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Обоснование применения крема пимекролимус 1% для проактивной терапии атопического дерматита у детей pimorimos 1%用于儿童积极治疗atp皮炎的理由
Pub Date : 2021-11-07 DOI: 10.15690/VSP.V20I5.2310
Н. Н. Мурашкин, Роман Алексеевич Иванов, Э. Т. Амбарчян, Р. В. Епишев, А. И. Материкин, Л. А. Опрятин, А. А. Савелова
Atopic dermatitis (AtD) is multifactorial inflammatory skin disease with high prevalence in pediatric population. It is crucial to implement long-term maintenance therapy to prevent AtD exacerbations according to current clinical guidelines and expert reports. The article summarizes the results of the major studies on using pimecrolimus 1% cream. Its efficacy and safety in long-term proactive therapy of children with AtD are presented.
特应性皮炎(AtD)是一种多因素炎症性皮肤病,在儿科人群中发病率较高。根据目前的临床指南和专家报告,实施长期维持治疗以预防AtD恶化至关重要。本文综述了1%吡美莫司乳膏应用的主要研究结果。对其在儿童AtD长期积极治疗中的有效性和安全性进行了评价。
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引用次数: 1
Об условиях, вопросах и проблемах паллиативной помощи детям на примере работы детского хосписа в г. Санкт-Петербурге 圣彼得堡儿童收容所为儿童提供姑息治疗的条件、问题和问题
Pub Date : 2021-09-20 DOI: 10.15690/VSP.V20I4.2288
А. С. Симаходский, А. Е. Ткаченко, И. В. Кушнарева, Л. Д. Севостьянова
The topicality of reforming the children palliative care (CPC) system due to the increase of the number of patients with cancer, congenital disorders, neurological damages, injuries consequences, genetically determined pathologies is discussed. The patterns of CPC service development, the importance to track those in need, to determine the required volume, forms, and methods of palliative care, and to develop human capacity were analyzed. The results of “Children's Hospice” (Saint Petersburg) activities in 2014–2019 years are presented alongside with the data on CPC development in Russia. This example shows the advantages of clear routing, establishment of indications for patients’ hospitalization, and availability of high-technology medical care and medications. All innovations have led to the significant change in medical conditions structure (over 80% of patients are children with neurological pathology), to the decrease in the number of hospitalizations, to the increase in the number of children who can get required respiratory support at home. The issues of high employees’ turnover and low staffing level in CPC institutions are discussed.
讨论了由于癌症、先天性疾病、神经损伤、损伤后果、遗传决定病理患者数量的增加,改革儿童姑息治疗(CPC)制度的话题性。分析了CPC服务发展模式、跟踪需求人群、确定所需的姑息治疗数量、形式和方法以及开发人力资源的重要性。2014-2019年“儿童临终关怀”(圣彼得堡)活动的结果与俄罗斯CPC发展数据一起呈现。这个例子显示了明确路线、确定患者住院指征以及提供高科技医疗护理和药物的优势。所有这些创新都导致了医疗条件结构的重大变化(超过80%的患者是患有神经系统疾病的儿童),住院人数减少,可以在家中获得所需呼吸支持的儿童人数增加。讨论了党性事业单位人员流动率高、人员编制水平低的问题。
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引用次数: 0
Новый порядок по детской онкологии и гематологии: слишком много вопросов 新的儿童癌症和血液学秩序:太多的问题
Pub Date : 2021-09-17 DOI: 10.15690/VSP.V20I4.2290
П. Г. Габай, С. А. Дронова
The article presents a legal analysis of the procedure for providing medical care in pediatric oncology and hematology which regulates the provision of medical care to children with neoplasms and diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. The place of the pediatric oncology and hematology profile in the system of existing regulatory legal acts and the role assigned by the new procedure to the pediatric oncologist are determined. The requirements to the structure of medical organizations providing medical care in pediatric oncology and hematology profile, the procedure of oncological and hematological diseases diagnosis and management are considered. Attention is drawn to the lack of timescales of pediatric oncologist-hematologist consultation and taking biopsic material. The algorithm of medical organizations actions on entering data into information systems is analyzed.
