Михаил Михайлович Костик, Е. А. Исупова, Е. А. Шилова, И. С. Аврусин, Ю. Ю. Корин, И. А. Чикова, М. Ф. Дубко, В. В. Масалова, Л. С. Снегирёва, Т. Л. Корнишина, Е. В. Гайдар, Ольга Владимировна Калашникова, Т. Ф. Панова, О. Л. Копчак, В. Г. Часнык
Background. Patients with malignant oncohematological diseases (OHD) may have such symptoms as fever, lymphadenopathy, hepatosplenomegaly, joint pain, arthritis, elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) concentration, anemia that require differentiation from clinical implications of systemic juvenile idiopathic arthritis (sJIA). Objective. Our aim was to determine diagnostic criteria that can differentiate rheumatic masks of OHD from sJIA. Methods. The retrospective study included 86 children with sJIA and 21 children with OHD who had rheumatic masks and were hospitalized in rheumatological departments with an initial diagnosis of sJIA. OHD were represented by acute lymphoblastic leukemia (n = 17), neuroblastoma (n = 1), and lymphomas (n = 3). Results . Blast cells in the peripheral blood test were detected in 9/17 (53%) patients with acute leukemia at different times from the appearance of complaints and hospitalization. Diagnostic criteria for differentiating OHD from sJIA were the number of active joints 3 (diagnostic odds ratio, OR, 4.4, 95% confidence interval, CI, 1.5–13.2), CRP concentration 43.3% (OR 28.8, 95% CI 5.6–149.2), absence of exanthema (OR 39.8, 95% CI 8.4–188.5). The most frequent symptoms with the greatest specificity were night pain (sensitivity 0.57, specificity 1.0), bone pain (sensitivity 0.95, specificity 1.0), pathological fractures (sensitivity 0.14, specificity 1.0). Conclusion. The identified diagnostic criteria can be used for differential diagnosis of OHD with rheumatic masks and sJIA.
{"title":"ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА ЮВЕНИЛЬНОГО АРТРИТА С СИСТЕМНЫМ ДЕБЮТОМ И РЕВМАТИЧЕСКИХ «МАСОК» ОНКОГЕМАТОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ: РЕЗУЛЬТАТЫ РЕТРОСПЕКТИВНОГО КОГОРТНОГО ИССЛЕДОВАНИЯ","authors":"Михаил Михайлович Костик, Е. А. Исупова, Е. А. Шилова, И. С. Аврусин, Ю. Ю. Корин, И. А. Чикова, М. Ф. Дубко, В. В. Масалова, Л. С. Снегирёва, Т. Л. Корнишина, Е. В. Гайдар, Ольга Владимировна Калашникова, Т. Ф. Панова, О. Л. Копчак, В. Г. Часнык","doi":"10.15690/VSP.V16I3.1732","DOIUrl":"https://doi.org/10.15690/VSP.V16I3.1732","url":null,"abstract":"Background. Patients with malignant oncohematological diseases (OHD) may have such symptoms as fever, lymphadenopathy, hepatosplenomegaly, joint pain, arthritis, elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) concentration, anemia that require differentiation from clinical implications of systemic juvenile idiopathic arthritis (sJIA). Objective. Our aim was to determine diagnostic criteria that can differentiate rheumatic masks of OHD from sJIA. Methods. The retrospective study included 86 children with sJIA and 21 children with OHD who had rheumatic masks and were hospitalized in rheumatological departments with an initial diagnosis of sJIA. OHD were represented by acute lymphoblastic leukemia (n = 17), neuroblastoma (n = 1), and lymphomas (n = 3). Results . Blast cells in the peripheral blood test were detected in 9/17 (53%) patients with acute leukemia at different times from the appearance of complaints and hospitalization. Diagnostic criteria for differentiating OHD from sJIA were the number of active joints 3 (diagnostic odds ratio, OR, 4.4, 95% confidence interval, CI, 1.5–13.2), CRP concentration 43.3% (OR 28.8, 95% CI 5.6–149.2), absence of exanthema (OR 39.8, 95% CI 8.4–188.5). The most frequent symptoms with the greatest specificity were night pain (sensitivity 0.57, specificity 1.0), bone pain (sensitivity 0.95, specificity 1.0), pathological fractures (sensitivity 0.14, specificity 1.0). Conclusion. The identified diagnostic criteria can be used for differential diagnosis of OHD with rheumatic masks and sJIA.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"94 1","pages":"220-225"},"PeriodicalIF":0.0,"publicationDate":"2017-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83899195","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}
