No 4 (2019)

Articles
INTRACRANIAL HEMORRHAGES IN LATE HEMORRHAGIC DISEASE OF THE NEWBORNS
Zaplatnikov A.L., Brazhnikova O.V., Medoev S.B., Nikitin V.V., Efimov M.S., Gorev V.V., Dement'ev A.A., Chabaidze Z.L., Ashurova B.A., Koroleva A.S., Potanina I.V., Trofimov A.A., Gaevyi O.V., Shablia V.V., Volokhin A.I.
Abstract
The following article presents the thorough analysis of the causes of severe hemorrhagic disorders in full-term children aged 1 -6 months who were hospitalized in the Bashlyaeva Children's City Clinical Hospital (n=41, with an observation period of 5 years). It was found that in 68.3% of cases, the cause of hemorrhagic syndrome was vitamin K deficiency (late hemorrhagic disease of the newborns). It was noted that the main risk factor for the development of vitamin K-deficiency was exclusively breastfeeding (78.6%), whereas biliary atresia, hereditary diseases with intrahepatic cholestasis and malabsorption syndrome were identified as the cause of late hemorrhagic disease of the newborn significantly less often (21.4%). It was found that in 22 of 28 children with a deep deficiency of vitamin K, intracranial hemorrhages occurred. It was noted that in most cases, intracranial hemorrhage was preceded by hemorrhages on the skin and/ or increased bleeding, which were not adequately evaluated, which determined the absence of timely therapy and the progression of hemostasis disorders.
Pediatrics. Consilium Medicum. 2019;(4):14-17
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ACUTE STENOSING LARYNGOTRACHEITIS IN CHILDREN. DIAGNOSIS AND EMERGENCY TREATMENT. LECTURE
Blokhin B.M., Lobushkova I.P., Prokhorova A.D., Suyundukova A.S.
Abstract
Acute respiratory failure in children is an urgent problem of modern emergency pediatrics. Their share in the structure of primary morbidity is about 60%. More than 25 million cases of respiratory organ diseases are registered annually in Russia among the children. Viral croup is one of the most frequent causes of the respiratory distress in young children. It is represented by a swelling of the mucous membrane of the lining of the larynx, accompanied by characteristic clinical symptoms: an inspiratory stridor, hoarseness, a rough "barking" cough. The article shows the features of clinical manifestations, methods for diagnosing acute stenosing laryngotracheitis, as well as supporting diagnostic criteria for alternative diseases that occur with stridor present. Urgent measures for croup treatment are aimed at the most rapid restoration of respiratory function possible as well as the improvement of the patient's condition, prevention of progression of laryngeal stenosis. The drug of choice in emergency treatment of croup are glucocorticosteroids - in inhaled, oral or parenteral forms. In cases of severe stenosis, epinephrine inhalations prove quite effective. The timely provision of qualified prehospital care is an important condition for optimizing the treatment of acute stenosing laryngotracheitis, which helps to prevent deterioration, reduce the incidence of complications, as well as the duration of inpatient treatment, and in some cases avoid hospitalization.
Pediatrics. Consilium Medicum. 2019;(4):18-22
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SYMPOSIUM "MODERN APPROACHES TO THE TREATMENT AND PREVENTION OF ACUTE RESPIRATORY VIRAL INFECTIONS FROM THE PERSPECTIVE OF A PEDIATRICIAN, IMMUNOLOGIST, OTORHINOLARYNGOLOGIST" (REVIEW)
- -.
Abstract
During the XVIII Russian congress "Innovative Technologies in Pediatrics and Pediatric Surgery" with international participation, a symposium on "Modern approaches to the treatment and prevention of acute respiratory viral infections from the perspective of a pediatrician, immunologist, otorhinolaryngologist" was held. Actual views on the problem of respiratory infections in children were presented.
Pediatrics. Consilium Medicum. 2019;(4):24-31
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RATIONAL THERAPY OF ACUTE RESPIRATORY INFECTIONS IN CHILDREN. BEST PRACTICE
Zaitseva S.V.
Abstract
As part of an educational program conducted by the “Pediatrics. Consilium Medicum”, the speeches on the topic of rational treatment of acute respiratory infections in children took place. A review of two lectures is presented below.
Pediatrics. Consilium Medicum. 2019;(4):32-38
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INTERCURRENT DISEASES IN TYPE 1 DIABETES IN CHILDREN AND ADOLESCENTS: PREVENTION OF ACUTE COMPLICATIONS. LECTURE
Kiseleva E.V., Okminyan G.F., Latyshev O.Y., Samsonova L.N., Kasatkina E.P.
