Vol 10, No 2 (2011)
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EDITORIAL
SOCIAL PEDIATRICS AND HEALTH CARE
12-14 869
Abstract
The article presents several aspects of legal regulation of auxillary reproductive technologies in treatment of infertility in Russia and other countries.
Key words: auxillary reproductive technologies, method of extracorporeal fertilization, newborn, premature newborn, multiple pregnancy, embryo, infertility, law.
ORIGINAL ARTICLES
16-21 4576
Abstract
High incidence of acute respiratory infections (ARI) in immunocompromised frequently ill children with chronic Epstein–Barr infection forces the prescription of drugs with complex antivirus and immunocorrecting effect. The objective: to study the efficacy of inosine pranobex (Isoprinosine) in treatment of active Epstein–Barr virus infection in frequently ill children. Methods: patients were randomized in group of standard treatment (n = 24) and standard treatment + inosine pranobex 50 mg/kg of body weight divided to 3–4 parts daily (3 courses of 10 days every other 10 days). Primary efficacy criterion was the incidence of ARI episodes during 12 months of observation. Results: the treatment with inosine pranobex resulted in decrease of incidence (4 and 25%) and duration of ARI (5.6 ± 1.2 and 8.8 ± 3.3 days) compared to standard treatment. Besides, inosine pranobex decreased the frequency of lymphoproliferation, arthralgic and cardiac syndromes, favored to rapid elimination of serologic markers of Epstein–Barr virus replication and normalization of blood concentrations of interferon _ and interleukine 4. Side effects of treatment with inosine pranobex were not registered. Conclusion: inosine pranobex is efficient and safe drug in treatment of active form of chronic Epstein–Barr virus infection in frequently ill children.
Key words: frequently ill children, Epstein–Barr virus, inosine pranobex, treatment.
22-27 632
Abstract
Pneumococcal infection remains the key cause of severe diseases of lower airways and deaths in children. The objective: to study the role of pneumococcal infection in pathogenesis of exacerbations of recurrent obstructive pulmonary diseases. Methods: etiological structure of lower airways infections was evaluated in 125 patients 1–15 years old with bronchial asthma or recurrent bronchitis. Results: etiologic role of Streptococcus pneumoniae in development of low airways infections was detected in 48% of patients with atopic asthma, 85% — with asthma without atopy, 97% — with recurrent bronchitis. Repeated microbiological examination confirmed chronic carriage of S. рneumoniae in nasopharinx in 31% of patients. Conclusion: early active prophylaxis with vaccine against pneumococcal infection including conjugated vaccines is able to prevent further progression of a disease.
Key words: children, bronchial asthma, obstructive bronchitis, exacerbation, pneumococcal infection.
PROFESSIONAL DEVELOPMENT
28-39 791
Abstract
The second part of the lecture analyzes etiology, key stages of pathogenesis, typical symptoms and principles of treatment of non gas and combined disorders of acid-base balance (ABB). Author characterizes the specificity of some non gas ABB disorders. Control and measure materials for self-control and correction of lecture leaning level are given.
Key words: acid-base balance, typical disorders, pathogenesis, principles of elimination.
Key words: acid-base balance, typical disorders, pathogenesis, principles of elimination.
40-48 1746
Abstract
The article presents data on incidence, etiology, pathogenesis and clinical presentation of iron deficiency anemia (IDA), principles of its diagnostics and treatment in children and adolescents. Author gives a description of iron drugs for oral and parenteral treatment that are frequently used in Russia, their advantages and shortcomings; principles of the control of their efficacy are described as well. Different types of prophylaxis are described: on population level (fortification), in the risk groups of IDA (supplementation), primary and secondary prophylaxis. The recommendation of American Academy of Pediatrics on prophylaxis of IDA in the most vulnerable group — infants and young children — is presented.
Key words: children, adolescents, iron deficiency anemia, diagnostics, treatment, iron drugs, prophylaxis.
Key words: children, adolescents, iron deficiency anemia, diagnostics, treatment, iron drugs, prophylaxis.
49-63 752
Abstract
Immunoglobulins are main component of immune defense; they take part in anti-infectious resistance of organism and regulate processes of different immune reactions. Intravenous immunoglobulins are the most frequently used products made from donor blood plasma. The need in these drugs is steadily increasing during last 15–20 years, and indications are widening due to modern hightechnology methods of production and cleaning. The article presents modern data on formula, mechanisms of action and indications for different groups of intravenous immunoglobulins (standard, hyperimmune, fortified) and description of possible adverse events.