Лейла Сеймуровна Намазова-баранова, Д. А. Новикова, Марина Владиславовна Федосеенко, Анна Геннадьевна Гайворонская, Н. Е. Ткаченко, Татьяна Альбертовна Калюжная, Ф. Ч. Шахтахтинская, М. И. Броева
Meningococcal infection is an acute disease caused by Neisseria meningitidis, which proceeds with a diverse clinical aspect from nasopharyngitis to meningococcal meningitis and meningococcemia. Since 2014, a tetravalent meningococcal conjugate vaccine has been registered in Russia. This vaccine creates protection against serogroups A, C, W-135, Y and can be used from the age of nine months to 55 years. The actual issue is a vaccine tolerability, including when combined with other vaccine preparations. Objective: Our aim was to evaluate the safety of a tetravalent meningococcal conjugate vaccine against serogroups A, C, Y and W-135 when it is combined with other vaccine preparations. Methods. A prospective full-design study assessed the tolerability of immunization with a meningococcal conjugate vaccine, both in case of monovaccination and in combination with a pneumococcal 13-valent conjugate vaccine, measles-mumps-rubella, viral hepatitis A, influenza, and chicken pox vaccines. Results. 97 children aged from 9 months to 18 years were vaccinated, 20 of them were healthy and 77 had medical issues (with allergic pathology, ENT diseases, cardiovascular and nervous system diseases, lung diseases as well as orphan diseases). Among vaccinated children, general reactions were observed in 3/97 (3.1%) children, local reactions — in 5 (5.2%). The post-vaccination period passed asymptomatically and uneventfully in the prevailing majority of children vaccinated with a tetravalent meningococcal conjugate vaccine (in 91, 93.8%). Conclusion. The immunization with a tetravalent meningococcal conjugate vaccine against serogroups A, C, Y, W-135 is well tolerated, both in case of monovaccination and in combination with other vaccine preparations, in healthy children of different age groups and in patients with different health status.
{"title":"Безопасность совместного применения четырехвалентной конъюгированной вакцины против менингококковой инфекции серогрупп А, С, Y, W-135 с другими вакцинными препаратами: проспективное исследование серии случаев среди детей здоровых и с различными отклонениями в состоянии здоровья","authors":"Лейла Сеймуровна Намазова-баранова, Д. А. Новикова, Марина Владиславовна Федосеенко, Анна Геннадьевна Гайворонская, Н. Е. Ткаченко, Татьяна Альбертовна Калюжная, Ф. Ч. Шахтахтинская, М. И. Броева","doi":"10.15690/VSP.V16I2.1717","DOIUrl":"https://doi.org/10.15690/VSP.V16I2.1717","url":null,"abstract":"Meningococcal infection is an acute disease caused by Neisseria meningitidis, which proceeds with a diverse clinical aspect from nasopharyngitis to meningococcal meningitis and meningococcemia. Since 2014, a tetravalent meningococcal conjugate vaccine has been registered in Russia. This vaccine creates protection against serogroups A, C, W-135, Y and can be used from the age of nine months to 55 years. The actual issue is a vaccine tolerability, including when combined with other vaccine preparations. Objective: Our aim was to evaluate the safety of a tetravalent meningococcal conjugate vaccine against serogroups A, C, Y and W-135 when it is combined with other vaccine preparations. Methods. A prospective full-design study assessed the tolerability of immunization with a meningococcal conjugate vaccine, both in case of monovaccination and in combination with a pneumococcal 13-valent conjugate vaccine, measles-mumps-rubella, viral hepatitis A, influenza, and chicken pox vaccines. Results. 97 children aged from 9 months to 18 years were vaccinated, 20 of them were healthy and 77 had medical issues (with allergic pathology, ENT diseases, cardiovascular and nervous system diseases, lung diseases as well as orphan diseases). Among vaccinated children, general reactions were observed in 3/97 (3.1%) children, local reactions — in 5 (5.2%). The post-vaccination period passed asymptomatically and uneventfully in the prevailing majority of children vaccinated with a tetravalent meningococcal conjugate vaccine (in 91, 93.8%). Conclusion. The immunization with a tetravalent meningococcal conjugate vaccine against serogroups A, C, Y, W-135 is well tolerated, both in case of monovaccination and in combination with other vaccine preparations, in healthy children of different age groups and in patients with different health status.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"26 1","pages":"156-162"},"PeriodicalIF":0.0,"publicationDate":"2017-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86058605","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}
