Vol 11, No 1 (2012)
SOCIAL PEDIATRICS AND HEALTH CARE
5-8 799
Abstract
Judging upon the results of recent studies we can state that over the past years there is a negative tendency in reproductive health of schoolgirls aged 12–15. Study objective was to evaluate dependency of reproductive function of schoolgirls from their lifestyle. A hypothesis has been stated upon presence of causal relations in the biosocial system «Health–Lifestyle» and upon necessity of healthy lifestyle motivation to preserve girl’s reproductive health. 128 girls took part in the study from 5–7 forms from 2 Moscow schools. Results of the study stand for well-timed correction of the girl’s lifestyles in order to prevent disorders of reproductive system.m.
10-13 1050
Abstract
We have reviewed a history of prophylactics development as a branch of maternity and child care in the republics of Northern Caucasus. We follow the development of this service from 1924; we make parallels between system of antenatal clinics development, that aimed at medical and sanitary literacy growth of the population, the development of system of regular medical check-ups of pregnant women in the country in general.
ORIGINAL ARTICLES
E. O. Hennesy,
T. L. Kuraeva,
S. A. Prokofyev,
N. B. Smirnova,
Y. V. Tishina,
E. V. Тitovic,
V. A. Peterkova
14-17 684
Abstract
We have studied incidenceof immunological markers of celiac disease in children with diabetes mellitus type 1 (DM1) and their correlation with clinical peculiarities and polymorphous alleles of HLA. It was shown that incidence of celiac markers is higher in DM1 children than in general population and makes up 7.4%. Patients who were seropositive with celiac antigens had gastrointestinal symptoms and iron deficiency more often. The occurrence rate of other autoimmune disorders in seropositive patients was 24%, with high count of autoantibodies towards transglutaminase (AbTT) — 50%. More than 78% of seroposetive patients possessed haplotypes DQ2 and|or DQ8 HLA. The occurrence rate was identical. In patients with high AbTT occurrence of HLA genotypes with DQ2 and/or DQ8 rose up to 100%.
18-36 2350
Abstract
Owing to their low reactogenicity, confirmed efficacy and availability in combination vaccines, acellular pertussis (aP)-inactivated poliovirus (IPV) combined vaccines are now included in various national immunization programs worldwide. We provide an overview of 16 years of clinical experience with a diphtheria (D), tetanus (T), aP, IPV and Haemophilus influenzae type b (Hib) polysaccharide conjugated to tetanus protein (PRP~T) combined vaccine (DTaP–IPV//PRP~T — Pentaxim, Sanofi Pasteur, France). Good immunogenicity has been demonstrated after primary vaccination with Pentaxim, regardless of the population ethnicity and primary vaccination schedule. A booster vaccination in the second year of life also resulted in a high immune response for each antigen. Furthermore, 10 years of national surveillance in Sweden has demonstrated the effectiveness of Pentaxim in controlling pertussis. As is the case for other aP-containing combined vaccines, Pentaxim is well tolerated, with the safety profile being better than for whole-cell pertussiscontaining combination vaccines for primary and booster vaccinations.
E. I. Alexeeva,
S. I. Valieva,
R. V. Denisova,
T. M. Bzarova,
K. B. Isaeva,
E. V. Mitenko,
T. V. Sleptsova,
E. G. Chistyakova
37-45 786
Abstract
This article contains results of the comparative study of rituximab and methotrexate efficacy in children with systemic juvenile idiopathic
arthritis. 115 patients aged 2 to 16 years were enrolled in the study, main group consisted of 75 patients receiving rituximabe, and 40 patients in control group receiving methtrexate. The efficacy of rituximab treatment was significantly higher, than that of methotrexate in standard doses. Evident improvement in patients receiving rituximab was seen already after 12 weeks of treatment. During this period in 90% of patients life-threatening systemic manifestations were relieved, acuteness of articular syndrome was decreased, lab parameters normalized. Within 24 weeks there was a significant decrease of the disease activity, improvement of joint functional activity and decrease in disability degree. 25% of patients were diagnosed with inactive stage of the disease. Methotrexate treatment had virtually no effect on systemic manifestations, there were still relapses seen in patients (including those of life-threatening conditions), persistence of active arthritis, high activity in lab parameters and disability progression were also seen against its background.
