Vol 7, No 2 (2008)
View or download the full issue
PDF (Russian)
SOCIAL PEDIATRICS AND HEALTH CARE
5-8 660
Abstract
The article provides analyses of key legal and regulatory acts that regulate medical and social care provided to incapacitated children and there families. The article specifies main measures for healthcare and social support provided to children of this category, mentions current achievements and remaining obstacles for providing complex rehabilitation of invalid children.
Key words: invalid children, rehabilitation, healthcare.
Key words: invalid children, rehabilitation, healthcare.
9-12 513
Abstract
Invalidity conditioned by diseases of the eye and its accessory apparatus constitutes approximately 1% of the overall structure of child invalidity in Russia. Maximum figures are registered in boys aged 10–14. The figures of child eye invalidity in federal regions (FR) are close to overall Russian figures. The most diresituation is registered in Privolzhky and south FO.
Key words: children, invalidity, eye diseases, regional specifics.
Key words: children, invalidity, eye diseases, regional specifics.
14-21 791
Abstract
The experience of organizing school nutrition in Europe and usais analyzed. It is noted that long term programs aimed at optimizing schoolchildren nutrition have a beneficial effect on the children's health, culture of their nutrition and quality of life. The importance of carrying out similar programs in Russia is beyond any doubt: according to population research, the basic principles of good nutrition are often not observed, and school breakfasts and lunches do not correspond to the age physiological needs of children and teenagers for nutrient materials and energy. In this situation, the available experience of using vitaminbenriched products as well as vitamin and mineral complexes in children will permit to quickly resolve the existing problems of the improper, and sometimes, insufficient, nutrition.
Key words: school nutrition, organization, international experience.
Key words: school nutrition, organization, international experience.
ORIGINAL ARTICLES
22-29 558
Abstract
The management of severe juvenile rheumatoid arthritis (JRA) is a complicated problem. The efficacy and safety of Rituximab was investigated in 32 infliximabrefractory patients with different types of JRA, who had failed standard immunosuppressive therapy. Rituximab induced remission in 52% of patients. Rituximab was well tolerated, some patients experienced infusionbrelated adverse events, infections of upper airways and neutropenias. It's recommended to carry out a management of patients with JRA in specialized rheumatological centers with modern diagnostic and medicamental technologies because of subsequent adverse events.
Key words: children, management, rituximab, B cells, juvenile rheumatoid arthritis.
Key words: children, management, rituximab, B cells, juvenile rheumatoid arthritis.
30-35 1049
Abstract
The objective of trial was to investigate the efficacy of oral dosing ibuprofen (Nurofen) in monotherapy or combined with local application of ibuprofen in gel in patients with juvenile arthritis (JRA). Distinct antibinflammatory and analgesic action was caused by ibuprofen 35–40 mg/kg in patients with mono and oligoarthritis with moderate degree of activity of pathologic process in first two weeks of treatment. The combination of oral dosing ibuprofen and its local application in gel prolongs the activity of drug, hastens the regression of swelling in the joints area; therapeutic action begins more rapidly. Ibuprofen was well tolerated. Adverse events leading to the drug withdrawal were in 6% of patients, they were more frequent in first days of treatment. Different forms of ibuprofen are recommended as initial treatment of juvenile arthritis.
Key words: children, juvenile arthritis, ibuprofen, management.
Key words: children, juvenile arthritis, ibuprofen, management.
36-39 768
Abstract
The activity of hyoscine butylbromide (buscopan) was evaluated in a placebobcontrolled trial, on pediatric patients with algid type of irritable bowel syndrome. Hyoscine butylbromide favored to the increase of quality of life in pediatric patients, alleviation of clinical symptoms of disease, reliable decrease of malonic dialdehyde and increase of antioxidant activity of blood plasma significantly superior to placebo. Clinical efficacy of hyoscine butylbromide accompanies to its good tolerance and safety.
Key words: children, irritable bowel syndrome, hyoscine butylbromide, placebo controlled trial.
Key words: children, irritable bowel syndrome, hyoscine butylbromide, placebo controlled trial.
