Vol 5, No 6 (2006)
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EDITORIAL
FORMATION OF THE STATE POLICY IN PUBLIC HEALTHCARE IN THE RUSSIAN FEDERATION: PROBLEMS AND SOLUTIONS
5-7 797
Abstract
The article analyzes the legal grounds for the state policy development in public healthcare in the Russian federation. The urgency of this program is well substantiated. The authors introduce the working definition of the governmental policy in public healthcare, which is viewed as a component of the internal policy of the state and which interacts with other trends of the state policy within the framework of its tasks. The adequate state regulation of the legal, social and economic and other relations within the society is necessary to achieve maximum full observance of the citizens' rights for the disease prevention, affordable highly qualified medical care and medical rehabilitation.
Key words: public healthcare, medical care.
Key words: public healthcare, medical care.
SOCIAL PEDIATRICS AND HEALTH CARE
8-12 713
Abstract
In Russia, along with the positive trends for infant mortality reduction there is the general mortality growth dependent on external reasons and unclearly indicated states. Special examination of the infant's death circumstances showed that the social portrait of families, in which they died both of injuries and unclearly indicated states was the following — these were extremely troubled, marginal and half marginal families. This is why, the dynamics of infant mortality dependent on external reasons and unclearly indicated states may be considered as the peculiar marker of the social trouble. The growth of the number of waifs and neglected children in Russia, who are about to reach the childbearing age in the nearest future, may lead to the growth of infant mortality.
Key words: infant mortality, children.
Key words: infant mortality, children.
13-17 830
Abstract
The article highlights the issues of social pediatry, arising from events aimed at preservation and promotion of health, prevention of diseases among children and teenagers at the outpatient level. Based on the findings of the lasting research, the authors described the state of social pediatry in the beginning of the 21st century. They examined the activity of medical and social care departments as new units of the children's outpatient hospitals. Special chapter is dedicated to the implementation of general practice and family practice principles into the activity of medical and preventive treatment facilities of the primary chain within the pediatric service.
Key words: social pediatry, public health organization, formation of pediatric service, child welfare.
Key words: social pediatry, public health organization, formation of pediatric service, child welfare.
18-23 523
Abstract
The article highlights the first results of the work of the new organization form of infant feeding optimization — regional children's center of sensible nutrition in Chelyabinsk region. It provides for combination of medical and psychohygienic work to support breast feeding and prevent eating disorders.
Key words: breast feeding support, prevention of alimentary conditioned diseases, infants.
Key words: breast feeding support, prevention of alimentary conditioned diseases, infants.
ORIGINAL ARTICLES
24-27 810
Abstract
The article deals with the data, which manifests the change in the serotypes of Bordetella рertussis in St. Petersburg, as well as dynamics of biological properties of the causative agent within 1990–2004. The researchers have described the dynamics of dominating serotype changes among the hospital patients from 1.2.3. between 1990–2000 Up to 1.0.3. between 2002–2004, as well as gradual change of chromosomal d na of Bordetellae from iii to iv and pertaktin (PRN) from 1 to type 2 (antigenic drifting). Analysis of the clinical picture and treatment of the disease among 138 children, suffering from pertussis, producing strains of Bordetella рertussis of serotypes 1.2.3. and 1.2.0. (93 people) along with Bordetella рertussis of serotypes 1.0.3 (45 people) showed that biological strain mutability of Bordetella рertussis causes changes in severity and clinical course of pertussis infection, without effecting the clinicial picture of the disease. Strains of pertussis bacilla of serotypes 1.0.3., iv (during electrophoresis in pulsating gel efppbgroup, prn 2 are associated with rarer development of the severe illness forms (by 2.5 times), as well as specific complications (breathbholding and pertussis encephalopathy). The patients had no life threatening complications (respiratory standstill and convulsive disorder).
Key words: pertussis, children, antigenic drifting of Bordetella рertussis, biological strain mutability, specific complications of pertussis.
Key words: pertussis, children, antigenic drifting of Bordetella рertussis, biological strain mutability, specific complications of pertussis.
