Vol 6, No 3 (2007)
View or download the full issue
PDF (Russian)
EDITORIAL
6-8 652
Abstract
In the recent years, both clinical and social pediatrics have been intensively studying quality of life of children. The article discusses the main trends of quality of life indicators study. In social pediatrics, they are oriented at studying quality of life of different segments of children; development of quality of life standards depending on the gender, age, health; regional peculiarities of quality of life; study of the indicator in disabled children, children from different social groups, and at the efficiency evaluation of preventive measures in pediatrics. In the clinical studies, the prevalent attention goes to the estimation of how the disease impacts quality of life of children, how efficient the treatment is, and focuses on pharmaeconomics. The article lists the results for the major trends and the significant tasks for the nearest future.
Key words: quality of life, medico-social study, clinical study.
Key words: quality of life, medico-social study, clinical study.
SOCIAL PEDIATRICS AND HEALTH CARE
9-11 494
Abstract
In the recent decades, the way outpatient pediatrics has lagged behind as opposed to the rapid development of stationary (specialized) pediatrics has become especially apparent. One of the ways to eliminate such negative trends, apart from salary raises and advancement of new technologies, is the improvement of post graduate pediatric education. The latter may include both immediate (launch of two curricula for a one year internship) and prolonged measures (two year internship, launch of a new major «district pediatrician»). This will enhance the priority of national medicine which was the worldwide pioneer in establishing an efficient and cost effective (compared to specialized pediatrics abroad) large scale pediatric service in the 20th century through a system of children's clinics and education of doctors at the departments of pediatrics.
Key words: pediatric service, post graduate pediatric education.
Key words: pediatric service, post graduate pediatric education.
V.I. Orel,
Yu.S. Alexandrovich,
E.L. Vologdina,
E.Yu. Kuznetsova,
D.Yu. Batrakov,
N.A. Gur'eva,
P.V. Kolobukhov
12-14 742
Abstract
The authors analyze infant mortality situation in a large agroindustrial region to the north west of Russia. Basing on a programmed goal oriented approach and the example of Vologda region, the authors suggest ways to reduce the sickness rate, perinatal, early neonatal and infant mortality, as well as the methods to improve medical aid to early children.
Key words: infant mortality, maternity and infant health protection, sickness rate, organization of health services.
Key words: infant mortality, maternity and infant health protection, sickness rate, organization of health services.
15-17 1157
Abstract
Current views on basic prenatal diagnostics techniques, as ultrasound, maternal serum biochemical markers (alpha fetoprotein, human chorionic gonadotropin, and unconjugated estriol), and fetal biologic material (chorionic villus sampling, placenta, amniotic liquid, fetal blood), obtained with invasive techniques (chorion biopsy, amniocentesis, cordocentesis), its' efficacy and possible practical application are given in the article. These new conception announce to consolidate three branches providing maternal and children — welfare should consolidate maternal welfare outpatient clinics, maternal hospital and newborn surgery hospital — into one institute, thus allowing to success work of all stages, to avoid transportation and late surgical treatment, to reduce lethal outcomes following surgical treatment of congenital malformations. Primary results of implementation of this conception are presented in the article.
Key words: prenatal diagnostics, newborns, congenital mal formations, prevention and prophylactics, diagnostics.
Key words: prenatal diagnostics, newborns, congenital mal formations, prevention and prophylactics, diagnostics.
ORIGINAL ARTICLES
18-23 590
Abstract
The work aimed at studying a series of diagnostic aspects and determination of the possible treatment of children with acute gastroenetrites according to the protocol based on international recommendations and standards. The study involved 130 children, of whom in 71 patients the presence of rotavirus antigen in coprofilters was checked via latex particle agglutination method. In 85% rotavirus infection was confirmed. It was shown that the majority of cases fall on November to may. Infant and early children are the most susceptible to rotavirus gastroenteritis. The analysis of therapy results showed that antibioticsfree treatment of watery diarrhea patients worked well, and prescription of antibacterial therapy for the concomitant bacterial infection does not influence the time of gastroenteritis reduction. The results of dehydration therapy show that oral rehydration is not always effective for the 2nd stage dehydration, especially with late treatment. However, the time of recovery (diarrhea reduction) does not depend on the type of rehydration or symptomatic therapy. A diagnostic algorithm that helps use the minimum diagnostic methods in stationary conditions and at the same time provides the optimum scope of therapeutic intervention was worked out.
Key words: rotavirus infection, children, rehydration, antibacterial therapy.
