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Organization and Implementation of Patient-Centered Anesthesia in Children in Terms of the Surgical Department in the Multidisciplinary Hospital 从多学科医院外科的角度看以患者为中心的儿童麻醉的组织与实施
Pub Date : 2024-01-10 DOI: 10.15690/vsp.v22i6.2659
Grigoriy E. Roytberg, N. V. Kondratova, O. V. Strunin, Igor’ V. Smirnov
Providing medical care based on a patient-centered medicine model supposes close collaboration with patients and their families based on partnership. The development of action plan aimed on implementation of comfortable conditions for the child during surgery and anesthesia, considering his needs and age characteristics, is a topical issue in pediatrics. This article provides an organizational model for anesthesia in child-friendly environment and covers all the main stages of the patient's stay in the hospital.
在以患者为中心的医疗模式基础上提供医疗服务,需要与患者及其家属密切合作。考虑到儿童的需求和年龄特征,制定旨在为儿童在手术和麻醉期间提供舒适条件的行动计划,是儿科领域的一个热点问题。本文提供了一个在儿童友好环境下进行麻醉的组织模式,涵盖了患者住院期间的所有主要阶段。
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引用次数: 0
Reforming Children’s Health Care in the Soviet Union after the World War II 二战后苏联的儿童医疗改革
Pub Date : 2024-01-10 DOI: 10.15690/vsp.v22i6.2655
Valerii Y. Albitskiy, S. A. Sher
The article presents the results of historical and medical research reflecting the issues of reforming children’s health care after the World War II. The aim of the study is to present the problems of reforming children’s health care in the USSR in the post-war decade (1946–1956). The study relevance is defined by necessity to examine the historical experience of reforming children’s health care during the most difficult for our country post-war period so we can learn crucial lessons from the past and use them further for the successful implementation of the federal project “Development of children’s health care, including the creation of modern infrastructure for medical care provision for children”. Published and unpublished documents of the USSR Ministry of Health and the USSR Academy of Medical Sciences, stored in the State Archive of the Russian Federation, as well as publications from medical journals, scientific collections, monographs were studied to cover this issue. The analysis of this study has shown that the most significant part in the state health reform started in the first post-war years was the merger of hospitals and clinics for adults, maternity hospitals with women’s consultations, children’s hospitals with children’s consultations and outpatients’ clinics. The post-war reform has contributed to the improvement of the quality of inpatient and outpatient medical care, to the increasing role of the hospital as the organizing and leading center of all united facilities. The integration of children’s hospitals with consultations and outpatients’ clinic, as well as the organization of the primary pediatric care according to the system of medical and preventive care provision for children aged from birth to 16 years by single pediatrician, have shown succession in the work of primary care doctors and hospitals. The increase in the health workers qualifications, the development of specialized types of medical care, the improvement in the quality of medical and preventive care were observed. The reform of children’s health care contributed to the diseases’ timely diagnosis and early patients’ hospitalization, strengthening the connection of the primary care doctor and nurse with the child’s family, and decreasing of child morbidity and mortality.
文章介绍了反映二战后儿童保健改革问题的历史和医学研究成果。研究的目的是介绍战后十年(1946-1956 年)苏联儿童保健改革的问题。研究的现实意义在于,有必要研究我国战后最困难时期儿童保健改革的历史经验,以便从过去的经验中汲取重要教训,并将其进一步用于成功实施 "发展儿童保健,包括为儿童提供医疗保健建立现代化基础设施 "的联邦项目。为了解决这一问题,我们研究了俄罗斯联邦国家档案馆保存的苏联卫生部和苏联医学科学院已发表和未发表的文件,以及医学杂志、科学文集和专著中的出版物。研究分析表明,战后最初几年开始的国家卫生改革中最重要的部分是将成人医院和诊所、妇产医院和妇科诊室、儿童医院和儿童诊室以及门诊诊所合并在一起。战后改革促进了住院和门诊医疗质量的提高,医院作为所有联合设施的组织和领导中心的作用日益增强。儿童医院与会诊和门诊的结合,以及根据由单一儿科医生为出生至 16 岁儿童提供医疗和预防保健服务的制度组织初级儿科保健,显示出初级保健医生和医院工作的继承。卫生工作者的资质得到提高,专业医疗类型得到发展,医疗和预防保健的质量得到改善。儿童保健改革促进了疾病的及时诊断和早期住院,加强了初级保健医生和护士与儿童家庭的联系,降低了儿童发病率和死亡率。
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引用次数: 0
International pediatrician’s day 国际儿科医生日
Pub Date : 2024-01-10 DOI: 10.15690/vsp.v22i6.2650
Stella A. Sher
20 ноября ежегодно в России и других странах отмечается Международный день педиатра. 