28-31 543
Abstract
In the paper were presented the results of an investigation of the nucleus area and metabolism DNA parameters (the level of nuclear DNA uptake, the level of a chromatin condensation and the concentration of plasma free cell DNA) in newborns with clinical manifestations of adaptation derangement (a perinatal CNS damage, an intrauterine pneumonia and a neonatal pneumopathy) in early neonatal period. In all cases the disorders of a DNA metabolism was obtained. However, the greatest divergence of all investigated parameters was founded in newborns with neonatal pneumo pathy. We made the assumption that lymphocyte apoptosis may be part of the reason for the origin of free cell DNA and we propose the possible mechanism of free cell DNA sharing in pathogenesis of derangement adaptation in neonatal period.
Key words: free cell DNA, nuclear DNA, intrauterine pneumonia, pneumopathy.
Key words: free cell DNA, nuclear DNA, intrauterine pneumonia, pneumopathy.
32-35 516
Abstract
The method of the peripheral electrogastroenteromyography has been used for appraisal of the motor function among 85 children (44 girls, 41 boys) aged between 6 and 15 years old with chronic gastroduodenitis at the stage of recrudescence (I group — 45 children), chronic gastroduodenitis without recrudescence (II group — 20 children), peptic ulcer disease at the stage of recrudescence (III group — 10 children) and chronic duodenal obstruction related in most cases to arteriomesen teric compression (iv group — 10 children). Palpable changes in electrogastroentrerography indices were noted only among children with chronic duodenal obstruction and manifested as the increase of electrobiological activity after taking the medication along with the reduction of the indices, which showed the contractive activity itself. Taking of the medications differentially affects the electrogastroentrerography indices: domperidone increases both electro biological activity itself and myo electrical activity, whereas mebeverine decreases them, acting as not only a spasmolysant but also a motility modulator.
Key words: electrobiological activity, chronic gastroduo denitis, peptic ulcer disease, children.
Key words: electrobiological activity, chronic gastroduo denitis, peptic ulcer disease, children.
36-39 667
Abstract
Within recent years, pediatricians have paid special attention to gastroesophageal reflux disease in relation to the risk of the metaplastic changes of mucous coat of esophagus. Intestinal metaplasia is an essential risk factor for the growth of esophagus adenocarcinoma. According to our data, diseases of the lower third of esophagus and Z-line were observed among almost 6% of patients, who underwent endoscopic examination. In the research, where 109 children with protractedly nonhealing defects of the lower third of esophagus and Z-line were involved, the authors uncovered intestinal metaplasia among 26 children (23,85%) and Gastral metaplasia among 24 children (22,02%). To clarify the character of the changes in the mucous coat of the lower third of esophagus, there was a research on esophagi of 32 deceased children aged between 6 months and 15 years old (deceased with neither gastroenterological pathology to be diagnosed when alive, nor implications of gastroesophageal reflux). In 4 cases, in the distal esophagus under the multilayered scaly epithelium the researchers discovered segments of the enteral epithelium. Some medications were noted to cause perforation of the intestinal epithelium by the enteral epithelium with its emergence onto the surface. We should not ignore the fact that a risk factor for intestinal metaplasia can be the congenital focuses of ectopia of the intestinal epithelium in the mucous coat of esophagus.
Key words: mucous coat of esophagus, barrett's syndrome, intestinal metaplasia, esophagus adenocarcinoma, Н. pilori, inesophageal РH-metrics, children.
Key words: mucous coat of esophagus, barrett's syndrome, intestinal metaplasia, esophagus adenocarcinoma, Н. pilori, inesophageal РH-metrics, children.