Key words: systemic idiopathic juvenile arthritis, rituximab, methotrexate, children.
arthritis. 115 patients aged 2 to 16 years were enrolled in the study, main group consisted of 75 patients receiving rituximabe, and 40 patients in control group receiving methtrexate. The efficacy of rituximab treatment was significantly higher, than that of methotrexate in standard doses. Evident improvement in patients receiving rituximab was seen already after 12 weeks of treatment. During this period in 90% of patients life-threatening systemic manifestations were relieved, acuteness of articular syndrome was decreased, lab parameters normalized. Within 24 weeks there was a significant decrease of the disease activity, improvement of joint functional activity and decrease in disability degree. 25% of patients were diagnosed with inactive stage of the disease. Methotrexate treatment had virtually no effect on systemic manifestations, there were still relapses seen in patients (including those of life-threatening conditions), persistence of active arthritis, high activity in lab parameters and disability progression were also seen against its background.
Key words: systemic idiopathic juvenile arthritis, rituximab, methotrexate, children.
LITERATURE REVIEW
46-50 839
Abstract
The article contains results of therapeutic efficacy of ibuprofen in pain syndrome management in children. Validity of its use is doubtless. Analgesic effect of Ibuprofen has been confirmed in clinical trials in patients with migraine and ENT-disorders. In this article we also review international experience of ibuprofen use in juvenile arthritis.
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51-55 934
Abstract
Macrolides remain one of the most popular types of antibiotics prescribed in the outpatient’s clinic and also are second most popular after penicillins in the amount of consumption. Activity against the majority of respiratory pathogens, including atypical ones, high tolerability, presence of special nonantimicrobal features that are unique for medications of this class — all this make them a favourable choice for bacterial out-of-hospital infections treatment. This article contains comparative analysis of drugs of this class. The role of azithromycin in pediatric respiratory out-of-hospital infections treatment is discussed.
56-60 1424
Abstract
Nowadays one of the most pressing problems of prophylactic pediatrics is the provision of children with vitamins and minerals. In the article we review physiological role of calcium, vitamin D and iron, prevalence and clinical presentations of respective deficits in childhood. We also provide with variants of dietary prophylaxis using various products enriched with vitamins and microelements adjusted to average daily norms of calcium, vitamin D and iron consumption.
PROFESSIONAL DEVELOPMENT
61-75 1865
Abstract
This lecture deals with etiology, pathogenesis and clinical presentation of thyroid and parathyroid hyper — and hypofunction, adrenal pathology. This lecture is also supplemented with multiple choice tests and a clinical case with keys for self testing.
76-82 1131
Abstract
This article covers one of the most pressing issues of pediatric gastroenterology and pediatrics in general — functional constipation.
Main pathophysiological mechanisms and etiological factors of constipation development are reviewed in the article adjusted for age and a period of child development. It also includes modern constipation classifications and therapeutic options in pediatric patients, developed in NASPGHAN including education of patients and their parents such as behavioral treatment.
Main pathophysiological mechanisms and etiological factors of constipation development are reviewed in the article adjusted for age and a period of child development. It also includes modern constipation classifications and therapeutic options in pediatric patients, developed in NASPGHAN including education of patients and their parents such as behavioral treatment.
EXCHANGE OF EXPERIENCE
83-90 1020
Abstract
Acute and/or chronic hypoxia is a leading cause of perinatal lesions of central nervous system. Severe consequences of this condition can be the reason of temporary withdrawal from breast-feeding started soon after birth. Study objectives included: scrutiny of lactation establishment, influence of various factors on lactation duration in mothers of children with perinatal lesions of CNS. Study included 86 pairs mother-child, with duration of 12 months. It has been shown that in cases where breast feeding was impossible, regular expression of breast milk with the help of breast pump in the early lactation period allows not only to organize breast feeding by the time of discharge from the hospital, but also to extend its duration almost to the normal one. Severity of perinatal CNS lesion does not correspond with the duration of lactation period of the mother.
