Vol 11, No 3 (2012)
SOCIAL PEDIATRICS AND HEALTH CARE 
7-9 821
Abstract
Aim. The analysis of a current drug-addiction situation in the Russian Federation and revealing the main causes influencing on drugs
distribution in youth. A substantiation of primary prophylaxis measures against drug-addiction in the education system. Methods. The content-analysis of the drug-addiction situation in modern Russia using various sources of information (the official statistics data, articles, decrees, reports); data received from questionnaires answered by the principals of 124 comprehensive and 65 high schools from various regions of Russia, who have represented themselves as the experts. Results. The main causes of drugs distribution in youth are specificity of age and what is more important, insufficient efficacy of the state anti-drug addiction policy. Conclusions. Implementation and severe control of the realization of the measures against illegal turn and use of drugs both at federal and regional level taking into account territorial special features are required. The necessity of the concept development of the formation of health environment, including anti-drug addiction environment, in educational institutions is also proved.
distribution in youth. A substantiation of primary prophylaxis measures against drug-addiction in the education system. Methods. The content-analysis of the drug-addiction situation in modern Russia using various sources of information (the official statistics data, articles, decrees, reports); data received from questionnaires answered by the principals of 124 comprehensive and 65 high schools from various regions of Russia, who have represented themselves as the experts. Results. The main causes of drugs distribution in youth are specificity of age and what is more important, insufficient efficacy of the state anti-drug addiction policy. Conclusions. Implementation and severe control of the realization of the measures against illegal turn and use of drugs both at federal and regional level taking into account territorial special features are required. The necessity of the concept development of the formation of health environment, including anti-drug addiction environment, in educational institutions is also proved.
10-11 634
Abstract
Experience of the work with women, who decided to leave their child, is shown in this article. Young mothers have lived under the children hospital temporarily until their family, social and other problems were solved. Within one year 90% of mothers changed their decision and took their children. The conclusion was made, that early determination of pregnant women with risk to leave their children and rendering them social, psychological and pecuniary assistance is necessary in order to prevent social orphanage.
LITERATURE REVIEW
12-17 1052
Abstract
Among immunocompromised patients morbidity and mortality rates from infections and infectious complications is significantly higher than in immunocompetent population. It is necessary to work out clear indications to vaccination of immunocompromised patients both with inborn and acquired immunodeficiency. Due to wider use of immunosuppressive therapy and introduction of new biological drugs with antycytokine actions, the number of secondary immunocompromised patients increases. The experience of specific prophylaxis of pneumococcal infection in different groups of patients with immunodeficiency is analyzed in this review.
PROFESSIONAL DEVELOPMENT
18-27 1399
Abstract
The first part of the lecture on «Heredity, mutability and pathology», in which the problems of etiology, pathogenesis and clinical manifestations of hereditary diseases (genetic and chromosomal) are analyzed, is published in the current issue of the journal. The following issue of the journal will include the second part of this lecture, discussing modern information on sex chromosomes disorders, diseases with hereditary predisposition, congenital malformations, and the questions of their diagnostics, treatment and prophylaxis. At the end of the second part of the lecture you will find tests and clinical challenges for evaluation of learning level and also the answers for afore-mentioned tasks.
34-42 1040
Abstract
Causes, mechanisms and peculiarities of cough in children and also the possibilities of its treatment with N-acetylcysteine, as effective direct mucolytic and antioxidant agent, in first days of ARVI are discussed in this article. It also includes indications, contra-indications, schemes and special features of this drug usage in children.
43-48 868
Abstract
Irritated bowel syndrome is a significant and underestimated problem in childhood. This condition is not so good studied in pediatrics in comparison with adult practice. Pediatricians often diagnosed this disease in infants and young children without proper reasons. The authors analyze current opinions about etiology and pathogenesis, clinical presentation, diagnosticsand treatment of irritated bowel syndrome in children. An emphasis is made on diagnostic criteria, which allow suggesting and confirming the diagnosis.