42-54 556
Abstract
The study analyses efficiency and safety of using mono clone antibodies for tumor necrosis factor (infliximab) for children with system (n = 21) and articular (n = 59) juvenile arthritis (JA). Infliksimab was injected intravenously (average dose of 6,8 ± 2,3 mg/kg/per injection) by a standard scheme (0, 2, 6, and each 8 following weeks). Together with antibcytokine therapy children still received immunity depressants (cyclosporine, methotraksat, leflunomid, peroral glucocorticoids). Research results prove that infliximab has pronounced hormone like anti-inflammatory effect after first injection for both patients with early and delayed articular JA variants. It reserved articular syndrome, reduced laboratory activity parameters, reduced degree of invalidity, improved quality of patients' lives. At the same time after three first infusions 88% of patients with system JA the effect was neutralized, articular syndrome activity increased, laboratory activity parameters increased, systematic indicators recurred. On the contrary, patients with both early and delayed JA variant the medication quickly and efficiently reduced activity of articular syndrome, personal estimations of pain levels and disease activity. Index of life quality was significantly improved, much like the selfbservice ability. Medication effect was registered after the first injection and remained over the whole period of observation (up to two years) in 61% cases of delayed and 93% of early articular ja variant. Thus, infliximab therapy is a reasonable, efficient and safe treatment of patients with both early and delyed articular JA.
Key words: juvenile arthritis, infliximab, treatment.
Key words: juvenile arthritis, infliximab, treatment.
55-61 598
Abstract
Atopic dermatitis (ad) is prevalent disease in younger children. Calcium inhibitor pimecrolimus (elidel, cream 1%) is the latest anti-inflammatory drug offered for management of ad. The activity of pimecrolimus was evaluated in open, prospective, randomized, comparison trial, on 60 children (age from 3 months to 7 years) with mild and moderate ad. Pimecrolimus was more effective in management of mild ad on the assumption of regular use of drug (TIS < 17), and topical corticosteroids were effective in patients with moderate ad.
Key words: children, atopic dermatitis, pimecrolimus, topical corticosteroids, management.
Key words: children, atopic dermatitis, pimecrolimus, topical corticosteroids, management.
62-67 694
Abstract
Complex clinical and neurophysiologic examination of 102 children (age 4–16 years) with verterobasilar insufficiency as a result of perinital lesion of central nervous system (CNS) was provided in this trial. 25% of patients (n = 25) had syncopal state (SS). Criteria of exclusion of pediatric patients from trial were rough organic CNS disorders, somatogenic and cardiogenic SS. Risk factors of SS were: Initially low bioelectric activity and decrease of compensatory function of cerebral cortex, initial and loading pulse volume deficit in verterobasilar pool, stenosis of vertebral arteries with decrease of blood velocity during functional tests, omegametry and stange's test data.
Key words: children, perinatal lesion of central nervous system, syncopal state, risk factors.
Key words: children, perinatal lesion of central nervous system, syncopal state, risk factors.
68-71 567
Abstract
The activity of ribomunyl in treatment and rehabilitation of 40 pediatric patients with relapsing stenosing laryngotracheitis, developed on the basis of acute respiratory viral infection was investigated. Treatment with ribomunyl recovers microbiocenose of nasopharynx and fauces, normalizes pulmonary ventilation and decreases liminal sensitivity of respiratory tract to the histamine.
Key words: relapsing stenosing laryngotracheitis, ribomunyl, prophylactics, children.
Key words: relapsing stenosing laryngotracheitis, ribomunyl, prophylactics, children.
72-76 587
Abstract
The immunomodulating activity of pidotimod (imunorix) was evaluated in a doublebblind, placebobcontrolled, randomized, multicentre trial, on 120 pediatric patients affected by recurrent respiratory infections. Antibiotic therapy and time of hospitalization were shorter in the patients taking pidotimod, and clinical recovery began more rapidly. A significant trend to normalization of the immune response, evidenced by chemotaxis and leukocyte phagocytosis index, was found only in patients treated with pidotimod. A significant decrease in the risk of relapses was observed in patients treated with pidotimod (35%), as well as a reduction of hospitalization (86%) and a decreased antibiotic therapy (47%). If a relapse occurred, the response of treated patients was quicker (fever, antibiotic therapy, hospitalization). No side effects, including significant alterations in main laboratory parameters were observed. The management of children with recurrent respiratory infections with pidotimod reduces the duration and severity of acute condition of infections and risk of relapse. pidotimod is well tolerated and maintains beneficial effect of treatment.
Key words: children, pidotimod, recurrent respiratory infections, management.
Key words: children, pidotimod, recurrent respiratory infections, management.
LITERATURE REVIEW
77-81 1730
Abstract
Pertussis vaccination with the use of DPT vaccines is a necessary condition for fighting the infection called bordetella pertussis. At the same time, it is known that the use of whole cellular DPT vaccines is accompanied with high incidence of side effects and serious neurological complications, and, as a result, reasonable refuse from injections by the population. Creation of less reactogenic, acellular vaccines would not only permit to decrease the incidence of side effects, but also increase the efficiency of pertussis vaccination. Maximum protective effect is achieved by using threebcomponent vaccines ( 80%), containng pertactin — outer membrane protein b. pertussis. the absence of this antigen in twobcomponent DPT vaccines predetermines their significantly lower efficacy.
