Vol 9, No 3 (2012)
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VACCINATION
8-11 662
Abstract
A new WHO position paper has been published recently stressing the high priority of the inclusion of PCVs in childhood immunization programs worldwide. Planning for national use of pneumococcal vaccines should take besides other factors the distribution of pneumococcal serotypes in different age groups into consideration. In addition to the serotypes included in PCV7, PCV13 contains serotypes 1, 3, 5, 6A, 7F and 19A and this vaccine provides the broadest serotype coverage of PCVs globally. In Europe and the US, the vaccine was approved in late 2009 and early 2010, respectively. Only two years after introduction of PCV13 introduction into many NIPs globally, vaccine effectiveness for the PCV13 serotypes has been documented for several clinical outcomes (invasive pneumococcal disease (IPD), including sepsis/bacteremia and acute meningitis, community-acquired pneumonia, and acute otitis media) and nasopharyngeal carriage from several countries (USA, England and Wales, Germany, Spain, Uruguay, Israel). Moreover, serotype-specific effectiveness has been demonstrated for serotypes 1, 6A, 7F and 19A, which were the most prevalent and emerging serotypes pre-PCV13 immunization.
A. A. Korsunskiy,
D. Y. Ovsannikov,
D. N. Degtarev,
I. N. Yakovleva,
E. A. Degtareva,
E. L. Bokeriya,
E. S. Keshishan,
O. V. Shamsheva,
E. S. Pavlova,
I. V. Krsheminskaya,
Z. S. Igityan,
H. M. Markhulia,
E. D. Balashova,
G. A. Alamovskaya,
O. V. Mironyuk,
O. V. Potapova
22-31 765
Abstract
The respiratory syncytial viral (RSV) infection is the leading cause of lower respiratory infections (bronchiolitis, pneumonia) in young children. Premature children and children with an inherent heart defect experience a heavy course of the infection, they require treatment in the resuscitation department, oxygen therapy and ALV. This article summarizes the first experience in Russia of executing a regional program on immunoprophylaxis of the RSV infection using monoclonal RDV-antibodies prepared with palivizumab among the following categories of children: premature children, children with a bronchopulmonary dysplasia and an inherent heart defect. The inclusion of palivizumab into the rehabilitation program of these categories of patients allowed to decrease the frequency of lower respiratory infections and corresponding hospitalizations by 4.6 and 4.8 times respectively. Not a single patient out of the 5 hospitalized with a lower respiratory infection, immunized with palivizumab, had his treatment connected with RSV. A high level of the drug’s safety was also determined — none of the children experienced any sort of unwanted effects.
URGENT ISSUES OF A TREATMENT OF EAR, NOSE, THROAT DISEASES
19-21 1589
Abstract
The problem of acute tonsillitis retains its relevance over the past few years. Its most frequent causative agent is the ß-hemolytic streptococcus group A. This article covers the clinical presentation of the disease and its differential diagnosis as well as modern methods of diagnosing and treating the disease. The therapy of acute tonsillitis is based on a complex approach, which allows to increase its effectiveness considerably. It is offered to use local-effect antibacterial drugs alongside the systemic antibacterial therapy. There are recommendations on the usage of pastilles for local antibacterial treatment, which allow to decrease the pain intensity during streptococcal tonsillitis and to decrease the probability of complications.
LECTURE
L. S. Namasova-Baranova,
O. A. Malakhov,
N. I. Taybuilatov,
S. D. Polyakov,
O. M. Konova,
O. O. Malakhov,
O. B. Chelpachenko,
K. V. Jerdev,
E. E. Tabe,
S. B. Lazurenko
32-39 821
Abstract
The rehabilitation of patients after surgery is an integral part of treatment in modern medicine. Restorative treatment is a complex of measures which includes participation of different medical specialists. The goal of child post-surgery rehabilitation is the restoration of physical and social adaptation of the patient. This article covers the main principles of restorative treatment in a multi-profile children’s medical institution. Examples of child rehailitation after reconstructive surgery of most frequent orthopedic pathologies are included.
40-45 1619
Abstract
Infections caused by the Coxsackie and ECHO enteroviruses is a group of acute diseases with a variety of clinical forms: from virus bearing and light feverish conditions to manifestations in the form of an enteroviral exanthema, serous meningitis, myalgia etc. Manifestations are polymorphic, and are often combined with a lesion of the central nervous system, muscles, myocardium, and skin. Epidemic outbursts and/or increases in morbidity are being registered in different regions of Russia and other countries worldwide. The article highlights the special features of the infection’s pathogenesis, as well as the ways of its transmission and peculiarities of prophylaxis. Taking into account its prevalence, peculiarities of the course and seasonal character, an awareness of specialists is needed in relation to the causative agents.
