Vol 8, No 5 (2011)
View or download the full issue
PDF (Russian)
AN EDITORIAL ARTICLE
A.A. Baranov,
L.S. Namazova-Baranova,
A.K. Gevorkyan,
V.M. Krasnov,
L.M. Kuzenkova,
G.A. Kashkaradze,
N.D. Vashakmadze,
T.V. Podkletnova
6-12 473
Abstract
The paper is devoted to one of the rare genetically determined diseases — mucopolysaccharidosis. Despite the great achievement of science — the development of the pathogenetic enzyme replacement therapy, many challenges remain. Among them — the lack of timely diagnosis, causing delayed treatment and disease progression, the lack of a national register of patients with common approaches to treatment and rehabilitation of these patients. Objective and subjective obstacles to resolving these problems are demonstrated. The authors developed and represent an efficient system for providing high quality medical care for children with MPS which consists of hospital and rehabilitation phases to colleagues. In addition, the article highlights the issues and postinfuzional reactions during enzyme replacement therapy.
Key words: mucopolysaccharidosis, the organization of medical care, diagnosis, treatment, enzyme replacement therapy, the organization of infusion, rehabilitation, supervision, children.
(Pediatric Pharmacology. — 2011; 8 (5): 6–12.)
Key words: mucopolysaccharidosis, the organization of medical care, diagnosis, treatment, enzyme replacement therapy, the organization of infusion, rehabilitation, supervision, children.
(Pediatric Pharmacology. — 2011; 8 (5): 6–12.)
NEW TECHNOLOGIES IN MEDICINE
13–19 627
Abstract
The consequences of misuse of the term «validity» in the Russian medical literature are presented. The hypothesis that the replacement of the term «statistical significance» by the widespread term «validity» depending on the context can lead to a distortion of the research perception in general is being checked. It is shown that the mechanisms of this process can be described in terms of the theory of the formation of mythological constructs of the French structuralism school, as well as on the basis of representations of memetics. The recommendations for researchers and editors of medical publications on the right and the best optimal use of those terms and the context language.
Key words: scientific terminology, validity, significance, scientometrics, linguistic analysis, semantics, myths formation, memetics.
(Pediatric Pharmacology. — 2011; 8 (5): 13–19.)
EMERGENCY CONDITIONS IN CHILDREN
21-27 3451
Abstract
The fate of the patient often depends on the ability of doctors to interpret the pain that has arisen in the abdomen. The paper gives a detailed analysis of the pathogenesis of abdominal pain and arranges the main causes of the «acute abdomen» in children. Particular attention is paid to the differential diagnosis of the acute surgical abdominal diseases in children. The structure of the syndrome of «acute abdomen» in children over 1 year in hospital emergency clinic has been analyzed.
Key words: children, acute abdomen, pain, abdominal pain, causes, diagnosis, differential diagnosis, acute appendicitis, intestinal invagination.
(Pediatric Pharmacology. — 2011; 8 (5): 21–27.)
СOGNITIVE HEALTH AND IDENTITY OF THE CHILD
37-41 661
Abstract
In practical pediatrics specialists paid wrongly little attention to identification and treatment of cognitive disorders in children. At the same time it is difficult to overestimate the influence of cognitive functions on the formation of human personality and social maladjustment in this part of population. The paper is devoted to the diagnosis and treatment of cognitive impairments. In addition, the classification of this pathology, highlighting aetiopathogenetic factors, prognosis are showed. One of the important problems of early revealing of cognitive impairments and appropriate management of children with this pathology according to the authors opinion are the following: the deficiency of educational programs for training specialists in neurology, lack of knowledge concerning the possibilities of psychological-pedagogical correction, inefficient system of neurological techniques for primary care.
Key words: cognitive function, mild cognitive impairment, classification, diagnosis, treatment, prognosis, social maladjustment, psychopedagogical support, children.
(Pediatric Pharmacology. — 2011; 8 (5): 37–41.)
Key words: cognitive function, mild cognitive impairment, classification, diagnosis, treatment, prognosis, social maladjustment, psychopedagogical support, children.
(Pediatric Pharmacology. — 2011; 8 (5): 37–41.)
URGENT ISSUES OF A TREATMENT OF EAR, NOSE, THROAT DISEASES
42-45 1244
Abstract
Fungal infection of tonsils (tonsillomycosis) is a common disorder in childhood. In this paper we analyzed the clinical efficacy of topical aerosol containing gexetidin, possessing both antimicrobial and antimycotic activity, as compared with conventional topical
antifungal therapy of tonsillomicosis in children. According to the study, the clinical efficacy of the investigated product is comparable to the conventional treatment, but the therapy firepower was significantly higher with gexetidin aerosol. The obtained results allow to recommend an aerosol containing gexetidin for widespread use in the treatment of inflammatory diseases of the oropharynx, including fungal nature.