Key words: immuglobulines, prophylaxis, treatment, unfavorable reaction, children.
Key words: immuglobulines, prophylaxis, treatment, unfavorable reaction, children.
64-70 1098
Abstract
The article analyzes modern data on diagnostic approaches in children and adolescents with cardiogenic syncopal status. Clinical symptoms of vasovagal attack and common diagnostic algorithm of episode of syncope in children and adolescents are briefly described. Author pays attention to the main cardiac causes of syncope related to organic pathology of a heart and primary disorders of heart rate. The complex of clinical symptoms and signs from medical history is proposed as a predictor of high risk of cardiac origin of syncope; main methods of functional diagnostics in probable cardiogenic syncopal states in children and adolescents are discussed.
Key words: children, adolescents, syncope, diagnostics.
Key words: children, adolescents, syncope, diagnostics.
71-76 778
Abstract
Sudden infant death syndrome (SIDS) is sudden non-violent death of apparently healthy infant with absence of adequate reasons of the death according to the medical history and pathomorphological examination. At the present times SIDS is one of the most significant causes of postneonatal infants’ mortality in most developed countries in the world. The main and stable characteristics of SIDS are: death during the sleep and, mainly, in prone position; the peak of SIDS cases is in 2–4 months old; it frequently occurs in premature children and infants with low inborn body weight and in boys (60%); symptoms of mild respiratory infection precede SIDS. Clinical data, analysis of heart rate and breathing in children dead by SIDS afterwards, and experiments with animal models show that the leading pathologic mechanism of SIDS are cardio-respiratory disorders. The program of prophylaxis of ominous states and SIDS includes definition of risk groups with typical clinical and instrumental criteria and observation of children from risk groups.
Key words: sudden infant death syndrome, mechanisms, prophylaxis.
Key words: sudden infant death syndrome, mechanisms, prophylaxis.
78-81 671
Abstract
The review presents an analysis of literature data on pathogenesis of sudden infant death syndrome (SIDS) in comparison with author’s experience of infants dead in home. Diagnostic significance of qualified autopsy examinations in analysis of infants’ death is shown. Frequent combination of morphogenetic cardiopathy and early signs of atrial myocarditis can be estimated as pathogenetic basis of SIDS.
Key words: sudden infant death syndrome, morphogenetic cardiopathy, atrial myocarditis.
Key words: sudden infant death syndrome, morphogenetic cardiopathy, atrial myocarditis.
PROBLEMS. EXPERT OPINION
Discussion questions of influence of corticosteroid treatment in pregnant women on children’s health
82-85 638
Abstract
Synthetic corticosteroids are used in treatment of pregnant women with threat of premature birth or high risk of inborn dysfunction of adrenal cortex (IDAC) in fetus. The treatment results in the decrease of mortality of premature children and lessening of virilization of external genitals and brain in female fetus with IDAC. The safety of synthetic corticosteroids is actively discussed during last decade because of possible unfavorable effects of dexamethasone on fetus status and health of future child. Results of studies with animal models show effect of synthetic corticosteroids influences hypothalamus-hypophysis-adrenal gland system of fetus mediately through placenta. As a result, hyperactivity of hypothalamus-hypophysis-adrenal gland system, arterial hypertension, tendency to metabolic syndrome, alteration of behavior and decrease of cognitive function in generation was shown. There are only few studies of long-term effects of treatment with corticosteroids in pregnant women, they are contradictory.
Key words: corticosteroids, pregnancy, long-term effects, behavior, children.
Key words: corticosteroids, pregnancy, long-term effects, behavior, children.
EXCHANGE OF EXPERIENCE
86-90 606
Abstract
Two-year program of controlled tooth cleaning in group of younger schoolchildren showed high efficacy of active use of toothpaste with calcium-phosphate complex and toothpaste with low fluoride concentration. Oral hygiene index (OHI) increased in 57–73%, caries increment of permanent teeth decreased in 29–32%. Remineralizing toothpastes without fluoride, pastes with aminofluoride (F- = 500 ppm) and sodium fluoride (F- = 1000 ppm) have similar effect in improvement of health of oral cavity in schoolchildren.
Key words: schoolchildren, prophylaxis of oral cavity diseases, toothpastes.
Key words: schoolchildren, prophylaxis of oral cavity diseases, toothpastes.
