Vol 13, No 5 (2014)
SOCIAL PEDIATRICS AND HEALTH CARE
14-16 709
Abstract
In this paper we describe a system of charity for orphans in Kazan province during the work of the zemstvo. Analyzed the work of local authorities for the organization of social assistance to children. In keeping zemstvo was handed orphanage, located in a rented room. Already in the first years of the Kazan province zemstvo for these purposes was purchased its own building and taken to hiring additional. This allowed the students to differentiate different age. Deficit funding for social care has led to the fact that since 1896, active distribution system has received the patronage of the family, which means the transfer of children to grow up in farming families with an award from the zemstvo. Although some shortcomings of this system, the number of children prizrevaemyh thus increased annually. By the beginning of the XX century in Kazan province has developed a system of charity childhood, which was based on the rural and private charities. During the years of zemstvo institutions in Kazan province created the conditions for an effective institutions to help children transferred from the Order of public charity, and laid the foundations for the development of a network of institutions charity childhood in the countryside.
LITERATURE REVIEW
17-25 1320
Abstract
Deficiency of micronutrients in a diet of the modern children increases risk of the formation of chronic neurologic and somatic pathology. Magnesium deficiency, which initiates a various neurologic symptomatology, has a particular importance in the progress of nervous system diseases at children. Diagnosis of neurologic manifestations of a micronutrient deficiency requires comprehension of the main mechanisms of their development, and also peculiarities of laboratory diagnostics. In treatment of consequences of a magnesium deficiency the special role belongs to the micronutrient stock replacement (medication, alimentary) combined with traditional methods of treatment of neurologic disorders.
26-30 806
Abstract
Modern clinical practice for the care of the prematurely born infants has markedly improved their rates of survival. Since the clinical follow-up is of short duration, only limited data are available to relate diseases in adult life to events and interventions in the neonatal period. The major factors that could have a programming (which could lead to disease) effect include: 1) intrauterine growth restriction; 2) interruption of pregnancy with change in oxygenation and water environment; 3) nutritional and pharmacological protocols for clinical care. The available clinical and experimental data are discussed in the context of perturbations in DNA methylation and its possible programming effects. The consequences of antenatal and postnatal administration of glucocorticoids are discussed. We speculate that premature interruption of pregnancy and neonatal interventions by affecting DNA methylation may cause programming effects on the immature baby.
31-36 1329
Abstract
Review describes modern approaches to the study of pathogenic mechanisms of perinatal hypoxic-ischemic brain injury. The classification of modeling methods hypoxic-ischemic brain injury in vivo reflects the basic approaches to disease modeling. Given the nature of the brain pathology in the perinatal period, the article details the characteristic of global cerebral ischemia models, which are currently in use. It should be remembered that there is still no single ideal experimental model of hypoxia-ischemia in vivo, which completely mimics the human pathology, and that must be considered when planning experiments.
ORIGINAL ARTICLES
37-41 1217
Abstract
Background: Currently, there is a well-publicised worldwide increase in obese patients. The origins of adult obesity, in the majority of cases, are in children. Objective: Our aim was to study the prevalence and gender features of excess weight and obesity in adolescents in Perm. Methods: The study included adolescents aged 13–14, living in the city of Perm. Medical examinations were compared in statistics from 2005 and 2013. Weight, height and waist circumference were measured on all children. Body mass index was calculated, as was a standard deviation coefficient. Sexual development was evaluated according to the criteria of Tanner. Results: 828 adolescents were viewed (444 in 2005 and 384 in 2013). The prevalence of overweight adolescents in 2005 was 12.5%, including 3.1% who were obese. In 2013, 20.3% of adolescents were diagnosed as overweight, with 5.5% being diagnosed as obese. Abdominal obesity to type was diagnosed in 52.4% of obese children. Over the past 8 years, the number of adolescents who are overweight and obese has increased by more than half. A statistically significant increase has beenrecorded for overweight adolescents (ᵪ2 = 5,16; p = 0,023). In adolescents with excess body weight, growth rates were higher than in those children with either normal body weight or obesity; these differences were statistically significant in boys (p = 0.016). The total score of puberty in boys who were overweight was statistically significantly higher than adolescents with normal body weight orobesity (p = 0.0116). Conclusion: The percentage of children who are overweight and obese hasincreased by 74% and 67%, respectively over an 8-year period, resulting ina statistically significant increase in relation to overweight children. There was a significant increase in the number of teenage girls who are overweight.
