Vol 8, No 5 (2009)
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SOCIAL PEDIATRICS AND HEALTH CARE
5-8 558
Abstract
The prevalence of psychical disorders in Russian federation increases constantly. The method of integral ratios calculations was used for the purpose of obtaining the summarized data on influence of different regional factors on the morbidity with psychical and behavioral disorders in children. This method allows performing reduction different information to the common denominator. There is a significant variability of integral rates among the regions of Russia. The state of children’s psychical health in Russia mostly depends on medical and demographic factor of indicators and sources of health care system.
Key words: children, psychical disorders, morbidity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):5-8)
Key words: children, psychical disorders, morbidity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):5-8)
9-13 667
Abstract
The results of a trial studying health state and quality of life of girls-adolescents from Orenburg school of general education are presented in this article. The lowest rates of quality of life were detected in 14-year old girls. Estimation of some components of quality of life, given by parents and girls themselves differs. It was marked that girls-adolescents from III health group showed lower rates of quality of life than girls from I and II health groups. Low rates of functioning in school were marked in all girls-adolescents.
Key words: girls-adolescents, morbidity, quality of life.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):9-13)
Key words: girls-adolescents, morbidity, quality of life.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):9-13)
14-18 887
Abstract
The increase of morbidity with diabetes mellitus (DM) in children and adolescents during last years, and absence of adequate control of disease reveal the need of complex study of quality of life in these patients. The article presents the results of evaluation of quality of life rates, obtained with Russian versions of questionnaires PedsQL 4.0 Generic Core Scale and Diabetic Module in children and adolescents with diabetes type I, treated with different combinations of insulin drugs. The results showed that quality of life differs between group of healthy adolescents and patients with DM. There was correlative dependence between the level of glycated hemoglobin and parameter «school function» of quality of life. Administration of insulin analogs improves some indices of adolescents’ with DM quality of life. Estimation of it is one of the main criteria of treatment effectiveness.
Key words: children, adolescents, insulin, diabetes type 1, quality of life.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):14-18)
Key words: children, adolescents, insulin, diabetes type 1, quality of life.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):14-18)
ORIGINAL ARTICLES
E.I. Alexeeva,
S.I. Valieva,
T.M. Bzarova,
E.L. Semikina,
K.B. Isaeva,
A.O. Lisitsin,
R.V. Denisova,
E.Yu. Gudkova
19-30 540
Abstract
The treatment of patients with severe juvenile idiopathic arthritis is difficult problem. The article presents the results of a study of effectiveness and safety of repeated courses of rituximab in 55 patients with different types of juvenile arthritis, resistant to infliximab and standard inmmunosuppressive therapy. Remission of diseases was registered in 25% of patients after 1st course of treatment (24 weeks), in 52% — after 2nd course (48 weeks), in 75% — after 3rd course (72 weeks), and in 93% of patients after 4th course of treatment with rituximab (96 weeks).
Key words: children, treatment, rituximab, B-cells, juvenile idiopathic arthritis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):19-30)
Key words: children, treatment, rituximab, B-cells, juvenile idiopathic arthritis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):19-30)
31-34 602
Abstract
72 children with eye’s refraction anomalies (myopia, hypermetropia, astigmatism) underwent diagnostics of the cerebral and extra cerebral hemodynamics via the ultrasound Doppler echography and duplex scanning. The clinical and ultrasound signs of undifferentiated dysplasia of connective tissue were: bone deformations, disembriogenetic stigma, vegetative dysfunction, and symptoms of angiodystonia (disorders of peripheral arterial resistance, acceleration of blood flow in deep cerebral veins, disorders of vessels of eye’s fundus, tortuosity of vertebral and internal carotid arteries). Obtained data testify to significance of vessel’s factor in ophthalmological disorders (eye’s refraction pathology) forming.
Key words: children, connective tissue dysplasia, refraction pathology, angiodystonia, deformation of brachiocephalic arteries.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):31-34)
Key words: children, connective tissue dysplasia, refraction pathology, angiodystonia, deformation of brachiocephalic arteries.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):31-34)
36-39 537
Abstract
Restrictive cardiomyopathy (RCMP) is heart disorder with unclear etiology; it can be characterized as disease with disorder of diastolic myocardium function of left ventricle, conditioned by restriction. The chronic heart failure as a syndrome of RCMP can develop as a result of disbalance in system of complex biochemical, structural, and geometrical mechanisms of myocardium re-modeling. Extra cellular matrix play significant role in heart structure and geometry breaking. The destruction of heart is realized by matrix metalloproteinases (MMP). The activity of MMP, in its turn, is controlled by its tissue inhibitors. The present study analyzed the role of MMP in process of collagen’s synthesis and catabolism deregulation, myocardium fibrosis, change of heart chambers, and development of diastolic dysfunction in children with RCMP.