Key words: gexetidin, tonsillomicosis, treatment, children.
(Pediatric Pharmacology. — 2011; 8 (5): 42–45.)
antifungal therapy of tonsillomicosis in children. According to the study, the clinical efficacy of the investigated product is comparable to the conventional treatment, but the therapy firepower was significantly higher with gexetidin aerosol. The obtained results allow to recommend an aerosol containing gexetidin for widespread use in the treatment of inflammatory diseases of the oropharynx, including fungal nature.
Key words: gexetidin, tonsillomicosis, treatment, children.
(Pediatric Pharmacology. — 2011; 8 (5): 42–45.)
46-48 678
Abstract
The article highlights the issues of treatment of children, observed with a diagnosis of «Contortion of nasal septum». The authors recommend deep examination of patients with this disease (ENT examination, performance of endoscopic examination, computed tomography, rhinomanometry) to work out the therapy adequate to present changes. After the diagnosis has been precised, all children had septoplastic, but if necessary, at one time with it they also underwent to rhinoplastic, lower turbinates vasosection, bullosa modified medium turbinates correction. If decongestants were necessary, we used xylometazon to reduce swelling of the nasal mucosa. It in addition to α2-adrenoceptor agonists contains moisturizing ingredients to prevent mucous membranes dryness.
Key words: curvature of the nasal septum, examination, treatment, rhinoplastic, septoplastc, vasosection, children.
(Pediatric Pharmacology. — 2011; 8 (5): 46–48.)
Key words: curvature of the nasal septum, examination, treatment, rhinoplastic, septoplastc, vasosection, children.
(Pediatric Pharmacology. — 2011; 8 (5): 46–48.)
LECTURE
49-53 8597
Abstract
Wolff–Parkinson–White (WPW) syndrome — is the most common cause of tachycardia in children. The clinical significance of WPW udden cardiac death. Data are presented on the principles of diagnosis of various types of WPW syndrome and characteristics of various types of tachycardia occurring in this disease. At present there is a radical method of treatment of the WPW syndrome — radiofrequency ablation of atrioventricular additional connections. Antiarhythmic therapy remains relevant in arresting attacks of tachycardia, as well as in the treatment of young children who have the age limits for radiofrequency ablation. The principles of choice of treatment and relief of the attack algorithm tachycardia syndrome WPW are described.
Key words: Wolff–Parkinson–White syndrome, paroxysmal atrioventricular reciprocal tachycardia, children.
(Pediatric Pharmacology. — 2011; 8 (5): 49–53.)
Key words: Wolff–Parkinson–White syndrome, paroxysmal atrioventricular reciprocal tachycardia, children.
(Pediatric Pharmacology. — 2011; 8 (5): 49–53.)
54–60 2109
Abstract
The lecture is devoted to the changes of intestinal microflora. The author pays particular attention to the need for proper use of terms, explaining the meaning of dysbacteriosis and dysbiosis. Besides, the states needed therapy aimed at the restoration of the intestine biocenosis and the basic principles of treatment of children are described in details. A classification of drugs used in pediatric practice for the correction of biocenosis, indications for use of a particular group of drugs is cited. There are given the recommendations for use of the substances of vegetative origin based on authors experience.
Key words: microbiota, intestinal biocenosis, dysbiosis, dysbacteriosis, treatment, prebiotics, probiotics, children.
(Pediatric Pharmacology. — 2011; 8 (5): 54–60.)
REVIEW
61-64 423
Abstract
It is known that the interferon beta therapy is more effective for multiple sclerosis. The literature review focuses on the problem of neutralizing antibodies (NAbs) in interferon beta therapy of multiple sclerosis for children and adolescents. The authors provide domestic and foreign data concerning therapy of multiple sclerosis, NAbs negative effects on bioactivity and bioavailability of diseasemodifying treatment, methods of NAbs detection and their impact on multiple sclerosis clinical course, and approaches to management of NAbs high titers.
Key words: multiple sclerosis, disease-modifying treatment, interferon beta, interferon beta-1a, interferon beta-1b, neutralizingantibodies, children.
(Pediatric Pharmacology. — 2011; 8 (5): 61–64.)
Key words: multiple sclerosis, disease-modifying treatment, interferon beta, interferon beta-1a, interferon beta-1b, neutralizingantibodies, children.
(Pediatric Pharmacology. — 2011; 8 (5): 61–64.)