每年 11 月 20 日,俄罗斯和其他国家都会庆祝国际儿科医生日。
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引用次数: 0
Yoghurts in Infants’ Nutrition: Opportunities of Infectious and Non-Communicable Diseases’ Prevention 婴儿营养中的酸奶:预防传染病和非传染性疾病的机会
Pub Date : 2023-08-25 DOI: 10.15690/vsp.v22i4.2591
I. Belyaeva, E. Bombardirova, T. Turti
This review provides data on the use of yogurts in infants’ nutrition. The properties of these fermented milk products and associated urgent and delayed sanogenetic effects are described. The experience of yogurts (enriched with pre- and probiotics) implementation in the nutrition therapy of children who have undergone infectious diseases is shown. The yogurt usage for intestinal microbiota disorders correction in children with functional digestive disorders and chronic somatic pathology is discussed.
这篇综述提供了关于在婴儿营养中使用酸奶的数据。这些发酵乳制品的性质和相关的紧急和延迟的胚胎发育效应进行了描述。展示了酸奶(富含益生菌和益生菌)在感染性疾病儿童营养治疗中的应用经验。讨论了酸奶在功能性消化障碍和慢性躯体病理儿童肠道微生物群失调纠正中的应用。
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引用次数: 0
Abnormal Uterine Bleeding in Adolescence Burdened with Severe Anemia: Clinical Case 青少年重度贫血并发子宫异常出血1例
Pub Date : 2023-08-25 DOI: 10.15690/vsp.v22i4.2612
L. Adamyan, E. Sibirskaya, I. Karachentsova, L. Pivazyan, M.A. Loshkareva, Y. Kirillova, Sabina K. Murvatova, K. Murvatova
Background. Abnormal uterine bleeding (AUB) in adolescence is one of the urgent problems of medicine nowadays. It is on the 2nd place among all the reasons for hospitalization in gynecological departments, and its incidence among girls during puberty is 50%. Clinical case description. This is the clinical case of 15-year-old girl admitted to the gynecology department with complaints   on long-lasting bloody vaginal discharge, fatigue, dizziness. The diagnosis of «abnormal uterine bleeding in adolescence» burdened with iron deficiency anemia (IDA) was established according to laboratory and instrumental examinations. The patient underwent RBC-transfusion with specific buffy coat and was administered with hormonal hemostatic and anti-anemic therapy. Conclusion. We can conclude (with reference to this observation and the reviewed literature) not only that IDA is one of the most common complications of AUB in adolescence, but also what management should be used in such clinical cases.
背景。青春期子宫异常出血(AUB)是当今医学亟待解决的问题之一。它在妇科住院的所有原因中排名第二,在青春期女孩中的发病率为50%。临床病例描述。这是一名15岁的女孩,以长时间阴道带血分泌物,疲劳,头晕为主诉进入妇科的临床病例。诊断“青春期子宫异常出血”负担缺铁性贫血(IDA)是建立根据实验室和仪器检查。患者接受了带有特定灰白色外套的红细胞输血,并给予激素止血和抗贫血治疗。结论。我们可以得出结论(参考这一观察结果和文献综述),IDA不仅是青春期AUB最常见的并发症之一,而且在这种临床病例中应该采用什么管理方法。
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引用次数: 0
Remarkable Event in the History of Russian Children Healthcare (to the 260th Anniversary of the Imperial Moscow Orphanage Foundation) 俄罗斯儿童保健史上的重大事件(纪念莫斯科帝国孤儿院基金会成立260周年)
Pub Date : 2023-08-25 DOI: 10.15690/vsp.v22i4.2590
Alexander A. Baranov, V. Albitskiy
1 сентября (12 сентября по новому стилю) 1763 года навсегда вошло как красная дата в историю развития российской системы охраны здоровья матери и ребенка, отечественной педиатрической науки и практики. В этот день 260 лет назад императрица Екатерина Вторая подписала Манифест об учреждении в Москве «Сиропитального дома» с госпиталем для бедных родильниц, названного Императорским Московским воспитательным домом (ИМВД).
