their absorption within themselves and their inability to communicate with the outside world.

Active and kind animals help break the shell in which a child is imprisoned and bring him out to emotions. A child who finds it difficult to open up with his own kind may be interested in communicating with representatives of another world, he trusts them, allows himself to open up. The psychologist’s task is to maintain openness after the baby comes onto land, into the human world.

In addition to autism and Down syndrome, dolphin therapy has shown its effectiveness in the treatment of such adolescent and childhood pathologies as:

• acute neuroses, stuttering, nervous tics;
• addictions of all types: alcohol, drugs, gaming;
• decreased vision and hearing.

Young patients who have completed dolphin therapy courses become more receptive to learning, more easily join identical social groups, and are capable of making independent decisions.

STRIDOR in newborns and children of the first year of life

Stridor is a rough, variable-pitched sound caused by turbulent air flow as it passes through a narrowed area of ​​the airway [36]. Stridor in newborns and infants is a pathology that is a symptom of respiratory obstruction [7]. Stridor can be a symptom of life-threatening illnesses. The most important characteristics of stridor are its volume, pitch, and the breathing phase at which it occurs.

Loud stridor is usually a symptom of severe airway narrowing. In the case of progressively worsening stridor, a sudden weakening of the sound may be a sign of increased obstruction, weakening of respiratory movements and the occurrence of airway collapse [28].

High-sounding stridor is usually caused by obstruction at the level of the vocal folds [26], while low-sounding stridor is usually caused by pathology above the vocal folds (the laryngeal part of the pharynx, the upper part of the larynx). Mid-range stridor is most often a symptom of obstruction below the vocal folds [41].

The most important sign to suspect the level of damage is the respiratory phase in which stridor is best heard. On this basis, stridor can be divided into three types: inspiratory, expiratory and biphasic. Inspiratory stridor is usually caused by a lesion located above the vocal folds and is produced by the collapse of soft tissue under negative pressure during inspiration [22]. Biphasic stridor is usually high-pitched. It is caused by a lesion at the level of the vocal folds or subglottic region [16, 18]. Expiratory stridor occurs more often with damage to the lower respiratory tract [42].

History is very important for diagnosing the disease. Key historical data are the reasons and duration of intubation (if previously performed) in the neonatal period. Other anamnestic features include age at onset of stridor, duration of stridor, association with crying or feeding, and position of the child; the presence of other associated symptoms, such as coughing paroxysms, aspiration or regurgitation [40, 41].

When examining a child, you should evaluate his general condition, respiratory and heart rate, and skin color. In addition, you should pay attention to possible anomalies in the structure of the head, the participation of additional muscles in the act of breathing, retraction of the compliant areas of the chest and other signs, and exclude a possible infectious disease [36].

If the child’s condition does not require immediate intervention, an x-ray of the larynx and soft tissues of the neck in the anterior and lateral projection, chest, as well as x-ray of the esophagus with a water-soluble radiopaque substance should be performed. In addition, ultrasound examination of the larynx, computed tomography, and nuclear magnetic resonance may be useful [12, 30].

The most informative method for diagnosing a disease manifested by congenital stridor is endoscopic examination: fiberoscopy; direct laryngoscopy under anesthesia, preferably using a microscope; tracheobroncho- and esophagoscopy [11, 36]. In this case, it is necessary to take into account the possibility of an abnormal structure of several parts of the respiratory tract [23, 25].

• The most common causes of stridor in newborns and infants

Laryngomalacia is the most common cause of stridor [16, 30]. Anatomically, the following forms of laryngomalacia can be distinguished: due to the retraction of the soft epiglottis into the lumen of the larynx (Fig. 1); due to the arytenoid cartilages, when inhaling, they are pulled up or pulled up initially, due to the shortened aryepiglottic fold (Fig. 2); mixed form, when both the epiglottis and arytenoid cartilages fall into the lumen of the respiratory tract. Laryngomalacia usually occurs

