Vol 8, No 4 (2009)
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SOCIAL PEDIATRICS AND HEALTH CARE
5-9 774
Abstract
The analysis of dynamics of official statistics rates (population size, morbidity, disability, and mortality), and results of special scientific studies (morbidity, physical development), make it possible to show basic tendencies of children’s health state changes in modern conditions. The result of pediatrists from out-patient clinics survey, questioning of parents and adolescents (12–17 years old), on the problem of children’s health service, are presented. Questionnaire poll was held in regions of Central, Privolzhskiy, and Siberian Federal Districts. The complex analysis of obtained results show low quality level and accessibility of prophylactic and treatment medical service in children. This data became the basis of main directions of work of controlling and public health service in the field of increasing of quality and accessibility of pediatric medical service in out-patient clinics.
Key words: children, medical service, out-patient clinics, quality, accessibility.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):5-9)
Key words: children, medical service, out-patient clinics, quality, accessibility.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):5-9)
10-16 648
Abstract
The article continues the series of publications on development of informational system of interdisciplinary monitoring of children’s and adolescents’ health. The results of factor analysis, obtained during examination of more than 10,000 schoolchildren of 1–11 forms living in Moscow, Vologda, Nalchik, Reutov, Petropavlovsk-Kamchatskiy cities are described in this article. Authors formed the list of factors, which allow classification of child’s health from the anthropological positions: physical development, functional state, development of personality, and characterizing the social environment of child’s education. The probabilistic-statistical model of health was developed on the base of linear conversion of indices (numerical expression of factor). The article show 2 forms of data visualization, facilitating the information perception and allowing the making of relative analysis of health rates (on discoordination, density, dispersion).
Key words: children, health, informational systems.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):10-16)
Key words: children, health, informational systems.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):10-16)
18-22 566
Abstract
The article presents the analysis of pedestrian traumas in the world and in Russian Federation. The basic principles of reorganization strategy of traffic security for the achievement of fundamental changes in the questions of decreasing of accidents’ rate with participation of children and lessening the severity of medical consequences of trauma, basing on the principles of in- and interdepartmental integration.
Key words: children, pedestrian traumatism, epidemiology.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):18-22)
Key words: children, pedestrian traumatism, epidemiology.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):18-22)
23-25 584
Abstract
The article reflects basic stages of development of questionnaire studying peculiarities of health-saving behavior of adolescents of 15–17 years old, and factors influencing on it. Necessary condition to the questionnaires’ working out is to keep in mind the specific changes, taking place in this age. The results of questionnaire may be useful in distribution of adolescents into groups depending on criteria of psychological compatibility, primary behavioral risk factors, attitude, etc. It creates conditions for the optimization of work in the field of stable health-saving behavior.
Key words: adolescents, health-saving, questionnaire.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):23-25)
Key words: adolescents, health-saving, questionnaire.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):23-25)
26-31 1772
Abstract
The need in hospitalization of pediatric patients was significantly decreased in last 20 years due to including of innovative methods of treatment into the practice. This fact leaded to arising of questions, related to ambulatory treatment. The article presents analysis of advantages and shortcomings of present being practice of children’s with acute diseases management at ambulatory and hospital stages. It was shown that the number of beds (calculated to 10 000 children under the age 0–14 years old) is differ from 4–5 in USA to 90 in Russian Federation, with tendency to beds’ concentration in large hospitals. The main reason of hospitalization is nosocomial respiratory (up to 40% of cases) and rotaviral (up to 25% of cases in epidemic season) infections. It was marker, that shortening of stay in hospital and implementation of hospital-replacing technologies (day hospital) for the treatment of children with chronic pathology can decrease the rate of morbidity with nosocomial infections. Lessening the need in hospital stay can be realized by optimization of ambulatory care, particularly, shortening of patient’s visits at home, and using diagnostic abilities of out-patient clinics for the needs of patients with acute diseases.
Key words: children, hospitalization, ambulatory treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):26-31)
Key words: children, hospitalization, ambulatory treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):26-31)
32-36 575
Abstract
The data on children’s under the age of 14 years old morbidity with syphilis and gonorrhea analysis around the territory of the Russian Federation during the period from 2000 to 2006 are presented in this article. It is mentioned that the rate of children’s morbidity with syphilis has always been 2 times higher than by gonorrhea. The decrease of rate of children’s morbidity in Russia with syphilis is reduced twice, with gonorrhea — in 2.4 times. Authors detected essential interregional variability of rates, with the best results in European and South part of the country and with the worst results in Siberia and in the Far East. The social macroeconomic and national factors of children’s morbidity formation with syphilis and gonorrhea in Russia, and the various quality of registration of the pathology in regions of the country are supposed.