Е. М. Камалтынова, Ю. П. Часовских, З. А. Маевская, С. О. Салугина, Е. С. Фёдоров, И. Э. Гербек
Cryopyrin associated periodic syndromes (CAPS) are rare monogenic autoinflammatory diseases from the group of hereditary periodic syndromes caused by a regulation defect of inflammatory cytokines, in particular interleukin 1 β . They include familial cold autoinflammatory syndrome (FCAS), Muckle–Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (CINCA/NOMID). Previously, Muckle–Wells syndrome was considered as a triad of symptoms — urticaria, deafness, and reactive amyloidosis. Today, the spectrum of symptoms is constantly expanding: it includes fever, fatigue, conjunctivitis, arthralgia, arthritis, myalgia, irritability, headache, abdominal pain, mouth ulcers, pericarditis, which involves doctors of different specialties in the diagnostic and treatment process, who are not always familiar with this disease. In Russia, single observations of this disease have been described. We present the clinical case of Muckle–Wells syndrome in a 5-year-old child, whose first symptoms appeared at the age of 2 months. This observation underscores the complexity of diagnosing the syndrome in children.
{"title":"Синдром Макла–Уэллса у ребенка с рецидивирующей крапивницей","authors":"Е. М. Камалтынова, Ю. П. Часовских, З. А. Маевская, С. О. Салугина, Е. С. Фёдоров, И. Э. Гербек","doi":"10.15690/VSP.V16I2.1721","DOIUrl":"https://doi.org/10.15690/VSP.V16I2.1721","url":null,"abstract":"Cryopyrin associated periodic syndromes (CAPS) are rare monogenic autoinflammatory diseases from the group of hereditary periodic syndromes caused by a regulation defect of inflammatory cytokines, in particular interleukin 1 β . They include familial cold autoinflammatory syndrome (FCAS), Muckle–Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (CINCA/NOMID). Previously, Muckle–Wells syndrome was considered as a triad of symptoms — urticaria, deafness, and reactive amyloidosis. Today, the spectrum of symptoms is constantly expanding: it includes fever, fatigue, conjunctivitis, arthralgia, arthritis, myalgia, irritability, headache, abdominal pain, mouth ulcers, pericarditis, which involves doctors of different specialties in the diagnostic and treatment process, who are not always familiar with this disease. In Russia, single observations of this disease have been described. We present the clinical case of Muckle–Wells syndrome in a 5-year-old child, whose first symptoms appeared at the age of 2 months. This observation underscores the complexity of diagnosing the syndrome in children.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"29 1","pages":"180-183"},"PeriodicalIF":0.0,"publicationDate":"2017-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90229462","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}
Наталья Анатольевна Ильенкова, И. Н. Протасова, Е. С. Соколовская
The key to effective treatment of a bacterial infection is a rapid and proper selection of antimicrobial therapy. WHO and UNICEF developed the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) aimed to elimination of the preventable causes of child death by 2025 by optimizing diagnosis and treatment. The main pneumonia agents are fastidious microorganisms that require special nutrient media and cultivation conditions that are absent in many laboratories. Due to low effectiveness of the etiological diagnosis, the choice of antibiotic therapy for pneumonia in the practice of a pediatrician is usually empirical. The article describes clinical cases of community-acquired pneumonia in children caused by strains of Streptococcus pneumoniae with a multiple antibiotic resistance. The above experience can be used by pediatricians in everyday practice.