“benign” and disappears spontaneously, usually by 1.5 - 2 years of life.
Boys are affected twice as often as girls. Stridor usually appears from birth, but in some cases it does not occur until the second month of life. Symptoms may be transient and worsen when the child lies on his back or during crying and agitation. The severity of the disease may vary. Most children experience only noisy, sonorous breathing, but in some cases laryngomalacia causes laryngeal stenosis, requiring intubation and even tracheotomy. In severe cases, surgical treatment is resorted to, usually using a laser - making incisions on the epiglottis, dissecting the aryepiglottic folds or removing part of the arytenoid cartilages. Vocal fold paralysis is the second most common cause of congenital stridor [39, 41]. It is usually found in children with other congenital anomalies or central nervous system involvement [29]. Often the cause of paralysis remains unclear, and this type of paralysis is considered idiopathic. In cases of idiopathic paralysis (possibly caused by birth trauma), it is often

spontaneous healing occurs.
In other cases, the cause may be hemorrhages in the ventricles of the brain, meningoencephalocele, hydrocephalus, perinatal encephalopathy and other diseases [29]. In addition, iatrogenicity (for example, when the recurrent laryngeal nerve is damaged) can be identified as the cause of the development of vocal fold paralysis. Bilateral paralysis causes high-pitched stridor and aphonia. About half of children with bilateral paralysis require tracheotomy [22, 26, 39].

With unilateral paralysis (Fig. 3), a weak cry is usually noted, the voice gradually improves with age. Respiratory function is usually not affected by unilateral paralysis [28].

Congenital cicatricial membrane (Fig. 4) and subglottic stenosis develop as a result of incomplete separation of the germinal mesenchyme between the two walls of the developing larynx [33]. Acquired cicatricial stenoses are found much more often (Fig. 5), usually developing as a result of prolonged transglottic nasotracheal intubation. The severity of the disease depends on the degree of damage: a small scar membrane, localized only in the area of ​​the anterior commissure, is clinically manifested only by a change in voice (“cock crow”); complete laryngeal atresia is compatible with life only theoretically [30].

The leading clinical symptoms of the disease are obstruction of the upper respiratory tract, such as biphasic stridor, tachypnea, cyanosis, anxiety, flaring of the wings of the nose when breathing, participation of auxiliary muscles in the act of breathing, etc. When the membrane is localized in the area of ​​the vocal folds, voice disorders up to aphonia are noted .

The leading diagnostic method is endoscopy [30], although radiography of the larynx and trachea in anterior and lateral projections indirectly helps.

Treatment is determined by the severity of symptoms. Only children with small anterior commissural synechiae can be kept under observation without surgical treatment; patients with a medium-sized membrane that causes breathing problems require surgical treatment (usually laser destruction) during the neonatal period. Children with severe membrane usually require tracheotomy in the neonatal period followed by surgery (using a laser or external approach) at an older age [17, 38].

In some cases, congenital subglottic stenosis is accompanied by other congenital lesions [34]. When choosing treatment tactics, it is necessary to take into account that breathing can improve with the growth of the larynx.

Laryngeal cysts. Stridor occurs when a cyst grows into the lumen of the respiratory tract or compression of the soft tissues of the larynx. In addition, when localized on the laryngeal and especially on the lingual surface of the epiglottis (Fig. 6), they can cause dysphagic phenomena [20, 30].

The localization of cysts can be varied - epiglottis, supraglottic region, aryepiglottic folds, subglottic region. Often cysts develop in children with a history of intubation, and in such cases they can be multiple. Small cysts of the vocal folds (Fig. 7) are clinically manifested only by hoarseness. With mirror laryngoscopy, especially if the submucosal cyst is localized at the border of the anterior and middle third of the vocal fold, it is mistakenly diagnosed as a “singing” nodule. In this case, the correct diagnosis can only be established by examining the larynx under anesthesia using optics.

For treatment, aspiration of the cyst contents is used, followed by excision of its walls with microinstruments or a CO2 laser [6, 8, 30].

Cysts often recur. In some cases, external surgery is required to excise large multiple recurrent cysts [31].

