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Anna Nikolaevna Bek is the First Pediatrician in Eastern Transbaikal Region Anna Nikolaevna Bek是东外贝加尔地区的第一位儿科医生
Pub Date : 2022-10-05 DOI: 10.15690/vsp.v21i4.2423
V. Shcherbak
The article is devoted to the history of pediatrics in Transbaikal Region and Anna Nikolaevna Bek role in children healthcare development. The topicality of Anna Nikolaevna and Evgeniy Vladimirovich Bek works in studying of Urov disease is discussed. The little-known facts about the first kindergartens implementation in Chita are presented.
这篇文章致力于外贝加尔地区儿科的历史和安娜·尼古拉耶夫娜·贝克在儿童保健发展中的作用。讨论了安娜·尼古拉耶夫娜和叶夫根尼·弗拉基米罗维奇·贝克作品在乌洛夫病研究中的时代性。介绍了中国第一所幼儿园实施的鲜为人知的事实。
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引用次数: 0
Children’s Health Care in Chuvashia Region During the Great Patriotic War of 1941–1945 1941-1945年卫国战争期间Chuvashia地区儿童保健
Pub Date : 2022-10-05 DOI: 10.15690/vsp.v21i4.2432
R. Matveev, V. Y. Albitskiy, T. Denisova, S. A. Sher, Melsik S. Denisov, Ludmila L. Kozyreva
This article presents the results of historical and medical study reflecting the state of child health care system in Chuvash Autonomous Soviet Socialist Republic during the Great Patriotic War of 1941–1945. The aim of the study is to analyze the situation regarding children’s health care during the most crucial period for our country. We have studied published and unpublished documents from the State Archive of Russian Federation, archives of Chuvash Republic, newspapers, journals, collections of scientific articles, and monographs to cover this issue. Local health authorities have significantly reorganized their work during the war years and set new tasks for protection of local and evacuated children’s health and lives. People’s Commissariat of Public Health of Chuvash Autonomous Soviet Socialist Republic has managed to prevent the reduction in the number of pediatric medical and preventive institutions, implemented their adequate staffing level, increase the efficacy of therapeutic and preventive measures, and resist infectious diseases outbreaks even under the evacuation measures, insufficient funding, and lack of qualified specialists. The child health care system created before the war in the whole USSR (Chuvashia included) and the medical and preventive work that was carried out during the war gave positive results. Child mortality decreased by 1.7 times compared to the pre-war 1940. Thus, children’s health care in Chuvashia withstood this difficult test and proved its efficacy during the Great Patriotic War.
本文介绍了1941-1945年卫国战争期间楚瓦什苏维埃社会主义自治共和国儿童保健制度状况的历史和医学研究结果。本研究的目的是分析我国在最关键时期的儿童保健状况。我们研究了来自俄罗斯联邦国家档案馆、楚瓦什共和国档案馆、报纸、期刊、科学文章集和专著的已发表和未发表的文件,以涵盖这一问题。地方卫生当局在战争年代对其工作进行了重大调整,并为保护当地和撤离儿童的健康和生命制定了新的任务。苏维埃社会主义自治共和国丘瓦什公共卫生人民委员部设法防止了儿科医疗和预防机构数量的减少,实现了适当的人员配备水平,提高了治疗和预防措施的效力,即使在撤离措施、资金不足和缺乏合格专家的情况下,也能抵御传染病的爆发。战前在整个苏联(包括Chuvashia)建立的儿童保健系统以及在战争期间开展的医疗和预防工作取得了积极成果。与1940年战前相比,儿童死亡率下降了1.7倍。因此,Chuvashia的儿童保健经受住了这一艰难考验,并在卫国战争期间证明了其有效性。
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引用次数: 0
Requiem on Hippocratic Medicine or 20th Century Clinic as the Final Stage of Classic Medicine in Russia (Therapeutic and Pediatric Clinics Models) 希波克拉底医学的安魂曲或20世纪俄罗斯经典医学的最后阶段(治疗和儿科诊所模式)
Pub Date : 2022-10-05 DOI: 10.15690/vsp.v21i4.2424
V. Borodulin, V. Albitsky
The article is devoted to the end of the final (according to the authors) period in the development of classic medicine in Russia, that was based on principles dating back to the Hippocratic oath. Authors have concluded that the main paradigm has been changed from humanistic to market one after discussion of all the patterns and features of Russian medicine during XIX–XX centuries on the therapeutic and pediatric clinics models.
