Vol 7, No 6 (2008)
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SOCIAL PEDIATRICS AND HEALTH CARE
7-16 542
Abstract
For the purpose of provision of wide range of specialists with authentic information about health state of children and ado les cents it's necessary to create new systems of their observation, based on interdisciplinary principles. An expert model of health, which gives a basis for a construction of such systems, is described in this article. 132 experts took part in this trial; they were doctors, psychologists, teachers, philosophers, sociologists, and elder adolescents and adults independently of their profession. A del phi method was used in this expert model. A factorial analysis was used for a classification of health indicators and factors, which influence on it. A detailed nominal expert classification was suggested, and the state of health can be estimated on the basis of it as an object, having definite behaviors and depending of some external factors. A nominal expert classification includes 36 indices of state of health and 37 factors, influencing on it. An ordinal expert classification was obtained as a result of factorial analysis, which allows estimation of significance level of every index.
Key words: health, monitoring, expert questionnaires, heath monitoring.
Key words: health, monitoring, expert questionnaires, heath monitoring.
18-23 508
Abstract
Increase of availability and quality of high9tech medical services is one of main problems of state policy in sphere of public health service, and it is one of directions in priority national project «health». Federal medical institutions play an important role in provision of children with medical care in Russian federation. Some indices, characterizing results of provision of high techcare to children, are presented. According to results of these indices, a conclusion of presence of negative appearance in present system of provision of children with high9tech medical care was made. Principal ones are distinctive difference in consumption levels of medical high9tech care in different regions of Russian federation, absence of planning of care volumes in subjects of Russian federation, and incomplete fulfillment of appropriate state assignment with these institutions.
Key words: children, high tech medical care.
Key words: children, high tech medical care.
24-27 659
Abstract
104 schoolchildren, studying in 1–4 forms of Arkhangelsk school were examined for the purpose of estimation of psychological peculiarities of younger children in different health groups. differentiation between health groups and psychological methods (Kettell's multiple factor personality question naire, method «house tree human», and index of psychological wellbeing) were used. Younger school children, relative to health group had such qualities as openness, benevolence, commutability, obedience, pliability, honesty, observance. Children from II health group had distinct forming of intellectual functions, independence, forcefulness, composure, they were optimists. School children from III and IV health groups had distinct disorders of psychological adaptation, apparent in difficulties of interpersonal communication, increased uneasiness, and sense of inferiority, hostility and propensity to conflicts, what was related with their functional disorders.
Key words: psychological peculiarities, health groups, younger school children.
Key words: psychological peculiarities, health groups, younger school children.
28-29 597
Abstract
An urgency of studying of quality of life in clinical pediatrics is described in this article. Some results of trials, studying quality of life of children with chronic diseases was presented. These results include information of influence of chronic disease, peculiarities of quality of life in patients with different nosologic forms, long9term disorders of quality of life.
Key words: children, quality of life, chronic diseases.
Key words: children, quality of life, chronic diseases.
ORIGINAL ARTICLES
R.V. Denisova,
E.I. Alexeeva,
V.Yu. Al'bitsky,
I.V. Vinyarskaya,
S.I. Valieva,
T.M. Bzarova,
A.M. Alekseeva,
V.V. Chernikov
30-38 751
Abstract
Juvenile rheumatoid arthritis (JRA) is chronic disease, leading to early incapacitating injury in patients. Treatment of JRA with new expensive biological agents allows obtaining long term remission of disease and improving its prognosis. Estimation of quality of life is one of the main effectiveness criteria of treatment. A quality of life in children who were 2–4 years old treated with infliximab was estimated. 43 patients with different types of JRA were examined. A quality of life was estimated with the help of questionnaire PEDSQL generic core scale, PEDSQL rheumatology module. Index of functional disability was estimated by childhood health assessment questionnaire (CHAQ). Significant increase of quality of life rates and decrease of index of functional disability was registered in 6 weeks of therapy with infliximab. The rates of quality of life in patients with JRA treated with infliximab were significantly equal to that in healthy children in the same age in 6, 12 and 24 months of treatment. Thus, treatment with infliximab significantly increases quality of life in children in 2–4 years old with JRA and their families, decreases negative influence of disease on child's living, improves physical activity and emotional state of patients, and allows improving contact between patients and healthy children in the same age.