Abstract
The main goal of the treatment of type 1 diabetes mellitus lies in the prevention of the development of acute and chronic complications of the disease. The acute complications of diabetes and its therapy include diabetic ketoacidosis and hypoglycemia. Diabetic ketoacidosis is the leading cause of death in childhood diabetes cases. At the heart of diabetic ketoacidosis development is an absolute or relative insulin deficiency. In turn, increased insulin demand and insulin deficiency occur mainly with the development of a patient with diabetes with intercurrent diseases and the implementation of surgical aids. Hypoglycemia is a major complication of the diabetes treatment that has the tendency of limiting the achievement of blood glucose targets. A number of intercurrent diseases affecting the absorption of carbohydrates in the gastrointestinal tract increase the risk of hypoglycemia. Algorithm for the action of patients, as well as the medical practitioners of various specialties, is, first and foremost aimed at prevention of the development of diabetic ketoacidosis and hypoglycemia in intercurrent diseases, presented in the following publication.
Pediatrics. Consilium Medicum. 2019;(4):39-44
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RATIONAL ANTIBACTERIAL THERAPY OF URINARY TRACT INFECTIONS IN CHILDREN: A NEW OPINION BASED ON ANTIBIOTIC RESISTANCE DATA
Zakharova I.N., Kasjanova A.N.
Abstract
Today, rational treatment of urinary tract infections (UTI) is an urgent task, since increasing antibiotic resistance leads to a significant decrease in its effectiveness with previously used drugs. The review provides current information on the etiological structure of UTI in children, demonstrating the results of large studies, as well as the existing data on the resistance of uropathogenic microorganism strains to modern antibiotics. Recommendations for the use of antibacterial drugs for UTI in children are also shown, including effective antibiotic regimens.
Pediatrics. Consilium Medicum. 2019;(4):45-50
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EXPERIENCE OF TREATMENT WITH GROPRINOSIN (INOSINE PRANOBEX) FOR HERPES VIRUS INFECTION IN CHILDREN WITH EPILEPSY AND INFANTILE CEREBRAL PALSY
Savenkova M.S., Balakireva G.M., Kuznetsova E.S., Rumiantseva I.G., Afanas'eva A.A., Savenkova A.M., Osipova K.V., Karazhas N.V., Rybalkina T.N., Lysenkova M.l., Dushkin R.V.
Abstract
Relevance. Previous studies showed an important role of herpes viruses in children with epilepsy and infantile cerebral palsy (ICP). Materials and methods. This study was conducted from 2014 to 2018 on the basis of the Voino-Yasenetski Scientific and Practical Center for Specialized Medical Care for Children and the Morozov Children's City Clinical Hospital. Serological and microbiological molecular genetic (PCR test) methods, ELISA test, indirect immunofluorescence reaction and rapid culture method were used to confirm herpes infection. In the open prospective study 298 children with epilepsy and ICP were included, in 131 (44%) of them herpes infection was revealed. 100 children who received inosine pranobex (Groprinosin®) were under follow-up: 92 children were in the hospital and 8 children were outpatient. Inclusion criteria were: children aged 3-15 years with epilepsy and ICP. Most children have symptomatic focal epilepsy. Exclusion criteria were: age less than 3 years, severe hematological, oncological and somatic diseases. Children were divided into the following groups: group 1 - epilepsy (n=36); group 2 - epilepsy + ICP (n=20); group 3 - ICP (n=44). The comparison group (group 4) included 31 children aged 3 to 15 years with herpes virus infections: epilepsy (n=25) and cerebral palsy (n=6), who took conventional anticonvulsant therapy without inosine pranobex. Results. In the group of children examined, mainly aged 3-6 years, the most prevalent infections were cytomegalovirus (75.3%) and human herpes virus (HHV)-6 (86.2%) along with Epstein-Barr virus and HHV-1, HHV-2. Patients infected with cytomegalovirus and HHV-6 have mainly an acute course of disease (40.9 and 51.9%, respectively) while patient with Epstein-Barr virus and HHV-1, HHV-2 have a persistent chronic course of disease (76.1 and 75.5%, respectively). Most of the examined children showed mixed infection with 2 or 3 different herpes viruses. In groups of children who took inosine pranobex, treatment showed highly beneficial effect on dynamics of clinical, laboratory and instrumental parameters.
Pediatrics. Consilium Medicum. 2019;(4):51-57
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OBSERVATION OF TRICHOBEZOAR OF STOMACH AND SYNDROME RAPUNZEL AT 9-YEAR-OLD GIRL. CLINICAL CASE
Sokolov Y.Y., Stonogin S.V., Korovin S.A., Koshurnikova A.S., Afonin D.V., Lyubanskaya S.Y., Rappoport L.M.
Abstract
Extremely rare case of a giant stomach trichobezoar in a 9-year-old girl. The disease was asymptomatic for a long time. Presence of a mass which could be palpated through the abdominal wall in stomach area suggested stomach bezoar formation. Owing to it’s big size, the trichobezoar was removed surgically with a good clinical result. The girl was discharged fully recovered. This case demonstrates the choice of optimum diagnostic and surgical tactics in a child with a giant trichobezoar.
Pediatrics. Consilium Medicum. 2019;(4):58-61
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STATE OF GASTROINTESTINAL TRACT IN THE JOINT HYPERMOBILITY SYNDROME: FUNCTIONAL DISORDERS OR THE FIRST CALLS OF ORGANICS?