ORIGINAL ARTICLES
A. P. Potemkina,
T. V. Margieva,
O. V. Komarova,
P. E. Povilaitite,
L. V. Leonova,
T. V. Vashurina,
O. I. Zrobok,
A. N. Tsygin
46-51 1789
Abstract
Hematuria is a significant manifestation, which can reflect both renal disorders and other urinary tract diseases and also be a symptom of systemic illnesses. High prevalence, diversity of etiological and trigger factors, latent course of hematuria and phenotypic resemblance of a number of underlying nephropathies symptoms cause increased interest and urgency of further investigations of such diseases features. The examination of 56 children showed that the most common cause of glomerular hematuria was hereditary kidney diseases, associated with collagen IV type mutations — 64% (Alport syndrome — 56%, thin basement membrane disease — 44%) and IgA-nephropathy — 36%. Comparative analysis of these conditions is presented in this study.
52-57 644
Abstract
We investigated the polymorphism of the gene p53 exon 4 Arg72Pro and intron 3 ins/del 16 b. p. in children with juvenile idiopathic arthritis in order to identify the influence of gene polymorphisms on the course and outcome of the disease. The children were divided into several groups according to the sex, type of articular lesion and the effectiveness of treatment. The main criteria of therapy effectiveness was defined as achieving "inactive" arthritis as well as a clinical (pharmacologic) remission. The correlation between p53 gene genotypes among girls with oligo-, polyarthritis of juvenile idiopathic arthritis was shown for the first time. The data obtained demonstrates the necessity for further studies of the correlation between genotype p53 and juvenile idiopathic arthritis.
58-64 1164
Abstract
The problem of status epilepticus (SE) in infancy and early childhood is very important due to a high occurrence of SE, serious consequences of prolonged seizures for the child's developing brain, atypical variants of SE accompanying specific age-dependant forms of epilepsy in the first year of life (infantile epileptic encephalopathies), high rate of pharmacoresistant forms and severe disability of patients. Out of the total of 407 pediatric patients with revealed cases of SE 267 children had the SE onset before 3 years of age (65,6%), and 147 patients (36,1%) had SE onset in infancy. In the structure of ES at infancy and early childhood 38,6% of cases were represented by epileptic encephalopathies, 27% — by focal forms of epilepsy, 15,7% — hereditary neurodegenerations, 14,2% — acute symptomatic SE and 4,5% — isolated febrile SE. SE in infancy was treated with benzodiasepines — diazepam (0,5 mg/kg per rectum, i. m. or i. v.), midazolam (0,15–0,4 mg/kg i. v. in bolus, supporting infusion — 1–3 µg/kg/min), and valproates (convulex) in the initial dose of 10–25 mg/kg followed by a supporting infusion of 1–4 mg/kg/hour. The refractory cases of SE were treated with sodium oxybate (100–150 mg/kg with the speed of 400 mg/min), propofol (3 mg/kg i. v. in bolus followed by a supporting infusion — 100 µg/kg/min), sodium thiopental (4 mg/kg followed after 2 minutes by an infusion of 0,2 mg/kg/min).
S. V. Minaev,
A. N. Obedin,
Yu. N. Bolotov,
E. A. Tovkan,
A. V. Isaeva,
T. A. Horanova,
R. M. Tohchukov,
E. V. Stepanova
65-67 662
Abstract
Background. Newborns often develop purulent septic complications soon after surgical treatment of inherent gastrointestinal pathology. The aim: to define the prognosis significance of catelicidine (LL-37) as the marker of inflammatory complications during the post-operation period in neonates with gastrointestinal pathologies. Patients and methods. 21 newborns with inherent intestinal obstruction were included into the study. Each child received surgical correction of the defect. The children were divided into 2 groups: group 1 (n = 10) — newborns with purulent inflammatory complications after the operation (anastomosis failure — 2, peritonitis with ileus — 3, sepsis and pneumonia — 5); group 2 (n = 11) — children with no post-surgery complications. Healthy newborns formed the reference group (n = 20). The level of catelicidine LL-37 in the blood plasma was determined in all the children at delivery (BCM Diagnostics). Patients in groups 1 and 2 had their catelicidine LL-37 concentration measured on the 1,3,7 and 14th day after surgery.Results. A statistically significant (p < 0,05) difference in catelicidine was revealed only on the first day. While investigating the difference in LL-37 levels in the blood serum between children from the reference group and children from groups 1 and 2, statistically significant differences were found on all days. Conclusion. Determining the catelicidine level is an effective way of predicting post-surgery complications in the correction of developmental gastrointestinal defects.
68-71 852
Abstract
Background. Staphylococcus aureus function in atopic dermatitis (AD) children skin is double-handed: an infectious trigger and an allergen. The aim of the study was to evaluate the frequency of S. aureus enterotoxins the IgE in children with infected AD skin and to compare the IgE levels with antibiotic resistance of S. aureus. Methods: specific IgE to S. aureus enterotoxins A and B (ImmunoCap, Phadia AB, Sweden) were detected in the serum of 90 children infected with AD. The IgE levels were compared with the resistance to antibiotics (McNemar test and 95% confidential intervals of related frequencies). Results: specific IgE > 0,35 kUA/l to S. aureus enterotoxin A were found with a frequency of 0,29; to enterotoxin B — 0,36; to at least one of them — 0,43. The number of children with IgE > 0,35 kUA/l and S. aureus resistant to antibiotics was about 1/3 of the number of children with IgE < 0,35 kUA/l and S. aureus sensitive to antibiotics (р < 0,001). S. aureus in children with IgE > 0,35 kUA/l remained sensitive to oxacillin. Conclusion. In children infected with AD S. aureus enterotoxins A or/and B are revealed in 25–50% of cases. Specific IgE levels to S. aureus enterotoxins are similar in antibiotic resistant and antibiotic sensitive S. aureus skin swabs — about 30%. The IgE level to enterotoxins of S. aureus and its antibiotic resistance don't seem to be conditioned by each other.