Key words: children, juvenile rheumatoid arthritis, quality of life, infliximab.
Key words: children, juvenile rheumatoid arthritis, quality of life, infliximab.
39-43 462
Abstract
Hygienic peculiarities of nutrition of schoolchildren in 2–3 forms were analyzed in this article. Decreased consumption of biologically valuable food staffs, misbalanced receipt of basic nutrients and insufficient use of some micronutrients (iodine, zinc, vitamins d, с and в1, folat) were discovered. Comparison between nutrition of schoolchildren in city and in village showed that there's a significant differences between using of most of nutrients.
Key words: schoolchildren, nutrition, macronutrients, micronutrients.
Key words: schoolchildren, nutrition, macronutrients, micronutrients.
44-48 799
Abstract
Clinical course of acute enteric infection (AEI) in patients from 6 months to 5 years was analyzed. addition of diosmectit (neosmectin) in suspension to the complex therapy of AEI in children (n = 70) reduced duration of intestinal syndrome and eliminated intoxication faster then in group of children, treated with only basic therapy (n = 55). Effectiveness of diosmectit was strongly pronounced in children upwards 1 year old and did not depend on period of its prescription (from the onset of disease). Confirmed laboratory effectiveness of diosmectit allows using it in treatment of patients with viral and bacterial AEI.
Key words: children, acute enteric infection, diosmectit, treatment.
Key words: children, acute enteric infection, diosmectit, treatment.
49-53 641
Abstract
Results of evaluation of clinical effectiveness of ribomunyl in complex of medical and rehabilitative measures in 43 children with recurrent stenosing laryngotracheitis on the basis of respiratory viral infections, and with ii degree of dysbiosis of mucous tunics of nasopharynx, fauces and bowel are presented. Ribomunyl allows recovering of disturbed microbiocenosis of mucous tunics not only in upper airways, but in bowels, and decreasing rate of common Ige and nitric oxide, what indicates to reduction of persisting infectious9allergic inflammation. Treatment with ribomunyl leads to termination of recurrence of disease.
Key words: dysbiosis of mucous tunics, recurrent stenosing laryngotracheitis, ribomunyl, children.
Key words: dysbiosis of mucous tunics, recurrent stenosing laryngotracheitis, ribomunyl, children.
LITERATURE REVIEW
54-59 539
Abstract
This review is dedicated to treatment of rheumatoid diseases in adults and children with one of TNF blockers adalimumab. The data from single, open9labeled, and multicenter double blinded placebo controlled studies of effectiveness and safety of adalimumab is presented. Analysis of many published information showed high activity and safety of adalimumab for treatment of rheumatoid arthritis, ankylosing spondylitis, rheumatoid uveitis in adults and children.
Key words: children, rheumatoid arthritis, juvenile rheumatoid arthritis, uveitis, treatment, adalimumab.
Key words: children, rheumatoid arthritis, juvenile rheumatoid arthritis, uveitis, treatment, adalimumab.
60-64 659
Abstract
According to the literature data, transvaginal echocardiography (Echocg) is the method, used for the doppler diagnostics in early terms of pregnancy (if principles of safety are observed). This method allows detecting about 70–97% of all prognostic cally significant inborn heart diseases in fetus, beginning at 12 week of pregnancy. a scheme of research includes estimation of four chamber cut of fetus heart, and study of state of its main arteries. This is an expert investigation, because it needs special grounding of specialist, high resolution ultrasonic equipment, and considerable expense of time. Wile parameters are estimated, it is necessary to use normative rates of sizes of ventricles and main arteries of fetus, developed by Russian experts, taking into account individual variations.
Key words: transvaginal echocardiography, diagnosis, inborn heart disease.
Key words: transvaginal echocardiography, diagnosis, inborn heart disease.
66-71 447
Abstract
Modern data of effectiveness prophylaxis of pneumococcal infection in children younger 1 year old with vaccine is presented in this article. Including of 7 - valency pneumococcal conjugated vaccine (PCV-7) in immunization program of some countries resulted in decrease of morbidity as in vaccinated group, as in all population. It was marked that vaccination with PCV-7 plays important pathogenetic role in termination of hidden forms of disease and prevention of spreading of pneumococcal infection, including the most severe types, hardly treated with antibiotics.