Subglottic hemangioma (Fig. threatens the life of the child. According to foreign literature, the average mortality from this disease is 8.5% [43]. In most cases, subglottic hemangioma is present from birth and undergoes growth during the first months of life. Stridor usually appears at 2 -3 months of life, the first symptoms of the disease are usually mistakenly diagnosed as croup [27]. In three of our cases, respiratory stenosis developed on the first day after cryodestruction of skin hemangiomas. Stridor is usually biphasic, the voice may not be changed. More than half of the children have skin hemangiomas. How and with skin hemangiomas, girls suffer three times more often than boys [9].The severity of the disease depends on the size of the hemangioma, in the case of acute respiratory viral infection or anxiety, breathing may worsen.

The leading diagnostic method is endoscopy. Usually a pink or red soft tissue protrusion is found under the vocal fold (usually under the left) [5]. If the child has been previously intubated due to respiratory stenosis, the hemangioma may not be diagnosed when examining the airway immediately after extubation.

Treatment uses CO2 laser destruction of hemangioma followed by hormonal therapy [6, 24]. In case of hemangioma of the anterior surface of the neck that grows into the larynx, tracheotomy is necessary, followed by close-focus radiotherapy or treatment with corticosteroids [2].

Juvenile respiratory papillomatosis (JRP) (Fig. 9) is the most common tumor of the upper respiratory tract in children. The etiological factor of papillomatosis is the human papillomavirus, most often types 6 and 11 [3]. Although in the vast majority of patients the first symptoms of the disease develop at 2–3 years of life, in some cases we can talk about congenital laryngeal papillomatosis, when the first symptoms of the disease are noted from the moment of birth [1].

The initial symptom of the disease is usually hoarseness, gradually turning into aphonia. Subsequently, as papillomas grow and the lumen of the glottis narrows (obstructive form), progressive laryngeal stenosis occurs, manifesting itself as inspiratory or biphasic stridor [10].

The most common primary localization of laryngeal papillomas is the area of ​​the commissure and the anterior third of the vocal folds. At later stages of the disease, papillomas can affect all parts of the larynx, as well as extend beyond its limits. Papillomas usually have a wide base, but the growth of conglomerates of papillomas on a small stalk is possible. In appearance, papillomas resemble a mulberry or a bunch of grapes. During microlaryngoscopy, the surface of papillomas is usually uneven, fine-grained or finely lobed, the color is often pale pink, sometimes with a grayish tint. The severity of the disease is determined by the growth rate of papillomas and the frequency of recurrence [15].

The main method of eliminating stenosis in children with JRP is surgical removal of papillomas using microinstruments and/or a CO2 laser. However, surgical treatment alone does not prevent relapse of the disease in most patients. Currently, the most pathogenetically justified and promising is long-term continuous administration of interferon drugs [13, 19, 21].

Tracheomalacia. There are diffuse and local forms of tracheomalacia, i.e. weakness of the tracheal wall associated with the pathological softness of its cartilaginous frame. Clinically, the disease manifests itself as expiratory stridor. During endoscopy, a sharp narrowing of the tracheal lumen is detected during exhalation, which can take various shapes. Symptoms of the disease often disappear spontaneously by 2–3 years of life [32]. Severe respiratory distress may require tracheotomy [41].

Congenital tracheal stenosis (Fig. 10) can have a different nature. Organic stenoses are associated with a local defect in the cartilaginous half-rings of the trachea (lack or absence of cartilage) or excessive formation of cartilage tissue, leading to the formation of a hard cartilaginous protrusion into the tracheal lumen [42].

Functional stenoses are associated with excessive softness of the cartilage and in this case are a local form of tracheomalacia. Expiratory stridor is usually detected immediately after birth. Stridor gets worse when the baby is restless or feeding. The patient's condition usually worsens sharply during ARVI; in some cases, attacks of suffocation are noted, which are mistakenly diagnosed as croup. To exclude external compression of the trachea, an X-ray contrast examination of the esophagus is necessary. The main diagnostic method is endoscopic. Tracheal stenosis, especially due to tracheomalacia, has a favorable prognosis and, in most cases, heals spontaneously.