Key words: children, syphilis, gonorrhea, morbidity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):32-36)
Key words: children, syphilis, gonorrhea, morbidity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):32-36)
ORIGINAL ARTICLES
37-41 1072
Abstract
Clinical trial for polymer-subunit trivalent influenza vaccine Grippol plus reactogenicity assessment in 153 children aged 3–17 years old was conducted in the frames of post-registration studies. Prior to the vaccination the written informed agreement was signed by every participant’ parent. In post-vaccination period physical examination and thermometry was performed daily in post-immunization days 1–5, on days 21–28 and then on a monthly basis for 4 months. Study results demonstrated that Grippol plus possesses low reactogenicity and can be applied in pediatrics for immunization in accordance with National Immunization schedule.
Key words: children, influenza, vaccination.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):37-41)
Key words: children, influenza, vaccination.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):37-41)
E.I. Alexeeva,
T.V. Sleptsova,
S.I. Valieva,
T.M. Bzarova,
R.V. Denisova,
A.O. Lisitsin,
E.Yu. Gudkova,
A.M. Chomakhidze,
K.B. Isaeva,
A.A. Grigor’eva,
O.L. Lomakina
42-50 514
Abstract
The article presents the results of a study of effectiveness and safety of infliximab — monoclonal antibodies to tumor necrotizing factor (TNF) _ in treatment of 47 patients in age 11 months — 16 years old with early pauciarticular and polyarticular types of juvenile rheumatoid arthritis. The duration of observation was from 3 months to 1 year. Infliximab was administrated intravenously according to scheme: infusions on 0, 2, 6 and further every 8 weeks. Single dose of infliximab in patients with polyarticular type of juvenile arthritis was 6.75 ± 2.16 mg/kg, and in patients with pauciarticular type — 7.35 ± 2.09 mg/kg of body weight. Treatment with anti-TNF medication during 54 weeks resulted in development of clinical remission, decrease and normalization of laboratory rates of disease’s activity, complete restoration of joints’ function, and increase of quality of life in 83% of patients. The secondary absence of effectiveness developed in 3 patients, and they were excluded from the study. The tolerability to the medication was satisfactory: there was no any unfavorable event needed abolition of treatment during all period of observation.
Key words: children, early juvenile rheumatoid arthritis, treatment, infliximab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):42-50)
Key words: children, early juvenile rheumatoid arthritis, treatment, infliximab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):42-50)
51-55 513
Abstract
The study included 101 adolescents with increased blood pressure (BP). They undergo rheoencephalography, which showed considerable disorders of cerebral tissue perfusion, affecting different parts of blood flow, and depending on severity of arterial hypertension (AH). It was detected, that the ability of concentration of attention was lowered in adolescents with stabile AH, which allow considering cognitive abilities of personality as a target function to increased AH.
Key words: adolescents, arterial hypertension, cerebral blood flow, cognitive function.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):51-55)
Key words: adolescents, arterial hypertension, cerebral blood flow, cognitive function.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):51-55)
56-62 648
Abstract
The article presents the results of a study of mineral metabolism in healthy children of pre- and pubertal age. Factors leading to the disorders of bone tissue mineralization and parameters of physical development of children are analyzed. Authors describe the results of study of bone remodeling and mineral density of bone tissue biochemical markers in adolescents of 10–15 years old.
Key words: children, pubertal age, mineral density of bone tissue, osteopenia, sport.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):56-62)
Key words: children, pubertal age, mineral density of bone tissue, osteopenia, sport.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):56-62)
63-71 520
Abstract
This trial studied effectiveness of prebiotic dose of lactulose in 200–400 ml of milk compound «Bifidus», in nutrition of infants under first year old, hospitalized with inflectional enterocolitis. Catamnestic observation of patients with diagnostics of faecal microflora showed increase of rate (on 29%) of durable stool normalization in children, whose nutrition contained of «Bifidus» compound during 1–1.5 months, compared to children, receiving compounds without prebiotic substances (p = 0.048). Besides, statistically significant increase of obligate populations of microbes in intestine of children, receiving breast feeding or lactulose-containing compound was detected. Such changes were revealed on the basis of stopping the symptoms of intestinal inflammatory process. Children, receiving compound with lactulose, showed restoration of micro biocenosis and decrease of rate of proliferation of opportunistic gram-negative pathogens.
Key words: children under first year old, inflectional enterocolitis, intestinal microflora, lactulose.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):63-71)
Key words: children under first year old, inflectional enterocolitis, intestinal microflora, lactulose.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):63-71)
S.I. Valieva,
E.I. Alexeeva,
T.M. Bzarova,
A.O. Lisitsin,
A.M. Chomakhidze,
R.V. Denisova,
O.L. Lomakina
72-78 575
Abstract
The article presents the data on effectiveness of new form of probiotic medication, containing Bifidobacterium BB-12 and Streptoccocus thermophilus TH-4, in children with severe rheumatoid arthritis treated with antibiotics. It was shown that antibacterial treatment combined with probiotics was not accompanied with dyspeptic symptoms, including antibiotic-associated diarrhea, in 90% of children from probiotic group. Administration of probiotic in patient with presenting diarrhea and other dyspeptic disorders, developed at the time of treatment with antibiotics, in following group resulted in stopping of its unfavorable effects in 3 days of treatment. The results of the study show that administration of probiotic medication in combination with wide spectrum antibiotics can be recommended in patients with juvenile rheumatoid arthritis for the purpose of dyspeptic disorders preventing.
