Pediatrics. Consilium Medicum

The journal publishes the works of scientists and practicing pediatricians, including experts in the field of neonatology, gastroenterology, otolaryngology, pulmonology, cardiology, endocrinology, allergy, dermatology, rheumatology, dentistry, clinical pharmacology, neurology, nutrition, emergency care in Russia and CIS countries. During its existence the magazine has gained wide recognition among professionals. 

 

Main sections: Healthy child, neonatology, endocrinology, otolaryngology and pulmonology, allergology, gastroenterology, cardiology, interdisciplinary problem, childhood infections, methods of diagnosis and treatment, the results of the original clinical trials, scientific reviews, scientific events reports. 

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Current Issue

No 1 (2021)

Articles
History of the development of Russian pediatric neurourology. To the 80th anniversary of Professor Evgeny Leonidovich Vishnevsky
Guseva N.B., Vishnevsky A.E., Ignatev R.O., Ignatev G.R.
Abstract

Neurogenic bladder, which is accompanied by urinary incontinence and causes numerous complications resulting in chronic kidney disease, is one of the most severe consequences of malformations and spinal injuries in children. They limit the child’s ability to live, even to the point of total disability, and the problem of impaired bladder emptying has no universal solution. The staff of the Department of Pediatric Urology of the Moscow Research Institute of Pediatrics and Children’s Surgery of the Russian Ministry of Health started working on the strategy of urinary tract function recovery in children more than 50 years ago, and the main inspirer and ideologist of the whole pleiad of scientists was E.L. Vishnevsky. For the first time, separate developments in the treatment and socialisation of spinal patients were brought together in a unified system of medical care, which remains relevant today. E.L. Vishnevsky initiated the creation of the unique scientific and practical centre «Pathology of Urinary Drainage» on the basis of Speransky Children’s City Clinical Hospital №9. Under the leadership of E.L. Vishnevsky defended 15 candidate theses and 5 doctoral theses. Evgeny Leonidovich is an author of 10 inventions, 180 scientific publications, including 7 monographs. On the initiative of E.L. Vishnevsky and with his direct support similar centres were established by his students and associates in Vladivostok, Omsk, Petrozavodsk and Kazan. Having unquestionable authority in this field, E.L. Vishnevsky has forever remained a classic of the national school of pediatric neurourology, which has no equals in the world.

Pediatrics. Consilium Medicum. 2021;(1):10-12
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Etiology and features of the course of the wound process in neonates
Avanesyan A.A., Astamirova T.S., Budkevich L.I.
Abstract

Introduction. Despite the significant progress made in recent decades in reducing the mortality rate, the risks of adverse outcomes in infectious and inflammatory soft tissue diseases in newborns are still high. The high-risk group consists of children from mothers with a pre-morbid background, as well as premature infants with intrauterine hypoxia and intracranial birth trauma. Traumatization and infection can also occur during medical manipulations (tracheal intubation, vascular catheterization, damage to the baby’s skin during obstetrical procedures, etc.). The variety of pathological processes that cause wounds of different etiology is due to the anatomical and physiological features of the skin of newborns. In addition, neonatal skin lesions may be a manifestation of systemic diseases and may themselves be the cause of manifestation.

Materials and methods. Medical records of 147 neonates treated in infectious and burn units of Speransky Children’s City Clinical Hospital №9 were analyzed. Clinical examples of children in the first month of life with wounds of various etiologies are presented.

Conclusion. Treatment of newborn infants with inflammatory processes of the skin and underlying tissues of different etiology requires multidisciplinary approach with the involvement of not only surgical specialists.

Pediatrics. Consilium Medicum. 2021;(1):13-18
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The use of functional foods in children
Zakharova I.N., Berezhnaia I.V., Sgibneva A.I.
Abstract

The article presents the concept of functional nutrition through which general health improvement of the organism takes place. The functional components of nutrition are vitamins, carotenoids, micro- and macronutrients (calcium, magnesium, sodium, potassium, iron, iodine, selenium), dietary fiber, protein hydrolysates, polyunsaturated fatty acids, probiotics and prebiotics. The concept of functional nutrition has been developing in Russia since 1993, and these ideas were enshrined in law in 1998. Specialized products for children are created taking into account age, safety of ingredients, balance of fats, proteins and carbohydrates, vitamins, microelements, with addition of pro- and prebiotics.