91-95 1448
Abstract
The article describes main etiological and pathogenetic factors of neurocirculatory dystonia (NCD). The most frequent type of NCD is arterial hypotension. Arterial hypotension is main cause of energetic deficiency and, as a result, hypoxemia of tissues. L-carnitine plays significant role in formation of energetic compounds; consequently administration of L-carnitine to children and adolescents with neurocirculatory hypotension is reasonable. Treatment with L-carnitine results in beneficial effect on subjective symptoms of the disease, functional parameters of vegetative nervous system and vagus-dependent electrocardiologic parameters. The results of a work allow optimization of NCD treatment in children and adolescents.
Key words: children, adolescents, neurocirculatory dystonia, L-carnitine, treatment.
Key words: children, adolescents, neurocirculatory dystonia, L-carnitine, treatment.
96-101 478
Abstract
Authors studied clinical and laboratory efficacy of natural enterosorbate Filtrum-STI in treatment of acute bacterial diarrhea in patients 1–14 years old. The drug has significant detoxication effect resulting in the dynamics of infection syndrome and terms of endotoxicosis laboratory markers normalization. This sorbate has protective effect on obligatory micro flora of intestinum.
Key words: children, bacterial intestinal infections, endotoxicosis, enterosorption.
Key words: children, bacterial intestinal infections, endotoxicosis, enterosorption.
102-106 530
Abstract
The article analyzes an experience of feeding with liquid ready formula Similac Special Care as a product for initial enteral feeding in children with extremely low and very low body weight (n = 31, body weight — 800–1600 g). Children started nutrition with the formula on an average at 4th day of life with progressive increase of its volume up to 100% of common enteral feeding. The registration of actual intake of energy and protein, volume of food and body weight was performed daily. Enteral feeding with ready formula didn’t show any complication in all patients. Stable increase of body weight was shown after transition to complete enteral feeding. Sterility of liquid formula provides additional protection from possible bacterial contamination of food and excludes «human factor» at the time of its preparation.
Key words: children, extremely low and very low body weight, enteral nutrition, liquid formula.
Key words: children, extremely low and very low body weight, enteral nutrition, liquid formula.
A DOCTOR’S AID
125-131 533
Abstract
The article analyzes modern data on infants’ intestinal colics. Peculiarities of nutrition, intestinal microbiocenose in healthy infants, methods of colcs’ correction are discussed. Author describes the principles of probiotics choice based on their clinical effectiveness in infants. Milk formula «Nan Comfort» can be useful in prophylaxis and treatment of functional disorders of gastrointestinal tract in children.
Key words: infants, gastrointestinal tract, anatomy, physiology, intestinal colics, nutrition, probiotics.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 125–131)
Key words: infants, gastrointestinal tract, anatomy, physiology, intestinal colics, nutrition, probiotics.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 125–131)
132-136 470
Abstract
Disorder of normal intestinal flora is widespread state in children with different types of somatic pathology. Intestinal disbiosis disturbs homeostasis, leads to significant disorders in function of other organs and systems. Thus the correction of intestinal disbacteriosis is an actual problem of clinical pediatrics, and different specialists meet this problem. One of common causes of intestinal disbiosis is antibacterial treatment. Almost all antimicrobial drugs influence gastrointestinal tract and their administration lead to dyspepsia and antibiotic-associated diarrhea. Normalization of intestinal microflora is significant stage of complex treatment of these pathological states in children. The choice of probiotic drug should be well grounded. The article presents main data on epidemiology, pathogenesis, clinical symptoms, diagnostics and treatment of antibiotic-associated diarrhea in children, efficacy of probiotic drugs is demonstrated.
Key words: children, indigenous intestinal microflora, antibiotic-associated diarrhea, probiotics, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 132–136)
Key words: children, indigenous intestinal microflora, antibiotic-associated diarrhea, probiotics, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 132–136)
137-140 728
Abstract
Functional disorders of digestion are the most widespread disturbances of adaptation in infants. The article presents classification of colic in newborns and infants, characterizes their etiology and pathogenesis depending on maturity of a child, presence of perinatal pathology, defects of nursing and nutrition. Authors describe main principles of intestinal colic correction including diet and medicamental treatment in infants. «Mild» drugs (herbal therapy) have some advantages in treatment of colic. The results of an observation of 47 mature and premature infants treated with Plantex are presented.
