Vol 9, No 4 (2010)
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EDITORIAL
7-15 945
Abstract
Progress of biology leading to the decoding of genome and forming of post-genome cell regulation of human development, resulted in separation of new pediatric speciality: children’s hematologist/oncologist. Clinical studies in children’s hematology/oncology are dedicated to study of pathogenesis and development of scientifically-based methods of diagnostics and treatment of hereditary and obtained diseases of blood and immune system, oncological diseases of newborns, children and adolescents. Interdisciplinary approach in science and organization of service in children’s hematology/oncology departments on the basis of multisectoral children’s hospitals led to significant results. The article presents most significant scientific and practical achievements of Russian scientists and doctors in diagnostics and treatment of hematological and oncological diseases in children and adolescents.
Key words: children’s hematology, immunology, oncology.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):7-15)
Key words: children’s hematology, immunology, oncology.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):7-15)
SOCIAL PEDIATRICS AND HEALTH CARE
16-20 594
Abstract
Authors discuss organization of medical service for children with juvenile arthritis. Characteristics of PC program «Register of children with rheumatic diseases» is presented. The article describes problems of patients’ provision with drugs and suggests measures of improvement of medical service for children with juvenile arthritis.
Key words: children, juvenile arthritis, medical service, register.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):16-20)
Key words: children, juvenile arthritis, medical service, register.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):16-20)
ORIGINAL ARTICLES
22-26 623
Abstract
According to normative documents regulating anti-tuberculosis measures, children with hyperergy to tuberculin (papule _ 17 mm) are in risk group of development of local tuberculosis. Patients with hyperergy to tuberculin are treated with two anti-tuberculosis drugs for minimization of this risk. Children and adolescents with high sensitivity to tuberculin (papule = 15–16 mm) can be treated with one drug. Present study proved that selection of patients into corresponding risk groups based on subjective measures of papule diameter lead to low effectiveness of preventive treatment in children with high sensitivity to tuberculin. An analysis showed that patients with high sensitivity and hyperergy to tuberculin have comparable frequency of different social, epidemiological, clinical and immunopathological states and rates of immunological tests. This fact shows necessity of observation of children with papule 15–16 mm as a reaction for 2 tuberculin units in frames of VI B group and performance of preventive treatment with two antituberculosis drugs.
Key words: children, tuberculin, sensitivity, hyperergy, immune system.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):22-26)
Key words: children, tuberculin, sensitivity, hyperergy, immune system.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):22-26)
A.O. Lisitsyn,
E.I. Alexeeva,
S.I. Valieva,
T.M. Bzarova,
R.V. Denisova,
A.M. Chomakhidze,
K.B. Isaeva
27-33 543
Abstract
The article presents results of a study of mineral density of bone tissue in patients with juvenile arthritis treated with immunosuppressive agents and blocker of tumor necrotizing factor (TNF) alpha infliximab. Administration of immunosuppressants is unfavorable factor of osteoporosis development in all types of juvenile arthritis. Therapy with infliximab combined with methotrexate provided normalization of Z-score in patients with «early» arthritis and osteopenia (р < 0.01), and its increase in patients with «late» arthritis and osteoporosis (р < 0.001). Treatment with methotrexate, cyclosporine and prednisolone induced its decrease (р < 0.01). Obtained data proved the fact that early administration of genetically engineered biological agent allows prevention of serious complication of juvenile arthritis — systemic osteoporosis.
Key words: juvenile arthritis, mineral density of bone, osteoporosis, immunosuppressants, infliximab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):27-33)
Key words: juvenile arthritis, mineral density of bone, osteoporosis, immunosuppressants, infliximab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):27-33)
34-39 1778
Abstract
Disseminated sclerosis is chronic progressive disease of central nervous system, which is characterized by demyelination, degeneration of nerve fibers and polymorphous clinical symptoms. According to literature data, 2–10% of patients have onset of a disease in childhood and adolescence. Frequent clinical symptoms of disseminated sclerosis, especially in adolescents, are paroxysmal states and neuropsychological disorders. Drugs containing interferon beta which are used for immunomodulating treatment, can increase the rate of paroxysmal neuropsychological disorders in patients with disseminated sclerosis. Present study with participation of 78 adolescents analyzed frequency and spectrum of neuropsychological disorders and paroxysmal states in patients 12–17 years old and relation of revealed disorders with a treatment with interferon beta.