本文对儿科肿瘤学和血液学提供医疗服务的程序进行了法律分析,该程序规范了向患有肿瘤和血液和造血器官疾病以及涉及免疫机制的某些疾病的儿童提供医疗服务。确定了儿科肿瘤学和血液学在现有监管法律行为体系中的地位,以及新程序分配给儿科肿瘤学家的角色。探讨了儿科肿瘤血液学专业对医疗机构结构的要求、肿瘤血液学疾病的诊断和管理程序。值得注意的是,缺乏儿科肿瘤学家-血液学家会诊和采取活检材料的时间尺度。分析了医疗机构将数据输入信息系统的行为算法。
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引用次数: 1
Роль факторов питания в организации сна детей раннего возраста 营养因素在儿童睡眠组织中的作用
Pub Date : 2021-09-02 DOI: 10.15690/VSP.V20I4.2289
Татьяна Владимировна Турти, Ирина Анатольевна Беляева, Е. П. Бомбардирова, П. Е. Садчиков, А. Ю. Нагонов
The organized infant’s sleep schedule is the crucial part of normal individual development. On the contrary, restless sleep, nocturnal awakening, long wakefulness can lead to deviations in physical, psychomotor, and cognitive development. Feeding schedule organized according to the time of a day and circadian rhythms (chrono-nutrition concept) can be useful for prevention and correction of such disorders. You are aware of the effect of such factors as feeding before night's sleep, nutrition at dark time of a day, diet enriched with triptophane and nucleotides, on the maturation and consolidation of infants sleep. The correlation between intestinal microbiota and factors affecting the circadian and metabolic activity of the body are presented: day-night cycles, sleep and wake, diet and nutrition. Targeted regulation of the intestinal microbiota through products enriched with functional components (prebiotics) can lead to the development of healthy sleep in infants via axis “brain – intestine – microbiota”.
有组织的婴儿睡眠时间表是正常个体发展的关键部分。相反,不安分的睡眠、夜间觉醒、长时间的清醒会导致身体、精神运动和认知发展的偏差。根据一天的时间和昼夜节律(时间营养概念)安排喂养时间表,可用于预防和纠正此类疾病。你知道诸如睡前喂养、一天中黑暗时的营养、富含雷丙氨酸和核苷酸的饮食等因素对婴儿睡眠的成熟和巩固的影响。肠道菌群与影响人体昼夜节律和代谢活动的因素之间的相关性包括:昼夜周期、睡眠和觉醒、饮食和营养。通过富含功能成分的产品(益生元)有针对性地调节肠道微生物群,可以通过“脑-肠-微生物群”轴促进婴儿健康睡眠的发展。
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引用次数: 2
On the Anniversary of Albitsky Valery Yu. 在阿尔比茨基周年纪念上。
Pub Date : 2021-05-18 DOI: 10.15690/VSP.V20I2.2217
S. A. Sher
.
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引用次数: 0
Pulmonary Involvement at Connective Tissue Systemic Diseases in Children 儿童结缔组织全身性疾病的肺部累及
Pub Date : 2021-05-18 DOI: 10.15690/VSP.V20I2.2257
M. Kaleda, S. Salugina, E. Fedorov, L. Ananyeva
Поражение легких при системных заболеваниях соединительной ткани у детей — редкая патология, которая, однако, оказывает существенное влияние на выбор терапевтической тактики и прогноз. В статье представлены данные о частоте, сроках развития, спектре клинических проявлений и результатах визуализирующих методов обследования при поражении легких у детей с такими системными заболеваниями соединительной ткани, как системная склеродермия, ювенильный дерматомиозит, системная красная волчанка и синдром Шегрена. Рассматриваются вопросы патогенеза, возможные факторы риска развития поражения легких, терапевтические подходы и прогноз. Ключевые слова: системная склеродермия с ювенильным началом, ювенильный дерматомиозит, системная красная волчанка с ювенильным началом, синдром Шегрена у детей, интерстициальное поражение легких, легочная артериальная гипертензия Для цитирования: Каледа М.И., Салугина С.О., Фёдоров Е.С., Ананьева Л.П. Поражение легких при системных заболеваниях соединительной ткани у детей. Вопросы современной педиатрии. 2021;20(2):134–143. doi: 10.15690/vsp.v20i2.2257
然而,儿童在系统性结缔组织疾病中肺部的损伤是一种罕见的病理,对治疗策略和预后的选择产生了重大影响。本文介绍了系统硬皮病、青霉素皮肤病、系统性红斑狼疮和舍格伦综合征等结节疾病的发病率、发病率、临床表现和可视化检测方法的结果。我们正在研究病原体,可能的肺损伤风险因素,治疗方法和预后。关键词:系统硬皮病,初级皮肤炎,系统红斑狼疮,儿童中枢神经系统红斑狼疮,儿童中枢神经系统红斑狼疮,儿童中枢神经系统红斑狼疮现代儿科的问题。2021年;20(2):134 - 143。doi: 10.15690 / vsp.v20i2.2257
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引用次数: 0
Mortality of Children Born on Early Gestational Age: is it the Impassable Barrier or the Reserve for Reducing the Infants Mortality? 低胎龄儿死亡率:是降低婴儿死亡率的不可逾越的障碍还是储备?