ORIGINAL ARTICLES
66-69 424
Abstract
The paper presents an assessment of the physical health of children 4–7 years old, brought up in Moscow children’s educational institutions. Statistically significant positive dynamics of indicators of physical development and functional training has been showed. Introduction
of corrective exercises to the recreational and educational complex for children in low-and below-average levels of motor function helps improve the motor skills.
Key words: preschool children, physical health, physical development, functional fitness.
(Pediatric Pharmacology. — 2011; 8 (5): 66–69.)
of corrective exercises to the recreational and educational complex for children in low-and below-average levels of motor function helps improve the motor skills.
Key words: preschool children, physical health, physical development, functional fitness.
(Pediatric Pharmacology. — 2011; 8 (5): 66–69.)
70-75 431
Abstract
The aim of this work was to study the effect of netilmicin on the auditory analyzer of immature animals (rabbits). This paper presents the results of a survey of 20 intact animals and 24 control animals of the experimental group who received netilmicin in a therapeutic dosage equal to 5 mg/kg per day for 7 days starting from the 12th day of life. Auditory function was assessed according to the registration of short stem-evoked potentials (SSEP) and otoacoustic emission distortion product (OEDP). As a result of therapeutic doses of netilmicin the ototoxic effect has been reveales, which manifests itself in raising the registration threshold of the first peak amplitude of the SSEP and lower average OEDP mainly by reducing the amplitude at frequencies of 4 and 6 kHz. At the same time the experimental group showed a reduction in body weight during the observation period.
Key words: immature animals (rabbit), netilmicin, auditory analyzer, the hair cells, Short-stem evoked potentials, otoacoustic emission distortion product.
(Pediatric Pharmacology. — 2011; 8 (5): 70–75.)
Key words: immature animals (rabbit), netilmicin, auditory analyzer, the hair cells, Short-stem evoked potentials, otoacoustic emission distortion product.
(Pediatric Pharmacology. — 2011; 8 (5): 70–75.)
L.V. Feklisova,
A.V. Gorelov,
V.P. Drinevskii,
A.A. Ploskireva,
E.V. Tselipanova,
E.Yu. Shvets,
E.V. Kanner,
Yu.N. Lin'kova,
E.V. Chernyaeva
76-82 3226
Abstract
The paper analyzes the results of a comparative clinical trial of drugs recombinant human interferon alpha-2b in the dosage form of suppositories for their use in the treatment of ARVI in infants, babies and toddlers age. In accordance to the selection criteria 100 children who were hospitalized, aged from 6 months to 3 years with clinically diagnosed ARVI were included in the study. Two study groups were formed: basic, which patients within 5 days received suppositories containing taurine and interferon alpha (125,000 IU), and the comparison group, where patients received suppositories with interferon (150,000 IU). The patients of both groups were subjects of medical observation for 5 days with an estimate of the effectiveness of treatment on the 6th day of therapy. The eliminating activity of the exploring drugs was determined using standard laboratory techniques (PCR or DFA scrapings from the nasopharynx). The study established the high effectiveness and wide safety profile of both drugs. No cases of the adverse events that have established link with the study medications.
Key words: influenza, ARVI, recombinant human interferon alpha-2b, taurine, suppositories, children.
(Pediatric Pharmacology. — 2011; 8 (5): 76–82.)
Key words: influenza, ARVI, recombinant human interferon alpha-2b, taurine, suppositories, children.
(Pediatric Pharmacology. — 2011; 8 (5): 76–82.)
CLINICAL RECOMMENDATIONS
For Pediatricians' Practice
POTENTIALITY OF MODERN ULTRASOUND EVALUATION OF LIVER STRUCTURE BY THE EXAMPLE OF GILBERT’S SYNDROME
88-90 578
Abstract
Technical advances in recent years have greatly expanded the diagnostic potentialities of ultrasound study, providing opportunities in a number of cases to diagnose and begin treatment as soon as possible. The authors propose to use the method of assessment of the liver parenchyma using acoustic histometry. We examined 200 children aged 8 to 16 years with a preliminary diagnosis of Gilbert’s syndrome. We studied gene UGT1A1 in all children, performed an ultrasound scan of the liver and spleen, and calculated the liver-spleen index. Two examples using the new method of noninvasive diagnosis have been cited. The obtained results of the study demonstrate the high sensitivity and specificity of this technique, and can be recommended in addition to the traditional ultrasound scan.
Key words: liver, spleen, Gilbert’s syndrome, ultrasound, acoustic histometries, liver-spleen index, children.
(Pediatric Pharmacology. — 2011; 8 (5): 88–90.)