Key words: children, chronic heart failure, restrictive cardiomyopathy, matrix metalloproteinases.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):36-39)
Key words: children, chronic heart failure, restrictive cardiomyopathy, matrix metalloproteinases.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):36-39)
40-46 471
Abstract
The article presents the results of a study, evaluating effectiveness of therapeutic use of bacterial lysates for the topical administration (IRS 19) in children under the age 3–9 months old. All children had repeated bacterial diseases of ENT-organs and respiratory tract; it is the clinical sign of immunological reactivity disorder in infants, which is estimated as so-called «syndrome of anti-infection defense disorder». Administration of drug resulted in decrease of rate and duration of infectious episodes in upper and lower airways, excluded the need of antibacterial treatment of these children. This effect is concerned with increase of resistance of children’s organism and indirect correction of previously detected immune disorders.
Key words: infants, infections of respiratory tract, disorders of anti-infection defense, bacterial lysates mixture.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):40-46)
Key words: infants, infections of respiratory tract, disorders of anti-infection defense, bacterial lysates mixture.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):40-46)
47-51 509
Abstract
Present study was dedicated to the assessment of the «Grippol plus» polymer-subunit vaccine effectiveness in Moscow region’ Podolsk town schoolchildren in season 2008–2009. The study included 3203 participants (1950 vaccineers and 1253 non-vaccineers). Post-vaccination influenza and acute respiratory infections (ARIs) morbidity 6-months monitoring demonstrated high Grippol effectiveness. It was shown that vaccineers’ influenza morbidity rate was 4,7-times lower than in non-vaccinated schoolchildren. Immunized children’ ARIs morbidity was 1,4 times lower in comparison with other. Grippol effectiveness indexes were 4,7 и 78,7%. An important role for herd immunity protection was also demonstrated clearly by means of overall influenza and ARIs morbidity level decline. The schools with high vaccination coverage ( 60% of children) showed the overall morbidity rate 40% lower than that in schools with low immunization coverage.
Key words: schoolchildren, influenza, ARI, vaccination, collective immunity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):47-51)
Key words: schoolchildren, influenza, ARI, vaccination, collective immunity.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):47-51)
LITERATURE REVIEW
52-55 508
Abstract
The article analyzes an international experience of «toilet education» practice in infants. It was marked that the most wide-spreaded approach to the children’s education to sanitary and hygienic skills is Brazelton’s method or, so-called, «approach with orientation to child». The method was directed, firstly, to the presence (or absence) in child signs of preparedness to the beginning of education: ability to sit properly, independently walk and sit on the pot; presence of understanding the purpose of pot and/or toilet sink purpose; presence of phrase speech (consisting at least of 2 words) or the signs of its near appearance; ability to signal with words or gesture to the need of physiological act performing; skill or attempt to take off paints-nappy (or panties) and tights by himself during the attempt to use a pot. Such approach can be estimated as physiological and maximal effective. According to the present recommendations (including the ones from experts of the Union of pediatricians of Russia) a «toilet education» should be started when the child is 18-months old.
Key words: children, «toilet education», Brazelton’s method.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):52-55)
Key words: children, «toilet education», Brazelton’s method.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):52-55)
56-61 544
Abstract
Viruses are the leading etiological factor of recurrent infections of respiratory tract. Experimental trials showed that influenza, respiratory syncytial and rhinovirus render toxic action on the elements of inborn and acquired immunity, resulting in hyperproduction of pro-inflammatory cytokines with damaging effect on tissues and organs. According to this fact application of immunomodulator treatment seems to be quite actually. At the present times, there’s only one immunomodulator, recommended by WHO for the treatment of patients with recurrent respiratory infections. It is pidotimod (Imunorix). The article presents data from experimental clinical trials, studying influence of pidotimod on parameters of inborn and acquired immunity and, accordingly, on the clinical course of respiratory infections in children’s and adults. Different double-blinded placebo-controlled studies showed that pidotimod decreases a severity and duration of respiratory infections, improves functional state of respiratory epithelium. Thus, pidotimod is perspective immunomodulator for the prophylaxis and treatment of respiratory tract.