For Pediatricians' Practice
86-90 703
Abstract
The results of a year-long examination of the physical health of the children attending Moscow’s preschool educational institutions are presented in this article. A statistically significant expansion of age-related child health reserves (р ≤ 0,001) was revealed. This was achieved over the course of 1 year by fulfilling the health-improving training schedule according to the developed recommendations, using the software «Express evaluation of preschool children’s physical fitness».
91-95 797
Abstract
Infections of the upper respiratory tract occupy a leading position among child diseases. During the past few years the number of children suffering from adenoiditis tends to increase. This article covers in detail the special features of etiology, clinical presentation, diagnosis, differential diagnostics, and treatment of this disease. The role of lymphoid formations in the formation of the upper respiratory immune system is also described in detail. The authors stress the necessity to increase indications for using conservative methods of treatment and warn against undertaking unfounded surgical interventions. The conservative treatment of an adenoid should be complex and should include irrigational therapy of the oral cavity and nasopharynx, local and systemic antibacterial therapy. A special attention is devoted to the usage of mucolytic drugs. We offer an observation of using an expectorant plant-based an antiinflammatory, antibacterial effect, which promotes the reduction of the phlegm viscosity its better discharge.
96-101 763
Abstract
The creation of a register of mucoviscidosis (MV) patients is necessary for determining the epidemic situation in the region, evaluating the efficacy of therapeutic strategies and the quality of healthcare provided. The regional register of Yaroslavl contains information about 53 MV patients. The average age of these patients is 12.9 years, the amount of patients older than 18 is 22.7%, the average age of diagnosis is 3.4 years. The overall survival median is 26.8 years (by the beginning of 2012). The prevalence of the disease is 1:8005 newborns according to the results of neonatal screening. The amount of patients infected with Pseudomonas aeruginosa and Burkholderia cepacia is 30,2% and 2,5% respectively. The F508del mutation occurs in 43,4% of all cases. The next most prevalent mutations are N1303K, 394delTT, CFTRdele2,3 (21kb) (4,72% each), the number of unidentified mutations is only 8.49%. A comparative evaluation of therapeutic approaches (basic therapy) was conducted in the Yaroslavl region and in a number of European countries. Data obtained from the register allows to solve not only clinical and epidemiological problems, but also sort out organizational issues, plan medicine provisions and conduct medical and social rehabilitation.
AN EDITORIAL ARTICLE
MEDICAL AND PSYCHO-PEDAGOGICAL CARE FOR CHILDREN
72-76 1246
Abstract
The only way for children with an inherent loss of hearing to be able to hear is cochlear implantation. The author covers important problems of medical, psychological and pedagogical rehabilitation of children, which had undergone such surgery. The necessity of cooperation between doctors, psychologists, deaf-and-dumb pedagogues and the child’s family in order to achieve a successful restoration of the lost skills or to form new ones: perception of sound, speaking skills, social adaptation is being stressed. A personal experience of rehabilitating children after cochlear implantation is described.
СOGNITIVE HEALTH AND IDENTITY OF THE CHILD
77-84 4604
Abstract
The article covers in detail the problems of diagnosis and treatment of cognitive impairment in children with cerebral palsy. Diagnosis of cognitive disorders, cerebral palsy is a challenging task, due to various combinations of these disorders with physical, speech and sensory disorders, which requires a differentiated approach. The authors have developed a differential-diagnostic criteria to distinguish between impaired mental function and mental retardation with cerebral palsy, as well as the proposed comprehensive system of rehabilitation of cognitive disorders, including medical and social, and psychological-pedagogical correction, which is aimed at compensating for cognitive deficits, the formation of mental functions, and the restoration of the mechanisms of social integration of children with cerebral palsy.
MATERIALS OF THE WORLD HEALTH ORGANIZATION
DEBATABLE ISSUES OF PHARMACOTHERAPY
102-105 3142
Abstract
Nijmegen breakage syndrome (NBS) is a rare autosomal recessive syndrome of chromosomal instability mainly characterized by microcephaly at birth, dysmorphic facial features, combined immunodeficiency and predisposition to malignancies. Due to a founder mutation in the underlying NBN gene (c.657_661del5) the disease is encountered most frequently among Slavic populations. We report on a patient with NBS complicated acute leukemia.
FROM THE UNION OF PEDIATRICIANS OF RUSSIA
SHORT REPORT
Page for pediatric nurse
ISSN 1727-5776 (Print)
ISSN 2500-3089 (Online)
ISSN 2500-3089 (Online)