42-46 913
Abstract
Background: Neurocardiogenic syncope (NCS) is widespread among adolescents, which makes it relevant to study the factors contributing to the implementation of syncopic readiness in susceptible persons. Objective: The aim was to assess the connection between extracurricular activities of adolescents and the emergence of NCS. Methods:The questionnaire survey among the Lyceum students aged 14–18 tried to find out the presence of syncope (presyncope) and its nature in a child’s medical history; the nature and intensity of extracurricular loads; and intensity and success of curricular activities. Results: The study included the results of the questionnaire survey among 286 students (62.2% girls). Syncope and presinkope states were observed in a medical history of 136 (47.6%) students, and 105 (77%) of them had NCS. Independent risk factors for the development of NCS were private lessons with tutors, and only in cases where a child had no other extracurricular classes (creative, sports) — OR 6.4 (95% CI 1.7–24.8). The NCS risk was also higher in adolescents, who had good grades at school — OR 2.2 (95% CI 1.1–4.6). Conclusion: The risk of NCS development in teenage schoolchildren is defined by the area of subject education: high risk of this kind of syncope is in children, who have private classes with tutors and no other extracurricular loads, as well as in children, who have good grades at school.
PROFESSIONAL DEVELOPMENT
47-54 3035
Abstract
Chronic inflammatory demyelinating polyneuropathy (CIDP) in children is a rare autoimmune disease of the peripheral nervous system. The article analyzes current international diagnostic criteria and clinical presentation features of the disease in childhood. The article discusses general principles of CIDP treatment and focuses on the pathogenetic therapies: intravenous immunotherapy using a standard human immunoglobulin (IVIG) with the content of IgG > 95%, prescription of large doses of glucocorticoids and plasmapheresis. It analyzes the recommendations for prioritizing the use of different types of treatment when initiating the therapy and describes the main drug prescription protocols and recommended doses. Two clinical cases of CIDP in children are described. It is shown that the use of adequate doses of IVIG, glucocorticoids and long-term maintenance treatment can completely reverse the symptoms of peripheral lesion, prevent repeated exacerbations of the disease and significantly improve the quality of life.
55-70 1515
Abstract
The lecture discusses the types, causes, key links in the pathogenesis of water imbalance; their clinical manifestations, consequences and implications; and treatment principles.
EXCHANGE OF EXPERIENCE
А. А. Alekseyeva,
L. S. Namazova-Baranova,
S. G. Makarova,
Ye. А. Vishneva,
Yu. G. Levina,
А. Yu. Tomilova,
N. I. Voznesenskaya
71-75 1094
Abstract
Recent decades have recorded an increase in the prevalence of food intolerance reactions, as well as in the number of severe food allergies. Currently, there has been an increase in children’s allergic reactions to cereal food, primarily wheat and rye proteins (gluten), more rarely — corn, rice, oats, and buckwheat proteins. In case of reasonable suspicion for food allergies associated with a particular food product, an important diagnostic and therapeutic measure is the prescription of an elimination diet. This diet is widely used in cases of long-term symptoms and when the suspected causally relevant product is a daily food product. It is known that in the case of a food allergy an adequately chosen diet can lead to a clinical recovery in the initial stages of the disease, and in severe cases — promotes more rapid remission of the allergic disease and its long-term preservation.