Key words: children, pidotimod, viral infections, prophylaxis, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):56-61)
Key words: children, pidotimod, viral infections, prophylaxis, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):56-61)
62-69 594
Abstract
The article is dedicated to the actual problem of modern health care — pneumococcal infections and opportunities of its prophylaxis. Authors describe risk groups of development of invasive pneumococcal infections. A characteristics of available at the present times in Russia and all over the world vaccines, including pneumococcal 7-valent vaccine (PCV7) Prevenar, intended to the prophylaxis of pneumococcal infections in children under the age 2 months — 5 years old. An experience of PCV7 use in the world in analyzed. The article gives an estimation of perspectives of inclusion of PCV7 to the national immunizations schedule.
Key words: children, pneumococcal infections, prophylaxis, pneumococcal conjugated 7-valent vaccine.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):62-69)
Key words: children, pneumococcal infections, prophylaxis, pneumococcal conjugated 7-valent vaccine.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):62-69)
70-79 512
Abstract
Vitamin D is key part of bone tissue metabolism as in children, as in adult. It is considered that the needed quantity of vitamin D is synthesized by skin cells within ultraviolet light. As a result, provision with endogenous vitamin D significantly changes during the year; the maximum can be reached in summer months, lessening in winter. Straight consequence of these changes is insufficient bone mineralization in children. A correction of insufficiency of vitamin D, depending on season, seems to be well-grounded. But still there are some unsolved questions. It’s not clear, when «season» prophylaxis should be started, and how long should it be prolonged. Shall we use fortified food? What criteria can be used for the control of effectiveness of these measures? There is no research on this theme in Russia. Only data from single studies allow supposing that more than a half of Russian children have vitamin D insufficiency.
Key words: children, vitamin D, «season» insufficiency, prophylaxis, bone mineral density.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):70-79)
Key words: children, vitamin D, «season» insufficiency, prophylaxis, bone mineral density.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):70-79)
EXCHANGE OF EXPERIENCE
80-83 454
Abstract
The analysis of specific difference and quantitative state of intestinal micro flora in infants, delivered by Caesarian section, depending of nutrition type, was performed. It was shown that in almost healthy term infant, the intestinal micro biocoenosis becomes formed depending on type and character of nutrition. It was proved that synbiotical formula application is effective for the purpose of stimulation and development of bifido- and lacto bacteria, preventing pathological intestine’s colonization in infants.
Key words: newborns, Caesarian section, nutrition, intestinal micro flora.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):80-83)
Key words: newborns, Caesarian section, nutrition, intestinal micro flora.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):80-83)
84-87 585
Abstract
The microbial inflammatory diseases of urinary system in children can be often accompanied with fever and pain. The article presents an experience of ibuprofen (Nurofen for Children) administration for the purpose of stopping fever and pain in 420 children in age 3 months — 3 years old with microbial inflammatory diseases of urinary system. The observation showed high effectiveness of short treatment with ibuprofen course (2–5 days). As clinical and laboratory observation showed, the short-termed administration of the drug was well-tolerated and did not cause significant adverse effects, excluding single cases of allergic rash and light dyspeptic disorders.
Key words: children, microbial inflammatory diseases of urinary system, ibuprofen, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):84-87)
Key words: children, microbial inflammatory diseases of urinary system, ibuprofen, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):84-87)
88-92 765
Abstract
Hypertrophy of palatine and lingual tonsils in pre-schoolchildren is the most frequent pathology and thus it is not a strictly specialized, but common pediatric problem. The significance of lymphoid organs for the growing organism and its age involution give us the need to rearrange the approaches to its surgical treatment and to develop the conservative methods of treatment. The article analyzes the effectiveness of application of herbal medications Sinupret and Tonsilgon N in pre-schoolchildren with functional pathology of tonsils.
