А. В. Червинская, Ольга Михайловна Конова, М. А. Хан
The primary focus of medical rehabilitation is the approach of model simulation of natural environment. Halotherapy is one of the nonpharmacological methods widely used in Russian public health care delivery including prophylaxis and rehabilitation in children. This method is based on the recreation of the air environment of a natural underground salt mine. The article presents an innovative method using a next generation of equipment for halotherapy: a guided halocomplex where the control on dosage regiments and aerodisperse medium parameters is implemented. The mechanisms of the effect of halotherapy are considered, the data of the clinical effectiveness for various paediatric diseases are outlined.
{"title":"ГАЛОТЕРАПИЯ ДЛЯ ПРОФИЛАКТИКИ И МЕДИЦИНСКОЙ РЕАБИЛИТАЦИИ В ДЕТСКОМ ЗДРАВООХРАНЕНИИ","authors":"А. В. Червинская, Ольга Михайловна Конова, М. А. Хан","doi":"10.15690/VSP.V16I5.1805","DOIUrl":"https://doi.org/10.15690/VSP.V16I5.1805","url":null,"abstract":"The primary focus of medical rehabilitation is the approach of model simulation of natural environment. Halotherapy is one of the nonpharmacological methods widely used in Russian public health care delivery including prophylaxis and rehabilitation in children. This method is based on the recreation of the air environment of a natural underground salt mine. The article presents an innovative method using a next generation of equipment for halotherapy: a guided halocomplex where the control on dosage regiments and aerodisperse medium parameters is implemented. The mechanisms of the effect of halotherapy are considered, the data of the clinical effectiveness for various paediatric diseases are outlined.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"222 1","pages":"406-412"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76419146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Д. В. Прометной, Ю. С. Александрович, Алексей Николаевич Шмаков
Background. Incorporation of death risk factors in case of urgent pathology in children remains a matter of argument. Objective. Our aim was to determine death predictors in children hospitalized in emergency. Methods. In a retrospective cohort study, we analyzed the data of inpatient's medical records (form 003/u) of resuscitation patients aged 0–17 years hospitalized in the Rostov region in 2006–2017. We recorded a favourable outcome of the underlying disease in case of patient discharge from the hospital and death in case of death in the hospital. Results. We studied the data of 151 children (boys — 61%), median age 10 (2; 36) months. Among the predictors of death in a hospital (90 out of 151 patients, 60%), we determined the disease duration up to 24 hours (odds ratio, OR, 2.1, 95% confidence interval, CI, 2.1–4.1), self-referral hospitalization (OR 3.0, 95% CI 1.1–10.4), hospitalization in a moderate (OR 19.6, 95% CI 12.6–337.4) or extremely critical condition (OR 103.1, 95% CI 6.2–1,718.9), sepsis/generalized infection (OR 5.8, 95% CI 2.3–15.0), decrease in diastolic blood pressure (BP) ≥ 20% of the reference value (OR 7.0, 95% CI 1.3–38.4), score ≤ 14 points by the Glasgow coma scale (OR 10.6, 95% CI 4.1–24.6). Predictors of death at the resuscitation phase (72 of 133 patients, 54%) included cerebral dysfunction (OR 3.8, 95% CI 1.5–9.1), shock (OR 3.1, 95% CI 1.3–7.0), decrease of ≥ 20% in the reference value for respiratory rate (OR 24.2, 95% CI 3.1–186.2), heart rate (OR 29.0, 95% CI 1.7–497.2), systolic blood pressure (OR 5.2, 95% CI 1.9–14.7), diastolic blood pressure (OR 5.4, 95% CI 1.9–15.3), increase of ≥ 20% in the reference value for glucose level (OR 2.1, 95% CI 1.1–4.5), and creatinine (OR 4.3, 95% CI 1.5–12.6). Conclusion. We identified the predictors of death in children hospitalized in emergency. They can be used to consistently assess the risk of death in a hospital.