Key words: adolescents, disseminated sclerosis, interferon beta, treatment, depression, paroxysmal states, anxiety, neuropsychological testing.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):34-39)
Key words: adolescents, disseminated sclerosis, interferon beta, treatment, depression, paroxysmal states, anxiety, neuropsychological testing.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):34-39)
44-49 622
Abstract
This article presents the safety data for cell-derived inactivated subunit adjuvanted influenza vaccine «Grippol Neo» in children 3–17 years old in comparison with reference egg-derived inactivated subunit vaccine «Grippol plus». Good test vaccine tolerability and high efficacy profile is demonstrated. Based on the results obtained vaccine «Grippol Neo» is recommended for mass influenza prophylaxis in pediatry, including National Immunization Schedule.
Key words: children, influenza, vaccination, «Grippol Neo».
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):44-49)
Key words: children, influenza, vaccination, «Grippol Neo».
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):44-49)
50-56 808
Abstract
Topicality of problem of constipation is conditioned by steady growth of its prevalence in children, and by need of timely revelation of such patients for administration of proper therapy. The objective of this study was evaluation of prevalence and clinical peculiarities of constipation in children taking into account diagnostic criteria of Rome Consensus III. A questionnaire poll of 1,216 children or their parents in Central, North and South Federal Districts of Russian Federation was performed. Patients 1 month — 18 years old participated this study. Frequency of constipation was 59%. The study showed high frequency of functional intestinal disorders: impediment of defecation, prolonged stay in toilet, overflow or swelling of stomach, feeling of incomplete defecation, pathological changes of stool. Spastic component plays significant role in formation of constipation. The frequency of complications of constipation was low. Authors showed frequent presence of functional disorders in children with normal regimen of defecation. Analysis of quality of life was performed. It showed that constipation has an influence on common state of health, usual activity and studying of patients. Authors made a conclusion that present data does not reflect true rate of children’s constipations.
Key words: children, functional constipation, prevalence.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):50-56)
Key words: children, functional constipation, prevalence.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):50-56)
57-67 892
Abstract
Neurological and neuropsychological examination of 104 patients (58 boys and 46 girls) 12–19 years old who had closed moderate or severe craniocerebral injury (CCI) (cerebral contusion, diffusive axonal injury) 6 months — 5 years before inclusion to this study. Authors analyzed differences in clinical symptoms of CCI in adolescents compared to previously published data for pediatric patients. CCI consequences in adolescents are prolonged; they can be accompanied with disorders of movement coordination, high psychical functions, behavior and social adaptation. Obvious disorders can be hidden in adolescents experienced CCI until they are back to school education, though they reveal decrease of ability to education. Peptidergic nootropic drug Cerebrolysin proved its effectiveness for correction of disorders of behavior, high psychical (memory, attention, controlling functions) and motor (coordination) functions, and speed of cognitive and motor operations.
Key words: adolescents, craniocerebral injury, consequences, therapy, nootropic drugs, cerebrolysin.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):57-67)
Key words: adolescents, craniocerebral injury, consequences, therapy, nootropic drugs, cerebrolysin.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):57-67)
LITERATURE REVIEW
68-72 4571
Abstract
The problem of perinatal periventricular brain lesions in newborns, playing leading role in forming of disability and disadaptation of nervous system, is discussed in this article. Authors present literature data on periventricular leucomalacia: modern information on etiology and pathogenesis, morphology, clinical symptoms and outcomes.