E.G. Chistyakova,
S.I. Valieva,
L.S. Namazova,
A.G. Surkov,
O.N. Volkova,
M.P. Kostinova,
S.V. Suloeva
40-44 647
Abstract
The research objective is to appraise the effectiveness of topic lysates in prevention and treatment of respiratory infections of nasal pharynx among the patients with juvenile arthritis. The authors have examined 118 children aged between 12 and 16 years old. The main group comprised 68 children with juvenile arthritis without any implications of the acute respiratory infection or within the decubation (in 5–10 days after the acute respiratory infection), who underwent 14bdays course of the medication from the group of topic lysates according to the prevention scheme. The comparison group comprised 20 children with juvenile arthritis, who did not receive any topic immunomodulators. The control group comprised 30 practically healthy children (AVERAGELY AGED 14,8 Ѓ 2,3 YEARS). Before the prescription of the prevention course of topic lysates and in 1 and 3 months after the treatment children underwent clinical and laboratory examination. The research findings showed that the application of the medication from the group of topic lysates among children with juvenile arthritis ensured the reduction of acute respiratory infection growth frequency by 2,3 times and reduction of entinflammatory change implications by 2,2 times (Р < 0,05). The treatment with the bacterial lysate caused the firm reduction of S. аureus and S. saprophyticus sowing for the period of no less than 3 months (Р < 0,05). The firm reduction of sowing was observed in 50% of cases, whereas the normalization of microflora of nasal pharynx was observed among 41% of the patients. The application of local immunomodulators among children led to normalization of Igg and siga indices in the saliva (p < 0,05) for the period of no less than 3 months, which was accompanied by the reduction of acute respiratory infection frequency by 2,3 times, reduction of ent inflammatory change implications by 2,2 times and necessity in the antibacterial therapy if compared with the pervious year by 2,1 times (P < 0,05).
Key words: juvenile arthritis, children, acute respiratory infections, prevention.
Key words: juvenile arthritis, children, acute respiratory infections, prevention.
45-54 3651
Abstract
Deficiencies of iron and zinc are associated with delayed development, growth faltering, and increased infectious disease morbidity during infancy and childhood. Combined iron and zinc supplementation may therefore be a logical preventive strategy. Objective: the objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth, psychomotor development, and incidence of infectious disease. Design: Indonesian infants (n = 680) were randomly assigned to daily supplementation with 10 mg Fe (Fe group), 10 mg Zn (Zn group), 10 mg Fe and 10 mg Zn (Fe + Zn group), or placebo from 6 to 12 mo of age. Anthropometric indexes, developmental indexes (bay ley scales of infant development; sid), and morbidity were recorded. Results: at 12 mo, two factor analysis of variance showed a significant interaction between Iron and Zinc for weight for age z score, knee heel length, and sid psychomotor development. Weight forage z score was higher in the Zn group than in the placebo and Fe + Zn groups, knee heel length was higher in the Zn and Fe groups than in the placebo group, and the sid psychomotor development index was higher in the Fe group than in the placebo group. No significant effect on morbidity was found. Conclusions: single supplementation with zinc significantly improved growth, and single supplementation with iron significantly improved growth and psychomotor development, but combined supplementation with iron and zinc had no significant effect on growth or development. Combined, simultaneous supplementation with iron and zinc to infants cannot be routinely recommended at the iron to zinc ratio used in this study.
Key words: infants, growth, knee heel length, development, iron, zinc.
Key words: infants, growth, knee heel length, development, iron, zinc.
A.A. Tarasova,
M.P. Kostinov,
O.N. Volkova,
M.S. Deulin,
S.V. Suloeva,
I.V. Mayanskaya,
N.I. Tolkacheva
55-59 634
Abstract
20 children with the insulin dependent diabetes have been vaccinated with pneumo 23 against pneumococcal infection during the two week prevention course by immunomodulating spray IRS 19. Topical lysate was prescribed on the day of vaccination in the season, immediately preceding the flu epidemy. Before application of topical lysate, as well as in a month and in 3 months after the pre vention course was over, the researchers evaluated the biocenose indices of nasal and fauces cavity mucosa. Alongside, otorhinolaryngologist examined the children. IRS 19 prescription helped to avoid the emergence of intercurrent diseases during the post vaccinal period, in the meantime, it led to the reduction of pathogenic flora sowing, intensity of the inflammatory changes in the nasal pharynx and fauces. Vaccination against pneumococcal infection and combined application of Pneumo 23 with IRS 19 among children with the insulin-dependent diabetes contributed to the reduction of frequency and severity of the respiratory ingections if compared with the similar indices of 43 patients with diabetes, who did not receive immunization.
Key words: children, insulin dependent diabetes, chronic tonsillitis, tissue immunity, immunoregulatory spray, vaccine against pneumococcal infection.
Key words: children, insulin dependent diabetes, chronic tonsillitis, tissue immunity, immunoregulatory spray, vaccine against pneumococcal infection.