这篇文章致力于俄罗斯经典医学发展的最后阶段(根据作者的说法),这是基于可以追溯到希波克拉底誓言的原则。通过对19 - 20世纪俄罗斯医学在治疗模式和儿科诊所模式上的所有模式和特点的讨论,作者得出结论,俄罗斯医学的主要范式已经从人文主义范式转变为市场范式。
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引用次数: 0
Ear Deformities in Children 儿童耳畸形
Pub Date : 2022-10-04 DOI: 10.15690/vsp.v21i4.2434
N. A. Daikhes, K. Diab, D. Kondratchikov, O. Pashchinina, Liudmila V. Balakina
Ear deformities occur in 5–50% of newborns [1, 2]. Usually ear deformities minimally affect hearing, however, they can lead to psychological disorders, anxiety, social isolation, and behavioral problems. Ear deformities can spontaneously self-correct without any treatment in about 30% of cases. Surgical or non-surgical correction of ears’ shape is the only alternative for the rest of the patients. Molding is an effective method for non-surgical correction of ear deformations. It is possible to achieve better treatment results if you start the procedure during the first days of life due to sufficient plasticity of ear cartilage in newborns. Otherwise, otoplasty would be necessary at the age of 3–6 years.
5-50%的新生儿有耳部畸形[1,2]。通常耳畸形对听力的影响很小,然而,它们会导致心理障碍、焦虑、社会孤立和行为问题。在大约30%的病例中,耳朵畸形可以自发地自我矫正而无需任何治疗。手术或非手术矫正耳型是其余患者的唯一选择。耳廓成型是非手术矫正耳廓畸形的有效方法。由于新生儿耳软骨有足够的可塑性,如果在生命的最初几天就开始手术,可能会获得更好的治疗效果。否则,在3-6岁时需要进行耳成形术。
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引用次数: 0
Prevalence of Vitamin D Insufficiency/Deficiency and Their Role in Atopic Dermatitis Development and Course in Children 维生素D不足/缺乏的患病率及其在儿童特应性皮炎发展和病程中的作用
Pub Date : 2022-10-04 DOI: 10.15690/vsp.v21i4.2435
Tatiana S. Kashinskaya, N. Shakhova, Yrij F. Lobanov, E. M. Kamaltynova
Various conclusive evidence on the role of vitamin D in the pathogenesis of atopic dermatitis (AD) has been obtained in recent decades. Many studies have shown that patients with AD have low concentration of 25(OH)D in blood associated with high concentration of allergen specific IgE (according to several reports). The analysis of low 25(OH)D concentration prevalence, association of vitamin D deficiency with AD severity and sensitization to allergens, and association of vitamin D disorders with risk of AD development is presented.
近几十年来,关于维生素D在特应性皮炎(AD)发病机制中的作用的各种确凿证据已经获得。许多研究表明,AD患者血液中25(OH)D浓度低,并伴有高浓度的过敏原特异性IgE(据多篇报道)。本文分析了低25(OH)D浓度的患病率,维生素D缺乏与AD严重程度和对过敏原的敏感性的关系,以及维生素D紊乱与AD发展风险的关系。
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引用次数: 0
Visceral Obesity: Terminology, Measurement, and Its Correlation with Inflammation 内脏性肥胖:术语、测量及其与炎症的相关性
Pub Date : 2022-10-04 DOI: 10.15690/vsp.v21i4.2433
A. A. Tarabrina, L. M. Ogorodova, O. Fedorova
The prevalence of childhood obesity in the world is significant and it is topical issue due to the high risk of chronic non-communicable diseases development. This article presents the analysis of pathogenetic role of visceral obesity, describes modern methods for measuring visceral adipose tissue, discusses major terminology on obesity. The current data on inflammation induced by excess of visceral adipose tissue and inflammasome’s role in this process are summed up. All the findings are crucial for the development of tools for prevention any obesity associated adverse effects in children.