Key words: periventricular leucomalacia, infantile cerebral paralysis, perinatal lesions of brain.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):68-72)
Key words: periventricular leucomalacia, infantile cerebral paralysis, perinatal lesions of brain.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):68-72)
78-84 488
Abstract
Due to National Program of Infant Nutrition in Russian Federation Optimization publication in 2010 and new infant nutrition products’ appearance, need improvement of knowledge in this field rises for many doctors. The article is devoted to such aspects of weaning as smooth transition from liquid nutrition to solid, choice of first weaning product, consideration of individual development features, importance of adapted products’ use. Introduction of weaning food to babies with difficulties in transition to solid products is viewed. Use of new milk-based cereal products — Vallings as well-balanced, nourishing food, allowing weaning following an individual scheme and also as a dietetic food is discussed.
Key-words: babies of first year of life, nutrition, weaning, milk-based cereal products, Vallings.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):78-84)
Key-words: babies of first year of life, nutrition, weaning, milk-based cereal products, Vallings.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):78-84)
LECTURES
85-93 1375
Abstract
The lecture analyzes etiology and key parts of pathogenesis of a form of extreme states — a shock. Author characterizes its types and symptoms and principles of treatment and prophylaxis.
Key words: sludge, disseminated formation of thrombus and fibrinolysis, «shock lungs», «shock kidney».
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):85-93)
Key words: sludge, disseminated formation of thrombus and fibrinolysis, «shock lungs», «shock kidney».
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):85-93)
EXCHANGE OF EXPERIENCE
E.I. Alexeeva,
S.I. Valieva,
T.M. Bzarova,
E.L. Semikina,
K.B. Isaeva,
A.O. Lisitsyn,
R.V. Denisova,
E.G. Chistyakova,
T.V. Sleptsova,
E.V. Mitenko
94-100 532
Abstract
Treatment of patients with severe clinical course of juvenile rheumatoid arthritis (JRA) is difficult problem. During the last years genetically engineered biological drugs are used equally with traditional immunosuppressive agents in treatment of severe forms of juvenile arthritis. High effectiveness of these drugs can be accompanied with development of unfavorable effects, for example, febrile neutropenia. The article presents results of a study of effectiveness and safety of recombinant human granulocytic colony-stimulating factor — filgrastim (Leucostim) — in treatment of granulocytopenia developed during immunosuppressive therapy in 16 patients with JRA. It was shown that administration of filgrastim arrests leucopenia in 100% of patients and granulocytopenia — in 93% of patients in 24 hours after first injection. High effectiveness of drug was combined with good tolerability and safety.
Key words: children, treatment, granulocytopenia, filgrastim, juvenile rheumatoid arthritis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):94-100)
Key words: children, treatment, granulocytopenia, filgrastim, juvenile rheumatoid arthritis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):94-100)
101-105 561
Abstract
Results of performed pre-clinical and clinical studies with volunteers 18-60 years old allowed registration of vaccine «INFLUVIR» (live monovalent vaccine for the prophylaxis of influenza A/H1N1, strain A/17/California/2009/38 (H1N1), developed by NPO «Microgen» in Russian Federation so timely vaccination campaign was performed. As a result, the level of morbidity with influenza A/H1N1 in Russia was decreased, and development of complication was prevented. Clinical studies in different groups of children were performed for the purpose of widening indications for vaccine «INFLUVIR» administration. According to the results of studies vaccine «INFLUVIR» has good tolerability and safety, low reactogenicity, and significant immunogenicity. This fact will allow changing of present normative documentation and administration of «INFLUVIR» in children of different age for prophylaxis of influenza A/H1N1.
Key words: children, influenza, virus A/H1N1, live influenza vaccine, tolerability, safety, immunogenicity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):101-105)
Key words: children, influenza, virus A/H1N1, live influenza vaccine, tolerability, safety, immunogenicity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):101-105)
A.N. Mironov,
A.A. Romanova,
R.Ya. Meshkova,
I.V. Fel’dblyum,
N.V. Kupina,
D.S. Bushmenkov,
A.A. Tsaan
106-109 614
Abstract
NPO «Microgen» developed vaccine «PANDEFLU» — influenza inactivated subunit adsorbed monovalent vaccine, strain A/California/7/2009 (H1N1), for specific prophylaxis of pandemic influenza in different age groups of citizens. Reactogenicity, safety and immunogenicity were analyzed in a study of volunteers 18–60 years old. The article presents results of administration of vaccine «PANDEFLU» in children. The study performed in two clinical centers proves good tolerability, reactogenicity, safety and high immunogenicity of this vaccine.