Vascular ring. The abnormal configuration of large vessels can cause compression of the trachea, usually its distal parts.
In addition, the esophagus may also be compressed. Stridor gets worse when crying or feeding, or when the baby is lying on his back. Regurgitation is often noted. The diagnosis is established using radiography of the esophagus with a radiopaque agent (Fig. 11) and aortography. The most common type of aortic arch duplication is the accessory left pulmonary artery [14, 37]. During endoscopy, bulging and, in some cases, pulsation of the anterior wall of the trachea can be detected. Treatment is surgical.

Laryngotracheoesophageal hiatus is a rare congenital developmental defect. Over a long distance, the respiratory tract communicates with the esophagus. The cause of this defect is non-fusion of the dorsal part of the cricoid cartilage. This disease is clinically manifested by moderately loud biphasic stridor and episodes of aspiration. Children with this defect often experience repeated pneumonia. Paroxysms of cough and cyanosis are typical. The voice is quiet. Approximately 20% of children also have a tracheoesophageal fistula, typically located in the distal trachea [35]. To establish a diagnosis, in addition to endoscopy, chest X-ray with contrast is required. Treatment requires not only a tracheotomy, but also a gastrostomy tube to feed the child.

Tracheoesophageal fistula (Fig. 12) manifests itself during the first feeding of the child with severe attacks of suffocation, coughing and cyanosis [41]. The defect is based on incomplete development of the tracheoesophageal wall. Often this defect is combined with esophageal atresia. Subsequently, severe aspiration pneumonia quickly follows. Treatment is surgical only, the results often depend on the timing of the operation. The prognosis is more favorable the earlier the intervention is undertaken.

• Medical genetic counseling

Considering that malformations of the larynx and trachea are a manifestation of embryopathies, in patients with congenital pathologies of these organs, manifestations of embryopathies from other organs and systems are very likely. In clinical practice, the greatest difficulty in establishing the nosological form of the disease is its syndromic forms. The syndromic examination method is based on the fact that most developmental defects can be isolated or be part of known syndromes or unspecified complexes of multiple congenital defects. Establishing a syndromic diagnosis influences the following factors: 1) conducting a thorough diagnosis of hidden developmental defects and functional abnormalities within the established syndrome; 2) performing specific preoperative preparation of the patient to prevent possible complications during surgery or in the postoperative period; 3) tactics and results of treatment, which in some cases is expressed in the refusal of surgical interventions, including changes in the surgical technique for correcting certain developmental defects.

According to our data, a syndromic diagnosis can be established in approximately 25% of patients [4]. Only 8-10% of children have an isolated form of congenital pathology of the larynx and trachea. The remaining patients with congenital diseases of the larynx and trachea have other developmental defects - the central nervous, musculoskeletal, cardiovascular systems, developmental anomalies of the auricles, facial developmental defects, connective tissue abnormalities, congenital tumor-like formations of the skin, etc. A combination of developmental defects of several organs systems that are not induced by each other in this group of patients can be regarded as multiple unspecified congenital malformations.