儿童肥胖在世界范围内普遍存在,由于慢性非传染性疾病发展的高风险,这是一个热门问题。本文分析了内脏肥胖的发病机制,介绍了测量内脏脂肪组织的现代方法,讨论了肥胖的主要术语。总结了目前关于内脏脂肪组织过量引起的炎症以及炎症小体在这一过程中的作用的研究资料。所有这些发现对于开发预防儿童肥胖相关不良影响的工具至关重要。
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引用次数: 1
Efficacy and Safety of Standardized Protocol of CPAP Therapy for Full-Term Newborns in Delivery Room at Transient Tachypnea: Clinical Trial with Historical Control 产房内一过性呼吸急促足月新生儿CPAP标准化治疗方案的疗效和安全性:历史对照临床试验
Pub Date : 2022-10-04 DOI: 10.15690/vsp.v21i4.2445
E. V. Shestak, O. Kovtun, O. Ksenofontova, D. Dodrov
Background. Nowadays there is no consensus on the tactics and optimal protocol for Continuous Positive Airway Pressure (СРАР) at transient tachypnea of newborns (TTN) in delivery room. Objective. The aim of the study is to examine the efficacy and safety of standardized protocol of CPAP therapy for newborns with TTN in delivery room. Methods. The clinical study (implementation of standardized CPAP protocol) included full-term infants (gestational age — 37–41 weeks) with diagnosed TTN and CPAP therapy during first 60 minutes of life. Similar inclusion criteria were applied for the historical control group (born within previous year for whom CPAP was implemented according to “usual” protocol). Initiation of mononasal CPAP in main group was carried out when respiratory disorders were assessed according to Downes scale ≥ 3 points with control points at 20–40–60 minutes via the same scale, in control group at ≥ 4 points — for all cases, and according to the doctor's decision at 1–3 points. Mean airway pressure was maintained at 8 and 5–10 cm H2O, CPAP duration was 20–60 and 5–30 min, respectively. The major endpoints: the frequency of patient transfer from delivery room to intensive care unit or hospitalization to the neonatal pathology department, as well as total period of hospitalization. Moreover, frequency of invasive manipulations (intravenous catheterization, parenteral feeding), antibacterial therapy, cerebral injuries (cerebral ischemia, intracerebral hemorrhage), nasal passages injuries, pneumothorax (in the first 24 hours of life) were recorded during the entire hospitalization period. Results. 140 newborns with TTN were included in the clinical study, 30 were excluded from the study, specifically 13 due to violation of the CPAP protocol. The historical control group included 165 newborns. This groups were comparable for most baseline (before the start of CPAP) indicators except for maternal COVID-19 frequency during pregnancy and twin newborns frequency. This groups were comparable for most baseline (before the start of CPAP) indicators except for the frequency of maternal COVID-19 cases during pregnancy and the frequency of twin newborns. Hospitalization rate in intensive care units (18.2 versus 70.3%; p < 0.001) and neonatal pathology departments (31.8 versus 80.0%; p < 0.001), as well as total period of hospitalization (3 versus 10 days; p < 0.001) were lower in the standardized CPAP therapy group. Lower frequency of invasive manipulations, antibacterial therapy, and cerebral ischemia was recorded in this group. The safety of СРАР administration in delivery room was confirmed by the absence of nasal passages injuries in both groups, as well as comparable frequency of pneumothorax. Conclusion. The use of standardized CPAP protocol in delivery room for full-term newborns with TTN had higher rate of favorable hospitalization outcomes. Study limitations require validation of all the findings in independent studies.
背景。目前对产房新生儿短暂性呼吸急促(TTN)持续气道正压通气(СРАР)的策略和最佳方案尚无共识。目标。本研究旨在探讨产房CPAP治疗新生儿TTN的标准化方案的有效性和安全性。方法。临床研究(实施标准化CPAP方案)包括在出生后60分钟内诊断为TTN并接受CPAP治疗的足月婴儿(胎龄- 37-41周)。历史对照组(前一年内出生,按“常规”方案实施CPAP)采用类似的纳入标准。当呼吸障碍按Downes量表≥3分进行评估时,主组开始单鼻CPAP,对照组所有病例均按≥4分进行评估,控制点为20-40-60分钟,1-3分根据医生决定。平均气道压力维持在8和5-10 cm H2O, CPAP持续时间分别为20-60和5-30 min。主要终点:患者从产房转至重症监护病房或住院至新生儿病理科的频率,以及总住院时间。此外,记录整个住院期间有创操作(静脉置管、肠外喂养)、抗菌治疗、脑损伤(脑缺血、脑出血)、鼻道损伤、气胸(出生后24小时)的发生频率。结果:140名患有TTN的新生儿纳入临床研究,30名因违反CPAP协议而被排除在研究之外,其中13名因违反CPAP协议而被排除。历史对照组包括165名新生儿。这两组在大多数基线(CPAP开始前)指标上具有可比性,但妊娠期间孕产妇COVID-19频率和双胞胎新生儿频率除外。除了妊娠期间孕产妇COVID-19病例的频率和双胞胎新生儿的频率外,这两组在大多数基线(CPAP开始前)指标上具有可比性。重症监护病房的住院率(18.2比70.3%;P < 0.001)和新生儿病理科(31.8% vs 80.0%;P < 0.001),以及总住院时间(3天vs 10天;p < 0.001),标准化CPAP治疗组较低。有创手法、抗菌药物治疗及脑缺血发生率均较低。两组患者均无鼻道损伤,气胸发生率相当,证实了产房中СРАР给药的安全性。结论。在产房采用标准化CPAP方案治疗TTN足月新生儿的住院预后良好率较高。研究的局限性需要对独立研究中的所有发现进行验证。
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引用次数: 1
Pediatricians’ Competence in Prevention, Risk Determination or Detection of Suicidal Behavior in Children: Cross-Sectional Survey Study 儿科医生对儿童自杀行为的预防、风险判定或检测能力:横断面调查研究
Pub Date : 2022-07-15 DOI: 10.15690/vsp.v21i3.2430
