Vol 11, No 2 (2012)
SOCIAL PEDIATRICS AND HEALTH CARE
7-10 1953
Abstract
The article takes up priority directions of preventive paediatrics concerning health formation of rising generation, organization of health care for children, decrease of morbidity, disability and mortality rate. The authors mention the importance of vaccination in control of the most common infections, base the necessity of complex rehabilitation health care system organization for disable children and need of wide spreading of developed and used in practical Russian health care types and methods of prophylaxis of rare (orphan) diseases. The ways of prophylaxis, maintenance, strengthening and recovery of children’s health are suggested in this article.
11-13 986
Abstract
Informed voluntary consent precedes any medical involvement. It is a result of patient’s sensible decision after receiving the full information about forthcoming procedure. The aspects of medical law are discussed in this article along with the algorithm of actions during the official registration of informed voluntary consent in paediatrician practice.
ORIGINAL ARTICLES
T. E. Borovik,
N. N. Semenova,
N. G. Zvonkova,
R. A. Zhetishev,
E. A. Kamyshova,
S. M. Alabova,
F. A. Zakhokhova,
I. S. Zhetisheva
13-21 908
Abstract
Analysis of usage of specific hypoallergenic formula in atopic dermatitis prophylaxis in children of the 1st year of life with high risk of allergy development is reviewed in this article. Sixty-six children of the 1st year of life with compromised anamnesis were included into the study. In multicenter researches it was shown that this formula meets modern requirements, which are raised to composition of children adapted hypoallergenic formulas, that it fits physiological needs of nutrients and energy and is well-tolerated by infants, including newborns, with high risk of allergy development
LITERATURE REVIEW
PRINCIPLES OF ANTIBIOTIC TREATMENT OF OUT-OF-HOSPITAL UPPER RESPIRATORY TRACT INFECTIONS IN CHILDREN
22-29 1694
Abstract
Special features of etiology of respiratory tract bacterial infections in children in depending of localization of involvement are analyzed in this study. In the article the main principles of rational antibacterial therapy of infectious and inflammatory diseases of respiratory tract in paediatrician practice are discussed. The authors offer the algorithms of first-line antibiotics choosing according to various entities of upper and lower respiratory tract infections in children. There are also suggested the regimens of antibacterial agents dosing in out-patient clinics in children with bacterial respiratory infections.
PROFESSIONAL DEVELOPMENT
30-42 2156
Abstract
Glycogenosis is a hereditary carbohydrate metabolism disease, which is caused by mutations in various genes, coding enzymes needed for glycogen synthesis and decay. Due to enzymes defects redundant glycogen deposits in cells of different tissues, mainly in liver and muscles. Despite the high specificity of glycogenosis symptoms, this condition is still underdiagnosed nowadays because of low awareness of physicians. The article includes modern aspects on etiology, classification, clinical presentation, laboratory and instrumental symptoms and histopathology signs of glycogenosis in children and also the data about treatment and management of such patients.
44-47 1191
Abstract
The data on efficacy and safety of 7- and 13-valent pneumococcal conjugate vaccines are shown in this article. The authors have analyzed the experience of immunization with 13-valent vaccine Prevenar. Post-vaccination reactions were mild or moderate consisting in localized tenderness in site of injection and febrile fever and were not registered more frequently than in cases of 7-valent vaccine usage. There were no severe post-vaccination side-effects. This facts confirm low reactogenicity of this vaccine and the possibility of its usage in children.
48-55 1533
Abstract
Antibacterial treatment has wide usage in modern practical medicine, as it allows achieve rapid positive effect in treatment of infectious diseases. However it is necessary to remember, that various side-effects are not rare during antibacterial therapy. One of the main side-effects is intestinal microflora disturbances, including antibiotic-associated diarrhea. That is why it is so important to understand the principles of its prophylaxis and treatment. The fundamental knowledge about normal intestinal microflora and its functions, epidemiology, pathogenesis, clinical presentation, diagnostics, treatment and prophylaxis of antibiotic-associated diarrhea in children are reviewed in this study.
56-61 970
Abstract
The questions of adaptations of formulas for infants to protein, lipid, carbohydrate, micro- and macronutrients composition of women breast milk are discussed in this article. The authors consider new functional components, used in production of modern adapted formulas: taurine, long-chain polyunsaturated fatty acids (LCPFA), carotenoids, including lutein, prebiotics etc.