{"title":"Внебольничная пневмония у детей, вызванная пневмококками MLSB- и M-фенотипа: клинические случаи","authors":"Наталья Анатольевна Ильенкова, И. Н. Протасова, Е. С. Соколовская","doi":"10.15690/VSP.V16I2.1720","DOIUrl":"https://doi.org/10.15690/VSP.V16I2.1720","url":null,"abstract":"The key to effective treatment of a bacterial infection is a rapid and proper selection of antimicrobial therapy. WHO and UNICEF developed the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) aimed to elimination of the preventable causes of child death by 2025 by optimizing diagnosis and treatment. The main pneumonia agents are fastidious microorganisms that require special nutrient media and cultivation conditions that are absent in many laboratories. Due to low effectiveness of the etiological diagnosis, the choice of antibiotic therapy for pneumonia in the practice of a pediatrician is usually empirical. The article describes clinical cases of community-acquired pneumonia in children caused by strains of Streptococcus pneumoniae with a multiple antibiotic resistance. The above experience can be used by pediatricians in everyday practice.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"13 3","pages":"175-179"},"PeriodicalIF":0.0,"publicationDate":"2017-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91427566","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}
Т. С. Тумаева, Лариса Александровна Балыкова, А. С. Моторкина
The brain activity of a newborn affects postnatal adaptation, the disorder of which can cause dysfunction of organs and systems of the immature organism and the development of diseases in more distant periods of maturation. Objective: Our aim was to study the effect of levocarnitine on dynamics of the brain bioelectrical activity formation in term infants delivered by cesarean section. Methods. The study included term infants (gestation period 38–40 weeks) delivered by cesarean section, with perinatal hypoxic lesion of the central nervous system (cerebral ischemia). Children were randomized into groups of standard (recommended) treatment and standard treatment enhanced with levocarnitine (plus levocarnitine) — 30% oral solution at a dose of 100 mg/kg per day for 3 weeks starting from the 7th day of life. The brain bioelectrical activity was assessed with electroencephalography (EEG) of the natural sleep period on the 3rd–6th day and then at 3, 6, and 12 months. Results. 45 children were randomized into groups of standard treatment and standard treatment plus levocarnitine, of which 44 and 40 children completed the study, respectively. Initially, the delayed formation of age-related brain activity was detected in 16/40 (40%) children receiving levocarnitine and in 19/44 (43%) in the experimental group (p = 0.767), disturbances in the EEG sleep pattern with generation of background anomalies — in 17 (43%) and 16 (36%) (p = 0.565), pathological graph elements — in 1 (3%) and 2 (5%) children (p = 0.536), respectively. According to the dynamic EEG control results, it was found that after 1 year the cerebral dysfunction was registered less frequently in children receiving levocarnitine — in 32 (80%) vs. 42 (96%) children in the group of standard treatment (p = 0.028). Conclusion. Adminisration of levocarnitine in the neonatal period reduces the risk of developing cerebral dysfunction by the end of the first year of life.
{"title":"Влияние левокарнитина на динамику формирования электробиологической активности головного мозга у доношенных детей, рожденных путем кесарева сечения: результаты открытого рандомизированного исследования","authors":"Т. С. Тумаева, Лариса Александровна Балыкова, А. С. Моторкина","doi":"10.15690/VSP.V16I2.1718","DOIUrl":"https://doi.org/10.15690/VSP.V16I2.1718","url":null,"abstract":"The brain activity of a newborn affects postnatal adaptation, the disorder of which can cause dysfunction of organs and systems of the immature organism and the development of diseases in more distant periods of maturation. Objective: Our aim was to study the effect of levocarnitine on dynamics of the brain bioelectrical activity