Key words: children, juvenile rheumatoid arthritis, probiotics, antibiotic-associated diarrhea.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):72-78)
Key words: children, juvenile rheumatoid arthritis, probiotics, antibiotic-associated diarrhea.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):72-78)
LITERATURE REVIEW
79-83 533
Abstract
The article describes the problem of pneumococcal infections (pneumonias, meningitis, otitis) in children and adults. The modern opportunities of vaccinoprophylaxis and its usefulness in public health service are shown. The perspectives and questions on safety and effectiveness of pneumococcal conjugated 7-valent vaccine as the basic method of pneumococcal infections prophylaxis in infants and children from risk groups (with bronchial asthma, sickle-cell anemia, etc.) are presented in details.
Key words: children, pneumococcal infection, vaccination, pneumococcal conjugated 7-valent vaccine.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):79-83)
Key words: children, pneumococcal infection, vaccination, pneumococcal conjugated 7-valent vaccine.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):79-83)
84-89 892
Abstract
The article presents mechanism of action of abatacept, literature data on clinical studies of its effectiveness in adults with rheumatoid arthritis, and results of clinical randomized double-blinded placebo-controlled study of abatacept effectiveness in treatment of different types of juvenile idiopathic arthritis. The analysis of literature data showed that abatacept is new perspective medication for the treatment of rheumatoid arthritis in adults and children.
Key words: children, rheumatoid arthritis, abatacept, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):84-89)
Key words: children, rheumatoid arthritis, abatacept, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):84-89)
90-94 804
Abstract
Endogenous nitric oxide (NO) influences on the processes taking place in skin by different ways as in norm, as in pathology. Constitutive (neuronal and endothelial) and inducible NO-syntases, responsible for NO synthesis, produce unequal volumes of it. This fact, finally, determine the degree of their participation in processes of skin reparation, and development of such diseases as psoriasis, melanoma, atopic dermatitis.
Key words: skin, nitric oxide, NO-syntases.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):90-94)
Key words: skin, nitric oxide, NO-syntases.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):90-94)
LECTURES
95-101 490
Abstract
The lecture discuss the role and mechanisms of cytokines’ effect realization as significant and integrating factors of nonspecific organism’s defense system; it characterizes main cytokine’s classes, its effects in normal state and in conditions of development of different disorders. Authors analyze etiology, pathogenesis, and signs of syndromes of organism’s immunobiological surveillance insufficiency, developing as a result of cytokine’s control mechanism disorder. The conclusion on lectures is presented.
Key words: cytokines, innate immunity, syndromes of innate immunity insufficiency.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):95-101)
Key words: cytokines, innate immunity, syndromes of innate immunity insufficiency.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):95-101)
EXCHANGE OF EXPERIENCE
102-105 546
Abstract
The trial presents the analysis of factors predisposing to exudative otitis media development in 709 children, needing regular audiologist’s check-up. It was shown that dominating risk factor of auditory tube’s function disorders is hypertrophy of palatine tonsil (it was detected in 69% of children). Besides, doctors from children’s out-patient clinics often use conservative treatment in children with chronic exudative otitis media. Analysis of data obtained at the time of treatment of 180 hospitalized children under the age 1–17 years old with exudative otitis media showed that combination of tympanostomy with fenspiride (Erespal) allows achieving of more significant decrease (1.3 times low) audibility threshold of different oscillations than in children from control (treated without fenspiride).
Key words: children, exudative otitis media, timpanostomy, fenspiride.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):102-105)
Key words: children, exudative otitis media, timpanostomy, fenspiride.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):102-105)
A DOCTOR’S AID
106-110 756
Abstract
The anatomic and physiological peculiarities of upper airways in infants are discussed in this article, and the necessity of its normal functioning in child’s organism. Authors give Russian practical rhinitis classification, which is used in pediatric practice. The article gives a detailed description of stages and peculiarities of clinical course of rhinitis in infants, and also shows the principles of treatment and modern approaches to the therapy of patients with rhinitis.
Key words: infants, rhinitis, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):106-110)
Key words: infants, rhinitis, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):106-110)
111-115 489
Abstract
Despite the relatively simple pharmacology of vitamins, pediatricians have much questions and difficulties in administration of these drugs.
