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ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА ЮВЕНИЛЬНОГО АРТРИТА С СИСТЕМНЫМ ДЕБЮТОМ И РЕВМАТИЧЕСКИХ «МАСОК» ОНКОГЕМАТОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ: РЕЗУЛЬТАТЫ РЕТРОСПЕКТИВНОГО КОГОРТНОГО ИССЛЕДОВАНИЯ 青少年关节炎鉴别诊断与系统初次登场和风湿性癌症“面具”癌症疾病:回溯研究结果
Pub Date : 2017-07-15 DOI: 10.15690/VSP.V16I3.1732
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.
背景。恶性血液病(OHD)患者可能出现发热、淋巴结病变、肝脾肿大、关节疼痛、关节炎、红细胞沉降率(ESR)和c反应蛋白(CRP)浓度升高、贫血等症状,需要与系统性青少年特发性关节炎(sJIA)的临床意义进行鉴别。目标。我们的目的是确定能够区分OHD和sJIA的风湿病口罩的诊断标准。方法。回顾性研究纳入86例sJIA患儿和21例OHD患儿,这些患儿戴风湿口罩,在风湿科住院,初步诊断为sJIA。急性淋巴细胞白血病17例,神经母细胞瘤1例,淋巴瘤3例。9/17例(53%)急性白血病患者在出现主诉和住院的不同时间外周血检测到胚细胞。鉴别OHD与sJIA的诊断标准为活动关节数3(诊断优势比OR为4.4,95%可信区间CI为1.5-13.2)、CRP浓度43.3% (OR为28.8,95% CI为5.6-149.2)、无白斑(OR为39.8,95% CI为8.4-188.5)。最常见且特异性最强的症状为夜痛(敏感性0.57,特异性1.0)、骨痛(敏感性0.95,特异性1.0)、病理性骨折(敏感性0.14,特异性1.0)。结论。确定的诊断标准可用于OHD与风湿口罩和sJIA的鉴别诊断。
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引用次数: 0
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 血清组a、c、Y、W-135和其他疫苗共享安全:对健康儿童和不同健康状况的一系列病例进行积极研究
Pub Date : 2017-06-20 DOI: 10.15690/VSP.V16I2.1717
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.
脑膜炎球菌感染是一种由脑膜炎奈瑟菌引起的急性疾病,其临床表现多样,从鼻咽炎到脑膜炎球菌性脑膜炎和脑膜炎球菌血症。自2014年以来,俄罗斯已注册了一种四价脑膜炎球菌结合疫苗。该疫苗可针对A、C、W-135和Y血清群提供保护,可在9个月至55岁期间使用。实际问题是疫苗的耐受性,包括与其他疫苗制剂联合使用时。目的:我们的目的是评估一种针对a、C、Y和W-135血清群的四价脑膜炎球菌结合疫苗与其他疫苗制剂联合使用的安全性。方法。一项前瞻性全设计研究评估了脑膜炎球菌结合疫苗的免疫耐受性,包括单独接种和与肺炎球菌13价结合疫苗、麻疹-腮腺炎-风疹、病毒性甲型肝炎、流感和水痘疫苗联合接种。结果:97名9个月~ 18岁的儿童接种疫苗,其中健康儿童20人,有医学问题(过敏病理、耳鼻喉科疾病、心血管和神经系统疾病、肺部疾病和孤儿病)的儿童77人。在接种疫苗的儿童中,3/97(3.1%)儿童出现全面性反应,5(5.2%)儿童出现局部反应。在接种四价脑膜炎球菌结合疫苗的绝大多数儿童中,接种后期无症状且平安无事(91.93.8%)。结论。针对a、C、Y、W-135血清群的四价脑膜炎球菌结合疫苗免疫,在不同年龄组的健康儿童和不同健康状况的患者中,无论是单独接种还是与其他疫苗制剂联合接种,都具有良好的耐受性。
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引用次数: 1
Синдром Макла–Уэллса у ребенка с рецидивирующей крапивницей mcl - wells综合征是一个患有复发性荨麻疹的孩子。
Pub Date : 2017-06-20 DOI: 10.15690/VSP.V16I2.1721
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.