76-79 1032
Abstract
The probability of the caries development largely depends on the oral microflora imbalance. This imbalance can be corrected with probiotics. The article analyzes the results of studies on the use of adapted milk formulas with probiotics to prevent caries in early childhood. It shows that the use of adapted formulas with probiotics is accompanied by a decrease in the frequency of releasing cariogenic streptococci and actinomycetes with a simultaneous increase in the frequency of detecting bacterial antagonists of the cariogenic flora, normalization of sIgA concentration in saliva, and decrease in the severity of the caries process. The survey results will contribute to the development of effective approaches to prevention of dental caries in children.
80-85 1118
Abstract
The article presents the literature data on the age characteristics of allergic reactions, their classification and clinical manifestations. The authors’ own data are given — the results from the examination of 143 families, including 120 children with frequent respiratory diseases (main group) and 23 children with occasional diseases (comparison group). It is shown that the incidence of allergic diseases in children in the main group and their parents is significantly superior to that in the control group. A clinical case of an allergic reaction in a child with a mixed intracellular infection is described. The principles of a macrolide therapy are stated.
86-90 721
Abstract
The article discusses the mechanisms of action, different effects of non-steroidal anti-inflammatory drugs, an agreed view on the risks of damages to the upper and lower gastrointestinal tract induced by these drugs, as well as ways to eliminate them. The drugs with a relatively small adverse effect on the gastrointestinal tract are described.
91-94 1083
Abstract
Functional nutrition is one of the main factors ensuring infants’ balanced growth and development, as well as learning abilities, immunity to unfavourable environment conditions during infancy period. It also provides for a morphofunctional development of infant organs and body systems, and ensures that an infant will grow up to his or her genetically determined age growth and development level. Choosing the proper nutrition for infants, one can prevent nutritional disorders, rickets, anaemias, acute infectious and non-contagious diseases. It can also reduce the probability of the development of chronic diseases, and allows to sustain relatively high quality of life of infants with congenital and genetic anomalies. Using breast milk as a primary source of nutrition is the most optimum choice of infant feeding. However, according to the statistical data, the numbers reported for occurrence and duration of breastfeeding in Russia are far from being perfect.
SHORT REPORTS
95-96 864
Abstract
The most common causes of children's sore throat are infectious and inflammatory diseases of the pharynx. The optimal treatment of these diseases is the appointment of local antiseptic and anesthetic drugs.
CLINICAL OBSERVATIONS
97-99 1142
Abstract
Hereditary angioedema is a rare and dangerous hereditary disease, the differential diagnostics of which is very difficult up to date. Children with this disorder come with acute abdominal pain that may be caused by diseases of the digestive and urinary system, various gynecological diseases, and infectious processes in the body. The main task of the children's surgeon is to exclude acute surgical pathology and perform differential diagnostics with diseases such as acute appendicitis, Meckel diverticulum, intestinal obstruction, omentum infarction and the other as soon as possible. The article presents the clinical observation of a 14-year-old female patient with angioedema.
100-103 878
Abstract
The article describes a case of an early debut and difficult treatment of systemic juvenile idiopathic arthritis resistant to peroral glucocorticoids. The described clinical example demonstrates the successful use of tocilizumab, a monoclonal antibody drug, against interleukin-6 receptors. After the 1st drug infusion the systemic manifestations of the disease were alleviated, by the 6th week of the tocilizumab treatment inflammatory changes in the joints were reduced, and by the 16th week the inactive stage of the disease was registered, which made it possible to stop the administration of glucocorticoids per os. Duration of remission of articular syndrome and extra-articular manifestations was 10 months.
104-107 1393
Abstract
Velopharyngeal insufficiency is one of the main causes of speech disorders in children with congenital cleft palate, leading to social exclusion and disability of patients. This article describes an integrated approach to the treatment of velopharyngeal insufficiency, aimed in improving the anatomical and physiological function of velopharyngeal ring. Velopharyngeal ring is considered as the nervemuscle complex in the treatment of patients with this pathology. It is shown that a one-time complex treatment of velopharyngeal insufficiency, estimated with the program «Compare» in the below-described clinical example, increased velopharyngeal closure ring by 25%, thus eliminating nasality and significantly improve the quality of speech.
ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)
ISSN 1682-5535 (Online)