Literature

1. Bogomilsky M. R., Soldatsky Yu. L., Maslova I. V., Nurmukhametov R. Kh. Congenital juvenile respiratory papillomatosis of the larynx // Bulletin of Otorhinolaryngology. 1998. No. 6. P. 28 - 29. 2. Vodolazov S. Yu., Pospelov N. V. Combined treatment of children with widespread hemangiomatosis of the head, neck, face in combination with subglottic hemangioma of the larynx. In the book: Materials of the XV All-Russian Congress of Otorhinolaryngologists, September 25-29, 1995, Volume II. St. Petersburg, 1995. P. 273 - 275. 3. Gerain V., Chireshkin D. G. Molecular biological aspects of juvenile respiratory papillomatosis and its combined treatment // Bulletin of Otorhinolaryngology. 1996. No. 4. P. 3 - 8. 4. Maslova I.V., Solonichenko V.G., Soldatsky Yu.L., Onufrieva E.K. Genetic aspects of congenital pathology of the larynx and trachea // Bulletin of Otorhinolaryngology. 1999. No. 2. P. 30 - 33. 5. Soldatsky Yu. L., Onufrieva E. K. Subglottic hemangioma as a cause of laryngeal stenosis in young children // Bulletin of Otorhinolaryngology. 1997. No. 6. P. 19 - 21. 6. Soldatsky Yu. L., Maslova I. V., Onufrieva E. K. Laser endoscopic surgery of congenital diseases of the larynx in children // Laser medicine. 1998. T. 2. No. 2 - 3. P. 36 - 38. 7. Soldatsky Yu. L., Onufrieva E. K., Maslova I. V. Stridor in newborns and infants. In the book: Materials of the V Congress of Pediatricians of Russia “Healthy Child”, 02.16-18.1999. Moscow, 1999. P. 430 - 431. 8. Tsvetkov E. A., Fadeeva I. A. Surgical treatment of congenital laryngeal cysts // Bulletin of Otorhinolaryngology. 1999. No. 3. P. 42 - 45. 9. Chireshkin D. G., Onufrieva E. K., Soldatsky Yu. L. Vascular tumors of the larynx, pharynx and oral cavity in children // Bulletin of Otorhinolaryngology. 1994. No. 4. P. 29 - 32. 10. Chireshkin D. G. Chronic obstruction of the laryngeal part of the pharynx, larynx and trachea in children. M.: Rapid-Print, 1994. P. 144. 11. Chireshkin D. G., Maslova I. V., Onufrieva E. K., Soldatsky Yu. L. Structure and early symptoms of congenital diseases of the larynx and trachea // Bulletin otorhinolaryngology. 1996, No. 5. P. 13 - 18. 12. Shanturov A. G., Subbotina M. V. Ultrasound diagnostics in pediatric laryngology. Irkutsk: Papyrus, 1994. P. 140. 13. Avidano MA, Singleton GT Adjuvant drug strategies in the treatment of reccurrent respiratory papillomatosis // Otolaryngology - Head and Neck Surgery. 1995. Vol. 112. P. 197 - 202. 14. Backer CL, Ilbawi MN, Idriss FS Vascular anomalies causing tracheoesophageal compression // J. Thorac Cardiovasc. Surg. 1989. Vol. 97. P. 725 - 731. 15. Bauman NM, Smith RJ Recurrent respiratory papillomatosis // Pediatr. Clin. North. Am. 1996. Vol. 43. P. 1385 - 1401. 16. Belmont JR, Grundfast KM Congenital laryngeal stridor (laryngomalacia): etiologic factors and associated disorders // Ann. Otol. Rhinol. Laryngol. 1984. Vol. 93. P. 430 - 436. 17. Benjamin B., Jacobson I., Eckstein R. Idiopathic subglottic stenoses: diagnosis and endoscopic laser treatment // Ann. Otol. Rhinol. Laryngol. 1997. Vol. 106. P. 770 - 774. 18. Benjamin B., Mair EA Congenital interarytenoid web // Arch. Otolaryngol. Head Neck Surg. 1991. Vol. 117. P. 1118 - 1122. 19. Chmielik M., Piekarniak P., Snieg B. Microsurgical treatment of laryngeal papillomatosis // Otolaryngol. Pol. 1997. Vol. 51. P. 26 - 30. 