crypyrin相关周期性综合征(CAPS)是一种罕见的单基因自身炎症性疾病,是由炎症细胞因子(特别是白细胞介素1 β)的调节缺陷引起的遗传性周期性综合征。它们包括家族性感冒自身炎症综合征(FCAS)、Muckle-Wells综合征(MWS)和新生儿发病的多系统炎症性疾病(CINCA/NOMID)。以前,Muckle-Wells综合征被认为是一种三重症状——荨麻疹、耳聋和反应性淀粉样变。今天,症状的范围在不断扩大:它包括发烧、疲劳、结膜炎、关节痛、关节炎、肌痛、易怒、头痛、腹痛、口腔溃疡、心包炎,在诊断和治疗过程中涉及不同专业的医生,他们并不总是熟悉这种疾病。在俄罗斯,对这种疾病的单一观察已被描述。我们提出了一个5岁儿童的Muckle-Wells综合征的临床病例,他的第一个症状出现在2个月大的时候。这一观察结果强调了诊断儿童综合症的复杂性。
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引用次数: 0
Внебольничная пневмония у детей, вызванная пневмококками MLSB- и M-фенотипа: клинические случаи MLSB和M型肺炎引起的儿童非医院性肺炎:临床病例
Pub Date : 2017-06-20 DOI: 10.15690/VSP.V16I2.1720
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.
有效治疗细菌感染的关键是快速和正确选择抗菌药物治疗。世卫组织和儿童基金会制定了《预防和控制肺炎和腹泻全球行动计划》,旨在通过优化诊断和治疗,到2025年消除可预防的儿童死亡原因。主要的肺炎病原体是挑剔的微生物,需要特殊的营养培养基和培养条件,这在许多实验室中是不存在的。由于病因诊断的有效性较低,儿科医生在肺炎抗生素治疗的选择通常是经验性的。本文描述了由多种抗生素耐药的肺炎链球菌菌株引起的儿童社区获得性肺炎的临床病例。以上经验可供儿科医生在日常实践中使用。
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引用次数: 1
Влияние левокарнитина на динамику формирования электробиологической активности головного мозга у доношенных детей, рожденных путем кесарева сечения: результаты открытого рандомизированного исследования 左旋硬化对经剖腹产出生的转基因婴儿脑电波活动形成的影响:公开随机试验的结果
Pub Date : 2017-06-20 DOI: 10.15690/VSP.V16I2.1718
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.
新生儿的大脑活动影响出生后的适应,这种适应的紊乱会导致未成熟有机体的器官和系统的功能障碍,并在更遥远的成熟时期引起疾病的发展。目的:研究左卡尼汀对剖宫产足月儿脑电活动形成动态的影响。方法。该研究包括剖宫产分娩的足月婴儿(妊娠期38-40周),围生期伴有中枢神经系统缺氧损伤(脑缺血)。儿童被随机分为标准(推荐)治疗组和标准治疗组,左卡尼汀(加左卡尼汀)- 30%口服溶液,剂量为100mg /kg /天,从出生第7天开始,持续3周。采用脑电图(EEG)测定大鼠自然睡眠第3 ~ 6天、第3、6、12个月时的脑电活动。结果:45例患儿随机分为标准治疗组和标准治疗加左卡尼汀组,分别有44例和40例患儿完成了研究。最初,在接受左卡尼汀治疗的16/40(40%)儿童和实验组19/44(43%)儿童中检测到年龄相关脑活动的延迟形成(p = 0.767),在17(43%)和16 (36%)(p = 0.565)中检测到脑电图睡眠模式紊乱并产生背景异常(p = 0.565),在1(3%)和2(5%)儿童中检测到病理图元素(p = 0.536)。根据动态脑电图控制结果,1年后左卡尼汀组患儿脑功能障碍发生率较低,标准治疗组为32例(80%),对照组为42例(96%)(p = 0.028)。结论。在新生儿期给予左卡尼汀可降低在生命第一年结束时发生脑功能障碍的风险。
{"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}
引用次数: 1
Применение тоцилизумаба у 40 пациентов с полиартикулярным вариантом ювенильного идиопатического артрита: результаты ретроспективного исследования 40名患有多节性视网膜关节炎的患者的胸膜炎的应用:回顾性研究的结果
Pub Date : 2017-06-19 DOI: 10.15690/vsp.v16i2.1716
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.