背景。在儿童紧急病理病例中纳入死亡危险因素仍然是一个有争议的问题。目标。我们的目的是确定急诊住院儿童的死亡预测因素。方法。在回顾性队列研究中，我们分析了2006-2017年罗斯托夫地区0-17岁住院复苏患者的住院病历(表格003/u)数据。我们记录了一个有利的结果，基础疾病的情况下，病人出院和死亡的情况下，在医院死亡。结果。我们研究了151名儿童的数据(男孩占61%)，中位年龄为10岁(2岁;36个月。在医院死亡的预测因子中(151例患者中有90例，60%)，我们确定了疾病持续时间长达24小时(优势比，OR, 2.1, 95%可信区间，CI, 2.1 - 4.1)、自我转诊住院(OR 3.0, 95% CI, 1.1-10.4)、中度住院(OR 19.6, 95% CI 12.6-337.4)或极度危重住院(OR 103.1, 95% CI 6.2 - 1718.9)、败血症/全身性感染(OR 5.8, 95% CI 2.3-15.0)、舒张压(BP)下降≥参考值的20% (OR 7.0, 95% CI 1.3-38.4)，格拉斯哥昏迷评分≤14分(OR 10.6, 95% CI 4.1-24.6)。在复苏阶段死亡的预测因子(包括72 133例,54%)脑功能障碍(或3.8,95%可信区间1.5 - -9.1),冲击(或3.1,95%可信区间1.3 - -7.0),降低呼吸速率的参考价值≥20%(或24.2,95% CI 3.1 - -186.2)、心率(或29.0,95% CI 1.7 - -497.2)、收缩压(或5.2,95% CI 1.9 - -14.7)、舒张压(或5.4,95%可信区间1.9 - -15.3),增加血糖水平的参考价值≥20%(或2.1,95%可信区间1.1 - -4.5),和肌酐(OR 4.3, 95% CI 1.5-12.6)。结论。我们确定了急诊住院儿童死亡的预测因素。它们可以用来持续评估医院的死亡风险。
{"title":"ПРЕДИКТОРЫ ЛЕТАЛЬНОГО ИСХОДА У ГОСПИТАЛИЗИРОВАННЫХ В ЭКСТРЕННОМ ПОРЯДКЕ ДЕТЕЙ: РЕЗУЛЬТАТЫ РЕТРОСПЕКТИВНОГО КОГОРТНОГО ИССЛЕДОВАНИЯ","authors":"Д. В. Прометной, Ю. С. Александрович, Алексей Николаевич Шмаков","doi":"10.15690/VSP.V16I5.1807","DOIUrl":"https://doi.org/10.15690/VSP.V16I5.1807","url":null,"abstract":"Background. Incorporation of death risk factors in case of urgent pathology in children remains a matter of argument. Objective. Our aim was to determine death predictors in children hospitalized in emergency. Methods. In a retrospective cohort study, we analyzed the data of inpatient's medical records (form 003/u) of resuscitation patients aged 0–17 years hospitalized in the Rostov region in 2006–2017. We recorded a favourable outcome of the underlying disease in case of patient discharge from the hospital and death in case of death in the hospital. Results. We studied the data of 151 children (boys — 61%), median age 10 (2; 36) months. Among the predictors of death in a hospital (90 out of 151 patients, 60%), we determined the disease duration up to 24 hours (odds ratio, OR, 2.1, 95% confidence interval, CI, 2.1–4.1), self-referral hospitalization (OR 3.0, 95% CI 1.1–10.4), hospitalization in a moderate (OR 19.6, 95% CI 12.6–337.4) or extremely critical condition (OR 103.1, 95% CI 6.2–1,718.9), sepsis/generalized infection (OR 5.8, 95% CI 2.3–15.0), decrease in diastolic blood pressure (BP) ≥ 20% of the reference value (OR 7.0, 95% CI 1.3–38.4), score ≤ 14 points by the Glasgow coma scale (OR 10.6, 95% CI 4.1–24.6). Predictors of death at the resuscitation phase (72 of 133 patients, 54%) included cerebral dysfunction (OR 3.8, 95% CI 1.5–9.1), shock (OR 3.1, 95% CI 1.3–7.0), decrease of ≥ 20% in the reference value for respiratory rate (OR 24.2, 95% CI 3.1–186.2), heart rate (OR 29.0, 95% CI 1.7–497.2), systolic blood pressure (OR 5.2, 95% CI 1.9–14.7), diastolic blood pressure (OR 5.4, 95% CI 1.9–15.3), increase of ≥ 20% in the reference value for glucose level (OR 2.1, 95% CI 1.1–4.5), and creatinine (OR 4.3, 95% CI 1.5–12.6). Conclusion. We identified the predictors of death in children hospitalized in emergency. They can be used to consistently assess the risk of death in a hospital.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"51 1","pages":"424-430"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80821859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Height, body weight and body mass index are important parameters of health and are widely used in clinical practice, for assessing health of children, and for population studies. Amid the general globalization, the main trend of the present time is joining efforts of various countries for prevention and treatment of diseases in children. The work of the World Health Organization (WHO) on creation of international standards of anthropometric measures and parameters of children's development is based upon this trend. A key point of the WHO standards is their creation based on a survey of a large cohort of children (from 5 countries of 6 continents) who were in optimal conditions: who were breast-fed and received the up-to-date level of care and quality of the provided medical care. This actually allowed to eliminate the main exogenous factors that affect such parameters and to make them, in fact, the reference ones. The application of a unified approach using the WHO standards allows to carry out multicenter studies involving different countries as well as to compare the data obtained in different regions. Studies have shown that the WHO standards for physical development are applicable in different regions of the world. In this regard, the creation of «regional» reference curves for height and body weight of children that are different from the generally accepted standards is currently inappropriate, but it is really relevant to use the WHO standards.
{"title":"ДЕЙСТВИТЕЛЬНО ЛИ СУЩЕСТВУЕТ НЕОБХОДИМОСТЬ В СОЗДАНИИ «РЕГИОНАЛЬНЫХ ПЕРЦЕНТИЛЬНЫХ КРИВЫХ» МАССО-РОСТОВЫХ ПОКАЗАТЕЛЕЙ? (КОММЕНТАРИЙ К СТАТЬЕ Р.Р. КИЛЬДИЯРОВОЙ «ОЦЕНКА ФИЗИЧЕСКОГО РАЗВИТИЯ ДЕТЕЙ С ПОМОЩЬЮ ПЕРЦЕНТИЛЬНЫХ ДИАГРАММ»)","authors":"Светлана Геннадьевна Макарова","doi":"10.15690/vsp.v16i5.1809","DOIUrl":"https://doi.org/10.15690/vsp.v16i5.1809","url":null,"abstract":"Height, body weight and body mass index are important parameters of health and are widely used in clinical practice, for assessing health of children, and for population studies. Amid the general globalization, the main trend of the present time is joining efforts of various countries for prevention and treatment of diseases in children. The work of the World Health Organization (WHO) on creation of international standards of anthropometric measures and parameters of children's development is based upon this trend. A key point of the WHO standards is their creation based on a survey of a large cohort of children (from 5 countries of 6 continents) who were in optimal conditions: who were breast-fed and received the up-to-date level of care and quality of the provided medical care. This actually allowed to eliminate the main exogenous factors that affect such parameters and to make them, in fact, the reference ones. The application of a unified approach using the WHO standards allows to carry out multicenter studies involving different countries as well as to compare the data obtained in different regions. Studies have shown that the WHO standards for physical development are applicable in different regions of the world. In this regard, the creation of «regional» reference curves for height and body weight of children that are different from the generally accepted standards is currently inappropriate, but it is really relevant to use the WHO standards.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"47 1","pages":"438-440"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85527430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Treatment efficacy for children with cancer depends on the diagnosis timeliness since the earlier expert care has been started, the higher likelihood there is to achieve remission. In this regard, a special role belongs to primary care physicians — district pediatricians who should timely recognize the malignant neoplasm and refer the patient to a pediatric oncologist for advice. Wherein, a limited number of primary patients and atypical course of oncological diseases are the causes of a decrease in oncological alertness. This lecture is aimed at a wide range of specialists (pediatricians, radiologists, pathologists) and devoted to clinical manifestations and diagnosis of malignant neoplasms in children — hemoblastosis and solid tumours. The suggested algorithms for the examination of patients will allow to make a diagnosis faster and timely initiate expert care in specialized departments. The article is illustrated with unique pictures — images of histological specimens, MRI, and CT of patients with the most neglected cases of malignant neoplasms being the result of diagnostic errors of pediatricians.