Key words: children, pneumococcal infection, vaccination.
Key words: children, pneumococcal infection, vaccination.
72-77 619
Abstract
This article is dedicated to the analysis of randomized controlled trials, studying influence of milk and diary products (yoghurt, cheese), including fortified with calcium ones, on bone mineral density (BMD) in children. It was shown that addition of such products to the dietary intake of children and adolescents in 9–24 months leads to additional increase of BMD. This property expressed in fortified foods more then in milk in usual (habitual) quantity. In conditions of optimal nutrition, while physiological needs of child's organism in calcium is provided owing to regular use of diary products, a necessity of addition of complementary doses of this macro element to the dietary intake is not proved. Besides, the data from controlled studies showed that adherence of children to some diary products (fortified cheese, for example), is inadequately low. Use of milk, including aromatized one, and yoghurt, allows considerable increasing of compliance. It's important for forming of wholesome nutritive preferences and habits in children.
Key words: children, milk, diary products, calcium, bone mineral density.
Key words: children, milk, diary products, calcium, bone mineral density.
78-84 1064
Abstract
Rotavirus — one of the most frequent reasons of acute gastroenteritis in children, especially in younger age. The modern conception of epidemiology, pathogenesis and treatment of rotavirus infection in children are presented in this literature review. Basic methods of treatment of rotaviral infection in present time are application of enterosorbents (smectite in doubled age specific dose) and oral regidratation, which can reduce duration of disease, decrease the risk of complications and intrahospital infections.
Key words: children, rotavirus infection, treatment, smectite.
Key words: children, rotavirus infection, treatment, smectite.
LECTURES
85-90 704
Abstract
An epidemiology and clinical symptomatology of frequently occurred acute respiratory viral infections (ARVI) and opportunities of treatment of patients with these diseases in outpatient clinics are described. New information about effectiveness and safety of antiviral medications in treatment and prophylaxis of ARVI in children are discussed.
Key words: children, acute respiratory viral infections, antiviral medications, interferon, interferon inductors.
Key words: children, acute respiratory viral infections, antiviral medications, interferon, interferon inductors.
91-96 1757
Abstract
A physiological role of microelements (zinc, selenium, iodine, chrome, molybdenum, silicon, vanadium) and its participation as co-factors of key enzymes in normal vital functions in human was examined. A significance of microelements in formation and functioning of immune system, bowels and antioxidant defense in children was analyzed. A consequence of deficiency of microelements was described. While children of first year of life are most vulnerable for a deficiency of microelements, it's necessary to consider in development of nutrition of this age group.
Key words: microelements, deficiency, nutrition.
Key words: microelements, deficiency, nutrition.
97-103 936
Abstract
Cough in children: new decision of old problem the mechanism of development of cough, classification of its types and main reasons of it are described in this article. Special attention was given to the problem of diagnostics of chronic cough, to peculiarities of modern instrumental diagnostic methods and to principles of therapeutic tactics. The results of treatment with anti inflammatory medication fenspiride (eurespal) are presented. Russian and foreign literature data and information from american guideline in cough treatment was used in this article.
Key words: cough, children, fenspiride.
Key words: cough, children, fenspiride.
EXCHANGE OF EXPERIENCE
E.I. Alexeeva,
I.E. Shakhbazyan,
S.I. Valieva,
T.M. Bzarova,
K.B. Isaeva,
A.M. Chomakhidze,
E.Yu. Afonina,
O.S. Rozvadovskaya,
V.Ya. El'yashevich,
D.V. Apaeva
104-117 564
Abstract
A data of fifteen year experience of use of cyclosporin in treatment of systemic type of juvenile rheumatoid arthritis is presented in this article. Ciclosporin is high effective medication in mono therapy and combined with methotrexate. Cyclosporine in dose 3,5–4,5 mg/kg of bogy mass has no significant adverse events as in mono therapy, as in combination with methotrexate in moderate and high dose. Proper data of treatment of severe systemic type of rheumatoid arthritis in more then 100 children is presented.