Delyagin V.M., Aksyenova N.S., Olimpieva S.P.
Abstract
Relevance. Joint hypermobility syndrome (JHS) is the most common variant of connective tissue dysplasia. The syndrome proceeds with changes in the gastrointestinal tract, but the structure and possible causes of this need to be clarified. Aim. Determine the relationship between JHS and the nature of changes in the gastrointestinal tract. Materials and methods. 113 children with joint hypermobility syndrome and 106 without this syndrome were examined. The frequency of functional and organic changes in the groups was determined. Results. Inorganic changes (functional disorders of swallowing, abdominal pain, globe, etc.) prevailed among patients with JHS, but a double gall bladder, cysts of the gall bladder, choledoch were recorded. Among patients with organic lesions (inflammatory diseases of the colon, peptic ulcer, lymphomas, etc.), JHS was recorded very rarely. Conclusion. In children and adolescents with JHS, functional disorders of the gastrointestinal tract predominate. However, already at this age, an organic pathology begins to form, associated with a genetically determined lesion of the connective tissue (diverticulum of the hollow organs).
Pediatrics. Consilium Medicum. 2019;(4):62-65
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ACTUAL ASPECTS OF THE DIAGNOSIS AND TREATMENT OF HELMINTHIC INFESTATIONS. LECTURE
Blokhin B.M., Prokhorova A.D., Suyundukova A.S., Lobushkova I.P.
Abstract
At present the problem of worm infestation is quite common in clinical practice of primary care physicians (pediatricians). In Russia, up to 80 nosological species of helminths are detected and found. Helminths have certain adaptive mechanisms that allow them to effectively suppress the host’s immune system and exist in a macroorganism state. All helminthic invasions are characterized by a common clinical and pathogenetic stages. Clinical manifestations depend on the location of the helminth, the state of the macroorganism, and the activity of the process. For primary contact doctors, it is important to know the main indications for screening for helminth infections. Diagnostic algorithms are approved by the standards of the World Health Organization. The “gold standard” of diagnosis is helminthoproscopy. However, serological diagnostic methods can be used for tissue helminthiases, as well as in the diagnosis of the acute phase of the disease. In the treatment of helminthic infestations, anthelmintic drugs of the II and III generations are mainly used. In order to eliminate helminth infections transmitted through the soil, the new programme of preventive measures endemic areas will be launched by the World Health Organization in 2020. It includes, among other things, the prophylactic administration of anthelmintic drugs to children, such as mebendazole and albendazole.
Pediatrics. Consilium Medicum. 2019;(4):66-70
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SOME ASPECTS OF THE ADAPTIVE CAPABILITIES OF TEENAGE GIRLS (SCHOOLGIRLS) STUDYING IN DIFFERENT SPECIALIZED PROGRAMS
Danilova O.V., Ryzhova E.G., Kholodova I.N.
Abstract
The article presents the results of a study of the state of the bodily regulatory systems in teenage girls (e.g. schoolgirls) studying in different profile classes using the diagnostic system of the Varicard complex, which evaluates the adaptive capabilities of the body based on the analysis of heart rate variability using the electrocardiogram method. The advantages of this method include speed, information content, the possibility of its use in an outpatient network, as well as economic feasibility. Aim. To study the adaptive capabilities and evaluate the functional state of the body in girls of grades 9-11 who study in different specialized programs using the “Varicard” diagnostic complex,. Materials and methods. The study included 208 students of grades 9-11 studying in various specialized programs. The average age of the subjects was 15.61±0.93 years. Results. Disorders in the system of autonomic homeostasis were found in students of all profiles, and the equilibrium state of autonomic homeostasis is more characteristic of adolescent girls - students of grade 10 compared to grades 9 and 11. The state of adaptation of high school students was characterized by unfavorable indicators at the beginning of specialized education (9th grade), which testified to the formation of adaptation processes, as well as in the 11th grade, when the tension in connection with preparation for exams increased. The level of adaptation in students of 10th grade was significantly less often characterized by a decrease in the stress index compared with nine and eleven graders. No profile differences in indicators have been identified; therefore, it is not the orientation of the training that matters, but the fact of the transition to the study of a particular specialty. The use of the diagnostic system of the Varicard complex made it possible to quickly and informatively identify violations in the adaptation system and early deviations in the state of health, identify risk groups for students requiring a more detailed examination, differentiated medical and social support and correction.
Pediatrics. Consilium Medicum. 2019;(4):71-74
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OMSK SCHOOL OF PEDIATRICIANS IS THE FIRST IN SIBERIA. LECTURE
Krivtsova L.A., Fedorova G.V., Sobotyuk N.V.
Abstract
The article shows the first pediatricians school formation history and the role in its creation of leading Russian scientists O.D. Sokolova-Ponomaryova and V.P Bisyarina.
Pediatrics. Consilium Medicum. 2019;(4):75-77
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