LECTURES
60-63 757
Abstract
In the article the characteristic of ethiology and key parts of pathogenesis of inflammation is given; modern data on the role of adhesive molecules, active forms of oxygen, lipoperoxidation processes, cytokines and other mediators in the development of acute and chronic inflammation are analyzed; the principles of its treatment are substantiated.
Key words: inflammation, phlogogenic agents, alteration, adhesion molecules.
Key words: inflammation, phlogogenic agents, alteration, adhesion molecules.
64-70 709
Abstract
The article deals with the data about opportunity to enrich the modern infant foodstuffs with pro and prebiotics. The authors name the contents of the foodstuffs with pro and prebiotic properties, findings of the multicentric research according to the estimate of their clinical efficiency among healthy and ill infants. They show the safety and high efficiency of the use of the given healthful and dietary foodstuffs.
Key words: infant food, foodstuffs, probiotics, prebiotics, bifidus bacteria, lactic acid bacilli, oligosaccharides, lactulose, inulin.
Key words: infant food, foodstuffs, probiotics, prebiotics, bifidus bacteria, lactic acid bacilli, oligosaccharides, lactulose, inulin.
71-76 597
Abstract
The article highlights the issues related to the prescription of supplemental feeding to the children with various pathology: food intolerance (food allergy, lactase deficiency, gluten sensitive enteropathy) and alimentary dependent diseases (iron deficiency anemia, oligotrophy). The authors substantiated the necessity and expediency of supplemental feeding introduction. They also examined the basic principles of its purpose. The authors described the peculiarities of each of the supplemental feeding groups and noted the expediency of manufactured product use. Along with that, they pointed out to the dependence of terms and order, in which different products and dishes of supplemental feeding are introduced, upon the character of the disease and the nutritive status of a child.
Key words: children, supplemental feeding, manufactured Supplemental feeding products, food intolerance, alimentary dependent diseases.
Key words: children, supplemental feeding, manufactured Supplemental feeding products, food intolerance, alimentary dependent diseases.
77-80 718
Abstract
The article deals with the etiology, growth mechanisms, clinical implications, diagnostics and treatment of the infant food allergy. The author highlights the status of the allergy to the proteins of cow milk within this age group of children. Alongside the article describes the modern approaches to the diet therapy of the infants with the allergy to the proteins of cow milk.
Key words: infant, food allergy, allergy to the proteins of cow milk, diet therapy.
Key words: infant, food allergy, allergy to the proteins of cow milk, diet therapy.
LITERATURE REVIEW
81-86 701
Abstract
At present, one of the most urgent issues in children's cardiology is the problem of tachyarrhythmia among patients, who have undergone the operation for congenital heart diseases. The overview generalizes the information on the diagnostics and treatment of supraventricular and ventricular arrhythmias in early post operation period and within long terms after congenital heart disease correction. The authors examined opportunities for the endocardiac radio frequency ablation and implantation of cardioverters defibrillators in treatment of arrhythmias and prevention of oxymortia.
Key words: heart rhythm disturbance, treatment, congenital heart diseases, children.
Key words: heart rhythm disturbance, treatment, congenital heart diseases, children.
EXCHANGE OF EXPERIENCE
88-91 1000
Abstract
The purpose of the works consisted in the study of the diet therapy efficiency along with the use of the modern adapted formula based on the goat's milk "Nanny" in feeding of the infants, who are bottle fed and who suffer from atopic dermatitis. The researchers have observed 58 children aged between 3 and 12 months old with atopic dermatitis complicated by the mycotic infection. The main group was made up of 32 children, who received the formula based on the goat's milk within the hypoallergic diet. The control group was made up of 26 children, who received a formula based on the soy protein isolates. Introduction of the formula based on the goat's milk into the food ration of the infants with atopic dermatitis provided the high clinical efficiency in 78% of cases. It manifested itself in achievement of the disease remission by the 10–20th day from the moment the therapy started, reduction of scorad index by 3,5 times, reduction of the atopic dermatitis recrudescence period by 2 times, protraction of the remission by 3 times, reduction of the backsets by 2,5 times against concentration reduction of IgE and allergen specific IgE to the cow milk proteins and casein in blood serum as far as it concerns the adequate growth and development of a child. Thus, the replacement of the products based on the cow milk for the wholesome children formula based on the goat's milk in the food ration of the patients, suffering from atopic dermatitis, allowed for both optimizing the diet therapy of the infants, ensuring their adequate physical growth and contributing to the control over the symptoms of disease.