A. Basova, M. Bebchuk, N. Ustinova, L. Namazova-Baranova, Kamilla E. Efendiyeva, E. Vishneva
Background. Child and adolescent suicides remain one of the most painful public issues. The COVID-19 pandemic has aggravated this topic as the number of suicides among children population has increased in this period. Research and practice guidelines identify the leading role of primary care physicians in the prevention, identification, and routing of patients with suicidal behavior. At the same time, there were no studies on pediatricians’ competence in the field of suicides.Objective. The aim of the study is to study pediatricians’ competence in prevention, risk determination or and detection of suicidal behavior.Methods. Cross-sectional study was conducted with the usage of original electronic questionnaire aimed on identifying the level of pediatricians’ competence in evaluating suicidal behavior in children. Questionnaire included 18 questions.Results. We have received 208 electronic questionnaires. 97.1% of specialists have confirmed that they evaluate emotional status of their patients during admission. During admission: 86.1% of specialists have considered the characteristics of children appearance, facial expression, voice intonation, 65.4% — have asked questions about mood, 62.5% — have interviewed parents. 98.6% of specialists pay attention to the presence of self-inflicted injuries marks, 88.4% — ask about the origin of these injuries. Only 36.1% of respondents ask patients about suicidal thoughts, intentions, or actions. Only 69.3% of specialists are ready to refer their patients to psychologist, and 51.7% — to psychiatrist.Conclusion. Even though most surveyed pediatricians notice signs of suicidal intent (low mood, self-inflicted injuries), they avoid discussing the topic of suicide during admission. Increasing the competence of pediatricians should be aimed on destigmatisation in the field of mental health, increasing the knowledge level, and developing practical skills in working with children with suicidal behavior.
背景。儿童和青少年自杀仍然是最令人痛苦的公共问题之一。2019冠状病毒病大流行加剧了这一话题,因为这一时期儿童自杀人数有所增加。研究和实践指南确定了初级保健医生在预防、识别和处理自杀行为患者方面的主导作用。同时,还没有关于儿科医生在自杀领域能力的研究。本研究的目的是研究儿科医生在自杀行为的预防、风险判断和检测方面的能力。采用原始电子问卷进行横断面研究,旨在了解儿科医生评估儿童自杀行为的能力水平。问卷共18个问题。我们收到了208份电子问卷。97.1%的专家确认他们在入院时评估过患者的情绪状态。入院时:86.1%的专家考虑了儿童的外貌特征、面部表情、语音语调,65.4%的专家询问了儿童的情绪,62.5%的专家采访了儿童的父母。98.6%的专家会注意自己造成的伤害痕迹,88.4%的专家会询问这些伤害的来源。只有36.1%的受访者询问患者自杀的想法、意图或行为。只有69.3%的专家愿意将患者转介给心理医生,51.7%的专家愿意将患者转介给精神科医生。尽管大多数接受调查的儿科医生注意到了自杀意图的迹象(情绪低落、自残),但他们在入院时避免讨论自杀的话题。提高儿科医生的能力应着眼于消除心理健康领域的污名化,提高知识水平,并发展与有自杀行为的儿童一起工作的实际技能。
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引用次数: 0
Progeria (Hutchinson-Gilford Syndrome): Literature Review and Clinical Case 早衰症(Hutchinson-Gilford综合征):文献回顾及临床病例
Pub Date : 2022-07-07 DOI: 10.15690/vsp.v21i3.2431
N. Buchinskaya, Aida Zh. Akhenbekova, Aliya A. Bugybay, M. Kostik
Progeria, or Hutchinson-Gilford Syndrome is a rare disease from the group of laminopathies characterized by premature aging with skin, bones and cardiovascular system lesions. Pathogenesis is based on pathogenic variants in the LMNA gene leading to anomalies in the nuclear membrane morphology, gene expression disruption, chromatin structure changes, mitochondrial dysfunction, DNA repair and alternative splicing defects, and telomere shortening acceleration. Major manifestations of the disease are: skin lesions (scleroderma-like syndrome and pigmented lesions), lipodystrophy, late teeth cutting, teeth crowding, alopecia, nail dystrophy, osteolysis of distal phalanges, hip joints valgus deformation, joints contractures, atherosclerosis, hearing loss, early heart attacks and strokes. Scleroderma-like skin changes, osteoporosis, flexion contractures of hands’ interphalangeal joints, and hip joints osteoarthritis require differential diagnosis with rheumatic diseases. The basic strategy in management of patients with progeria is the prevention and treatment of its cardiovascular manifestations (early strokes and heart attacks, arterial hypertension, and atherosclerosis), as well as the increase of patients’ quality of life and daily activity. The efficacy of therapy in patients with progeria via the use of farnesyltransferase inhibitors (monotherapy; combination with bisphosphonates or statins), retinoids, and 1,25(OH)2 — vitamin D3 is studied. This literature review is updated with clinical case description of a girl with progeria. The diagnosis was confirmed by sequencing of the LMNA gene (Sanger), and previously described pathogenic variant in exon 11 (c.1824C>T, rs58596362) in the heterozygous state (p.Gly608Gly, NM_170707.3) was revealed.