formation in term infants delivered by cesarean section. Methods. The study included term infants (gestation period 38–40 weeks) delivered by cesarean section, with perinatal hypoxic lesion of the central nervous system (cerebral ischemia). Children were randomized into groups of standard (recommended) treatment and standard treatment enhanced with levocarnitine (plus levocarnitine) — 30% oral solution at a dose of 100 mg/kg per day for 3 weeks starting from the 7th day of life. The brain bioelectrical activity was assessed with electroencephalography (EEG) of the natural sleep period on the 3rd–6th day and then at 3, 6, and 12 months. Results. 45 children were randomized into groups of standard treatment and standard treatment plus levocarnitine, of which 44 and 40 children completed the study, respectively. Initially, the delayed formation of age-related brain activity was detected in 16/40 (40%) children receiving levocarnitine and in 19/44 (43%) in the experimental group (p = 0.767), disturbances in the EEG sleep pattern with generation of background anomalies — in 17 (43%) and 16 (36%) (p = 0.565), pathological graph elements — in 1 (3%) and 2 (5%) children (p = 0.536), respectively. According to the dynamic EEG control results, it was found that after 1 year the cerebral dysfunction was registered less frequently in children receiving levocarnitine — in 32 (80%) vs. 42 (96%) children in the group of standard treatment (p = 0.028). Conclusion. Adminisration of levocarnitine in the neonatal period reduces the risk of developing cerebral dysfunction by the end of the first year of life.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"80 1","pages":"163-169"},"PeriodicalIF":0.0,"publicationDate":"2017-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84850635","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}
Михаил Михайлович Костик, И. А. Чикова, Е. А. Исупова, М. Ф. Дубко, В. В. Масалова, Т. С. Лихачева, Л. С. Снегирёва, Е. В. Гайдар, Ольга Владимировна Калашникова, В. Г. Часнык
The issue of a therapy of children with juvenile idiopathic arthritis (JIA) with intolerance or insufficient effectiveness of methotrexate remains actual. Objective: Our aim was to study the efficacy and safety of tocilizumab in patients with polyarticular JIA. Methods. In a retrospective study, we studied the results of the use of tocilizumab in patients with active polyarticular JIA ( 5 active joints) resistant to prior therapy with methotrexate or a combination of methotrexate with other nonbiologic disease-modifying antiinflammatory drugs. Results. The data of 40 children (83% girls) with the onset median of polyarticular JIA of 4.8 (2.9, 8.1) years and the interval between the disease onset and the initiation of tocilizumab therapy of 5.7 (1.8, 8.5) years was analyzed. Tocilizumab was used as an intravenous infusion of 8 mg/kg (with a weight 30 kg) or 10 mg/kg (with a weight < 30 kg) every 4 weeks. The duration of tocilizumab monotherapy in 5 (13%) children was 1,109 days (452; 1,542). The stages of inactive disease (according to the criteria of C. Wallace, 2004) in 6 months of tocilizumab therapy reached 6 (15%) patients, in 42 months — 32 (80%) patients. In 3 patients, tocilizumab was canceled due to persistent remission. After 6 months of treatment, there was a marked decrease in erythrocyte sedimentation rate, C-reactive protein concentration, number of leukocytes and platelets (in all cases, p < 0.001) to normal values, which persisted throughout the whole period of drug administration. Predictors for achieving inactive disease were the initial (at the onset of tocilizumab therapy) number of peripheral blood leukocytes < 9.0X109/l [relative risk (RR) 1.92; 95% confidence interval (CI) 0.9–4.6)] and the absence of prior biological therapy (RR 1.92, 95% CI 0.9–4.6). The most frequent side effects of tocilizumab therapy were transient hypercholesterolemia (in 13), hypertriglyceridemia (in 4), transient grade II neutropenia (in 1). Conclusion. The long-term efficacy and relative safety of tocilizumab in children with polyarticular JIA have been showed.