Pediatrics. Consilium Medicum. 2021;(1):19-24
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Impact of gut microbiota and vitamin A and D supplementation on child health
Zakharova I.N., Dedikova O.V., Kuchina A.E., Sgibneva A.I.
Abstract

The influence of nutrients on the development and health of a child from its prenatal development and throughout its life is discussed now. Particular attention is paid to maternal nutrition, the presence of breastfeeding, the intake of supplements such as vitamin D and probiotics. It is known that the composition of the intestinal microbiota of the newborn child is negatively affected by the mother’s taking antibiotics during pregnancy or in the early neonatal period, which affects the development of the infant’s immune system, contributes to atopic diseases, including atopic dermatitis and bronchial asthma, increases the risk of obesity and metabolic syndrome, Crohn’s disease, type 1 diabetes, etc. Differences in the microbiota are particularly significant after antibiotic therapy for emergency caesarean section. Studies have shown that it is possible to normalise the microbiota during the 1st year of life in exclusively breastfed infants. The synergism of probiotic strains of gut microbiota and vitamin D is discussed in the scientific literature.

Pediatrics. Consilium Medicum. 2021;(1):25-29
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Features of clinical manifestations of COVID-19 in children of the Samara region
Borisova O.V., Bochkareva N.M., Kitajchik S.M., Kabanova N.P., Yashkina O.N., Turko S.I.
Abstract

Relevance. The new coronavirus infection caused by the SARS-CоV-2 virus remains relevant all over the world and is an important medical, social and economic problem. For more than a year, the COVID-19 pandemic is preserved, the disease is characterized by high contagiousness and significant level of mortality among adult patients. According to the researchers of the whole world, children more often tolerate coronavirus infection in lungs and asymptomatic forms. However, many COVID-19 questions in children require deep analysis, in particular the polymorphism of the clinical picture of the disease.

Aim. Study of the characteristics of the clinic of a new coronavirus infection in children of the Samara region according to the data of the Samara Regional Children’s Infectious Hospital.

Materials and methods. 338 children were studied with a diagnosis of U07.1 (confirmed coronavirus infection) aged 2 months and up to 18 years.

Results. Children are more often infected in family foci of infection (72.6%). 23.4% of patients had an adverse premorbid background and concomitant diseases. Among hospitalized children prevailed patients with a slight course of the disease (72.5%), manifested by respiratory or gastrointestinal symptoms. Bilateral interstitial pneumonia is diagnosed in 93 patients (24.8% of moderate severity, 2.7% is heavy). Frequently frequent syndrome in children was excreted (12.4%). Critical flow of illness and deaths among children is not marked.

Conclusion. According to the results of the study, the main syndromes of the disease characteristic of childhood are revealed. Polymorphism of the clinical picture of the new coronavirus infection in children require further study.

Pediatrics. Consilium Medicum. 2021;(1):29-33
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Irrigation therapy in the treatment and prevention of allergic rhinitis in young children
Payganova N.E., Yastremskii A.P.
Abstract

The article outlines the basic provisions for the definition, classification, diagnosis and basic methods of treatment of allergic rhinitis (AR) in children. The role of irrigation-elimination therapy in treatment and prophylaxis of AR exacerbations in children has been singled out. The peculiarities of irrigation-elimination therapy in infants and young children and the most common mistakes in the care of the nasal cavity in infants and young children have been emphasized. The use of nasal shower helps to reduce the concentration of allergens on the mucous membrane of the nasal cavity and nasopharynx, while moistening, which essentially leads to the prevention of AR exacerbations, and also helps to reduce the concentration of viruses, remove dust particles and in some cases refluxant (if gastroesophageal reflux is present). The indications for the use of the Otrivin Baby aspirator and drops in the treatment and prevention of AR in children are outlined and the main points of use of the Otrivin Baby aspirator are explained. The advantages of using the Otrivin Baby device, including the aspirator and sterile isotonic solution drops for treatment and prevention of AR in infants are described.

Pediatrics. Consilium Medicum. 2021;(1):34-38
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Analysis of the mucous microbiome of the nasopharynx in children with chronic adenoiditis and otitis media of effusion
Karpova E.P., Gurov A.V., Burlakova K.Y.
Abstract

The role of pathology of the adenoid in the development of otitis media of effusion (OME) is currently being discussed. OME is a disease of the middle ear, which is characterized by the accumulation of exudate behind the tympanic membrane in the absence of perforation for three months or longer, leading to hearing loss, increasing the risk of delayed formation of correct speech in the child and behavioral problems. The question of the development of OME, in view of the presence of an infectious focus in the adenoid and further spread to the auditory tube, is ambiguous. In some works, the possible spread of the inflammatory process to the Eustachian tube with long-term preservation of pathogenic microorganisms in the structure of the lymphoid tissue, which is characteristic of persistent viral infections, and the further development of OME are considered. The mucous membrane of the nasopharynx is inhabited by many microorganisms: representatives of an indigenous microbiota, opportunistic and pathogenic.

Aim. To study the microbiome of the mucous membrane of the nasopharynx and middle ear in children with chronic adenoiditis (CA) and OME.