1763年9月1日(新风格的9月12日),俄罗斯妇幼保健系统(国内儿科和实践)的发展永远被铭记为红日。260年前的今天,凯瑟琳二世皇后签署了一份关于在莫斯科建立“孤儿之家”的宣言。
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引用次数: 0
Drug Dosing in Pediatrics: Possible Approaches 儿科药物剂量:可能的方法
Pub Date : 2023-08-25 DOI: 10.15690/vsp.v22i4.2593
A. Kolbin, K. S. Radaeva
Drug dosing remains one of the topical issues of modern pediatrics. Insufficient number of clinical studies, vulnerable patient populations (preterm newborns, patients with renal and/or hepatic insufficiency, obesity), and high risk of polypragmasy create additional difficulties for practicing physicians. This review provides description of currently used approaches to drugs dosing in children. It has been shown that prognostic models should be used for solving drugs dosing issues regarding characteristics of young patients. Such models include: physiologically based pharmacokinetic modelling; population pharmacokinetic analysis; model-based precision dosing; modeling and simulation approach; use of real world data; and pharmacogenetic testing-based dosing. These models use information from preclinical and clinical stu
药物剂量仍然是现代儿科的热门问题之一。临床研究数量不足、易受伤害的患者群体(早产新生儿、肾功能和/或肝功能不全患者、肥胖)以及多用途的高风险给执业医生带来了额外的困难。这篇综述提供了目前使用的儿童药物给药方法的描述。研究表明,预后模型应用于解决有关年轻患者特征的药物剂量问题。这些模型包括:基于生理学的药代动力学模型;群体药代动力学分析;基于模型的精确加药;建模与仿真方法;使用真实世界的数据;以及基于药物遗传学测试的剂量。这些模型使用来自临床前和临床研究的信息
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引用次数: 0
Psychoneurological Disorders in Children with Congenital Aniridia and PAX6-Associated Syndromes 先天性无虹膜和pax6相关综合征儿童的精神神经障碍
Pub Date : 2023-08-25 DOI: 10.15690/vsp.v22i4.2611
O. Kupriyanova, G. Karkashadze, N. Zhurkova, Leila S. Namova-Baranova, A. Mamedyarov
Congenital aniridia manifests with total or partial absence of the iris. The association of the disease with the PAX6 gene has been proven. Changes in the PAX6 structure lead to intrauterine pathology, visual organ malformation, malformation of master regulator proteins of organogenesis affecting various cells’ differentiation (central nervous system cells included). Such disorders result into the development of PAX6-associated syndromes with various brain malformations, neurological disorders, and systemic pathology (thyroid pathology, Wilms tumor, glucose intolerance). Isolated congenital aniridia is also accompanied by psychoneurological disorders. It can be associated with brain structures’ disorders during embryogenesis and with impact of external stress factors on the child (frequent medical checkup, surgical treatments). The psychoneurological disorders’ pathogenesis as well as congenital aniridia’s genetic mechanisms remain unclear. Thus, it is crucial to review new relevant data within the context of previously obtained information to gather full picture of the clinical signs of the disease and to improve the management of children with congenital aniridia.