Key words: children, influenza, influenza virus А/H1N1, inactivated influenza vaccine, reactogenicity, safety, immunogenicity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):106-109)
Key words: children, influenza, influenza virus А/H1N1, inactivated influenza vaccine, reactogenicity, safety, immunogenicity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):106-109)
110-113 1241
Abstract
Authors discuss etiology of bacterial purulent meningitis in 190 examined children (Krasnoyarsk, 2005–2009). Etiology of meningitis was detected in 68.5% of cases. 57.7% of 130 cases are generalized forms of meningococcal infection, 16.9% –meningitis caused by Haemophilus influenzae, 11.5% – pneumococcal, and 8.4% – streptococcal one. Pneumococcal meningitis differed not only by lesion of tunics but lesion of brain, by severity of disease, prolonged clinical course with development of complications which were life-threatening and in some cases leading to development of disability.
Key words: children, bacterial purulent meningitis, pneumococcal meningitis, clinical symptoms, clinical course, outcomes.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):110-113)
Key words: children, bacterial purulent meningitis, pneumococcal meningitis, clinical symptoms, clinical course, outcomes.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):110-113)
A DOCTOR’S AID
114-118 576
Abstract
Medications with intravenous immunoglobulin G (IVIG) had established a reputation of effective drugs in pediatric practice in treatment of initial immunodeficiency and some autoimmune and inflammatory diseases. Multiplicity of mechanisms of its effectiveness reflects physiologically many-sided functions of IgG in maintenance of organism’s homeostasis. Drugs containing IVIG differ in ways of production and, correspondingly, in its formulation. The choice of the drug to the patient should be based not only on its quality but on peculiarities of patient’s state.
Key words: newborns, intravenous immunoglobulin, autoimmune diseases, initial immunodeficiency.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):114-118)
Key words: newborns, intravenous immunoglobulin, autoimmune diseases, initial immunodeficiency.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):114-118)
119-123 526
Abstract
The article describes a problem of rational nutrition of infants with commercially produced additional feeding stuff containing fruits and vegetables. Equally with traditional form of fruits and vegetables in infants’ nutrition (juices, nectars, mashed products), there are new types of food — combined mush products containing fruits, cereals and milk. The article analyzes compound, properties of these products and peculiarities of their use in infants’ nutrition. Authors give recommendations on terms of inclusion these products in diet of infants.
Key words: infants, nutrition, additional feeding, mashed products.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):119-123)
Key words: infants, nutrition, additional feeding, mashed products.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):119-123)
124-131 636
Abstract
The article analyzes modern state of a problem of nutrition influence on formation of child’s health in early periods of its development. Author compares different opportunities of optimization of fetus and breast-fed child.
Key words: pregnant women, nursing mother, infants, nutrition.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):124-131)
Key words: pregnant women, nursing mother, infants, nutrition.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):124-131)
132-137 536
Abstract
Author examines a role of micronutrients in development and health state of children. Main causes of vitamins and mineral deficiency are presented. It was shown that prophylaxis of micronutrients insufficiency with complexes of vitamins and minerals must be obligatory. The article presents main criteria of choice of such drugs.
Key words: children, vitamins, minerals, hypovitaminosis, complexes of vitamins and minerals.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):132-137)
Key words: children, vitamins, minerals, hypovitaminosis, complexes of vitamins and minerals.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):132-137)
138-142 523
Abstract
Authors analyzed data on formation of intestinal biocenosis in infants and the role of pro- and prebiotics in this process. Beneficial effect of pre- and probiotics inclusion into formulas for children’s nutrition is discussed. The article presents a description of studies of effectiveness and safety of «Agusha GOLD» formula with symbiotic properties in infants.