50-56 821
Abstract
Children feeding with breast milk have significantly lower risk of gastrointestinal infectious diseases development, than children feeding with artificial milk formulas. At the beginning of feeding with additional food influence of allogenic antigens on child’s organism is increasing, which can lead to disturbances in microbiocoenosis of the gastro-intestinal tract. This causes stool disorders, intestinal colic, dyspepsia, dermatitis, allergic reactions, immunodeficiency with recurrent relapses of infections and development of non-infectious disease and their transition into chronic condition. Forming of the malabsorption syndrome at the background of such conditions leads to growth and mental development retardation of children. Numerous clinical trials proved the beneficial effects of the probiotic Hylak Forte on intestinal microflora in disbiosis.
57-64 781
Abstract
A qualitatively new approach to protein production for milk formulas for infants is discussed in this article. The advantage of membrane technologies usage is that they allow preserving protein biological value and make it possible to control the levels of amino-acids in protein by optimizing their proportion and quantity.
EXCHANGE OF EXPERIENCE
E. I. Vishneva,
L. S. Namazova-Baranova,
E. I. Alexeeva,
T. V. Turti,
R. M. Torshkhoeva,
Yu. G. Levina
65-69 910
Abstract
The prevalence of alimentary allergy in children of the 1st year of life is increasing overall. This kind of disorders involves different organs and tissues, and its clinical manifestations are not pathognomic. Among the most important allergens one of the key roles play cow milk proteins. Hypoallergenic formulas are recommended for the non-invasive dietary diagnostics and treatment. Amino-acid-based formulas meet the criteria of being hypoallergenic.
Z. M. Dyshlevaya,
A. N. Arkhipova,
Yu. V. Pashko,
L. V. Guk,
E. V. Skorobogatova,
G. P. Pavlova,
A. A. Bologov
70-74 616
Abstract
The study of efficacy and toxicity of daptoycin in treatment of Gram-positive infectons n children with hematological disorders was
performed. Twelve patients (4 girls and 8 boys) with signs of Gram-positive infections were examined. Staphylococcus aureus was
found in 66,6% (8 patients), among them in 3 patients strains were methicillin-resistant; Staphylococcus epidermidis — was found in 16,6% (2 patients); Enterococcus faecalis — in 16,6% (2 patients). By the time of development of infectious complications 7 patients (58,3%) have received antibiotic treatment, in 5 other patients daptomycin was the first-line antibacterial drug. The mean dosage of the drug was 5,8 mg/kg/day. In order to reveal the drug toxicity the monitoring of biochemical serum markers (fibrinogen, ALT, AST, LDG, CPK, creatinine) was performed. The complete resolution of infectious complications occurred in 12,1 ± 4,3 days. The mean duration of daptomycin treatment was 14,2 ± 3,2 days. During the treatment reliable lower of fibrinogen (6,4 ± 1,1 g/l and 3,1 ± 0,9 g/l, р = 0,05) and c-reactive protein (CRP) (12,5 ± 7,1 mg/dL and 3,4 ± 1,8 mg/dL, р = 0,04) was observed. No side effects were observed in all the patients. The performed study allowed to make a conclusion, that daptomycin is an effective and safe drug in treatment of Grampositive infections in children with hematological disorders even with concomitant hypogranulocytosis.
Key words: daptomycin, Gram-positive infections, onco-hematology.
performed. Twelve patients (4 girls and 8 boys) with signs of Gram-positive infections were examined. Staphylococcus aureus was
found in 66,6% (8 patients), among them in 3 patients strains were methicillin-resistant; Staphylococcus epidermidis — was found in 16,6% (2 patients); Enterococcus faecalis — in 16,6% (2 patients). By the time of development of infectious complications 7 patients (58,3%) have received antibiotic treatment, in 5 other patients daptomycin was the first-line antibacterial drug. The mean dosage of the drug was 5,8 mg/kg/day. In order to reveal the drug toxicity the monitoring of biochemical serum markers (fibrinogen, ALT, AST, LDG, CPK, creatinine) was performed. The complete resolution of infectious complications occurred in 12,1 ± 4,3 days. The mean duration of daptomycin treatment was 14,2 ± 3,2 days. During the treatment reliable lower of fibrinogen (6,4 ± 1,1 g/l and 3,1 ± 0,9 g/l, р = 0,05) and c-reactive protein (CRP) (12,5 ± 7,1 mg/dL and 3,4 ± 1,8 mg/dL, р = 0,04) was observed. No side effects were observed in all the patients. The performed study allowed to make a conclusion, that daptomycin is an effective and safe drug in treatment of Grampositive infections in children with hematological disorders even with concomitant hypogranulocytosis.