{"title":"Применение тоцилизумаба у 40 пациентов с полиартикулярным вариантом ювенильного идиопатического артрита: результаты ретроспективного исследования","authors":"Михаил Михайлович Костик, И. А. Чикова, Е. А. Исупова, М. Ф. Дубко, В. В. Масалова, Т. С. Лихачева, Л. С. Снегирёва, Е. В. Гайдар, Ольга Владимировна Калашникова, В. Г. Часнык","doi":"10.15690/vsp.v16i2.1716","DOIUrl":"https://doi.org/10.15690/vsp.v16i2.1716","url":null,"abstract":"The issue of a therapy of children with juvenile idiopathic arthritis (JIA) with intolerance or insufficient effectiveness of methotrexate remains actual. Objective: Our aim was to study the efficacy and safety of tocilizumab in patients with polyarticular JIA. Methods. In a retrospective study, we studied the results of the use of tocilizumab in patients with active polyarticular JIA ( 5 active joints) resistant to prior therapy with methotrexate or a combination of methotrexate with other nonbiologic disease-modifying antiinflammatory drugs. Results. The data of 40 children (83% girls) with the onset median of polyarticular JIA of 4.8 (2.9, 8.1) years and the interval between the disease onset and the initiation of tocilizumab therapy of 5.7 (1.8, 8.5) years was analyzed. Tocilizumab was used as an intravenous infusion of 8 mg/kg (with a weight 30 kg) or 10 mg/kg (with a weight < 30 kg) every 4 weeks. The duration of tocilizumab monotherapy in 5 (13%) children was 1,109 days (452; 1,542). The stages of inactive disease (according to the criteria of C. Wallace, 2004) in 6 months of tocilizumab therapy reached 6 (15%) patients, in 42 months — 32 (80%) patients. In 3 patients, tocilizumab was canceled due to persistent remission. After 6 months of treatment, there was a marked decrease in erythrocyte sedimentation rate, C-reactive protein concentration, number of leukocytes and platelets (in all cases, p < 0.001) to normal values, which persisted throughout the whole period of drug administration. Predictors for achieving inactive disease were the initial (at the onset of tocilizumab therapy) number of peripheral blood leukocytes < 9.0X109/l [relative risk (RR) 1.92; 95% confidence interval (CI) 0.9–4.6)] and the absence of prior biological therapy (RR 1.92, 95% CI 0.9–4.6). The most frequent side effects of tocilizumab therapy were transient hypercholesterolemia (in 13), hypertriglyceridemia (in 4), transient grade II neutropenia (in 1). Conclusion. The long-term efficacy and relative safety of tocilizumab in children with polyarticular JIA have been showed.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"2 1","pages":"148-155"},"PeriodicalIF":0.0,"publicationDate":"2017-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87024987","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}
T. V. Turti, I. Belyaeva, E. G. Bokuchava, T. E. Privalova, A. Gorbacheva
Determining risk groups for the development of vitamin-deficient conditions in infants is important for the timely appointment of preventive doses of the necessary vitamins and vitamin complexes by a practicing pediatrician. The article contains information on the causes of vitamin deficiency and the biological value of vitamins D, C, A. The data of real clinical practice allowing the doctor to decide on the appointment of a complex of vitamins for hypovitaminosis prevention in infants is highlighted.
{"title":"Актуальность профилактики гиповитаминозов у детей первого года жизни","authors":"T. V. Turti, I. Belyaeva, E. G. Bokuchava, T. E. Privalova, A. Gorbacheva","doi":"10.15690/vsp.v16i2.1714","DOIUrl":"https://doi.org/10.15690/vsp.v16i2.1714","url":null,"abstract":"Determining risk groups for the development of vitamin-deficient conditions in infants is important for the timely appointment of preventive doses of the necessary vitamins and vitamin complexes by a practicing pediatrician. The article contains information on the causes of vitamin deficiency and the biological value of vitamins D, C, A. The data of real clinical practice allowing the doctor to decide on the appointment of a complex of vitamins for hypovitaminosis prevention in infants is highlighted.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"23 1","pages":"131-141"},"PeriodicalIF":0.0,"publicationDate":"2017-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74460640","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}
Александр Александрович Баранов, Лейла Сеймуровна Намазова-баранова, Владимир Кириллович Таточенко, Елена Александровна Вишнёва, Марина Владиславовна Федосеенко, Лилия Робертовна Селимзянова, Д. С. Чемакина, Ю. В. Лобзин, Сусанна Михайловна Харит, Н. И. Брико, П. Д. Лопухов, Г. Т. Сухих, Елена Витальевна Уварова, В. Н. Прилепская, Владимир Георгиевич Поляков, М. А. Гомберг, В. И. Краснопольский, Н. В. Зароченцева, Михаил Петрович Костинов, Лариса Дмитриевна Белоцерковцева, А. А. Мельникова, Л. Р. Батыршина
The article is devoted to the urgent problem of papillomavirus infection, the extremely high prevalence of which determines the key contribution to the structure of morbidity and mortality from oncological diseases. A chronic persistent course, resulting in benign and malignant tumors in the infection atrium, makes scientists seek new ways of treatment. A specific vaccinal prevention is recognized to be the only reliable protection method today. The article is an updated review of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» in 2016 for a vaccinal prevention of the diseases caused by human papillomavirus, first published on pediatr-russia.ru. The widespread introduction of vaccines against human papillomavirus, which have confirmed the clinical efficacy and safety, can significantly reduce the global burden of diseases associated with papillomavirus infection.