The article gives an answer to the question of reasonability of vitamins and mineral complexes administration in autumn; and target groups of children, demanding additional correction of vitamin and mineral state of organism, are described. The article reflects the opinion of pharmacist on the criteria of choice of vitamin-mineral complex from the pharmaceutical and technological point of view.
Key words: children, school age, vitamins.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):111-115)
The article gives an answer to the question of reasonability of vitamins and mineral complexes administration in autumn; and target groups of children, demanding additional correction of vitamin and mineral state of organism, are described. The article reflects the opinion of pharmacist on the criteria of choice of vitamin-mineral complex from the pharmaceutical and technological point of view.
Key words: children, school age, vitamins.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):111-115)
116-120 577
Abstract
The balanced proper nutrition in infants is the one of the main factors of optimal children’s growth and development, and of their health forming. One of the leading types of additional food is cereal food stuffs — porridge. The choice of cereal food stuffs for infants must be held not only with the fact, that porridge is the source of complex carbohydrates, but that it is a source of protein, amino acids, microelements, vitamins, and dietary fibers.
Key words: infants, additional food, cereals, amino acids, porridge.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):116-120)
Key words: infants, additional food, cereals, amino acids, porridge.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):116-120)
121-124 2125
Abstract
148 children under the age from 1 month to 3 years old, educated in families with parents and in children’s homes were examined in this trial. It was proved that children from children’s home more frequently have delay of physical and neuro-psychical development.
Key words: children, physical and neuro-psychical development.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):121-124)
Key words: children, physical and neuro-psychical development.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):121-124)
125-129 574
Abstract
The work studied clinical and morphological peculiarities of esophagus lesions and factors favoring to its development in children with overweight. The vast majority of cases independently of body weight showed disregeneratory and dystrophic lesions of mucous tunic in distal part of esophagus. Morphological signs of reflux esophagitis were detected at 1 cm upper Z line in 78% of children with overweight. The main role in esophagus lesions’ forming play such habits as «stress limosis», use of high-calorie nutrition in big single dose in children with overweight and burden family history concerning diseases of gastrointestinal tract and obesity. Such children are characterized by active body weight increase during first year of life. Present study confirms the significance of proper food behavior and healthy nutrition habits forming in children from first months of life. This lay in the base of gastrointestinal system diseases prophylaxis and forming of overweight and obesity in future.
Key words: children, reflux esophagitis, overweight, risk factors, prophylaxis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):125-129)
Key words: children, reflux esophagitis, overweight, risk factors, prophylaxis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):125-129)
130-135 697
Abstract
The treatment with dornase alfa (Pulmozyme) plays one of the key roles in basic treatment of cystic fibrosis as in children as in adult patients. But effectiveness of this medication depends on different important constituents, starting from its proper administration, to precise execution of intake rules. The article earnestly shows that effectiveness of dornase alfa in many respects depends on proper fulfillment of kinesitherapy. Different rational schemes of drug intake combined with individual types of kinesitherapy exercises were presented.
Key words: children, cystic fibrosis, dornase alfa, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):130-135)
Key words: children, cystic fibrosis, dornase alfa, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):130-135)
136-140 536
Abstract
The article analyzes modern aspects of therapy in children with acute rhynosinusitis with atypical etiology (Chlamydia pneumoniae, Mycoplasma pneumoniae). Basic medications for the treatment of acute rhynosinusitis caused by atypical agents at the present times are antibiotics from macrolides group. The article reflects effectiveness of antibiotic with wide spectrum azithromycin in treatment of this pathology.
Key words: children, acute rhynosinusitis, atypical etiology, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):136-140)
Key words: children, acute rhynosinusitis, atypical etiology, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):136-140)
CLINICAL OBSERVATIONS
142-150 670
Abstract
The article presents the case report of early debut and severe course of system type of juvenile rheumatoid arthritis, refractory to methotrexate and blockers of tumor necrotizing factor _ monotherapy. Successful treatment with cyclosporine in daily dose 4.4 mg/kg of body weight combined with different regimen of methotrexate was described. Combined treatment with cyclosporine in daily dose 4.4 mg/kg of body weight and methotrexate in dose 15 mg/m2 of body surface once weekly intramuscularly and 50 mg/m2 of body surface once weekly intravenously during 8 weeks with further dose decrease to 25 mg/m2 of body surface intramuscularly induced remission development in 2–6 months, provided restoration of joints function, increased quality of life. Cyclosporine combined with pulse-therapy with methotrexate in more early stages stopped extra articulate signs of disease and reduced acute inflammatory joint’s lesions.
Key words: children, juvenile rheumatoid arthritis, cyclosporine, methotrexate.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):142-150)
Key words: children, juvenile rheumatoid arthritis, cyclosporine, methotrexate.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):142-150)
INFORMATION FROM THE UNION OF PEDIATRICIANS OF RUSSIA
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