Key words: liver, spleen, Gilbert’s syndrome, ultrasound, acoustic histometries, liver-spleen index, children.
(Pediatric Pharmacology. — 2011; 8 (5): 88–90.)
91-96 434
Abstract
This review considers specific problems of premature infants in the first year of life related to nutritional deficiencies and lack of basic food nutrients. The features of nutritional support of premature infants who underwent resuscitation phase in the first year of life, the usefulness of the new «mixes for premature infants, discharged from the hospital» in order to intensify the programming power of artificial feeding are discussed.
Key words: preterm infants, very low body weight, extremely low body weight, intensive care and neonatal intensive care, enteral nutrition, special mixtures for premature, «the mixture for premature infants, discharged from the hospital».
(Pediatric Pharmacology. — 2011; 8 (5): 91–96.)
Key words: preterm infants, very low body weight, extremely low body weight, intensive care and neonatal intensive care, enteral nutrition, special mixtures for premature, «the mixture for premature infants, discharged from the hospital».
(Pediatric Pharmacology. — 2011; 8 (5): 91–96.)
98-100 539
Abstract
Practically in all the cases of broncho-pulmonary system diseases, including acute bronchitis, the cough occurs as a clinical syndrome. The main cough function — is the restoration of the airway by removing secretions and restore mucociliary transport of bronchial secretions (mucociliary clearance). Among the variety of antitussives the combined drugs are widely used to treat cough. The combination of several active substances in one medicinal product can produce more effective therapy thanks to the multi-directional action of the components, as well as to improve its safety because of the possibility of using lower doses of drugs due to the combined synergies of their impact. The paper presents the experience of using combined medications in the treatment of cough in children.
Key words: cough, respiratory diseases, treatment, and antitussive combined medications, children.
(Pediatric Pharmacology. — 2011; 8 (5): 98–100.)
Key words: cough, respiratory diseases, treatment, and antitussive combined medications, children.
(Pediatric Pharmacology. — 2011; 8 (5): 98–100.)
102-105 370
Abstract
Control of growth, development and child health is carried out by district pediatricians and specialists of outpatient departments, the main principle in their work is to maintain the health of children and to support parents in the breeding of the child. A pediatrician should avoid deterioration of the existing pathology, carry out the rehabilitation of children of all ages, particularly in boys with congenital malformations and diseases of the genitals.
Key words: health, children’s surgeon, malformations of genitals, varicocele, cryptorchidism, hypospadias, morbidity, boys.
(Pediatric Pharmacology. — 2011; 8 (5): 102–105.)
Key words: health, children’s surgeon, malformations of genitals, varicocele, cryptorchidism, hypospadias, morbidity, boys.
(Pediatric Pharmacology. — 2011; 8 (5): 102–105.)
106–108 451
Abstract
Inflammatory disease of the throat — is a widespread pathology in childhood. The complex treatment of pharyngitis often includes solutions for gargling, sprays, tablets for sucking, hard candy or lozenges containing a variety of anti-inflammatory components. Their use reduces the severity of pain and the time treatment, but does not preclude the use of anti-inflammatory drugs for systemic effects.
Key words: pharyhgitis, sore throat, treatment, children
(Pediatric Pharmacology. — 2011; 8 (5): 106–108.)
Key words: pharyhgitis, sore throat, treatment, children
(Pediatric Pharmacology. — 2011; 8 (5): 106–108.)
109-112 455
Abstract
The problem of frequent respiratory infections is the most relevant for sickly children. The author stresses that young children and children attending organized child care centers are more prone to acute respiratory diseases. Paper is devoted to prevention and rational treatment of acute respiratory infections in sickly children. Examples of the improper use of the immunomodulating therapies encountered in practice are cited. It is shown that in the absence of specific prevention, the most effective in terms of evidence-based medicine, is an immunomodulator of bacterial origin, particularly ribosomal-proteoglikan complex.
Key words: sickly children, acute respiratory infections, prevention, treatment, immunomodulators, ribosomal-proteoglikan complex.
(Pediatric Pharmacology. — 2011; 8 (5): 109–112.)
114-117 495
Abstract
The article reveals the relevance of the correction of bacterial overgrowth syndrome in children with atopic dermatitis and concomitant diseases of digestive system. The main functions of the microflora, the influence of various factors on the colonization resistance of the body of the child have been identified. The results of our own observations are cited. On their basis we proposed approaches to the treatment of children with atopy and concomitant diseases of the gastrointestinal tract.
Key words: children, atopic dermatitis, microbiota, bacterial overgrowth syndrome.