本文致力于解决乳头瘤病毒感染的紧迫问题,其极高的流行率决定了肿瘤疾病发病率和死亡率结构的关键贡献。一个慢性的持续过程,导致感染心房的良性和恶性肿瘤,使科学家寻求新的治疗方法。目前,一种特定的疫苗预防被认为是唯一可靠的保护方法。这篇文章是对2016年由专业协会“俄罗斯儿科医生联盟”制定并批准的关于疫苗预防人乳头瘤病毒引起的疾病的临床指南的最新审查,该指南首次发表在pediatrics - Russia .ru上。广泛采用已证实临床有效性和安全性的人乳头瘤病毒疫苗,可显著减少与乳头瘤病毒感染相关疾病的全球负担。
{"title":"Вакцинопрофилактика заболеваний, вызванных вирусом папилломы человека: позиции доказательной медицины. Обзор клинических рекомендаций","authors":"Александр Александрович Баранов, Лейла Сеймуровна Намазова-баранова, Владимир Кириллович Таточенко, Елена Александровна Вишнёва, Марина Владиславовна Федосеенко, Лилия Робертовна Селимзянова, Д. С. Чемакина, Ю. В. Лобзин, Сусанна Михайловна Харит, Н. И. Брико, П. Д. Лопухов, Г. Т. Сухих, Елена Витальевна Уварова, В. Н. Прилепская, Владимир Георгиевич Поляков, М. А. Гомберг, В. И. Краснопольский, Н. В. Зароченцева, Михаил Петрович Костинов, Лариса Дмитриевна Белоцерковцева, А. А. Мельникова, Л. Р. Батыршина","doi":"10.15690/VSP.V16I2.1711","DOIUrl":"https://doi.org/10.15690/VSP.V16I2.1711","url":null,"abstract":"The article is devoted to the urgent problem of papillomavirus infection, the extremely high prevalence of which determines the key contribution to the structure of morbidity and mortality from oncological diseases. A chronic persistent course, resulting in benign and malignant tumors in the infection atrium, makes scientists seek new ways of treatment. A specific vaccinal prevention is recognized to be the only reliable protection method today. The article is an updated review of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» in 2016 for a vaccinal prevention of the diseases caused by human papillomavirus, first published on pediatr-russia.ru. The widespread introduction of vaccines against human papillomavirus, which have confirmed the clinical efficacy and safety, can significantly reduce the global burden of diseases associated with papillomavirus infection.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"37 1","pages":"107-117"},"PeriodicalIF":0.0,"publicationDate":"2017-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85814462","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}
Congenital heart diseases (CHD) — one of the most common malformations in children — remains the leading cause of death in the younger age group. The review presents the world statistics of incidence and mortality due to CHD; the reasons for variability of epidemiological data are considered. The association of CHD with defects of other organs and systems is discussed. The role of various risk factors in formation of CHD in fetus is showed.