Key words: infants, intestinal colics, dietotherapy, herbal therapy.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 137–140)
Key words: infants, intestinal colics, dietotherapy, herbal therapy.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 137–140)
141-145 517
Abstract
The article presents the literature review of one of the significant problems in modern threpsology — microelemental insufficiency. Main micronutrients, their significance and sources are described. Author pays attention to the opportunities of nutritive approaches to the correction and prophylaxis of microelemental status disorders in children with modern enriched milk products.
Key words: children, microelements, insufficiency, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 141–145)
Key words: children, microelements, insufficiency, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 141–145)
146-149 2213
Abstract
The article presents the description of children’s diseases related to primary and secondary disorders of cell energy exchange. Mechanisms of energotropic and antioxidant effect of ubiquinone (coenzyme Q10) in treatment of different diseases including those accompanied with deficiency of energy are described.
Key words: children, ubiquinone, antioxidants, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 146–149)
Key words: children, ubiquinone, antioxidants, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 146–149)
150-154 646
Abstract
Normal microflora of gastrointestinal tract provides colonization resistance of intestine, takes part in digestion, synthesis of vitamins and systemic stimulation of immune reactions. Prophylaxis of intestinal microbiocenosis disorders, their timely diagnostics and proper correction are significant for normalization of gastrointestinal function, formation of immune system and harmonious development of a child. There are several approaches to the regulation of intestinal micro biocenosis; the perspective one is diet with functional food containing prebiotic microorganisms. The article analyses data on physiological role of intestinal biocenosis, presents main standards of prebiotic strains. Modern studies show high clinical efficacy of Lactobacillus GG strain. This probiotic can be recommended in production of functional food for infants’ nutrition.
Key words: children, intestinal micro flora, probiotics, Lactobacillus GG.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 150–154)
155-161 886
Abstract
The prevalence of vitamins deficiency is widespread in the present times. Deficiency of vitamins is usual even in healthy growing child. It is largely presented in children with different diseases. The lack of sun, the air polluted with gases and worsening of nutrition quality aggravates the risk of hypovitaminosis development especially in winter and spring. The lack or absence of vitamins in diet leads to metabolic disorders, decrease of physical and mental activity and easy fatigability of organism. Reliable source of vitamins and minerals are polyvitamin drugs and vitamin-mineral complexes for prophylactic use. While treating with vitamins, the daily need, compatibility and balance of vitamin-mineral complexes should be taken into account.
Key words: children, vitamins, deficiency.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 155–161)
Key words: children, vitamins, deficiency.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 155–161)
162-169 688
Abstract
The publication gives a review of clinical peculiarities and prophylactic methods of initial headaches in children and adolescents: migraines and stress headaches. Modified and unmanageable trigger factors of migraine are analyzed; different methods of headaches prophylaxis are discussed.
Key words: initial headaches, children, adolescents, prophylaxis, ultrasonic Doppler analysis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 162–169)
Key words: initial headaches, children, adolescents, prophylaxis, ultrasonic Doppler analysis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 162–169)
170-172 513
Abstract
The article describes the problem of chronic cough in children: the reasons of its onset, drugs for cough stopping and ways of drugs introduction (systemic one and inhalations). The efficacy of multicomponent homeopathic drugs (particularly the syrup Stodal’) in treatment of different types of cough in children is analyzed.
Key words: children, chronic cough, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 170–172)
Key words: children, chronic cough, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 170–172)
173-179 503
Abstract
The article discusses questions of classification, anatomic and physiological peculiarities and pathogenetic aspects of chronic constipations forming in children. The problems of diagnostics of chronic constipation and its treatment with spasmolytics are analyzed.
Key words: children, chronic constipation, diagnostics, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 173–179)
Key words: children, chronic constipation, diagnostics, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 173–179)
180-183 514
Abstract
The article presents a review of studies of prebiotic Lactofiltrum efficacy in complex treatment of atopic dermatitis (AD) in children. AD takes significant place in the structure of allergic diseases in children. 70–80% of patients with AD have intestinal dysbiosis resulting in disorder of barrier function of intestine. Protocols of AD treatment of children include not only elimination diet, antihistamine drugs, topical treatment but enterosorbates. Drugs based on hydrolyzed lignin are actively used during recent years. One of these drugs is prebiotic with sorbent effect Lactofiltrum.