91-97 887
Abstract
Study objectives: novel approaches to complex rehabilitation system organization of children with attention deficit hyperactivity disorder
(ADHD) and efficacy analysis of the present system. A system of rehabilitation scrutinized in the article consists of three levels: familyschool/ kindergarten — medical institution. While designing a novel approach towards rehabilitation 150 teachers that work with ADHD children had their psychoemotional status checked. Analysis of the efficacy of complex rehabilitation of 100 ADHD children during 4 years and 50 ADHD children that refused being followed up was carried out. Primary critera of efficacy were as follows: decrease of carelessness, hyperactivity, impulsivity, determined by the questionnaire score, amelioration of cognitive function and of behaviour. Psychological escort of the teachers was designed on the basis of their psychoemotional characteristics. Reasonability and social importance of the complex rehabilitation system for ADHD children. Implication of the novel approach of system organization allows to maintain constant rehabilitation of such children in every society.
(ADHD) and efficacy analysis of the present system. A system of rehabilitation scrutinized in the article consists of three levels: familyschool/ kindergarten — medical institution. While designing a novel approach towards rehabilitation 150 teachers that work with ADHD children had their psychoemotional status checked. Analysis of the efficacy of complex rehabilitation of 100 ADHD children during 4 years and 50 ADHD children that refused being followed up was carried out. Primary critera of efficacy were as follows: decrease of carelessness, hyperactivity, impulsivity, determined by the questionnaire score, amelioration of cognitive function and of behaviour. Psychological escort of the teachers was designed on the basis of their psychoemotional characteristics. Reasonability and social importance of the complex rehabilitation system for ADHD children. Implication of the novel approach of system organization allows to maintain constant rehabilitation of such children in every society.
98-102 868
Abstract
In the article we observe questions of acute respiratory infections prophylaxis in organized groups of children along with means of boosting of body ant-infectious protection. We review efficacy data for Ocilococcinum, Anaferon for children, Grippferon used as means of seasonal prophylaxis of repiratory diseases in organized groups of children.
Key words: prophylaxis, children, complex homeopathic medications.
Key words: prophylaxis, children, complex homeopathic medications.
103-106 707
Abstract
We have evaluated specialized product «Celia Mama» for pregnant women nutrition. 15 women on 31–32 week of pregnancy took part in the study. The duration of the product intake was 6,5 ± 1,5 wk. Tolerability was evaluated according to a personal attitude towards it and impartial clinical parameters such as — skin and mucosa condition, presence of allergy, presence or worsening of gastrointestinal dysfunction (heartburn, flatulence, stomach ache), stools (amount, consistency, digestibility, pathological inclusions, colour, smell. It has been shown that this product possesses adequate organoleptic qualities and is well tolerated by pregnant women. This product has passed hygienic expertise in our Scientific Research Centre and judging upon results of our study we can conclude that it can be used as a food supplement for pregnant women.
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107-110 1328
Abstract
This article contains results of treatment of acute sinusitis in children using complex immunostimulator consisting of bacterial lysates — IRS 19, which was included into the basic treatment. There were 65 children with sinusitis under observation. Conparison was made with a control group of 65 children, age and sex comparable, that also were treated against acte sinusitis but without immunostmulants, including those with bacterial lysates.
EFFICACY AND SAFETY OF PEDIATRIC JUVENILE IDIOPATHIC ARTHRITIS AND UVEITIS TREATMENT WITH ADALIMUMAB
E. I. Alexeeva,
E. V. Mitenko,
S. I. Valieva,
T. M. Bzarova,
R. V. Denisova,
K. B. Isaeva,
T. V. Sleptsova,
A. M. Tchomakhidze
111-118 919
Abstract
The article contains results of the study of efficacy and safety of adalimumab treatment given to 110 patients with juvenile idiopathic arthritis (JIA) and arthritis with eye-lesions, refractory to classical immunosuppressive treatment. Follow up period was from 3 months
to 1 year long. The dosage regimen was as follows — 1 subcutaneous injection of Adalimumab 40 mg once in 2 weeks. Against the background of treatment with anti-TNF agents clinical remission, decrease and normalization of lab parameters of the disease activity, lower degree of disability, quality of life increase in 100 patients (90%), decrease in uveitis activity (N = 9, 18.75%), and remission of uveitis (N=39, 81.25%) were achieved. During the follow up period there were no adverse events that lead to drug withdrawal. Thereby, Adalimumab treatment is pathogenetically justified, effective and safe for patients with JIA and uveitis.