Key words: pre-schoolchildren, tonsils’ hypertrophy, herbal therapy.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):88-92)
Key words: pre-schoolchildren, tonsils’ hypertrophy, herbal therapy.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):88-92)
O.V. Komarova,
A.N. Tsygin,
L.V. Leonova,
A.G. Kucherenko,
O.A. Zrobok,
T.V. Vashurina,
M.V. Rozhkova
93-97 518
Abstract
The article demonstrates successful experience of treatment of focal segmental glomerular sclerosis (FSGS) with cyclosporine A in children. 25 children over the age 1,5–16 years old with FSGS were treated with cyclosporine A in medium dose 4–5 mg/kg combined with prednisolone 1–1,5 mg/kg every other day. Pulse treatment with methylprednisolone 30 mg/kg every other day, in total 3–9 injections, was administrated for the purpose of remission induction. After 5 months of treatment with cyclosporine A complete clinical and laboratory remission of steroid-resistance nephritic syndrome (SRNS) was achieved in 9 (36%) patients, partial response was registered in 6 (24%) patients, maintenance of SRNS activity was detected in 10 (40%) cases. After the year of treatment complete remission was shown in 13 (52%) children, partial response — in 5 (20%) patients, and absence of effect was registered in 7 (28%) cases. In 56% of cases, the treatment with steroids was completely stopped after achievement of SRNS remission within administration of cyclosporine A. At the present times, authors observe 14 children, whose duration of treatment with cyclosporine A is 2 years. 12 patients remain previously achieved complete or partial remission of nephritic syndrome without decrease of nitrogen excretion function of kidneys. 9 patients underwent repeated biopsy of kidneys for the exclusion of nephrotoxic effect of cyclosporine A. The results of biopsy allowed prolongation of therapy: in 6 children the previous dose maintained, and 3 children got double decreased dose. Thus, the treatment with cyclosporine A is effective in 76% of patients with FSGS. Prolongation of treatment with cyclosporine A up to 2 years and more is possible in conditions of regular diagnostic of kidneys function and absence of its nephrotoxic effect signs, according to a data from repeated biopsy.
Key words: children, focal segmental glomerular sclerosis, cyclosporine, methylprednisolone.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):93-97)
Key words: children, focal segmental glomerular sclerosis, cyclosporine, methylprednisolone.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):93-97)
A DOCTOR’S AID
98-105 717
Abstract
Atopic dermatitis in children is widespread disease and difficult medical and social problem. The article presents a literature data and authors’ own experience on scientific studies and treatment of patients with atopic dermatitis during 50 years. The analysis of pathogenesis and treatment of children with atopic dermatitis was performed, and data on safety of modern medications for topical use, containing glucocorticoids, in children from early age were presented in this article.
Key words: children, atopic dermatitis, perinatal pathology, serum IgE, external treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):98-105)
Key words: children, atopic dermatitis, perinatal pathology, serum IgE, external treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):98-105)
106-110 4050
Abstract
The article presents basic data on nutrition and vitamins and microelements deficiency in children under preschool and school age in Russia. The etiology of vitamins insufficiency is described. Authors observe the opportunities of vitamins and microelements deficiency correction with special children’s vitamin and mineral complexes.
Key words: children, adolescents, vitamins, microelements, deficiency, vitamin-mineral complexes, adverse reaction.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):106-110)
Key words: children, adolescents, vitamins, microelements, deficiency, vitamin-mineral complexes, adverse reaction.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):106-110)
111-114 545
Abstract
Suboptimal provision with vitamins is widely spread among children. Its significance, to a considerable degree, is determined by season, and the most active forming of vitamins’ insufficiency occurs in the beginning of autumn. The necessity of correction of these states is assigned with the fact that the most of the vitamins are water-soluble, and organism can’t accumulate it. The administration of vitamin complexes allows achieving proper compensation of present vitamins’ insufficiency, and to prevent its development in future.
Key words: children, vitamins, insufficiency, season.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):111-114)
Key words: children, vitamins, insufficiency, season.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):111-114)
115-118 649
Abstract
The article describes main problems related to the development of rhinitis in newborns and infants. Authors consider the advantages of irrigational therapy in children under this age for the purpose of nasal breathing recover and prophylaxis of diseases of nose and nasopharinx. The stages of its fulfillment, the medications, optimal for the daily hygiene of nasal cavity are described.
Key words: newborns, infants, rhinitis, hygiene of nasal cavity, irrigational therapy.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):115-118)
Key words: newborns, infants, rhinitis, hygiene of nasal cavity, irrigational therapy.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):115-118)
INFORMATION FROM THE UNION OF PEDIATRICIANS OF RUSSIA
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