20. Civantos FJ, Holinger LD Laryngoceles and saccular cysts in infants and children // Arch. Otolaryngol. Head Neck Surg. 1992. Vol. 118. P. 296 - 300. 21. Deunas L., Alcantud V., Alvarez F. et al. Use of interferon-alpha in laryngeal papillomatosis: eight years of the Cuban national program // J. Laryngol. Otol. 1997. Vol. 111. P. 134 - 140. 22. Ferguson CF Congenital abnormalities of the infant larynx // Ann. Otol. Rhinol. Laryngol. 1967. Vol. 76. P. 744 - 752. 23. Friedman EM, Vastola AP, McGill TJ, Healy GB Chronic pediatric stridor: etiology and outcome // Laryngoscope. 1990, Vol. 100. P. 277 - 280. 24. Froehlich P., Seid AB, Morgon A. Contrasting strategic approaches to the management of subglottic hemangiomas // Int. J. Pediatr. Otorhinolaryngol. 1996. Vol. 36. P. 137 - 146. 25. Gonzales C., Reilly JS, Bluestone CD Synchronous airway lessions in infants // Ann. Otol. Rhinol. Laryngol. 1987. Vol. 96. P. 77 - 80. 26. Grundfast KM, Harley EH Vocal cord paralysis // Otolaryngol. Clin. North. Am. 1989. Vol. 22. P. 569 - 597. 27. Healy GB, McGill T., Friedman EM Carbon Dioxide Laser in Subglottic Hemangioma. An update. //Ann. Otol. Rhinol. Laryngol. 1984. Vol. 93. P. 370 - 373. 28. Holinger LD Etiology of stridor in the neonatal, infant and child // Ann. Otol. Rhinol Laryngol. 1980. Vol. 89. P. 397 - 400. 29. Holinger LD, Holinger PC, Holinger PH Etiology of bilateral abductor vocal cord paralysis: A review of 389 cases // Ann. Otol. Rhinol. Laryngol. 1976. Vol. 85. P. 428 - 436. 30. Holinger LD, Lusk RP, Green CG Pediatric laryngology and bronchoesophagology. Philadelphia - NY: Lippincott - Raven, 1997. R. 402. 31. Holinger PH, Brown WT Congenital webs, cysts, laryngoceles and other anomalies of the larynx // Ann. Otol. Rhinol. Laryngol. 1967. Vol. 76. P. 744 - 752. 32. Jacobs I., Welmore R., Tom L. et al. Tracheobronchomalacia in children // Arch. Otolaryngol. Head Neck Surg. 1994, Vol. 120. P. 154 - 158. 33. McGill T. Congenital diseases of the larynx // Otolaryngol. Clin. North. Am. 1984. Vol. 17. P. 57 - 62. 34. Miller R., Gray SD, Cotton RT, Myer CM, Netterville J. Subglottic stenosis and Down syndrome // Am. J. Otolaryngol. 1990. Vol. 11. P. 274 - 277. 35. Myer CM, Cotton RT, Holmes D. Laryngeal and laryngotracheoesophageal clefts: The role of early surgical repair // Ann. Otol. Rhinol. Laryngol. 1990. Vol. 99. P. 98 - 104. 36. Nowlin JH, Zalzal G. The stridorous infant // ENT J. 1989. V. 70. P. 84 - 88. 37. Park SC Vascular abnormalites // Pediatr. Clin. North. Am. 1981. Vol. 28. P. 949 - 955. 38. Park SS, Streitz JM Jr., Rebeiz EE, Shapshay SM Idiopathic subglottic stenosis // Arch. Otolaryngol. Head Neck Surg. 1995. Vol. 121. P. 894 - 897. 39. Parnell FW, Brandenberg JH Vocal cord paralysis: A review of 100 cases // Laryngoscope. 1970. Vol. 70. P. 1036 - 1045. 40. Pransky SM, Grundfast KM Differentiating upper from lower airway compromise in neonates // Ann. Otol. Rhinol. Laryngol. 1985. Vol. 94. P. 509 - 515. 41. Richardson MA, Cotton RT Anatomic abnormalities of the pediatric airway // Pediatr. Clinic. North. Am. 1995. Vol. 31. P. 821 - 834. 42. Rimmell FL, Stool SE Diagnosis and management of pediatric tracheal stenosis // Otolaryngol. Clin. North. Am. 1995. Vol. 28. P.809 - 827. 43. Shikhani AH, Marsh BR, Jones MM, Holliday MJ Infantile subglottic hemangiomas. An update // Ann. Otol. Rhinol. Laryngol. 1986. Vol. 95. P. 336 - 347.