Key words: rotavirus infection, children, rehydration, antibacterial therapy.
24-27 668
Abstract
A prolonged open non comparative study of efficacy and safety of various doses of specific angiotensin II (type at1) irbesartan for curing arterial hypertension in children and teenagers was carried out. The average irbesartan efficacy in Ag monotherapy in children was 92,5%, in the younger group efficacy was somewhat higher than in the teenagers (95,7% compared to 88,2%, p < 0,05). On average, prolonged arterial hypertension therapy with various doses of irbesartan (from 0,5 to 0,5 mg/kg per day) in children reduces systolitic arterial pressure by 25,8 mm m.c. (17,9%) compared to the initial value, and diastolitic arterial pressure decreases by 13,8 mm m.c. (17,7%). Irbesartan therapy revealed good acceptability of the medicine.
Key words: children's arterial hypertension, specific receptor antagonist ii irbesartan, efficacy, safety, acceptability, children.
Key words: children's arterial hypertension, specific receptor antagonist ii irbesartan, efficacy, safety, acceptability, children.
28-31 529
Abstract
The article demonstrates the findings of the research, dealing with the energetic metabolism in lymphocytes of the peripheral blood among children with different forms of appendicular peritonitis. The objective of this works was to look for the informative criteria for the evaluation of the run of the early postoperative period of appendicular peritonitis among children. It was uncovered that changes in the cellular power exchange of lymphocytes were defined by the severity of a disease. The researchers discovered differences in the end enzyme activity among children with the uncomplicated and aggravated run of the early postoperative period. In the course of the aggravated run, on the 1st, 3rd and 7th day, they observed the inhibition of the power exchange in lymphocytes, whereas the marked metabolic imbalances were already noted on the 1st day after the surgery. Thus, the indices of the energetic metabolism in lymphocytes may be used to evaluate the run of the early post operative period among children with different forms of appendicular peritonitis.
Key words: children, enzymes, lymphocytes, appendicitis, appendicular peritonitis, postoperative complications.
Key words: children, enzymes, lymphocytes, appendicitis, appendicular peritonitis, postoperative complications.
33-41 829
Abstract
Although not currently recommended, dioctahedral smectite (smectite) is commonly used to treat acute infectious diarrheal in many countries. To evaluate systematically the effectiveness of smectite in treating acute infectious diarrhea in children. Using medical subject headings and free language terms, the following electronic databases were searched for studies relevant to acute infectious diarrhea and smectite: medline, embase, cinahl and the cochrane library; additional references were obtained from reviewed articles. Only randomized controlled trials were included. Nine randomized controlled trials (1238 participants) met the inclusion criteria. Combined data from six randomized controlled trials showed that smectite significantly reduced the duration of diarrhea compared with placebo. The pooled weighted mean difference was (22,7 h, 95% CI: 24,8 to 20,6) with a fixed model and remained significant in a random effect model (24,4 h, 95% CI: 29,8 to 19,1). The chance of cure on intervention day 3 was significantly increased in the smectite vs. the control group (RR 1,64, 95% CI: 1,36–1,98; number needed to treat 4,95% CI: 3–5). Adverse effects were similar in both groups. Smectite may be a useful adjunct to rehydration therapy in treating acute pediatric gastroenteritis. However, the results of this meta analysis should be interpreted with caution as most of the included studies had important limitations. Cost effectiveness analyses should be undertaken before routine pharmacological therapy with smectite is recommended.
Key words: dioctahedral smectite, meta_analysis, acute infectious diarrhea, children.
Key words: dioctahedral smectite, meta_analysis, acute infectious diarrhea, children.
42-46 863
Abstract
The article discusses the condition of cardiovascular system in the newborn children with medium and heavy hypoxic affection of the central nervous system. High frequency of post hypoxic cardiovascular dysfunctions in this segment of children is shown. The article characterizes the clinical, electrocardiographic and echocardiographic parameters of post hypoxic changes to the cardiovascular system, the acuteness of which depends on the extent of the central nervous system affection. The article describes the favorable course of post hypoxic car diodysfunctions which are to be gradually leveled off in the 1st six months of life on the complex treatment background.
Key words: newborn children, perinatal affection of the central nervous system, post hypoxic cardiovascular dysfunctions.
Key words: newborn children, perinatal affection of the central nervous system, post hypoxic cardiovascular dysfunctions.