Key words: children, pertussis, acellular DPT vaccines, pertactin.
Key words: children, pertussis, acellular DPT vaccines, pertactin.
82-92 839
Abstract
Background paper analyses the role of intestinal micro-flora at the stage of forming immunity, the importance of intestinal microflora abnormalities during the periods of allergic diseases development (primarily food allergies), as well as mechanisms of dysbiosis effect on the allergic processes in child's body. The study discusses the mechanisms of treatment and prevention effect of probiotics for cases of child allergic diseases. The work also specifies modern approaches to correcting dysbiotic abnormalities for children with food allergies, reviews the options of diet and medication treatment of food allergy, suggests a new algorithm of gradual treatment that targets correction of dysbiosis in this patient category.
Key words: children, food allergy, dysbiosis, probiotics, prebiotics, diet therapy.
Key words: children, food allergy, dysbiosis, probiotics, prebiotics, diet therapy.
93-100 858
Abstract
Invasive mycoses are a common complication of various categories of immune depressed patients that are characterized with heavy clinical presentations and high lethal rate. Many causatives of invasive mycoses are resistant to currently applied antifungal medications, and some are polybresistant. Posaconazole (Noksafil) is a new triazole antimycotic of second generation that is active both in vitro and in vivo against most causatives of invasive mycoses, including poly resistant microbmycets. Clinical study demonstrate high efficiency and safety of applying this medication. in russia posaconazole is allowed for prevention of invasive mycoses for hematological patients with longbrunning neutropenia resulting from chemical therapy, who are prescribed large doses of immune suppressors, recipients of transplants of hemapoietic stem cells, as well as for treatment of invasive candidoses, aspergillus, zigomicosys, criptococcosis, fuzariosis, chromomycosis and micetoma, as well as cocsidiodosis that are refractory towards other anti fungal medications, or in cases of intolerance.
Key words: mycoses, posaconazole, treatment.
Key words: mycoses, posaconazole, treatment.
102-106 489
Abstract
Traditionally, efficacy of treating allergic rhinitis (AR) in children is evaluated on the basis of subjective and objective criteria connected with the more or less express character of symptoms. At the same time, there are all reasons to say that the evaluation of the quality of life (QOL) of a child more fully reflects his health than sole consideration of AR symptoms. As a result, the change of QOL in the course of treating AR may more precisely reflect the efficacy of illness treatment. This is especially noticeable when analyzing the results of treatment with the use of sedative antihistamine drugs, which arrest AR symptoms but exert a negative influence over the QOL indicators, such as activity, learning ability, social adaptation. New generation antihistamine drugs and intranasal corticosteroids do not have such influence over children's QOL. moreover, their regular use may help in decreasing the risk of development bronchial asthma and atopic dermatitis in children, which is another objective of AR therapy.
Key words: children, quality of life, allergic rhinitis, treatment.
Key words: children, quality of life, allergic rhinitis, treatment.
EXCHANGE OF EXPERIENCE
O.V. Zaitseva,
V.A. Pastukhova,
E.V. Moiseeva,
S.V. Zaitseva,
N.A. Aleksandrina,
T.N. Praznikova,
T.L. Borisova,
E.E. Lokshina
107-110 730
Abstract
The activity of adapted milk formula «Nestogen 1» was investigated on healthy children of first six months of life, including patients with functional disorders of gastrointestinal tract. «Nestogen 1» was used as supplementary feeding or prime feeding in absence of breast milk. The increase of body weight and growth in children with these types of feeding was similar to age specific norm. Comfortable digestion provides abatement of intestinal colic, normalization of stool frequency and characteristics. Co program index improved and optimal intestinal micribiocenose restored in four weeks. There was no any allergic reaction or side effects during investigation.
Key words: healthy children, rearing, adapted milk formula «Nestogen 1».
Key words: healthy children, rearing, adapted milk formula «Nestogen 1».
111-113 817
Abstract
Research goal was studying antenatal and neonatal periods of infants born by children with gestational diabetes — main group (n = 66). Comparison group was comprised of 50 children born by women with no carbohydrate metabolism abnormalities. During research obstetric, genetic and social anamnesis was studied, alongside with pregnancy, birth, infant adaptation. It was established that gestation diabetes diagnosed mostly during the second part of pregnancy had negative effect on child development, promoting the risk of diabetic emryopathy. Besides, infants of the main group showed more cases of nervous and cardiovascular dysfunctions, respiratory dysfunction syndrome, intrauterine infection, early prolonged jaundice, signs of morphofunctional immaturity.