Note!

• Stridor in newborns is a symptom of partial obstruction of the large diameter airways
• To diagnose the disease, a thorough history and clinical examination of the child is necessary to assess the severity of his condition.
• The level of damage can be suspected by the stridor phase and associated symptoms, such as cough, regurgitation, cyanosis
• The main method of diagnosis is endoscopy, although radiographic and ultrasound examinations can be very useful in some cases
• All patients with congenital pathology of the larynx and trachea need to be examined in a medical genetic consultation

Step-by-step preparation for dolphin therapy

Interaction with dolphins, especially if we are talking about children, requires special training. Preliminary work is carried out with the parents to clarify the psychological characteristics of the little patient, and a medical history is collected.

Stages of preparatory work:

• The child is introduced to the world of dolphins by correspondence. Child psychologists advise purchasing toy animals, books, and coloring books with their images. Using the above or other means (for example, videos), the child should be given primary information about mammals, their way of existence, habitat, and habits.
• At the second stage, children, being on the platform of the pool, can get to know the dolphins in person, watch their movements, and hear the sounds of the sonar. The child can sit on the platform, put his legs in the water and dangle them. At this time, the dolphin following the trainer’s commands helps to establish a visual and emotional connection.
• Next, the baby learns to greet the animal and enjoy meeting it. At the same time, the games learned earlier are repeated.
• The child is ready for independent contact with a dolphin (of course, under the supervision of specialists). He completely immerses himself in the water and begins swimming together.
• At the fifth preparatory stage, communication between the child and the dolphin is already fully established. The baby himself chooses the ways of interaction, taking into account previously acquired skills.

At the end of each session, the child is asked to say goodbye to the dolphin and wish him well. The main goal of the preparatory work is to instill in the child a sense of security alone with the animal and consolidate the emotions of joy from communication.

How do dolphin therapy sessions work?

In animal-assisted therapy with the participation of dolphins, the play method is mainly used. But a game is not an arbitrary set of actions. Its course is clearly thought out taking into account the need to solve certain corrective problems.

The game is close, understandable and desirable for both the child and the dolphin, so the patient and the “doctor” play and frolic for a long time and with pleasure.

Taking into account individual characteristics, games such as ball tossing and volleyball are played. Children happily hug and pet the animal, try to cuddle up to it or climb on horseback.

Games take place either under the supervision of a psychologist and a coach, or with their direct participation, when the specialist becomes a third party to the interaction.

Dolphin therapy sessions can be supplemented with activities to develop motor skills and spatial orientation, as well as creative thinking. For example, immediately after communicating with animals, classes in modeling, drawing, and role-playing games are held.

Dolphin therapy services in Russia: where you can use them

Dolphin therapy is a fairly expensive service. This is due to the costs of maintaining the equipment and the animals themselves, and also includes the costs of paying for the services of specialists. On average, the price of treatment in Russia will be about 40 thousand rubles.

Today, dolphin therapy services are provided in the following cities: Moscow, St. Petersburg, Novosibirsk, Evpatoria, Alushta, Yalta, Sochi, Dzhugba, Anapa, Nizhny Novgorod, Rostov-on-Don, Yaroslavl, Naberezhnye Chelny, Yekaterinburg and Grozny.

When deciding whether to use dolphin therapy, you need to know the following. This type of therapy is not a panacea; it is one of the additional methods to the main treatment, although a very pleasant one.

The duration of treatment can be determined only after starting it; sometimes several sessions are enough, sometimes several months are required. Think about your financial capabilities, since an interrupted process will not bring much effect.

Dolphin therapy in Moscow: answers to your questions

invites you to on-site classes, which are held in sanatoriums on the Black Sea. You don’t need a foreign passport or visa, just visit Anapa, Alushta, Yevpatoria and other Russian cities. The center's specialists will help you choose the appropriate option.

Our advantages:

• extensive experience and highly qualified specialists;
• affordable cost of classes - our prices are lower than the market average;
• an integrated approach to solving your child’s problems;
• Constant control over the child, development of an individual lesson plan and strict adherence to it.

Detailed information about the treatment of the nervous system and other disorders with the help of animals is presented on our website. You have questions? Contact us! We will provide the necessary advice. You can choose the most convenient way of communication: a personal visit to the center, a telephone conversation or a video conversation via Skype.