Materials and methods. The study included 174 children with OME and CA (114 boys and 60 girls) aged 3 to 14 years (6.9±0.5 years). We have developed a staged diagnostic algorithm, including the collection of a life history, illness and complaints of the child (or his parents), as well as ENT examination, endoscopy of the nasopharynx, otoendoscopy, audiological examination, microbiological examination by real time PCR, whole genome sequencing NGS.

Results. The main microorganisms of the nasopharyngeal mucosa in children with CA and OME of different age groups are described.

Conclusion. In the treatment of children with CA and OME, it is necessary to take into account the features of the normal microbiota of the nasopharynx; it is important to understand that by acting on opportunistic and pathogenic microorganisms, it is necessary to remember to create favorable conditions for stimulating the growth and development of representatives of the indigenic microbiota, which in turn will contribute to the patient’s speedy recovery and absence of relapses in the future.

Pediatrics. Consilium Medicum. 2021;(1):39-45
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Non-specific prevention of acute respiratory viral infections: pitfalls and new facts
Bogdanova S.V., Garashchenko T.I., Il’enko L.I.
Abstract

Acute respiratory viral infections (ARVIs) occupy one of the leading places in the structure of infectious morbidity in the autumn-winter period among children and adults. Timely preventive measures must play a fundamental role in reducing the incidence of respiratory infections, especially recurrent infections. To reduce the incidence of ARVI and influenza, pediatricians recommend a set of measures, including specific and non-specific prophylaxis. The article presents the data of studies which compare the effectiveness and safety of drugs used to prevent ARVI (interferons, interferon inducers, homeopathic medicines).

Pediatrics. Consilium Medicum. 2021;(1):46-51
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Selection of a topical drug for the treatment of BHSA-negative tonsillopharyngitis in children
Radtsig E.I., Evsikova M.M., Kukes I.V., Raikina E.V., Brilliantova V.V.
Abstract

Introduction. Inflammation of the mucous membrane and lymphoid structures of the oropharynx (tonsillopharyngitis – TP) occurs frequently in paediatric practice, both against the background of acute respiratory infection and outside catarrhal manifestations. The main focus of the medical treatment of TP is on the indications for systemic antibacterial agents, and the choice of pathogenic and/or symptomatic agents is not strictly regulated and is left to the discretion of the physician. At the same time data on anti-inflammatory activity of different topical drugs for local treatment of TP are practically absent, though inflammatory process affects oropharyngeal mucosa, which is a part of mucosal immunity system (NALT-level MALT system) and can be of different genesis and connected to formation of different cytokines (both pro- and anti-inflammatory).

Objective. To determine cytokine levels in patients with acute TP (ATP) before and after administration of various topical medicines used for the treatment of ATP.

Materials and methods. Patients diagnosed with uncomplicated ATP over 3 years of age who agreed to be examined, treated and biomaterial (scraped oropharyngeal mucosa) were included in the study. All patients underwent routine ENT examinations, a rapid test for BHSA-positive TP and biomaterial sampling for proinflammatory cytokines. Patients included in the study were randomly allocated into 2 groups: Group 1 patients used benzidamine and Group 2 patients used benzyl dimethyl ammonium chloride monohydrate. Both drugs are indicated for the treatment of ATP in patients over 3 years of age and are available in the form of a throat spray.

Results. Forty-nine patients with BHSA-negative ATP were included. Forty-five of them received benzidamine and 24 received benzyl dimethyl ammonium chloride monohydrate by random assignment (both drugs were applied to the oropharyngeal mucosa). There was a significant reduction in the proinflammatory cytokine interleukin (IL)-1 in patients in whom benzidamine was used compared to the group of patients where benzildimethyl ammonium chloride was used. A similar trend was detected in the analysis of the proinflammatory cytokine IL-6. A marked decrease in the level of IL-8 under the influence of benzidamine compared to benzildimethyl ammonium chloride was also observed. The general dynamics of the proinflammatory cytokine level reduction was traced at the evaluation of the tumour necrosis factor α level.

Conclusion. The data obtained suggest that the use of benzidamine has a more pronounced anti-inflammatory effect. This aspect is important for the practitioner (otorhinolaryngologist, paediatrician) when choosing a topical drug for the treatment of TP, especially at the first symptoms of the disease.