{"title":"Врожденные пороки сердца у детей: распространенность, факторы риска, смертность","authors":"Саперова Екатерина Валерьевна, И. В. Вахлова","doi":"10.15690/vsp.v16i2.1713","DOIUrl":"https://doi.org/10.15690/vsp.v16i2.1713","url":null,"abstract":"Congenital heart diseases (CHD) — one of the most common malformations in children — remains the leading cause of death in the younger age group. The review presents the world statistics of incidence and mortality due to CHD; the reasons for variability of epidemiological data are considered. The association of CHD with defects of other organs and systems is discussed. The role of various risk factors in formation of CHD in fetus is showed.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"18 1","pages":"126-133"},"PeriodicalIF":0.0,"publicationDate":"2017-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86310471","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}
Екатерина Иосифовна Алексеева, М. А. Солошенко, Т. М. Дворяковская, О. Л. Ломакина, Рина Валериановна Денисова, К. Б. Исаева, А. В. Карасёва
Juvenile idiopathic arthritis (JIA) is one of the most frequent and most disabling rheumatic diseases in children. Children with JIA receiving immunosuppressive and genetically engineered biologic drugs belong to the high-risk group for the development of bacterial and viral infections, including those administered by preventive vaccines. Objective: Our aim was to evaluate the efficacy and safety of 13-valent pneumococcal polysaccharide vaccine (PPV) in children with JIA. Methods. In a prospective open-label comparative study, the efficacy of vaccination was determined by the level of specific anti-pneumococcal antibodies (anti-SPP)IgG to Streptococcus pneumonia in the blood serum in patients with JIA. The safety of vaccination was assessed by determining a high-sensitivity C-reactive protein and S-100 protein as well as by the number of adverse events, by recording the number of infections of the upper respiratory tract and pneumonias, by the number of joints with active arthritis. Vaccination with 13-valent PPV was performed subcutaneously with one dose of 0.5 ml during therapy of the main disease with methotrexate or etanercept or 3 weeks before the appointment of methotrexate or etanercept. Patients were followed up for 1 year. Results. The study included 42 children with JIA: 21 with JIA in the active phase of the disease, 21 in remission of the disease. As a result of vaccination, the level of anti-pneumococcal antibodies (antiSPP)IgG increased in the group of children with JIA in the active phase from 26.1 (14.3; 52.1) to 73.0 (52.5; 156.0) mg/l (p = 0.001), with JIA in remission — from 27.4 (18.2; 59.1) to 54.6 (35.3; 96.0) mg/l (p = 0.029). The concentration of the predictor of S-100 protein high activity after vaccination was not increased (p = 0.192). JIA aggravation episodes were not fixed in any patient. Serious adverse events were not observed during the trial. Conclusion. The vaccination of children with JIA with 13-valent PPV is highly effective, not accompanied by exacerbation/increase in the activity of the disease and the development of serious adverse events.
{"title":"Эффективность и безопасность иммунизации пневмококковой полисахаридной вакциной детей с ювенильным идиопатическим артритом: предварительные результаты проспективного открытого исследования","authors":"Екатерина Иосифовна Алексеева, М. А. Солошенко, Т. М. Дворяковская, О. Л. Ломакина, Рина Валериановна Денисова, К. Б. Исаева, А. В. Карасёва","doi":"10.15690/VSP.V16I2.1715","DOIUrl":"https://doi.org/10.15690/VSP.V16I2.1715","url":null,"abstract":"Juvenile idiopathic arthritis (JIA) is one of the most frequent and most disabling rheumatic diseases in children. Children with JIA receiving immunosuppressive and genetically engineered biologic drugs belong to the high-risk group for the development of bacterial and viral infections, including those administered by preventive vaccines. Objective: Our aim was to evaluate the efficacy and safety of 13-valent pneumococcal polysaccharide vaccine (PPV) in children with JIA. Methods. In a prospective open-label comparative study, the efficacy of vaccination was determined by the level of specific anti-pneumococcal antibodies (anti-SPP)IgG to Streptococcus pneumonia in the blood serum in patients with JIA. The safety of vaccination was assessed by determining a high-sensitivity C-reactive protein and S-100 protein as well as by the number of adverse events, by recording the number of infections of the upper respiratory tract and pneumonias, by the number of joints with active arthritis. Vaccination with 13-valent PPV was performed subcutaneously with one dose of 0.5 ml during therapy of the main disease with methotrexate or etanercept or 3 weeks before the appointment of methotrexate or etanercept. Patients were followed up for 1 year. Results. The study included 42 children with JIA: 21 with JIA in the active phase of the disease, 21 in remission of the disease. As a result of vaccination, the level of anti-pneumococcal antibodies (antiSPP)IgG increased in the group of children with JIA in the active phase from 26.1 (14.3; 52.1) to 73.0 (52.5; 156.0) mg/l (p = 0.001), with JIA in remission — from 27.4 (18.2; 59.1) to 54.6 (35.3; 96.0) mg/l (p = 0.029). The concentration of the predictor of S-100 protein high activity after vaccination was not increased (p = 0.192). JIA aggravation episodes were not fixed in any patient. Serious adverse events were not observed during the trial. Conclusion. The vaccination of children with JIA with 13-valent PPV is highly effective, not accompanied by exacerbation/increase in the activity of the disease and the development of serious adverse events.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"119 1","pages":"142-147"},"PeriodicalIF":0.0,"publicationDate":"2017-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82255361","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}