早衰症或Hutchinson-Gilford综合征是一种罕见的疾病,其特征是皮肤,骨骼和心血管系统病变的过早衰老。发病机制是基于LMNA基因的致病性变异导致核膜形态异常、基因表达中断、染色质结构改变、线粒体功能障碍、DNA修复和选择性剪接缺陷以及端粒缩短加速。疾病的主要表现为:皮肤病变(硬皮病样综合征和色素病变)、脂肪营养不良、晚期切牙、牙齿拥挤、脱发、指甲营养不良、远端指骨溶解、髋关节外翻变形、关节挛缩、动脉粥样硬化、听力下降、早期心脏病发作和中风。硬皮病样皮肤改变、骨质疏松、手指间关节屈曲挛缩和髋关节骨关节炎需要与风湿病鉴别诊断。早衰患者管理的基本策略是预防和治疗其心血管表现(早期中风和心脏病发作、动脉高血压、动脉粥样硬化),提高患者的生活质量和日常活动能力。使用法尼基转移酶抑制剂治疗早衰症患者的疗效(单一疗法;与双膦酸盐或他汀类药物联合使用),类维生素a和1,25(OH)2 -维生素D3进行了研究。这篇文献综述更新了一个女孩早衰症的临床病例描述。通过LMNA基因测序(Sanger)证实了诊断,并发现了先前描述的杂合状态(p.Gly608Gly, NM_170707.3)外显子11 (c.1824C>T, rs58596362)的致病变异。
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引用次数: 0
Social Support for Minors in the First Period of Great Patriotic War 卫国战争初期对未成年人的社会支持
Pub Date : 2022-06-08 DOI: 10.15690/vsp.v21i3.2425
R. S. Serebryaniy, D. V. Kamelskikh, O. Yaremchuk
This article presents a narrative that reveals the state of life and health of children in the first months of the Great Patriotic War. Special place goes to the analysis of archival documents indicating the distressful situation of evacuated children, faced unsanitary conditions, lack of food, and difficulties with settling in new places of residence. The activity of the Council of People's Commissars of the USSR, the People's Commissariat of Health of the USSR and the RSFSR on carrying out measures of social support for minors in the first period of the Great Patriotic War is presented. The maximum possible conditions for the protection of minors’ health were implemented as consequence of the execution of orders on places. Difficulties with the implementation of measures for the arrangement of evacuated children in various regions of the country are described depending on local resources and taken measures efficacy (Tula, Ryazan, Yaroslavl, Kuibyshev regions). The ongoing activities are clearly illustrated by the example of the work of the Middle Volga Institute for the Protection of Motherhood and Infancy.
这篇文章讲述了卫国战争头几个月里儿童的生活和健康状况。特别的地方是对档案文件的分析,这些文件表明撤离儿童的悲惨处境,面临不卫生的条件,缺乏食物,以及在新的居住地定居的困难。介绍了苏联人民委员会、苏联卫生人民委员部和俄罗斯苏维埃社会主义共和国联邦共和国在卫国战争第一阶段为未成年人实施社会援助措施的情况。由于执行了有关场所的命令,为保护未成年人的健康创造了最大可能的条件。根据当地资源和所采取措施的效力(图拉、梁赞、雅罗斯拉夫尔、古比雪夫等地区),叙述了在执行安排该国各地区撤离儿童的措施时遇到的困难。伏尔加河中部保护母亲和婴儿研究所的工作清楚地说明了正在进行的活动。
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引用次数: 1
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Current pediatrics
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