EXCHANGE OF EXPERIENCE
62-67 694
Abstract
Initial audiological test was performed in 136 premature children with various gestational age born from single fetation. The children were divided into 2 groups: prematures with intrauterine growth restriction (IUGR) and prematures with normal weight for their gestational age (normotrophy). The study showed that the rate of passing the initial audiological test using the method of DPOAE was lower in both ears in children with IUGR, than in children with normotrophy. The correlation between the results of initial audiological test and birth weight was found: the lower was weight, the higher was risk of absence of acoustic response registration on initial examination.
68-73 932
Abstract
The authors represent their own results of surgical treatment of cataract in children with implantation of various types of intraocular lenses: common Corneal, torus — AcrySof Toric and aspheric — AcrySof IQ. It was established, that post-surgical visual acuity in patients with astigmatism was higher in children with AcrySof Toric lenses implantation in comparison with implantation of common intraocular lenses, which simplifies post-surgical correction and improves the efficacy of amblyopia treatment. Good refraction results were received after implantation of intraocular lenses in children younger than 2 years old, which at the average approximates the agespecific refraction norms in children and creates favourable possibilities of the visual analyzer development according to the growth of the eye-bulb. On the basis of the own experience the authors suggest the algorithm of surgical tactics and optimal terms of treatment of congenital cataract and amblyopia.
74-76 814
Abstract
Fluoride-containing toothpaste is one of the main methods of exogenous caries prophylaxis. However in childhood when the mineralization of permanent teeth takes place, intake of redundant amount of fluorides can be associated with risk of dental fluorosis development. Thereby toothpaste can be one of the potential causes of increased fluoride-loading. When following a number of rules, usage of fluoride-containing toothpaste in children can be effective and safe.
77-81 839
Abstract
The cytological investigation of exudates, obtained during tympanostomies, showed the predomination of inflammatory-regenerative cytograms types when using Fenspiride (Eurespal) in treatment of secretory stage of chronic exudative otitis media. Received data confirm, that treatment with this drug shortens the course of exudative otitis media and contributes to more rapid change from destructive to reparative stage of inflammation, which prevents the development of adhesive process in the middle ear.
82-89 849
Abstract
In this study the results of the investigation of complex treatment with Infliximab and Methotrexate efficacy and safety of 28 patients
comparing with Methotrexate treatment of 41 patients with polyarticular juvenile idiopathic arthritis at the age of 8–17 years are analyzed. The follow-up period was 1 year. Infliximab was administered according to the following scheme: 0, 2, 6 weeks and then every 8 weeks. The dosage of Infliximab in children with early onset of juvenile idiopathic arthritis was 3,0 mg/kg per infusion. Clinical remission, decrease and normalization of laboratory markers, complete restoration of joints function and improvement of life quality in 57,7% were established after 46 weeks of treatment with Infliximab and Methotrexate comparing with 16% in children treated with Methotrexate monotherapy.
comparing with Methotrexate treatment of 41 patients with polyarticular juvenile idiopathic arthritis at the age of 8–17 years are analyzed. The follow-up period was 1 year. Infliximab was administered according to the following scheme: 0, 2, 6 weeks and then every 8 weeks. The dosage of Infliximab in children with early onset of juvenile idiopathic arthritis was 3,0 mg/kg per infusion. Clinical remission, decrease and normalization of laboratory markers, complete restoration of joints function and improvement of life quality in 57,7% were established after 46 weeks of treatment with Infliximab and Methotrexate comparing with 16% in children treated with Methotrexate monotherapy.
90-92 912
Abstract
Tonsillectomy is one of the most effective methods of treatment of chronic inflammatory diseases of tonsils. This article contains the principal indications and contraindications to performing of this procedure in children. The author describes the most common methods of tonsillectomy, ways of prevention of post-surgical complications and management of children during post-operative period.
94-97 911
Abstract
The cause of the sore throat in children is acute pharyngitis. The etiology and pathogenesis of this disease is discussed in the article. The authors explain the optimization of treatment with such topic drugs with anaesthetic and antibacterial actions as Strepsils in children with diseases associated with sore throat.