Key words: children, microbiocenosis, intestine, prebiotics, probiotics.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):138-142)
Key words: children, microbiocenosis, intestine, prebiotics, probiotics.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):138-142)
143-146 682
Abstract
The article analyzes mistakes and difficulties of kinesitherapy in children, predominantly in infants. New apparatus-controlled methods of kinesitherapy for children with chronic nonspecific pulmonary disease are characterized.
Key words: children, kinesitherapy, chronic nonspecific pulmonar diseases, mucostasis, viscous secretion, drainage, apparatus methods of drainage.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):143-146)
Key words: children, kinesitherapy, chronic nonspecific pulmonar diseases, mucostasis, viscous secretion, drainage, apparatus methods of drainage.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):143-146)
CLINICAL OBSERVATIONS
T.M. Bzarova,
E.I. Alexeeva,
S.I. Valieva,
A.M. Chomakhidze,
K.B. Isaeva,
A.O. Lisitsyn,
R.V. Denisova
147-154 653
Abstract
The article presents a case report of recurrent clinical course of polyarticular type of juvenile rheumatoid arthritis, which is characterized with rapid development of disability, low quality of life, high index of functional insufficiency, torpid flow. The disease developed with intolerance to metotrexate and presence of contra-indications to blockers of tumor necrotizing factor _. Authors describe successful treatment with inhibitor of T-lymphocytes co-stimulation abatacept. The dose of drug was 10 mg/kg of body weight during 24 weeks. In two weeks after the beginning of treatment pain and exudative lesions in joints were lessened, joint range of motions significantly increased. The quality of life of patient and her family increased in 4 weeks of treatment with abatacept. The drug induced clinical and laboratory remission in 24 weeks.
Key words: children, juvenile rheumatoid arthritis, abatacept, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):147-154)
Key words: children, juvenile rheumatoid arthritis, abatacept, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):147-154)
155-159 523
Abstract
The article analyzes results of successful prolonged treatment of children with focal segmental glomerulosclerosis (FSGS). Treatment with cyclosporine (median dose 4–5 mg/kg of body weight) combined with prednisolone (1–1.5 mg/kg/48 hours) was performed in 34 patients 1.5–16 years old with FSGS. Pulse-treatment with methylprednisolone (30 mg/kg every other day, 3–6 injections) was performed in 21 patients for the purpose of remission induction. In 6 month of treatment with cyclosporine, total clinical and laboratory remission of corticosteroid-resistant nephrotic syndrome (CRNS) was detected in 12 (35%) patients, partial one — in 9 (26%) patients, remaining CRNS — in 13 (38%) of children. In 12 months of treatment total remission of CRNS was detected in 18 (53%) children, partial one — in 7 (21%) children, unefficient treatment — in 7 (21%) patients. Dose of prednisolone was decreased to minimal supporting level in 68% of children, and in 32% of patients corticosteroids were canceled. Thus, treatment with cyclosporine was effective in most children with SRNS and FSGS. Prolonged administration of cyclosporine up to 2 years and longer can be performed if regular control of kidney function is provided and symptoms of nephrotoxic action of this drug is absent (according to results of repeated biopsy).
Key words: children, focal segmental glomerulosclerosis, cyclosporine, methylprednisolone.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):155-159)
Key words: children, focal segmental glomerulosclerosis, cyclosporine, methylprednisolone.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):155-159)
160-167 469
Abstract
The article presents a case report of a severe clinical course of systemic type of juvenile arthritis, resistant to treatment with corticosteroids and classic immunosuppressive agents in girl 9 years old. Biological agent — tocilizumab showed beneficial effect: exudative lesions of joints, morning joint stiffness stopped and the range of motions restored in almost all affected joints in 8 weeks of treatment. A girl became more active, her emotional state improved. Laboratory signs of disease’s activity (ESR, concentration of C-reactive protein in plasma) were normalized in 4 weeks. The drug induced development of clinical and laboratory remission of a disease.
Key words: children, juvenile arthritis, treatment, tocilizumab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):160-167)
Key words: children, juvenile arthritis, treatment, tocilizumab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):160-167)
SHORT REPORTS
HISTORY OF PEDIATRICS
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