Key words: daptomycin, Gram-positive infections, onco-hematology.
75-78 675
Abstract
The article deals with problems of development and functioning of breast milk bank, substantiation of necessity of such institution, peculiarities of collection, processing and storing of donor breast milk.
79-82 744
Abstract
The authors analyse the varicella morbidity in Volgograd. The main markers of the severity of the disease course in children are estimated retrospectively. Also the economical costs of the indoor patients treatment and annual economical losses are assessed. The article contains the results of the realization of the regional programme «Vaccination», during which 14 000 children were vaccinated with «Okavax». This programme showed both high efficiency and safety.
83-86 754
Abstract
New approaches to the organization of infants feeding are represented in this article. The author shows the special features of the adapted artificial formulas composition and the significance of their components for child health and development.
87-88 746
Abstract
Acute intestinal infections (AII) are still one of the main challenges in pediatrics because of their high prevalence, polyetiology, high rate of severe and complicated forms, especially in young children. The perfect feeding for infants is breast milk. The child feeding with artificial formulas must be supplied with appropriate balanced feeding, assisting not only in physical and mental development, but also in recovery. The article provides information on dietary correction in treatment of AII with formulas containing probiotics.
90-93 771
Abstract
The results of two-stage audiologic examination (otoacoustic emissions method and assessment of auditory evoked potentials) of 74 term and premature newborns are shown in this article. All patients received treatment for perinatal injuries of central nervous system (cerebral ischemia of various stages of severity). The assessment of brainstem auditory evoked potentials was established to be the most informative diagnostic method both in term and premature infants, moreover the majority of newborns with perinatal brain injuries had increased latencies of brainstem auditory evoked potentials parameters and signs of acoustic analyzer dysfunction, which character depended on the severity of cerebral ischemia.
84-97 669
Abstract
In current study the quality of the main processes of specialized out-patient health care to children with psychiatric problems was studied according to the method of expert judgment. Integral characteristics of the psychiatric aid quality were analyzed in view of assessment of their components. During the assessment the overuse of diagnostic procedures and insufficient (up to total absence) control of efficacy of performed treatment were revealed. The higher rate of defects was found in documentations of adolescents. The received data allowed to determine the necessity of performing a number of organizational changes in activity of pediatric psychiatric health care unit.
98-101 742
Abstract
The article covers the role of intestinal microflora in maintenance and regulation of all the vital body functions. The causes of intestinal microbiocoenosis and possibilities of probiotic usage in order to correct revealed disturbances are discussed in this article.
102-107 911
Abstract
Generally accepted approach to dietotherapy in children with cow milk protein allergy is hypoallergenic diet. When breast-fed, oligoantigenic diet is prescribed to a mother. When a child does not receive mother’s breast milk, it is necessary to use formulas, based on extensively hydrolyzed milk protein or amino-acids. The article includes critical analysis of goat’s milk-based formulas usage in order to prevent and treat cow milk protein allergy. The conception of hypoallergenity, causes of crossed reactions and conventional international recommendations are discussed in details.
108-111 819
Abstract
Diseases of gastro-intestinal tract are often accompanied by relative insufficiency of pancreas exocrine function, which can be asymptomatic, but demands including enzymes in complex treatment. The authors describe advantages of the microspheric enzyme drug Pancreatin (Creon) in treatment of different forms of relative exocrine insufficiency of pancreas in children.
112-115 646
Abstract
The questions of childhood constipations epidemiology, complications frequency and some statements of foreign conciliatory recommendation are discussed in this article. The authors show data on prevalence of this disorder in various countries. The importance of control of the clinical manifestations, which can be evidences of organic disorder, is highlighted. Also the authors pay special attention to age specificities of constipations development in children. The mechanisms and peculiarities of lactulose actions, indications and contraindications to its usage are discussed in detail. The article includes the data obtained from randomized clinical trials.