O. A. Malakhov,
E. I. Alekseeva,
S. J. Morev,
O. O. Malakhov,
S. I. Valieva,
T. M. Bzarova,
R. V. Denisova,
T. V. Sleptsova,
E. V. Mitenko,
K. B. Isaeva,
L. A. Semenova,
E. I. Zelenkovich,
G. V. Kurilenko,
M. I. Travina,
A. V. Anikin,
G. A. Bekdzhanyan
98-105 1201
Abstract
The results of surgical treatment of 34 patients with coxarthrosis due to juvenile rheumatoid arthritis (JRA) are shown in this article. The operations with endoprosthetics methodic were performed in the department of traumatology and orthopaedics of the Scientific Centre of Children Health RAMS since 2008 till 2012. The aim of the study was to evaluate the efficacy of surgical treatment and influence of this procedure on patients life quality. The main presenting complaints were pain and motion limitations in hip joints, differences in extremities length, limping, support disability and lower extremity dysfunction, which makes movement without additional support impossible in 90% of all cases. The indications to the total endoprosthetic hip joint replacement (TEHJR) in adolescents with
juvenile arthritis are represented. The special features of TEHJR in young patients with JRA. The assessment of X-ray pictures during the follow-up examinations showed adequate positioning of endoprosthesis components. One year after the surgical operation the mean level of points according to specialized questionnaire HHS was 88 (87; 89) points (Me [25;75]) (comparing with 55 [51; 58] before the operation, [p < 0,001]), and according to the questionnaire СHAQ — 0,4 (0,3; 0,5) points (comparing with 2,6 [2,3; 2,8] before the operation, [p < 0,001]). This facts confirm the efficacy of the performed treatment and significant improvement in functioning of operated joints and patients life quality. The marked correction of the lower limbs deformations and the normal or near-normal physiological functioning were achieved.
juvenile arthritis are represented. The special features of TEHJR in young patients with JRA. The assessment of X-ray pictures during the follow-up examinations showed adequate positioning of endoprosthesis components. One year after the surgical operation the mean level of points according to specialized questionnaire HHS was 88 (87; 89) points (Me [25;75]) (comparing with 55 [51; 58] before the operation, [p < 0,001]), and according to the questionnaire СHAQ — 0,4 (0,3; 0,5) points (comparing with 2,6 [2,3; 2,8] before the operation, [p < 0,001]). This facts confirm the efficacy of the performed treatment and significant improvement in functioning of operated joints and patients life quality. The marked correction of the lower limbs deformations and the normal or near-normal physiological functioning were achieved.
106-108 755
Abstract
The results of treatment of 52 children with acute respiratory viral infections (ARVI) aged from 4 to 10 years were studied based on
observation diaries, filled by parents, and data of the otorhinolaryngologists examinations on the 7th and 10th days from the onset of the disease. The children were divided into 2 groups: 1 group consisted of 30 children, which were treated with Sinupret monotherapy; 2 group consisted of 22 children, which were treated with endonasal irrigation, decongestants and antiseptics. The parallel analysis of the treatment results of children with ARVI showed, that Sinupret is well-tolerated by patients, contributes to milder course of the disease. Due to its anti-inflammatory and anti-viral actions this drug prevents development of such complications of respiratory tract infections as acute purulent rhino-sinusitis and acute otitis media. Sinupret also precipitates the processes of convalescence on 45% at the average and shorten the prolongation of disease on 5 days at the average, so it can be recommended to be included into the standard protocol of treatment children with ARVI.
observation diaries, filled by parents, and data of the otorhinolaryngologists examinations on the 7th and 10th days from the onset of the disease. The children were divided into 2 groups: 1 group consisted of 30 children, which were treated with Sinupret monotherapy; 2 group consisted of 22 children, which were treated with endonasal irrigation, decongestants and antiseptics. The parallel analysis of the treatment results of children with ARVI showed, that Sinupret is well-tolerated by patients, contributes to milder course of the disease. Due to its anti-inflammatory and anti-viral actions this drug prevents development of such complications of respiratory tract infections as acute purulent rhino-sinusitis and acute otitis media. Sinupret also precipitates the processes of convalescence on 45% at the average and shorten the prolongation of disease on 5 days at the average, so it can be recommended to be included into the standard protocol of treatment children with ARVI.
109-111 899
Abstract
The usage of vaccination against varicella as a post-exposure prophylaxis is discussed in this article. The data used in the study were received during the observation of the children, visiting closed groups and vaccinated against varicella after the contact with infected persons. Due to post-exposure prophylaxis in the centre of varicella outbreak the localization of the outbreak was achieved in 15 days after the 1st reported case of the disease. The immunization of the susceptible persons in the centre of varicella outbreak significantly decreased the number of children involved in epidemic process. The efficacy of Okavax vaccine in varicella prohpylaxis was confirmed.