Key words: children, juvenile rheumatoid arthritis, cyclosporin, treatment.
Key words: children, juvenile rheumatoid arthritis, cyclosporin, treatment.
118-121 491
Abstract
An experience of treatment of younger schoolchildren with acute respiratory infections (ARI) with bacterial lysates mixture (IRS 19) is presented. This medication favors to rapid regress of clinical signs of disease and to acceleration of a recovery. Cellratio in mucus, produced by mucous tunic of fauces and nasal cavity differs under the influence of treatment: the number of neutrophils and macrophages decreases, and the number of epiteliocytes increases. The 4 months prospective trial showed that use of mixture of bacterial lysates in younger school children greatly decreases the risk of incidence of new cases of ARI.
Key words: younger schoolchildren, acute respiratory infections, bacterial lysates mixture.
Key words: younger schoolchildren, acute respiratory infections, bacterial lysates mixture.
121-126 605
Abstract
Results of treatment of 30 children with visceral abdominal pain caused by different etiological factors with neurotropic selective m9cholinergic antagonist hyoscine butilbromide (buscopan) are presented in this article. Two groups of children were treated with hyoscine butilbromide and drotaverine accordingly. Administration of hyoscine butilbromide allows to stop pain in 93% of patients; mean duration of abdominal pain was 3,4 ± 1,2 days (4,2 ± 1,4 days in children treated with drotaverine, р < 0,05). Activity of dyspeptic disorders was decreased at the time of treatment. a tolerance to hyoscine butilbromide was satisfactory, and no adverse events were registered. hyoscine butilbromide is effective in treatment of visceral abdominal pain in children, allowing shortening its duration more actively then drotaverine.
Key words: children, visceral abdominal pain, hyoscine butilbromide.
Key words: children, visceral abdominal pain, hyoscine butilbromide.
127-131 469
Abstract
The questions of etiology, classification and management of children with sinusitis are discussed in this article. Special attention was given to the tactics of management of patients with permanent claims after standard course of medical treatment. Possible schemes of management of these patients and the results of proper clinical trial were presented.
Key words: children, acute sinusitis, treatment.
Key words: children, acute sinusitis, treatment.
132-136 587
Abstract
The results of retrospective study of children with juvenile rheumatoid arthritis (JRA), torpid to standard antirheumatic therapy, treated with leflunomide (arava) as basis medication, are presented in this article. An effectiveness and safety of leflunomide in complex treatment of JRA was shown. Treatment with leflunomide results in remission and decrease of dose of peroral corticosteroids.
Key words: children, juvenile rheumatoid arthritis, leflunomide.
Key words: children, juvenile rheumatoid arthritis, leflunomide.
137–140 680
Abstract
A problem of rehabilitation of frequently ailing children (FAC) is one of the actual problems in pediatrics. Disorders of mucosal immunity, depending on different factors including the state of mucociliary transport, play important role in formation of FAC group including patients with recurrent episodes of obstructive bronchitis. Morphological and functional unity of mucous tunic of respiratory tract allows determining the state of mucociliary clearance and effectiveness of secretolytic therapy by the state of mucosal tunic of nose and nasopharynx (it is the most accessible mucosal tunic for the objective examination). Specified rates of time of mucociliary transport in different groups of FAC are presented in this article. An effectiveness of mucoregulatory medication ambroxol in complex treatment of FAC with adenoids and recurrent episodes of obstructive bronchitis, and advisability of its prolonged (14–18 days) use for the recovery of disturbed system of mucociliary transport were described in this article.
Key words: frequently ailing children, somatotype, mucociliary clearance, treatment.
Key words: frequently ailing children, somatotype, mucociliary clearance, treatment.
141-144 594
Abstract
The results of treatment of 57 patients with atopic dermatitis (ATD) in age 7–18 years old with elidel cream are described. Cream was drifted on facial skin 2 times daily. Apparent effect was marked on 7–14 day. There was no any case of serious adverse events. Thus, taking to account safety and effectiveness profile, pimecrolimus can be used as a medication of first line of therapy in treatment of ATD, while lesion is located on sensitive sectors of skin.
Key words: children, atopic dermatitis, pimecrolimus.