Pub Date : 2020-12-24 DOI: 10.15690/vsp.v19i5.2209
A. S. Simakhodsky, Y. Gorelik, K. D. Gorelik, S. L. Ivanov, Y. Lukashova
The problem of premature infants is well recognized in Russia and all over the world. The article discusses the mortality level and structure of extremely premature infant during 2015–2019. The aim of the study was to identify significant cause-effect relations for high mortality of premature infants and infants with extremely low body weight (ELBW) according to reports from obstetric departments, pediatric outpatient clinics, children's hospitals, statistical agencies, queries results from Territorial Compulsory Medical Insurance Fund (TCMIF) in Saint Petersburg and Russian Association of Human Reproduction (RAHR). The main demographic indices are presented by the Petrostat association. Russian Federal State Statistics Service (Rosstat) forms provided by the Center for Analysis and Prediction of Maternal and Child Health of the Saint Petersburg Health care Committee (No. 32 “Information on medical care for pregnant women, women in labour and new mothers” (approved by order of Rosstat No. 591 of 27.11.2015); No. 19 “Information on children with disabilities” registered in children's clinics (approved by order of Rosstat No. 866 of 27.12.2016); No. 14 “Information on the activities of medical facilities units providing inpatient medical care” (approved by order of Rosstat No. 723 of 05.12.2014); No. 30 “Information on the medical facility” (approved by order of Rosstat No. 483 of 03.08.2018 “On the approval of statistical tools for the organization of federal statistical observation in the field of healthcare by the Ministry of Health of the Russian Federation”) presented by Saint Petersburg Medical Informational and Analytical Center (MIAC)), and answers from TCMIF in Saint Petersburg and RARCH have been investigated. The authors have analyzed the fertility and mortality rates of premature infants, the group of children with ELBW has been established. High mortality levels have been revealed in the first weeks of life (22–23), they were mainly associated with infectious processes. The authors associate the premature delivery increase with the widespread implementation of assisted reproductive technology (ART). ART can be performed either via compulsory medical insurance funds, or other non-government sources. The assumption was proposed that there are possible violations of ART indications, contraindications, and the number of procedures. The ART efficacy is difficult to estimate as well due to insufficient information provided by Rosstat report form No. 32. The need of implementation of the new statistical form that will cover the data on the of ART administration, the possibility of efficacy estimation of modern invasive methods for infertility treatment and mandatory submission of reports about the use of these methods by medical facilities is discussed.
早产儿的问题在俄罗斯和全世界都是公认的。本文讨论了2015-2019年极早产儿的死亡率水平和结构。该研究的目的是根据产科、儿科门诊、儿童医院、统计机构的报告、圣彼得堡领土强制医疗保险基金(TCMIF)和俄罗斯人类生殖协会(RAHR)的查询结果,确定早产儿和极低体重婴儿(ELBW)高死亡率的显著因果关系。主要人口指数由Petrostat协会提供。俄罗斯联邦国家统计局(Rosstat)由圣彼得堡卫生保健委员会母婴健康分析和预测中心提供的表格(第32号“孕妇、产妇和新妈妈的医疗保健信息”(经2015年11月27日第591号Rosstat命令批准);第19号:在儿童诊所登记的“残疾儿童信息”(经2016年12月27日第866号俄罗斯国家统计局命令批准);第14号"关于提供住院医疗服务的医疗设施单位活动的资料"(经2014年12月5日第723号俄罗斯国家统计局命令批准);圣彼得堡医疗信息和分析中心(MIAC)提交的第30号“医疗设施信息”(经2018年8月3日俄罗斯国家统计局第483号命令批准,“关于批准俄罗斯联邦卫生部在医疗保健领域组织联邦统计观察的统计工具”),并调查了圣彼得堡TCMIF和arch的答复。作者分析了早产儿的生育率和死亡率,建立了ELBW儿童组。在出生后的最初几周(22-23岁)死亡率很高,主要与感染过程有关。作者将早产的增加与辅助生殖技术(ART)的广泛实施联系起来。抗逆转录病毒治疗可以通过强制性医疗保险基金或其他非政府来源进行。假设存在可能违反ART适应症、禁忌症和程序数量的情况。由于Rosstat第32号报告表提供的信息不足,抗逆转录病毒治疗的疗效也难以估计。讨论了实施新的统计表格的必要性,该表格将涵盖抗逆转录病毒治疗的数据、估计现代侵入性不孕症治疗方法疗效的可能性以及强制提交医疗机构使用这些方法的报告。
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引用次数: 2
ВРОЖДЕННАЯ РАСЩЕЛИНА ГУБЫ И НЁБА У ДЕТЕЙ: РАСПРОСТРАНЕННОСТЬ В РОССИИ И В МИРЕ, ГРУППЫ ФАКТОРОВ РИСКА 与生俱来的唇裂和naba儿童:俄罗斯和世界的流行,风险因素组
Pub Date : 2020-06-21 DOI: 10.15690/vsp.v19i2.2107
Nataliya A. Kasimovskaya, Evgeniya A. Shatova
Congenital cleft lip and palate is one of the most common congenital anomalies in children. It has significant medical and social influence on the self-realization of these patients in society. This review of various researches' results from different countries and territories of the Russian Federation (according to the MEDLINE and eLIBRARY.ru databases) provides information on prevalence rate of this pathology among children of our country and worldwide. The role of medical care organization remains unknown among all the presented results of the studies about the role of risk factors of congenital cleft lip and palate development (such as: inheritance, lifestyle, environment).