{"title":"Злокачественные новообразования у детей: Клинические проявления и диагностика","authors":"М. Ю. Рыков, Д. Д. Севрюков, А. С. Вилкова","doi":"10.15690/VSP.V16I5.1801","DOIUrl":"https://doi.org/10.15690/VSP.V16I5.1801","url":null,"abstract":"Treatment efficacy for children with cancer depends on the diagnosis timeliness since the earlier expert care has been started, the higher likelihood there is to achieve remission. In this regard, a special role belongs to primary care physicians — district pediatricians who should timely recognize the malignant neoplasm and refer the patient to a pediatric oncologist for advice. Wherein, a limited number of primary patients and atypical course of oncological diseases are the causes of a decrease in oncological alertness. This lecture is aimed at a wide range of specialists (pediatricians, radiologists, pathologists) and devoted to clinical manifestations and diagnosis of malignant neoplasms in children — hemoblastosis and solid tumours. The suggested algorithms for the examination of patients will allow to make a diagnosis faster and timely initiate expert care in specialized departments. The article is illustrated with unique pictures — images of histological specimens, MRI, and CT of patients with the most neglected cases of malignant neoplasms being the result of diagnostic errors of pediatricians.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"17 1","pages":"370-382"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86931526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Пётр Францевич Литвицкий, Лариса Дмитриевна Мальцева
The lecture describes types, causes, pathogenesis key components, manifestations of typical forms of carbohydrate metabolism pathology: hypoglycemia, hyperglycemia, glycogenosis, aglycogenosis, hexosemia. A case problem and multiple choice tests are given.
{"title":"Расстройства углеводного обмена у детей: гипогликемия, гипергликемия, гликогеноз, агликогеноз, гексоземия","authors":"Пётр Францевич Литвицкий, Лариса Дмитриевна Мальцева","doi":"10.15690/vsp.v16i5.1800","DOIUrl":"https://doi.org/10.15690/vsp.v16i5.1800","url":null,"abstract":"The lecture describes types, causes, pathogenesis key components, manifestations of typical forms of carbohydrate metabolism pathology: hypoglycemia, hyperglycemia, glycogenosis, aglycogenosis, hexosemia. A case problem and multiple choice tests are given.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"39 1","pages":"362-369"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82141922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ирина Анатольевна Беляева, Е. П. Бомбардирова, Е. И. Токовая, Н. А. Харитонова, Светлана Борисовна Лазуренко, Татьяна Владимировна Турти, М. С. Илларионова
Drug-free rehabilitation treatment modalities of children with perinatal pathology of the nervous system are considered as an important component of the habilitation process and creation of a developing environment for infants with a high risk of disabling conditions. Corrective actions depend not only on the severity of perinatal pathology but also on the maturity of a child and individual characteristics of neuroonthogenesis. The article considers the main drug-free technologies of rehabilitation treatment — both already known and recently developed including methods of kinesi-, aqua-, music therapy, and correctional pedagogy. A separate section is devoted to breastfeeding as an important component of the adequate development of a child. A necessary condition for effective habilitation is a family-oriented approach, which implies active participation of parents in the implementation of rehabilitation programs for children.