(Pediatric Pharmacology. — 2011; 8 (5): 114–117.)
Key words: children, atopic dermatitis, microbiota, bacterial overgrowth syndrome.
(Pediatric Pharmacology. — 2011; 8 (5): 114–117.)
118-121 388
Abstract
Through the use of radionuclide method for the rate measuring of the urine passing by the ureter, it became possible to assess the outcome of the surgical correction of the vesicoureteral segment obstructive uropathy, based on the nature of urodynamics in the operated organ and urinary tract. This method allows to determine the degree of the urodynamics in the urinary tract violations, the tactics of further treatment and objectively evaluate the outcome of the surgery performed, based on mathematical calculation of the activity of the radiopharmaceutical, eliminating the assessment subjectivity.
Key words: radionuclide methods of investigation, obstructive uropathies, megaureter, vesico-ureteral reflux.
(Pediatric Pharmacology. — 2011; 8 (5): 118–121.)
Key words: radionuclide methods of investigation, obstructive uropathies, megaureter, vesico-ureteral reflux.
(Pediatric Pharmacology. — 2011; 8 (5): 118–121.)
TRAINING FOR TRAINERS — EDUCATIONAL PROGRAM FOR PARENTS
122-126 713
Abstract
Dornase alpha plays an important role in the basic treatment of cystic fibrosis, having three clinical effects: powerful mucolytic, anti-inflammatory and antibacterial. Early drug inclusion and its permanent administration in the basic therapy allows patients with cystic fibrosis to have an active life, with occasional illness recrudescence, long-lasting remissions, stable function of external respiration. The drug is appropriate to prescribe as preventive and curative for chronic bronchitis and chronic polypoid pansinusitis immediately if the diagnosis of «Cystic fibrosis» is established. The effectiveness of dornase alfa depends on strict adherence to the rules of its use.
Key words: cystic fibrosis, chronic bronchopulmonary disease, mukostasis, children, chronic pansinusitis, nasal polyps, basic therapy, dornase alfa, the rules of administration, inhalation therapy.
(Pediatric Pharmacology. — 2011; 8 (5): 122–126.)
FROM THE UNION OF PEDIATRICIANS OF RUSSIA
Materials (WHO, EPA/UNESPA, IPA)
Page for pediatric nurse
149-152 452
Abstract
The article analyzes the current role of nurses in the world and presents the position of the World Health Organization concerning nursing on the basis of the basic documents on this issue over the last 10 years.
Key words: nursing, nurses, public health organization, World Health Organization, policy documents.
Key words: nursing, nurses, public health organization, World Health Organization, policy documents.
DEBATABLE ISSUES OF PHARMACOTHERAPY
28-35 456
Abstract
The present study aimed to explore the use of herbal medicines among a sample of pregnant women and to determine whether the use of herbal medicines during pregnancy is associated with women’s attitudes towards herbal medicines and their sociodemographic features, such as age, education level, income, and smoking. A survey was conducted among 650 pregnant women in their third trimester of pregnancy, consecutively recruited in obstetrical ward. Response rate was 95,8%. Most women were under 30 (67,4%) and primipara (53,3%). The majority of subjects (63,5%) declared to have used one or more herbal medicines during their lifetime; 43,8% of pregnant women reported taking at least one herbal medicine during the current pregnancy. 54,2% of users took at least one prescribed medication concomitantly. Women’s habitual use of herbal medicines meant they were at higher risk of taking herbal medicines also during pregnancy. Women were more likely to take herbal medicines if they were housewives, smokers, had moderate family income, with chronic disorders and concomitant drug use. The most frequently herbs taken by interviewees were chamomile, valerian, green tea, cranberry, and garlic. The major purposes for using these products were to cure respiratory problems, CNS disorders and urinary tract infections. The majority of women resorted to obstetricians as the primary information source for of herbal medicines during pregnancy, while they mainly referred to general practitioner and family or friends when not pregnant. In the light of the scanty data concerning the safety of herbal medicines during pregnancy, these results confirm the need to investigate thoroughly the situation of pregnant women and of herbal medicines consumption.
Key words: herbal medicines, pregnancy, prevalence, use, maternal characteristics, pharmacoepidemiology.
(Pediatric Pharmacology. — 2011; 8 (5): 28–35.)
Key words: herbal medicines, pregnancy, prevalence, use, maternal characteristics, pharmacoepidemiology.
(Pediatric Pharmacology. — 2011; 8 (5): 28–35.)
IN MEMORY OF
ISSN 1727-5776 (Print)
ISSN 2500-3089 (Online)
ISSN 2500-3089 (Online)