Key words: children, atopic dermatitis, enterosorbates, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 180–183)
Key words: children, atopic dermatitis, enterosorbates, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 180–183)
CLINICAL OBSERVATIONS
T.M. Bzarova,
Ye.I. Alexeeva,
S.I. Valieva,
N.A. Tsurikova,
E.G. Chistyakova,
K.B. Isaeva,
R.V. Denisova,
T.V. Sleptsova,
E.V. Mitenko
184-192 480
Abstract
The article presents a case report of severe and prolonged polyarticular rheumatoid arthritis resistant to the treatment with classic immunosuppressive agents, nonsteroidal anti-inflammatory drugs and corticosteroids. Authors describe successful treatment with soluble receptors to TNF _ — etanercept 0.4 mg for 1 kg of body weight during 36 weeks. Pain and exudative inflammation in joints lessened and the range of motions in joints increased in 4 weeks after the beginning of treatment. 9 months of treatment significantly increased the quality of life of a child and parents.
Key words: children, juvenile rheumatoid arthritis, etanercept.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 184–192)
Key words: children, juvenile rheumatoid arthritis, etanercept.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 184–192)
193-200 575
Abstract
The article presents a case report of severe course of nodular polyarteritis. The disease was highly active, aggressive, and refractory to treatment with corticosteroids and cyclophosphamide combined with plasmapheresis and drugs for microcirculation improvement. The treatment with chimerical anti-CD20 monoclonal antibodies — rituximab — was successful. Symptoms of intoxication and tromboangiatic syndrome decreased in 4 weeks. Disease was stopped up to 16th week. The case report demonstrates high efficacy of rituximab: patient with severe nodular polyarteritis remains clinical and laboratory remission during 52 weeks.
Key words: children, nodular polyarteritis, rituximab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 193–200)
Key words: children, nodular polyarteritis, rituximab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 193–200)
201-204 484
Abstract
The article presents the case report of a child with juvenile rheumatoid arthritis, systemic type. The efficacy of infliximab (Remicade) in treatment of systemic types of juvenile rheumatoid arthritis (JRA) is analyzed. Treatment of JRA with high doses of prednisolone is inacceptable due to the risk of severe adverse events.
Key words: juvenile rheumatoid arthritis, systemic type, infliximab, prednisolone, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 201–204)
Key words: juvenile rheumatoid arthritis, systemic type, infliximab, prednisolone, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 201–204)
205-207 474
Abstract
The article describes the first case of biomaterial use for the skin defect restoration in patient 12 years old with congenital epidermolysis bullosa. High efficacy of bioplastic material based on native form of hyaluronic acid was shown. Ulcerous skin defect regenerated rapidly.
Key words: congenital epidermolysis bullosa, bioplastic material, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 205–207)
Key words: congenital epidermolysis bullosa, bioplastic material, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 205–207)
208-210 437
Abstract
Enteral nutrition provided to children in critical state is necessary area of pediatrician’s activity in children’s hospital. Enteral nutrition is able to improve the prognosis of the disease significantly along with maintenance of essential functions and treatment of pathologic process, decrease of duration of stay in intensive care department. Proper choice of method and volume of nutritional support and product for medical treatment depending on clinical situation is significant problem. The clinical case described in the article illustrates efficacy of modern technologies in correction of protein and energy deficiency in patient with severe sepsis and multiple organ failure developed as a result of severe untreated cystic fibrosis with cachexia and uncontrolled chronic pseudomonas infection as complications.
Key words: children, enteral nutrition, cystic fibrosis, sepsis, cachexia.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 208–210)
Key words: children, enteral nutrition, cystic fibrosis, sepsis, cachexia.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 208–210)
211-215 522
Abstract
The leading pathology in children is acute respiratory infections (ARI) according to the expert data of WHO. The incidence of prolonged and recurrent types of ARI increases during recent years. Patients with these diseases subsequently form the group of children with compromised immunity. Immunogens and immunomodulators are the drugs of nonspecific prophylaxis which are used for the prevention of ARI. The group of bacterial immunomodulators is big but most well-studied systemic drug from this group is Ribomunyl. Ribosomal complex is effective and safe in pediatric practice. The article presents the clinical case of treatment with ribosomal complex in immunocompronised child with allergic pathology.
Key words: children with compromised immunity, allergy, acute respiratory infections, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 211–215)
Key words: children with compromised immunity, allergy, acute respiratory infections, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 211–215)
SHORT REPORTS
INFORMATION FROM THE UNION OF PEDIATRICIANS OF RUSSIA
HISTORY OF PEDIATRICS
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