{"title":"Немедикаментозная абилитация детей с перинатальными поражениями нервной системы","authors":"Ирина Анатольевна Беляева, Е. П. Бомбардирова, Е. И. Токовая, Н. А. Харитонова, Светлана Борисовна Лазуренко, Татьяна Владимировна Турти, М. С. Илларионова","doi":"10.15690/VSP.V16I5.1802","DOIUrl":"https://doi.org/10.15690/VSP.V16I5.1802","url":null,"abstract":"Drug-free rehabilitation treatment modalities of children with perinatal pathology of the nervous system are considered as an important component of the habilitation process and creation of a developing environment for infants with a high risk of disabling conditions. Corrective actions depend not only on the severity of perinatal pathology but also on the maturity of a child and individual characteristics of neuroonthogenesis. The article considers the main drug-free technologies of rehabilitation treatment — both already known and recently developed including methods of kinesi-, aqua-, music therapy, and correctional pedagogy. A separate section is devoted to breastfeeding as an important component of the adequate development of a child. A necessary condition for effective habilitation is a family-oriented approach, which implies active participation of parents in the implementation of rehabilitation programs for children.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"55 1","pages":"383-391"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91332263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Measles is a well-studied manageable disease. Vaccination resulted in a significant reduction in the incidence of this infection. However, more recently, measles outbreaks have become more frequent in countries where it would seem there was one step left before the complete virus elimination. The article provides basic information about the measles agent, clinical manifestations, and preventive measures. The causes of new measles outbreaks in developed countries are discussed.
{"title":"ЭПИДЕМИЯ КОРИ. РЕАЛЬНА ЛИ УГРОЗА","authors":"И. В. Артемова, Татьяна Владимировна Куличенко","doi":"10.15690/VSP.V16I5.1799","DOIUrl":"https://doi.org/10.15690/VSP.V16I5.1799","url":null,"abstract":"Measles is a well-studied manageable disease. Vaccination resulted in a significant reduction in the incidence of this infection. However, more recently, measles outbreaks have become more frequent in countries where it would seem there was one step left before the complete virus elimination. The article provides basic information about the measles agent, clinical manifestations, and preventive measures. The causes of new measles outbreaks in developed countries are discussed.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"29 1","pages":"358-361"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84312522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Николай Андреевич Маянский, Н М Алябьева, О. А. Пономаренко, Татьяна Владимировна Куличенко, И. В. Артемова, А. В. Лазарева, Е. А. Бржозовская, О. В. Шамина, Л. К. Катосова
Background. Pneumococci (Streptococcus pneumoniae) represent major pathogens that cause acute infections in children. Objective. Our aim was to analyze dynamics of the distribution of nasopharyngeal pneumococcal serotypes and their antimicrobial susceptibility in children. Methods. A retrospective cohort study was conducted. We examined nasopharyngeal pneumococci isolated from children getting care at the National Medical Research Center of Children’s Health (Moscow) in 2010–2016. Serotyping was performed using specific antisera and/or by molecular typing employing PCR. Susceptibility to oxacillin (OXA), erythromycin (ERY), clindamycin (CLI), trimethoprim/sulfamethoxazol, chloramphenicol and tetracycline was tested by the disk diffusion method. In 2013–2016, penicillin (PEN), amoxicillin (AMX), ERY and CLI minimal inhibitory concentrations (MIC) were measured. Results. A total of 1,111 pneumococcal isolates were examined; the sample was obtained from children with a median age of 4 years (P25–P75, 2.4–6.5 years). We identified 48 pneumococcal serotypes; six leading serotypes were serotypes 3, 6А, 6В, 14, 19F and 23F aggregating a proportion of 63.2% in the overall distribution. From 2010 to 2016, the distribution of serotypes has not changed. Wherein, 13-valent pneumococcal conjugate vaccine covered 74% of serotypes in children under 5 years. The five leading serotypes (6А, 6В, 14, 19F, 23F and serotype 19A) had the highest resistance rate. Within 2010–2016, the proportion of OXA- and ERY-resistant pneumococci grew from 21.3% to 35.9% and from 24.5% to 36.9%, respectively. The majority (81.3%) of ERY-resistant isolates possessed an MLSB-phenotype, i. e. were resistant to macrolides, lincosamides, and streptogramin B. In 2013–2016, the rate of PEN- and AMX-resistant pneumococci was 34.6% and 3.5%, respectively. Conclusion. Within the seven year study period, no major shifts in the nasopharyngeal pneumococcal serotype distribution were observed. The pneumococci remained highly susceptible to AMX, but activity of macrolides was significantly reduced. Considering the leading mechanism of macrolide resistance, the use of any macrolides or lincosamides for empiric treatment of pneumococcal infections in children is questionable.