Key words: gestational diabetis, pregnancy, infants, disadaptation.
Key words: gestational diabetis, pregnancy, infants, disadaptation.
114-118 489
Abstract
The issue of functional disorder of children's digestive apparatus is becoming more topical. The article provides the findings of a one off cross cut survey conducted at a children's pre school institution. The authors substantiate the significance of the revealed risk factors, as well as prove the correlation between functional disorders and the age of a child. A survey was conducted to find out the effectiveness of lactulose (Dufalac) to correct biotic disorders of children suffering from the functional disorder of digestive apparatus. Basing upon the findings the authors recommend to use lactulose for the correction of disorders and disbiosis in intestines of children suffering from the functional disorder of digestive apparatus.
Key words: children, functional disorder of digestive apparatus, lactulose, treatment.
Key words: children, functional disorder of digestive apparatus, lactulose, treatment.
119-123 535
Abstract
The results of enter sorbent — dioctahedral Smectite (Neosmektin) — usage as part of complex therapy of children with atopic dermatitis (ATD). It is shown that the administration of Smectite favored better efficacy of baseline treatment of ATD, more express and quick regression of skin manifestations of the disease, decrease in number of children with eosinophilia. High efficacy of ATD treatment with Smectite indicates the pathogenetic justification of efferent therapy of the disease. Observation results witness the good tolerability of Smectite: side effects related to the treatment were only observed in 14 percent of children.
Key words: children, atopic dermatits, smectite, treatment.
Key words: children, atopic dermatits, smectite, treatment.
A DOCTOR’S AID
124-127 609
Abstract
The most frequent causes of cough in children of different age are overviewed in this article. Last years there was an in crease in the number of children with intensive, unproductive, persistent and exacting cough as a main symptom of even uncomplicated disease. The classification of drugs, influencing cough, is presented in this work. The positive properties and adverse events of some mucolytic and expectorative drugs were also overviewed.
Key words: children, respiratory infection, cough, management.
Key words: children, respiratory infection, cough, management.
128-130 1999
Abstract
Research targeted studying risk factors for delays physical development of children (n = 70) aged 7–11 years. Control group was comprised of 30 children of normal height of the same age. Physical development was evaluated by centile method using regional and international standards, studying data of life and disease anamnesis, family anamnesis, living conditions. Children had their thyroid glands studied ultrasonically. Blood levels of calcium, phosphor, magnesium, ferrum, zinc were identified by photometry method for some children in both groups. Correlation analysis makes it possible to state risk factors of children dwarfism: low educational status of parents, child height figures at the age of 1 and 3 years, calcium and phosphor blood levels, as well as thyroid hypo plasy.
Key words: dwarfism, children, risk factors, calcium deficit.
Key words: dwarfism, children, risk factors, calcium deficit.
131-138 912
Abstract
Acute diarrhea in children is a vital issue in pediatric practice. Diseases with diarrhea syndrome are widely disseminated; they have a tendency to chronicity and frequent relapse. Besides, irrational antibacterial treatment in children is a frequent cause of diarrhea. Diarrhea may be one of first symptoms of dyspepsia, which development is caused by anatomico-physiological features of gastrointestinal tract of children and mistakes in nutrition. The management of diarrhea syndrome is based on the principles of elimination of causative agent and correction of nutrition. Dietary cure, rehydration and enter sorbents are used in more severe cases. Intestinal micro biocenosis recovery is advisable in children on artificial feeding.
Key words: children, acute diarrhea, treatment.
Key words: children, acute diarrhea, treatment.
135-140 1831
Abstract
Allergic conjunctivitis is a widely spread disease, which is often accompanied with an allergic rhinitis. According to the up to date recommendations, the treatment of the allergic rhino conjunctivitis is based on 3 key principles: elimination of the allergen, conducting an allergen targeted immunotherapy and pharmacotherapy. The medication treatment of the allergic rhino conjunctivitis should include antihistamines of the 2nd generation and/or intranasal corticosteroids. Their effectiveness was proven with the findings of numerous place controlled surveys; in most cases they are safe. The usage experience of the intranasal formulation of mometasone furoate (Nasonex) shows that with a minimal biological availability of the medication and the absence of its influence upon the «hypothalamus–hypophysis–adrenal glands» system and growth of children, mometasone can be a medication of choice to treat children's rhino conjunctivitis.
Key words: children, allergic conjunctivitis, treatment.
Key words: children, allergic conjunctivitis, treatment.
INFORMATION FROM THE UNION OF PEDIATRICIANS OF RUSSIA
SHORT REPORTS
JUBILEE
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