to 1 year long. The dosage regimen was as follows — 1 subcutaneous injection of Adalimumab 40 mg once in 2 weeks. Against the background of treatment with anti-TNF agents clinical remission, decrease and normalization of lab parameters of the disease activity, lower degree of disability, quality of life increase in 100 patients (90%), decrease in uveitis activity (N = 9, 18.75%), and remission of uveitis (N=39, 81.25%) were achieved. During the follow up period there were no adverse events that lead to drug withdrawal. Thereby, Adalimumab treatment is pathogenetically justified, effective and safe for patients with JIA and uveitis.
119-123 1014
Abstract
This article contains analysis of modern data upon infantile lactase deficiency, diagnostics and clinical presentation. Special attention is paid to the disease treatment analysis and its dietary correction. We present clinical variants of the disorder.
124-131 832
Abstract
This article contains results analysis of the study that included 25 infants with congenital defects of urinary organs requiring surgical correction. All patients had their alimentary status checked with actual nutrition evaluation based upon somatometric and biochemical parameters. Adapted formulas enriched with pre- and probiotics («Nutrilaс Kislomolochniy (Cultured Milk Food)» and «Nutrilac Immuno Bifi») were used in the capacity of nutritive support in the early postoperative period. The advantage of prolonged use of enriched adapted formulas shown in comparison to, standard in urology departments, forced extended feeding scheme has been for infants in the early postoperative period.
132-134 848
Abstract
Hypospadias is one of the commonest congenital disorders of urethra in boys. We observe main stages of intrauterine development of external genitals of boys and possible abnormalities that can lead to formation of hypospadias. We describe our own experience of surgical correction, postoperative treatment and prophylaxis of scarring complications after surgical correction of hypospadias.
135-142 919
Abstract
This paper shows the research results of the biological therapy with chimeric monoclonal antibody to tumor necrosis factor (TNF) (infliximab). 33 children aged 6 to 18 years with various forms of Crohn’s disease were enrolled in the study. Therapy duration ranged from 3 months to 1 year or more. After the induction course of therapy efficacy was 94%, clinical remission was achieved in 70% of patients, after 1 year of therapy efficacy of therapy was reduced to 84%, clinical remission was observed in 70% of children. Endoscopic remission rate after induction was observed in 24% of children, and in 29% after 54 weeks of therapy. After one year of treatment in 9 out of 11 children glucocorticoid therapy was completely stopped. Adverse events after infliximab administration were observed in 9% of children. One child was withdrawn from the study due to infliximab intolerance.
A DOCTOR’S AID
143-146 698
Abstract
This article covers one of the most discussed issues of clinical immunology — the role of dendritic cells in acquired immunity. Modern conception of dendritic cells participating in antigen handling procedure and its presentation, interaction with other immune cells made it possible to change approach towards immunomodulating therapy dramatically and to develop a new class of immunostimulants, that influence simultaneously cell and humoral immunity both in loci of antigen intervention on the mucosal level and systemically.
147-151 799
Abstract
This review contains modern data on immunomodulation effect of breast milk feeding upon infants, on possibilities of adequate immune response formation using hypoallergenic formulas, and also evidences of efficacy of hypoallergenic formula enrichment with galactoand fructooligosaccharide prebiotic complex, confirmed by decrease in allergic and infectious morbidity.
152-157 883
Abstract
Acute respiratory diseases still occupy leading positions among all pediatric diseases. This article contains modern data upon etiology of acute and recurrent bronchitides, as well as that of out-of-hospital pneumonias in children. Special attention is paid to the choice of antibacterial therapy. We observe modern Russian and international data upon bacterial resistance to antibacterial drugs. This article also contains description of biological, pharmacokinetic and antibacterial traits of macrolides, especially these of clarytromycin with description of its use in treatment of pediatric respiratory disorders.