{"title":"ДИНАМИКА РАСПРОСТРАНЕННОСТИ СЕРОТИПОВ И АНТИБИОТИКОРЕЗИСТЕНТНОСТИ НОСОГЛОТОЧНЫХ ПНЕВМОКОККОВ, ВЫДЕЛЕННЫХ У ДЕТЕЙ В 2010–2016 ГГ.: РЕЗУЛЬТАТЫ РЕТРОСПЕКТИВНОГО КОГОРТНОГО ИССЛЕДОВАНИЯ","authors":"Николай Андреевич Маянский, Н М Алябьева, О. А. Пономаренко, Татьяна Владимировна Куличенко, И. В. Артемова, А. В. Лазарева, Е. А. Бржозовская, О. В. Шамина, Л. К. Катосова","doi":"10.15690/VSP.V16I5.1806","DOIUrl":"https://doi.org/10.15690/VSP.V16I5.1806","url":null,"abstract":"Background. Pneumococci (Streptococcus pneumoniae) represent major pathogens that cause acute infections in children. Objective. Our aim was to analyze dynamics of the distribution of nasopharyngeal pneumococcal serotypes and their antimicrobial susceptibility in children. Methods. A retrospective cohort study was conducted. We examined nasopharyngeal pneumococci isolated from children getting care at the National Medical Research Center of Children’s Health (Moscow) in 2010–2016. Serotyping was performed using specific antisera and/or by molecular typing employing PCR. Susceptibility to oxacillin (OXA), erythromycin (ERY), clindamycin (CLI), trimethoprim/sulfamethoxazol, chloramphenicol and tetracycline was tested by the disk diffusion method. In 2013–2016, penicillin (PEN), amoxicillin (AMX), ERY and CLI minimal inhibitory concentrations (MIC) were measured. Results. A total of 1,111 pneumococcal isolates were examined; the sample was obtained from children with a median age of 4 years (P25–P75, 2.4–6.5 years). We identified 48 pneumococcal serotypes; six leading serotypes were serotypes 3, 6А, 6В, 14, 19F and 23F aggregating a proportion of 63.2% in the overall distribution. From 2010 to 2016, the distribution of serotypes has not changed. Wherein, 13-valent pneumococcal conjugate vaccine covered 74% of serotypes in children under 5 years. The five leading serotypes (6А, 6В, 14, 19F, 23F and serotype 19A) had the highest resistance rate. Within 2010–2016, the proportion of OXA- and ERY-resistant pneumococci grew from 21.3% to 35.9% and from 24.5% to 36.9%, respectively. The majority (81.3%) of ERY-resistant isolates possessed an MLSB-phenotype, i. e. were resistant to macrolides, lincosamides, and streptogramin B. In 2013–2016, the rate of PEN- and AMX-resistant pneumococci was 34.6% and 3.5%, respectively. Conclusion. Within the seven year study period, no major shifts in the nasopharyngeal pneumococcal serotype distribution were observed. The pneumococci remained highly susceptible to AMX, but activity of macrolides was significantly reduced. Considering the leading mechanism of macrolide resistance, the use of any macrolides or lincosamides for empiric treatment of pneumococcal infections in children is questionable.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"9 1","pages":"413-423"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75180334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Namazova-Baranova, Olga V. Ginter, Tatyana A. Polunina, Irina V. Davydova, K. V. Savostyanov, A. A. Pushkov, Natalya V. Jourkova, Tatyana Y. Mospan
Chromosomal diseases, in particular microdeletions, determine the child's condition as well as the prognosis for a disease even at birth. With timely identified chromosomal abnormalities, we can diagnose not only obvious but also hidden disorders in the organs and their systems and timely correct the child's treatment at an early age. The algorithm for diagnosis of chromosomal abnormalities in children is an important component of a modern pediatric practice. It allows to increase the effectiveness of chromosomal pathology treatment.