Key words: children, atopic dermatitis, pimecrolimus.
A DOCTOR’S AID
145-149 678
Abstract
A system role of carotinoids in human organism and factors influencing on its bioavailability are described in this article. A data of content of carotinoids in some eatable plants and factual provision of German and Japanese population with β-carotin, and author's proper data of content of β-carotin in blood plasma of schoolchildren of St. Petersburg were presented. A factual provision of children with inflammatory and erosive ulcerous lesions of upper gastrointestinal tract (GIT) with β-carotin was compared to disorders of food behavior: preference of «fast food» and rare use of fruits and vegetables.
Key words: children, nutrition, carotinoids, diseases of gastrointestinal tract.
Key words: children, nutrition, carotinoids, diseases of gastrointestinal tract.
150-155 685
Abstract
Results of observation of children from 2,5 months to 4 years old, treated in hospital with diagnosis chronic diarrhea are analyzed in this article. Diarrhea debuted in first year of living in most cases. The reason of onset of diarrhea often was alimentary factor. Hereditary predisposition, pathologic pregnancy, and diseases in women at the time of pregnancy played an important role in development of disease. Nutrition of children in early age was characterized by low duration of breast feeding and early conversion of children to the mixed and artificial feeding. Main food stuffs in children's nutrition on mixed and artificial feeding was adapted milk formulas, and rarely non adapted milk food (cow's and goat's milk, kefir). Only 30% of mothers had a definite knowledge of proper child's feeding and advantages of breast feeding. This fact indicates necessity of more active educational work by medical staff.
Key words: children, chronic diarrhea, nutrition.
Key words: children, chronic diarrhea, nutrition.
156-160 616
Abstract
A term «frequently ailing children» (FAC) characterizes increased morbidity with acute respiratory infections compared with healthy coevals, and this term is widely used by pediatrists in present time. unfavorable course of pregnancy, prematurity, defects in immune system are predisposing to this state. Rational nutrition, regular day regimen, sanitary measures are necessary to the normal living of such children. In some cases medicamental correction with use of poly vitamins, immunocorrectors and phytotherapy is needed. Deficiency of vitamins and minerals is frequently occurring in children from FAC group. «sanasol extravit», containing extracts from black currant, dog rose and strawberry, was developed for the deficiency of microelements and vitamins and for a correction of immune system.
Key words: frequently ailing children, vitamins, immunity.
Key words: frequently ailing children, vitamins, immunity.
161-166 583
Abstract
Key questions of pathogenesis, diagnostics and treatment of functional constipation in children are described in this article. Pediatrists have to pay a great attention to this problem, because quality of life of children is decreases very much due to constipation. A dramatic and typical clinical case of chronic constipation in patient, who was 6 years old, was reported. An algorithm of management of such patients is presented, but authors give attention to the fact, that oversimplified methods of treatment and monotherapy frequently can't provide positive results.
Key words: children, functional constipation, diagnostics, treatment.
Key words: children, functional constipation, diagnostics, treatment.
CLINICAL OBSERVATIONS
167-172 551
Abstract
Questions of differential diagnosis in conditions of developed systemic inflammatory reaction in patients with systemic type of juvenile rheumatoid arthritis (JRA) are one of difficult problems in children's rheumatology. Clinical signs, similar to sepsis, accompanied by development of symptoms of inflammatory reaction may be observed in patients with systemic type of JRA at the time of exacerbation of main disease, or due to development of bacterial complications and medicinal reactions, or it may be the consequence of combination of these reasons. Presented case report allows making a conclusion that using of procalcitonin test, especially quantitative one, in usual practice of rheuma tologist permits to carry out a differential diagnosis between infectious and autoimmune reasons of developed systemic inflammatory reaction, to start an etiotropiс and/or pathogenetic treatment at the proper time, to estimate the severity of pathological process and activity of therapy in first days from its onset, and to determine an optimal duration of treatment.
Key words: juvenile rheumatoid arthritis, procalcitonine test, differential diagnosis.
Key words: juvenile rheumatoid arthritis, procalcitonine test, differential diagnosis.
INFORMATION FROM THE UNION OF PEDIATRICIANS OF RUSSIA
HISTORY OF PEDIATRICS
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