158-161 1130
Abstract
The problem of effective diagnosis and treatment of acute urinary tract infection (UTI) remains relevant in connection with a high prevalence of this nosology and the growth of antibiotic resistance. The need to use of antibiotics in the treatment of acute UTI in children has no doubt. At the same time there are different opinions on duration, and route of administration of the antibiotics. It is not always possible to achieve the desirable effect after a long courses of antibiotic therapy, and duration of fever as a clinical marker of inflammation, was not significantly different in the appointment of oral and parenteral antibiotics. The effectiveness of treatment of acute urinary tract infections in young children depends not on the way of administration but on the dose that ensures the achievement of the minimum inhibitory concentration of the drug. Drugs of choice in patients with acute UTI are: inhibitor-protected aminopenicillins and cephalosporins of II and III generation. However, in children with acute UTI who received antibiotic therapy previously, as well as in suspected obstructive uropathy, the most likely causative agent is toxin-producing E. coli, which has a high degree of resistance to aminopenicillins, including protected. Therefore, the drugs of choice in this category of children should be the antibiotics of the cephalosporin group II–III generation.
DIABETES MELLITUS TYPE 2 TREATMENT IN CHILDREN AND ADOLESCENTS: METFORMIN AS A FIRST AGENT OF CHOICE
162-166 1153
Abstract
In the past two years there has been seen a steady rise in diabetes mellitus type 2 sickness rate among youngsters. Thereby diabetes mellitus type 2 is no longer a problem exclusively of endocrinologists but also of pediatricians and pediatric endocrinologists. Diabetes mellitus type 2 that has several unique features if occurred in childhood. Also there are no therapeutical guidelines for this disease designed for treating children and adolescents, and that is why pediatric endocrinologists have to use guidelines for adult patients with
diabetes mellitus type 2. The article contains main stages and therapeutical methods of diabetes mellitus type 2 treatment, as well as reasonability of indications to start medicamental treatment.
diabetes mellitus type 2. The article contains main stages and therapeutical methods of diabetes mellitus type 2 treatment, as well as reasonability of indications to start medicamental treatment.
167-172 1190
Abstract
Vitamins — organic compounds with low molecular weight, possessing an exceptional characteristic — the ability to display high biological activity in small doses. The main source of vitamins and micro-elements for humans is food. The content of vitamins in the diet varies and depends on a number of reasons. However, food cannot fully meet the body’s need for vitamins and micro-elements, resulting in widespread subclinical deficiency of these nutrients. Children are vulnerable to this state especially during the period of intensive growth, increased mental and physical stress (for example at the beginning of kinder garden or school attendance) and during the period of illness. It is therefore necessary to pay special attention to diet and ensure these categories of children with vitamins.
173-176 716
Abstract
In the structure of infant morbidity acute and chronic inflammatory diseases of the oropharynx take a leading position. Finding the most effective approaches to the treatment and prevention of diseases in this group so far has not lost its relevance. Drugs containing lysates of bacteria are currently under consideration as an effective component of treatment of inflammatory of diseases the oropharynx, which allows to achieve a more effective elimination of the pathogen and reduce the number of relapses of disease.
CLINICAL OBSERVATIONS
CLINICAL AND ECONOMIC ANALYSIS OF ETANERCEPT EFFICACY IN A PATIENT WITH JUVENILE HEUMATOID ARTHRITIS
177-186 927
Abstract
Article contains clinical and economic analysis of treatment efficacy of a patient with a poliarticular form of juvenile rheumatoid arthritis (JRA) with soluble TNF receptors — etanercept. Such methods of analysis as «disease value» and «expense–efficacy» were used. It has been shown that «disease value» increases against the background of etarnecept use. However, further analysis has shown that from the «expense–efficacy» point etarnecept use decreases expenses in 6.3 times (both direct and indirect expenses, in 4.3 times using only direct expenses) in comparison to standard antirheumatic treatment, that lays economic grounds for etarnecept use for patients with refractory JRA.
TOWARDS THE 250 YEARS OF SCCH RAMS
HISTORY OF PEDIATRICS
188-196 965
Abstract
This article is an attempt to study the attitude towards the incurable child in different societies throughout the history. The attitude depended on the level of socio-economic development of the society, type and form of the institutionalization of the family and family relations, social, historical and cultural peculiarities of the nature and ierarchy of parental values, on the perception of childhood as a sociocultural phenomena, on existing juridical system, that defines parental and child rights, and on the level of healthcare system development, including pediatrics.
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