{"title":"АЛГОРИТМ РАННЕЙ ДИАГНОСТИКИ И ЛЕЧЕНИЯ СИНДРОМА ДЕЛЕЦИИ ХРОМОСОМЫ 22 (22q11.2)","authors":"L. Namazova-Baranova, Olga V. Ginter, Tatyana A. Polunina, Irina V. Davydova, K. V. Savostyanov, A. A. Pushkov, Natalya V. Jourkova, Tatyana Y. Mospan","doi":"10.15690/vsp.v16i5.1803","DOIUrl":"https://doi.org/10.15690/vsp.v16i5.1803","url":null,"abstract":"Chromosomal diseases, in particular microdeletions, determine the child's condition as well as the prognosis for a disease even at birth. With timely identified chromosomal abnormalities, we can diagnose not only obvious but also hidden disorders in the organs and their systems and timely correct the child's treatment at an early age. The algorithm for diagnosis of chromosomal abnormalities in children is an important component of a modern pediatric practice. It allows to increase the effectiveness of chromosomal pathology treatment.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"47 1","pages":"392-398"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84147448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The results of the analysis of methods assessing anthropometric measures in children are presented. A method for visual examination of physical development using author's percentile diagrams for height, body weight, and the harmony of development of children of different age groups is offered. The method can be quickly performed, it is recommended for mass screening examination of children under outpatient treatment. To monitor the health of a specific child, a monitoring assessment of physical development is possible. The analysis of Z-score is of great clinical importance when determining anthropometric measures below the 3rd percentile, for the assessment of premature infants with congenital malformations and other diseases, in the presence of obesity. Graphical curves of body weight, height to age, body weight according to the height of boys and girls can be used by pediatricians.
{"title":"ОЦЕНКА ФИЗИЧЕСКОГО РАЗВИТИЯ ДЕТЕЙ С ПОМОЩЬЮ ПЕРЦЕНТИЛЬНЫХ ДИАГРАММ","authors":"Р. Р. Кильдиярова","doi":"10.15690/VSP.V16I5.1808","DOIUrl":"https://doi.org/10.15690/VSP.V16I5.1808","url":null,"abstract":"The results of the analysis of methods assessing anthropometric measures in children are presented. A method for visual examination of physical development using author's percentile diagrams for height, body weight, and the harmony of development of children of different age groups is offered. The method can be quickly performed, it is recommended for mass screening examination of children under outpatient treatment. To monitor the health of a specific child, a monitoring assessment of physical development is possible. The analysis of Z-score is of great clinical importance when determining anthropometric measures below the 3rd percentile, for the assessment of premature infants with congenital malformations and other diseases, in the presence of obesity. Graphical curves of body weight, height to age, body weight according to the height of boys and girls can be used by pediatricians.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"13 1","pages":"431-437"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87604336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：