Pediatrics. Consilium Medicum. 2021;(1):53-56
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Eosinophilic esophagitis: still a difficult condition to diagnose. Case report
Zakharova I.N., Osmanov I.M., Pampura A.N., Khomeriki S.G., Vorobeva A.S., Goncharova L.V., Dmitrieva D.K., Koshurnikova A.S., Kvirkvelia M.A., Simakova M.A., Sgibneva A.I.
Abstract

The prevalence of eosinophilic esophagitis (EoE) has increased significantly over the past 20 years, which may be associated with an increase in awareness of the clinical features, the definition of criteria for the diagnosis of this condition. However, in our country, this disease remains rarely diagnosed. The difficulty in diagnosing EoE is due to the insufficiently high alertness of doctors regarding the detection of EoE, the peculiarities of differential diagnosis, and the need for invasive procedures. An important factor is the presence of a highly qualified pathologist on the staff to evaluate the obtained biopsy specimens. Further study of the pathogenesis of the disease, food triggers and the development of non-invasive methods for assessing the esophagus are required.

Pediatrics. Consilium Medicum. 2021;(1):57-62
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A rational approach to the treatment of urinary tract infections in children
Chugunova O.L.
Abstract

The article discusses the issues of complex therapy of urinary tract infection (UTI) in children on the basis of a discussion of modern features of etiology, pathogenesis, and clinical manifestations. The emergence of microbial biofilms and the increasing resistance of pathogens that cause the development of UTI dictate the need to search for new methods of treatment. To overcome the persistence of bacteria and reinfection, rational antibiotic therapy is required, taking into account the sensitivity of the sown flora to antibiotics, the rejection of the use of long-term antibiotic prophylaxis, the elimination of organic and functional disorders of urodynamics, as well as the use of herbal medicines. If the child does not have severe abnormalities or there is a functional obstruction, then alternative methods should be considered as a preventive anti-relapse measure. After courses of antibiotic and uroseptic, or simultaneously with them, the herbal medicinal product Canephron® N can be prescribed, which contains parts of three plants – the roots of lovage, herb centaury and rosemary leaves. The drug has antimicrobial, anti-inflammatory, antispasmodic and diuretic effects. Its use can increase the effectiveness of complex treatment of exacerbations and preventive therapy for recurrent UTI.

Pediatrics. Consilium Medicum. 2021;(1):63-71
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Botulinum toxin type A in pediatric urological practice: current state of the problem and future perspectives
Romashin M.A., Guseva N.B., Mlynchik E.V., Ignatyev R.O.
Abstract

Botulinum toxin was used in medicine in the middle of the 20th century. Studies in various fields around the world have proven its high safety profile and are successfully used in clinics in different countries. In pediatric urology, botulinum toxin is used for chemodenervation of the bladder detrusor and urethral sphincter. The main contingent for the use of botulinum toxin type A (BTTA) is children with myelodysplasia (that is, with organic lesions of the spinal cord and, as a result, impaired innervation of the pelvic organs), the manifestations of which are urgency urinary incontinence, which represents a significant deterioration in the quality of life and difficulties in socialization and normal life of children. In addition, gallbladder-dependent ureterohydronephrosis is often found in these patients, as a result of hyperactivity and hypertonicity of the detrusor, increased intravesical pressure and the presence of residual urine. In both of the above cases, chemodenervation of the detrusor using botulinum toxin shows excellent results, and therefore this method is gaining popularity all over the world. Nevertheless, in pediatric practice, the indications for the introduction of BTTA are not clearly formulated, and there are currently few studies and, accordingly, the results of its use. The aim of this work is to review the accumulated data on the use of BTTA and their interpretation.

Pediatrics. Consilium Medicum. 2021;(1):72-75
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Asthenic syndrome in schoolchildren: from the risk of development to diagnosis and treatment
Zakharova I.N., Tvorogova T.M., Pshenichnikova I.I., Sgibneva A.I.
Abstract

Asthenic syndrome is a common pathological condition of the child population, which the pediatrician has to deal with first of all. The results of our studies revealed the presence of asthenic varying degrees of severity in 59% of schoolchildren. From a pediatric perspective, the article highlights the main clinical manifestations of asthenic syndrome and its features, pathogenetic mechanisms of development, rational research methods to exclude «masks», outlines the importance of various therapy options for eliminating the manifestations of asthenia.

Pediatrics. Consilium Medicum. 2021;(1):76-83
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The accumulation of glycogen in neutrophilic granulocytes in children with glycogen disease
Pervichko O.V., Soboleva N.G., Evglevsky A.A., Baum T.G.
Abstract

Glycogen metabolism disorder due to genetic inherited defects is a rare disorder leading to pathological accumulation of the substance in liver, muscle tissue. Due to the expansion of genetic testing, it is possible to confirm the diagnosis and determine the type of glycogen storage disease. Here is a clinical example of type X glycogen disease in a 4-year-old girl.

Pediatrics. Consilium Medicum. 2021;(1):84-86
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Clinical tasks
Kholodova I.N.
Abstract

The heading is headed by Doctor of Medical Sciences, Professor I.N. Kholodov, Department of Pediatrics. G.N. Speransky.

Pediatrics. Consilium Medicum. 2021;(1):87-88
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