112-117 821
Abstract
The comparative characteristics of emotional condition of healthy schoolchildren and children with pollinosis at the age of 11–17 years old was performed with Spielberg-Hanin questionnaire on the basis of computer psychophysiological complex CPPC-99 «Psichomat».One hundred seventy-five healthy schoolchildren and 46 children with pollinosis at the age of 11–17 years old were included to the study. No significant difference in reactive anxiety between children with pollinosis and healthy children was found. It was shown, that pollinosis (in 35% significantly) and concomitant diseases, such as bronchial asthma (in 57 significant) influence on personality anxiety, in comparison with healthy children (significant personality anxiety was found in 3% of cases). It was revealed, that all children from control group with high anxiety rate (3%) were 17-year-old adolescents.
A DOCTOR’S AID
118-121 1858
Abstract
Adhesion of the labia minora is one of the most complicated diseases in girls at the age beginning with infancy. The occurrence of this condition in population is 0,6–3% of girls. It mainly can be found at the age of from 3 months to 6 years, the age from 12 to 23 months is the peak of disease prevalence. The relapse rate varies from 14 to 39%. During last decade the prevalence of disease has been reported to rise significantly. However there is lack of uniform guidelines of children with this condition management both in Russia and abroad. In this article the problem of management of infant girls with adhesions of the labia minora is highlighted, the advantages and disadvantages of various treatment options are discussed.
122-126 894
Abstract
Analysis of articles and clinical studies conducted in accordance with the principles of evidence-based medicine allows making a conclusion that new nasal corticosteroids have a favorable of safety profile and they can be widely used for the management of allergy and inflammatory diseases of nose and paranasal sinuses in adults and childhood.
128-131 1020
Abstract
Immunological and microbiological characteristics of chronic tonsillitis in children and various approaches to its treatment are discussed in this article. The principal attention is paid to diagnostics of the main infectious agent — group A -hemolytic streptococci. The study represents a qualitative immunochromatography screening test for the group A streptococci antigens detection — Streptatest. The main principles of rational antibacterial treatment in chronic tonsillitis in children are described.
132-139 3032
Abstract
The 15-years practice of Pulmozyme (dornase alfa) usage showed its high efficacy and safety in cystic fibrosis treatment in children of various age, including infants. The efficacy of the drug is associate with clinical effects: strong mucolytic, anti-inflammatory and antibacterial effects. The appropriateness of including this into the complex of the basic therapy of cystic fibrosis in order to prevent and treat chronic bronchitis and chronic polypous pansinusitis as soon as the disease is diagnosed was confirmed in studies. Regular use of this drug results in relapse rate decrease, remission periods prolongation and maintenance of external respiration at stable level, which enable patients to live active life. The therapeutic effect of dornase alfa depends on strict compliance to directions of its usage, as this agent is a proteolytic enzyme.
140-145 1344
Abstract
Periodic fever syndrome with mevalonate kinase deficiency, also known as hyperimmunoglobulinemia D syndrome, is characterized by early onset and relatively benign course. The article contains a history case of periodic fever syndrome with mevalonate kinase deficiency in a 2-years-9-months old girl. The challenges of differential diagnostics of this disease are accentuated in the article.
146-150 1353
Abstract
Tonsillopharyngitis is a common multietiological infectious disease, more often caused by streptococci infection. The development and adoption of oral III generation cephalosporins into clinical practice significantly widened the possibilities of treatment of inflammatoryinfectious diseases, including tonsillopharyngitis. One of the III generation cephalosporins is Ceftibuten (Cedax) — a drug with b-lactam properties, which inhibits bacterial peptidoglycan synthesis. It has relatively long post-antibiotic effect, characterized by high activity in point of majority of enterobacteria, and is very stable to destructive action of -lactamases. It also can be accumulated in tissues, providing high concentration of active substance in inflammation nidus. The therapeutic dose of the drug for adults is 400 mg/day. Ceftibuten is recommended and effectively used in pediatric practice in treatment of tonsillopharyngitis and otitis.
151-154 1678
Abstract
Atopic dermatitis (AD) is one of the most common allergic diseases in children which is assuming ever greater medical and social importance. Risk factors of AD include gastro-intestinal tract disturbances, especially intestinal dysbiosis, which is revealed in 89–94,1% of children with atopic dermatitis. Both correlation of the dysbiosis and AD manifestations severity and increase of underlying disease treatment efficacy as a result of target influence on intestinal microflora confirm that. For many decades guidelines of atopic dermatitis treatment in children along with elimination diet, antihistamine drugs and topic medicines include enterosorbents. The most effective drugs are those ones, consisting of prebiotics and sorbents. The wide experience of prebiotic drug with sorbent action (Lactofiltrum) in complex therapy of atopic dermatitis in children is reviewed in this article.