48-52 494
Abstract
The article discusses the study of cell metabolism condition in chronic constipation children based on the activities of the two mitochondrion enzymes, succinate dehydrogenate and glycerophosphate dehydrogenase detected in cytochemical analysis of blood lymphocytes over the light microscope. The study involved 79 children and proved that in children with chronic constipation the activity of both dehydrogenases goes down, which demonstrates the apparent reduction of energy exchange of blood lymphocyte mitochondria. The correlation analysis showed that the duration of chronic constipation and the associated changes in the large intestine negatively affect the energy processes in cells. Thus the longer the pathology goes on, the smaller the energy exchange in mitochondria is resulting in reduced compensatory abilities in the body.
Key words: children, chronic constipation, succinate dehydrogenase of blood lymphocytes, diagnostics.
Key words: children, chronic constipation, succinate dehydrogenase of blood lymphocytes, diagnostics.
LITERATURE REVIEW
53-61 523
Abstract
The literature overview is dedicated to the characteristics of intestinal microbiocenosis among infants under the influence of various end and exopathic factors, generation mechanism of local adaptive immune response under the influence of gut organisms. The authors showed probable ways to activate the acquired immune response and formation of food tolerance.
Key words: gut organisms, infants, children, immune response, secretory immunoglobulin А (SIGA), toll-like receptors (TLRS).
Key words: gut organisms, infants, children, immune response, secretory immunoglobulin А (SIGA), toll-like receptors (TLRS).
LECTURES
62-70 858
Abstract
This publication is the first one in a series of brief lectures dedicated to the characteristics of the immunobiological control system, aetiology and pathogenesis, which most frequently occur in the medical practices of the immunepathological syndromes: immunodeficiencies, allergic reactions, pathologic tolerance, graft-versus-host disease, immune autoaggression syndromes.
Key words: immunobiological control system, immunodeficiency, allergic reactions, pathologic tolerance, graft versus host diseases, immune autoaggression syndromes.
Key words: immunobiological control system, immunodeficiency, allergic reactions, pathologic tolerance, graft versus host diseases, immune autoaggression syndromes.
71-76 599
Abstract
An algorithm of choosing adequate vitamin combination for children's acute respiratory diseases is suggested on the basis of Pikovit vitamin complex (KRKA, Slovenia). It is emphasized that the choice of vitamins should be based on the peculiarities of their metabolism and their role in the body. The importance of vitamin therapy is in its immunomodifying effect and increasing child's abilities for adaptation. Choice of vitamin and mineral complex for seasonal child ARD prevention depends on physiological vitamin doses and the fact that vitamin and mineral complexes containing iron and copper should be excluded in the acute phase of the disease. Latest research data is provided demonstrating the inadvisability of using iron and copper additives to children with ARD. The article provides information on the necessity of qualified primary inspection of the sick child, diagnosing activities, composing an individual diet, vitamin and pharmacological therapy.
Key words: polyvitamin products, prevention, acute respiratory infections, children.
Key words: polyvitamin products, prevention, acute respiratory infections, children.
77-80 565
Abstract
The article describes the contemporary vision of the causes, pathogenesis, diagnostic criteria and clinical manifestation of intestinal colic in infants. The article also provides a detailed description of to correction of the gastrointestinal tract in the infants. Also the article opens a discussion about the benefits of using vegetable medications with a soft spasmolytic effect for this purpose.
Key words: infants, intestinal colic, gastrointestinal tract dysfunction.
Key words: infants, intestinal colic, gastrointestinal tract dysfunction.
EXCHANGE OF EXPERIENCE
81-84 503
Abstract
The article discusses the requirements to contemporary probiotics used for children's therapy. the paper presents the dynamic observation data for the most frequent clinic manifestations of gastrointestinal dysfunctions in the infants on the back ground of intestine microbiocenosis correction.
Key words: probiotc, prebiotic, symbiotic, gastrointestinal tract dysfunctions, dysbacteriosis.
Key words: probiotc, prebiotic, symbiotic, gastrointestinal tract dysfunctions, dysbacteriosis.
85-88 1314
Abstract
The article compares the efficacy of two medications containing cetirizine in the form of drops in treating atopic dermatitis in 6–24 months old children. It is shown that the use of both medications in complex treatment of atopic dermatitis children helps achieve a fast clinical effect. Cetirizine generic is no less effective than the original one in treatment of atopic dermatitis in children and is well accepted by the patients.
Key words: atopic dermatitis, children, treatment, cetirizine.
Key words: atopic dermatitis, children, treatment, cetirizine.