116-119 790
Abstract
This article opens a series of scientific and practical information on the problem of monosymptomatic enuresis in children. The authors analyze the data on diagnostics, modern views to etiology, pathogenesis and clinical presentation of this disorder. The conclusion is made, that it is necessary to perform complex diagnostics and rehabilitation of children and adolescents with monosymptomatic enuresis and to search for alternative ways of treatment and new approaches to usage of existing ones in order to improve patients quality of life.
E. S. Zholobova,
O. Yu. Konopel'ko,
D. V. Dagbaeva,
A. V. Bunin,
O. S. Rozvadovskaya,
M. N. Nikolaeva,
V. Ya. El'yashevich
120-125 829
Abstract
The article includes the results of observation of patients with resistant forms of juvenile arthritis, who have received treatment with infliximab in the period of time since 2004 till 2011. The drug was administered to 41 patients: 19 with systemic juvenile idiopathic
arthritis, 6 with articulate form and 16 with juvenile spondiloarthritis. It was given intravenous (drop at a time), at first in dosage 3–5 mg/kg according to the scheme 0, 2, 6 and then every 8 weeks. The best efficacy was noted in juvenile spondiloarthritis and articulate form of juvenile idiopathic arthritis. By the 12 th month of the observation all the patients in these groups have achieved good results, corresponding with 70 % of improvement according to pediatric criteria of the American College of Rheumatologists. In patients with systemic arthritis a moderate positive effect was seen in first two months of treatment. By the 6th month the signs of disease have not significantly differ from those before Infliximab administration.
arthritis, 6 with articulate form and 16 with juvenile spondiloarthritis. It was given intravenous (drop at a time), at first in dosage 3–5 mg/kg according to the scheme 0, 2, 6 and then every 8 weeks. The best efficacy was noted in juvenile spondiloarthritis and articulate form of juvenile idiopathic arthritis. By the 12 th month of the observation all the patients in these groups have achieved good results, corresponding with 70 % of improvement according to pediatric criteria of the American College of Rheumatologists. In patients with systemic arthritis a moderate positive effect was seen in first two months of treatment. By the 6th month the signs of disease have not significantly differ from those before Infliximab administration.
126-130 690
Abstract
The results of the study of clinical and immunological efficacy of the drug Ribomunyl in prophylaxis of acute respiratory infections (ARI) in children with moderate bronchial asthma and 6 or more episodes of ARI per year are shown in this article. The results of multicenter and our own investigations allow to conclude, that ribosomal complex is an effective drug in prevention and decrease of number of ARI episodes in children with moderate bronchial asthma. Furthermore, this drug leads to antibiotic use reduction by lowering bacterial resistance.
CLINICAL OBSERVATIONS
E. I. Alexeeva,
S. I. Valieva,
T. M. Bzarova,
K. B. Isaeva,
R. V. Denisova,
T. V. Sleptsova,
E. V. Mitenko
131-137 753
Abstract
A clinical case of severe juvenile scleroderma is represented in this article. The patient had a high activity and aggressive course of disease, he was resistant to steroid, cyclophosphomide and methotrexate therapy in combination with drugs, improving blood circulation. The authors describe the successful usage of chimeric monoclonal antibody against the protein CD20 — Rituximab. By the 4th week of the treatment the signs of intoxication and local manifestations of the disease (density and area of scleroderma patches) have diminished. By the 24th week the immunological markers of activity have become normal. Afore-mentioned clinical case demonstrates high efficacy of Rituximab in patient with severe course of juvenile scleroderma. By now the stage of clinical and laboratory remission has maintained for 52 weeks.
HISTORY OF PEDIATRICS
144-147 867
Abstract
The article deals with significance of heritage of academician of St. Petersburg academy of sciences M. V. Lomonosov for the medical practice. It includes the analysis of the scientist’s statements on the problems of diseases prevention, traumatism prophylaxis, birth rate increasing and maintenance of Russian population size. The author makes special mention of Lomonosov’s contribution to formation of pediatrics, organization and training of Russian medical personnel.
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