CLINICAL OBSERVATIONS
155-161 808
Abstract
The article represents a clinical case of severe Methotrexate- and Cyclosporine-resistant antibody-positive idiopathic juvenile arthritis in a teenage-girl. Treatment with T-cells costimulation inhibitor Abatacept was performed. In 24 weeks after treatment start inactive stage of disease was established: rheumatoid factor and cyclic citrullinated peptide antibodies serum concentrations were significantly lower, range of motion in the involved joints was completely restored, life quality increased to the level of the same age healthy adolescents.
162-165 1092
Abstract
The authors describe a history case of severe congenital dentofacial anomaly with congenital cleft lip, palate and alveolar ridge, associated with somatic disease. The diagnosis was confirmed histologically. The surgical treatment was performed after the careful presurgical preparation due to severe general condition of the child. The indication to the surgical treatment was a significant enlargement of the tumor mass since the child’s birth. The tumor filled the oral cavity and blocked oropharynx almost completely.
166-168 938
Abstract
Approximately 25% of children have some problems with sleep, from difficulties with falling asleep to more severe problems, such as apnea. The most common sleep disorder in children is obstructive sleep apnea hypopnea syndrome. The author represents a clinical case of a 6-year old boy with obstructive sleep apnea diagnosed by polysomnography method. The clinical signs of sleep apnea, methods of diagnostics of this disorder and evaluation of treatment efficacy are discussed in the study.
A. N. Fetisova,
E. I. Alexeeva,
T. M. Bzarova,
N. I. Taybulatov,
A. V. Starikova,
A. V. Anikin,
G. A. Bekdzhanyan
169-175 835
Abstract
A history case of juvenile ankylosing spondillo-arthritis onset with rapid development of asymmetric poliarticular involvement, sacroileitis, patient’s disabling and his and his family disabling is represented in this article. The activity of disease was arrested by usage of soluble TNF receptors — etanercept. The function of involved joints was completely restored, the boy’s life quality significantly improved. Inactive stage of disease was documented in 4 weeks, remission stage — in 7 months after the beginning of treatment.
SHORT REPORTS
176-179 830
Abstract
The problem of acute otitis media in children is discussed in this article. The author describes etiology, pathogenesis and methods of diagnostic of this disease. The article contains information about clinical efficacy and good tolerance of the drug “Otofa” in treatment of acute otitis media in children. The usage of this topic antibacterial agent in complex treatment of acute otitis media is safe in point of systemic side effects and undesirable medicinal interactions, which allows to achieve perfect result and improve life quality of children with inflammatory diseases of middle ear.
180-183 1411
Abstract
The prevalence of respiratory tract infections in children of the Russian Federation is high. That is why the questions of prophylaxis and treatment of acute respiratory viral infections (ARVI) are always of a great interest of paediatricians. During epidemic outbreaks essential oils inhalations become a new perspective in treatment of such conditions. In the period of time since September 2011 till February 2012 the research workers of Paediatrics department of Tyumen State Medical Academy have estimated the oil «Dyshi» («Breathe») efficacy in complex treatment of ARVI in children. The usage of this medicine for the prophylaxis of respiratory infections
decreased the morbidity rate to 35% during the observation period, while each child in the comparison group had at least one episode of ARVI. The usage of this drug in the group of frequently ill children at the first symptoms of ARVI allowed to relieve the severity of disease and to prevent complications. Furthermore, the oil «Dyshi» has a number of other advantages: it is not irritating and habit-forming, it does not dry the nasal mucous membrane, it is safe for children and can be used for a long period of time.
decreased the morbidity rate to 35% during the observation period, while each child in the comparison group had at least one episode of ARVI. The usage of this drug in the group of frequently ill children at the first symptoms of ARVI allowed to relieve the severity of disease and to prevent complications. Furthermore, the oil «Dyshi» has a number of other advantages: it is not irritating and habit-forming, it does not dry the nasal mucous membrane, it is safe for children and can be used for a long period of time.
HISTORY OF PEDIATRICS
198-202 662
Abstract
The article is dedicated to the 100th anniversary of the first Paediatricians Congress in Russian and Soviet history. The author recounts the premises to the Congress convocation in the era of paediatrics formation as a separate field of medical science, explains the role of I. V. Troitski as an initiator of International and All-Russian paediatricians congresses convocation. The scientific program and contents of the main reports of the Congress are discussed in the article.
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