先天性无虹膜表现为虹膜全部或部分缺失。该疾病与PAX6基因的关联已被证实。PAX6结构的改变导致宫内病变,视觉器官畸形,器官发生主调控蛋白畸形,影响各种细胞(包括中枢神经系统细胞)的分化。这些疾病导致pax6相关综合征的发展,并伴有各种脑畸形、神经系统疾病和全身病理(甲状腺病理、肾母细胞瘤、葡萄糖耐受不良)。孤立性先天性无虹膜也伴有精神神经障碍。它可能与胚胎发生期间的大脑结构紊乱以及外部压力因素对儿童的影响(频繁的医疗检查、手术治疗)有关。精神神经障碍的发病机制及先天性无虹膜的遗传机制尚不清楚。因此,在先前获得的信息的背景下审查新的相关数据,以收集该疾病的临床体征的全貌,并改善先天性无虹膜儿童的管理是至关重要的。
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引用次数: 0
Resolution of the II All-Russian Vaccine Assembly “Protecting Generations” 第二届全俄疫苗大会“保护世代”决议
Pub Date : 2023-08-25 DOI: 10.15690/vsp.v22i4.2597
A. Editorial
В период с 3 по 5 марта 2023 г. в Москве проводилась II Всероссийская вакцинальная Ассамблея «Защищая поколения», в рамках которой состоялось 14 научных симпозиумов, пленарных заседаний, круглых столов и экспертных советов, посвященных наиболее актуальным вопросам отечественной и глобальной иммунопрофилактики инфекционных болезней.
2023年3月3日至5日,在莫斯科举行了第二次全俄疫苗大会,“保护下一代”会议,举办了14次科学研讨会、全体会议、圆桌会议和专门讨论国内和全球传染病免疫问题的专家委员会。
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引用次数: 0
Idursulfase Beta (Hunterase) Therapeutic Experience in a Patient with Mucopolysaccharidosis Type II ⅱ型粘多糖病1例伊杜硫酶治疗体会
Pub Date : 2023-08-25 DOI: 10.15690/vsp.v22i4.2613
N. Vashakmadze, N. Zhurkova, E. Zakharova, Ludmila K. Mikhaylova, Marina A. Babaykina
Background. Mucopolysaccharidosis type II (MPS II, Hunter syndrome) is an X-linked recessive disease caused by lysosomal enzyme iduronate-2-sulfatase deficiency resulting in progressive glycosaminoglycans (GAG) accumulation in tissues (dermatan sulfate and heparan sulfate). GAG accumulation in cells leads to the development of progressive pathological disorders, malfunction of various organs and systems, early disability, and decrease in life expectancy. Enzyme replacement therapy (ERT) reduces the rate of life-threatening conditions development in patient. ERT would be more effective if it is prescribed early, especially at preclinical stage. This is the time when there are no severe irreversible changes in the cell, thus, pathogenetic therapy will decrease GAG accumulation in lysosomes, slow down the pathological process, and improve patient's condition. Clinical case description. Male patient diagnosed with MPS II was administrated with ERT idursulfase beta at the age of 6 months. It led to milder disease course compared to proband uncle who had similar mutation in the IDS gene, severe disease phenotype, and later initiation of ERT (at the age of 2.5 years). Conclusion. Early ERT initiation in patients with MPS II significantly slows down development of severe and life-threatening complications, increases the duration and improves the quality of life.
背景。粘多糖病II型(MPS II, Hunter综合征)是一种x连锁隐性疾病,由溶酶体伊杜醛酸-2-硫酸酯酶缺乏引起,导致组织(硫酸皮聚糖和硫酸肝素)中糖胺聚糖(GAG)的进行性积累。GAG在细胞中的积累导致进行性病理疾病的发展,各种器官和系统功能障碍,早期残疾和预期寿命降低。酶替代疗法(ERT)降低了患者危及生命的疾病发展的速度。如果在早期,特别是在临床前阶段开ERT会更有效。此时细胞内还没有发生严重的不可逆变化,因此病理学治疗可以减少GAG在溶酶体中的积累,减缓病理过程,改善患者的病情。临床病例描述。诊断为MPS II的男性患者在6个月大时给予ERT idursulase β。与IDS基因相似突变的先证者叔叔相比,其病程较轻,疾病表型严重,ERT开始较晚(2.5岁)。结论。MPS II患者早期启动ERT可显著减缓严重和危及生命的并发症的发展,增加持续时间并改善生活质量。
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引用次数: 0
期刊
Current pediatrics
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