先天性唇腭裂是儿童最常见的先天性畸形之一。它对这些患者在社会上的自我实现产生了重大的医学和社会影响。本文回顾了来自俄罗斯联邦不同国家和地区的各种研究结果(根据MEDLINE和eLIBRARY.ru数据库),提供了有关我国和全世界儿童中这种病理的患病率的信息。在所有关于先天性唇腭裂发生的危险因素(如:遗传、生活方式、环境)作用的研究结果中,医疗机构的作用尚不清楚。
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引用次数: 3
Новая коронавирусная инфекция: особенности клинического течения, возможности диагностики, лечения и профилактики инфекции у взрослых и детей 新的冠状动脉感染:临床流动的特征,诊断、治疗和预防成人和儿童感染的能力
Pub Date : 2020-06-21 DOI: 10.15690/vsp.v19i2.2105
Anna Starshinova, Ekaterina A. Kushnareva, Anna M. Malkova, I. F. Dovgalyuk, Dmitry A. Kudlay
First cases of new coronaviral infection were reported in Wuhan, Hubei Province, China in December 2019. The infection had caused the death of more than 100,000 people worldwide by the beginning of April 2020. This review analysed the characteristics of the infection course in adults and children, as well as capabilities of diagnostics, treatment and prevention of COVID-19. It is possible to allocate groups of high risk of development of severe forms of disease (elderly people, people with latent tuberculosis infection, adult patients with severe comorbidity) according to the published data. Currently there is limited epidemiological data on the prevalence, morbidity and mortality of COVID-19 in the child population. However, it is already possible to conclude that 90% of cases in children population have mild, moderate and asymptomatic course of the disease. Treatment of patients with COVID-19 is limited due to the lack of means for etiotropic therapy and the possibility of using of only symptomatic therapy. There are no vaccines for COVID-19 prevention.
2019年12月,中国湖北省武汉市报告了首例新型冠状病毒感染病例。到2020年4月初,这种感染已导致全球10多万人死亡。本文分析了成人和儿童感染过程的特点,以及COVID-19的诊断、治疗和预防能力。根据已公布的数据,有可能将严重疾病发展的高风险群体(老年人、潜伏性结核病感染者、患有严重合并症的成年患者)进行分配。目前,关于COVID-19在儿童中的流行率、发病率和死亡率的流行病学数据有限。然而,已经有可能得出结论,儿童人群中90%的病例病程轻、中度和无症状。由于缺乏致病因治疗手段和仅使用对症治疗的可能性,COVID-19患者的治疗受到限制。目前没有预防COVID-19的疫苗。
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引用次数: 28
Ювенильная локализованная склеродермия с позиции детского ревматолога. Вопросы диагностики 青少年局部硬皮病,从儿童风湿病的角度来看。问题诊断
Pub Date : 2020-06-21 DOI: 10.15690/VSP.V19I2.2109
Р. К. Раупов, А. И. Имельбаев, Михаил Михайлович Костик
The localized scleroderma (morphea) is the clinical option of the juvenile scleroderma, the third in prevalence rheumatic condition in pediatrics. The article summarizes all the data on the classification, diagnostics, and differential diagnosis of juvenile localized scleroderma. The recent international guidelines on the localized scleroderma in pediatrics (the European consensus of pediatric rheumatologists, the German and Japanese national guidelines) are presented in the article.
局限性硬皮病(morphea)是儿童硬皮病的临床选择,在儿科风湿病患病率中排名第三。本文综述了有关小儿局限性硬皮病的分类、诊断和鉴别诊断的资料。最近关于儿科局限性硬皮病的国际指南(欧洲儿科风湿病学家共识,德国和日本国家指南)在文章中提出。
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引用次数: 0
期刊
Current Paediatrics
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