Key words: goats milk formula, atopic dermatitis, infants, treatment.
Key words: goats milk formula, atopic dermatitis, infants, treatment.
A DOCTOR’S AID
92-95 637
Abstract
The article provides the research findings of the application efficiency of the complex plant based preparation Sinupret (Bionorica AG, Germany) for prevention of the acute respiratory diseases among sickly children. The authors showed that the application of the plant based preparation decreased the sick rate caused by the acute respiratory diseases and influenza, alleviated the run of the acute respiratory diseases, had some really good tolerance and might be recommended for the wide use, for the prevention of the acute respiratory diseases in organized children groups.
Key words: acute respiratory diseases, prevention, phytotherapy, children, homeopathic remedies, vaccines.
Key words: acute respiratory diseases, prevention, phytotherapy, children, homeopathic remedies, vaccines.
CLINICAL OBSERVATIONS
96-100 581
Abstract
The article describes the run of the severe systemic juvenile rheumatoid arthritis, which is resistant to the standard antirheumatic therapy. The disease was characterized by such systemic implications of the disease, as: fever, rash, pericarditis, lymphadenopathy, hepatomegaly accompanied by the generalized joint syndrome and high laboratory indices of activity. Introduction of rituximab into the treatment scheme allowed the researchers to decrease the general activity of the disease, arrest the systemic implications, improve functional status of the joints, and normalize the laboratory indices of activity. The effect duration was 5 months and 4 months after the first and second course of treatment by rituximab accordingly. The treatment results prove the perspective of rituximab application with in the complex therapy for the patients, suffering from juvenile rheumatoid arthritis. However, it is necessary to conduct further research to identify the location of antibodies to cd 20+ within the therapy scheme of this disease.
Key words: children, treatment, rituximab, juvenile rheumatoid arthritis.
Key words: children, treatment, rituximab, juvenile rheumatoid arthritis.
SHORT REPORTS
INFORMATION MESSAGE OF PEDIATRIC SCIENTIFIC COUNCIL
V.Yu. Al'bitskiy,
I.I. Balabolkin,
A.A. Baranov,
N.R. Belova,
T.E. Borovik,
I.K. Volkov,
S.N. Zorkin,
A.A. Efimova,
V.R. Kuchma,
L.S. Namazova,
G.V. Rimarchuk,
L.M. Roshal',
T.V. Sergeeva,
I.E. Smirnov,
V.M. Studenikin,
V.F. Uchaikin,
N.N. Chukanin,
S.E. Shlyakhtina,
V.K. Shurygin,
L.A. Shcheplyagina,
P.L. Shcherbakov,
G.V. Yatsyk
106-109 522
Abstract
This publication contains the predictions of the scientific studies in pediatric patients. The forecast is developed by leading pediatricians of the country. It was based on the analysis of pediatrics developement and pediatric practice in the Russian Federation in recent decades.
NATIONAL PROJECT «HEALTHCARE»
HISTORY OF PEDIATRICS
112-116 508
Abstract
The article disclose the important milestones in the life and activities of Ivan Vissarionovich Troitsky (1856–1923), the founder of the pleiad of Russian pediatricians of the second half of the XIX — the beginning of the ХХ centuries. Due to their efforts pediatrics have occupied a proper place among other medical disciplines. The author analyzes principle directions of scientific research and characterize I.V. Troitsky as a public figure and organizer of children's healthcare system. The article emphasis a role that Troitsky played in the calling for the first international and the first all Russian conference of children's doctors (1912).
Key words: pediatrics, I.V. Troitsky, scientific problems of pediatrics, principles for therapy in children, conference of children's doctors, «the drop of milk».
Key words: pediatrics, I.V. Troitsky, scientific problems of pediatrics, principles for therapy in children, conference of children's doctors, «the drop of milk».
JUBILEE
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