89-93 670
Abstract
An open comparative randomized study evaluates the probiotic therapy efficacy in 59 children aged 6–17 with a medication containing freeze dried strains of bifidobacterium infantis V. liberorum, lactobacillus acidophilus and streptococcus faecium (Linex, Lek, Slovenia). The treated disease was antibioticassociated intestinal dysbacteriosis developed on the back ground of antichelicobacterial therapy. The major group comprised 38 patients, and the comparison group comprised 21 children. Patients from both groups were comparable in terms of demographic and clinical characteristics. The study focused on the clinical data and the results of the intestinal flora and volatile fatty acid survey. The study showed that in the majority of patients antichelicobacterial therapy concurs with antibiotic-associated intestinal dysbacteriosis. Yet, the medication containing freeze dried strains of bifidobacterium infantis V. liberorum, lactobacillus acidophilus and streptococcus faecium reduces the antibiotic-associated intestinal dysbacteriosis development risk, and its effect manifests itself through clinical improvement, normalized intestinal micro flora and restored metabolism.
Key words: antibiotic-associated dysbacteriosis, children, probiotics, treatment, prevention.
Key words: antibiotic-associated dysbacteriosis, children, probiotics, treatment, prevention.
CLINICAL OBSERVATIONS
94-100 455
Abstract
The article describes the clinical case of a difficult systemic juvenile arthritis refractory to traditional immunosuppressant and TNF blocker therapy. The disease was characterized by such extra-articulate manifestations as fever, lymphadenopathy, hepatolienomegaly, polyorrhymenitis, generalized joint affection and high laboratory activity indicators (ESR, CRP). The inclusion of rituximab stimulated the remission of systemic manifestations and the joint syndrome, as well as normalized the laboratory disease activity indicators. The therapeutic effect duration was 22 weeks upon the initial infusion of rituximab. The results demonstrate that rituximab is a promising medication for treating systemic juvenile arthritis children.
Key words: children, treatment, rituximab, juvenile arthritis.
Key words: children, treatment, rituximab, juvenile arthritis.
101-106 1395
Abstract
The article describes the treatment of Epstein–Barr viral infection under the mask of the systemic variant of the juvenile rheumatoid arthritis. The clinical presentations of the disease included fever, rash, lymphadenopathy, hepatomegaly, polyarticular syndrome and high lab activity indices. the serologic research uncovered the antibodies to the Epstein–Barr virus in diagnostic titers, which allowed the researchers to verify the diagnosis. A child underwent the treatment with the immunoglobulin of a man with the high concentration of antibodies to cytomegalovirus, which induced the remission of the systemic representations, articular syndrome accompanied B normalization of the lab activity indices and reduction of the antibody titers towards the Epstein–Barr virus.
Key words: children, treatment, immune globulin intravenous, septic syndrome, epstein–barr virus.
Key words: children, treatment, immune globulin intravenous, septic syndrome, epstein–barr virus.
107-111 1926
Abstract
Galactosemia is a hereditary disease, the pathogenetic treatment of which is based on dietotherapy. Early diagnosing and the adequate choice of the diet improve the development forecasts for the ill child. The article describes a classical galactosemia case in a newborn. It is shown that despite diagnosing the disease on the second month of life, the adequate selection of etiopathogenetic dietotherapy and etiotropic therapy of the concurrent diseases helped compensate the inborn galactose metabolism defect and optimize the long-term forecast for the child.
Key words: inborn metabolism dysfunctions, alactosemia, dietotherapy, newborn children.
Key words: inborn metabolism dysfunctions, alactosemia, dietotherapy, newborn children.
SHORT REPORTS
PROCEEDINGS OF CONFERENCES
INFORMATION FROM THE UNION OF PEDIATRICIANS OF RUSSIA
HISTORY OF PEDIATRICS
123-126 760
Abstract
The article is dedicated to the scientific, pedagogical, organizational and public work of Nikolai Alexeyevich Tol'sky (1832–1891), one of the founders of national pediatrics. He organized the clinic of children's diseases at the department of medicine, his majesty's university of Moscow (now Moscow academy of medicine named after I.M. Sechenov), insisted on the independence of pediatrics, helped it transform from theory to the clinical discipline. Among his pupils were such outstanding pediatricians as N.F. Filatov, N.P. Gundobin, N.S. Korsakov, etc.
Key words: history of medicine, national pediatrics, N.A.Tol'sky, University of Moscow, Clinic of Children's Diseases.
Key words: history of medicine, national pediatrics, N.A.Tol'sky, University of Moscow, Clinic of Children's Diseases.
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