甲氨蝶呤不耐受或疗效不足的儿童特发性关节炎(JIA)的治疗问题仍然存在。目的:研究托珠单抗治疗多关节性JIA的疗效和安全性。方法。在一项回顾性研究中,我们研究了tocilizumab在对先前的甲氨蝶呤治疗或甲氨蝶呤与其他非生物疾病改善抗炎药物联合治疗有抵抗力的活动性多关节JIA(5个活动关节)患者中的应用结果。结果。对40例儿童(83%为女孩)的数据进行分析,多关节性JIA发病中位数为4.8(2.9,8.1)年,发病至开始托珠单抗治疗间隔为5.7(1.8,8.5)年。托珠单抗每4周静脉输注8mg /kg(体重30 kg)或10mg /kg(体重< 30 kg)。托珠单抗单药治疗5例(13%)儿童的持续时间为1109天(452天;1542)。根据C. Wallace, 2004年的标准,在tocilizumab治疗的6个月内,有6例(15%)患者达到非活动性疾病分期,在42个月内达到32例(80%)患者。在3例患者中,由于持续缓解,tocilizumab被取消。治疗6个月后,红细胞沉降率、c反应蛋白浓度、白细胞和血小板数量均显著下降(p < 0.001)至正常值,并持续整个给药期。达到非活动性疾病的预测因子是初始(开始托珠单抗治疗时)外周血白细胞数< 9.0X109/l[相对危险度(RR) 1.92;95%可信区间(CI) 0.9-4.6)]和缺乏既往生物治疗(RR 1.92, 95% CI 0.9-4.6)。tocilizumab治疗最常见的副作用是短暂性高胆固醇血症(13例),高甘油三酯血症(4例),短暂性II级中性粒细胞减少症(1例)。托珠单抗治疗儿童多关节性JIA的长期疗效和相对安全性已得到证实。
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引用次数: 1
Актуальность профилактики гиповитаминозов у детей первого года жизни 一年级儿童预防淋巴胺的紧迫性
Pub Date : 2017-06-19 DOI: 10.15690/vsp.v16i2.1714
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.
确定婴儿发生维生素缺乏症的风险群体对于儿科医生及时安排必要的维生素和维生素复合物的预防剂量非常重要。这篇文章包含了维生素缺乏的原因和维生素D, C, a的生物学价值的信息。真实的临床实践的数据,让医生决定一个复杂的维生素预约预防婴儿维生素缺乏症是突出的。
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引用次数: 0
Вакцинопрофилактика заболеваний, вызванных вирусом папилломы человека: позиции доказательной медицины. Обзор клинических рекомендаций 人类乳头状瘤病毒引起的疾病预防疫苗:证明医学的立场。临床建议审查
Pub Date : 2017-06-19 DOI: 10.15690/VSP.V16I2.1711
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}
引用次数: 10
Врожденные пороки сердца у детей: распространенность, факторы риска, смертность 儿童先天性心脏病:常见、危险因素、死亡率
Pub Date : 2017-06-19 DOI: 10.15690/vsp.v16i2.1713
Саперова Екатерина Валерьевна, И. В. Вахлова
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.
先天性心脏病(CHD)是儿童中最常见的畸形之一,仍然是导致低龄儿童死亡的主要原因。这篇综述介绍了冠心病发病率和死亡率的世界统计数据;考虑了流行病学数据变异性的原因。讨论了冠心病与其他器官和系统缺陷的关系。探讨了各种危险因素在胎儿冠心病形成中的作用。
{"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}
引用次数: 8
Эффективность и безопасность иммунизации пневмококковой полисахаридной вакциной детей с ювенильным идиопатическим артритом: предварительные результаты проспективного открытого исследования 青少年特发性关节炎肺炎球菌多糖疫苗免疫的有效性和安全性:开放研究的初步结果
Pub Date : 2017-06-19 DOI: 10.15690/VSP.V16I2.1715
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.
青少年特发性关节炎(JIA)是儿童最常见、致残性最强的风湿性疾病之一。接受免疫抑制和基因工程生物药物治疗的JIA患儿属于细菌和病毒感染的高危人群,包括那些接种预防性疫苗的儿童。目的:评价13价肺炎球菌多糖疫苗(PPV)治疗小儿JIA的疗效和安全性。方法。在一项前瞻性开放标签比较研究中,通过JIA患者血清中针对肺炎链球菌的特异性抗肺炎球菌抗体(anti-SPP)IgG水平来确定疫苗接种的效果。通过测定高灵敏度c反应蛋白和S-100蛋白以及不良事件的数量、记录上呼吸道感染和肺炎的数量、活动性关节炎关节的数量来评估疫苗接种的安全性。在使用甲氨蝶呤或依那西普治疗主要疾病期间,或在使用甲氨蝶呤或依那西普前3周,皮下接种一剂0.5 ml的13价PPV疫苗。随访1年。结果。该研究纳入了42例JIA患儿:21例处于疾病活跃期,21例处于疾病缓解期。由于接种疫苗,JIA患儿的抗肺炎球菌抗体(antiSPP)IgG水平从26.1 (14.3;52.1)至73.0 (52.5;156.0) mg/l (p = 0.001), JIA从27.4 (18.2;59.1)至54.6 (35.3;96.0) mg/l (p = 0.029)接种后S-100蛋白高活性预测因子浓度未升高(p = 0.192)。所有患者的JIA加重发作均未固定。在试验期间未观察到严重的不良事件。结论。JIA患儿接种13价PPV疫苗非常有效,不伴有疾病活动性的恶化/增加和严重不良事件的发生。
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引用次数: 1
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Current Paediatrics
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