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Characteristics of post COVID-19 condition in children after mild COVID-19 轻度COVID-19患儿COVID-19后病情特点
Q4 Medicine Pub Date : 2023-11-01 DOI: 10.21518/ms2023-386
A. S. Chernyavskaya, O. I. Simonova, N. Yu. Kashirskaya
Introduction. Post COVID-19 condition in children causes variety of persistent symptoms such as fatigue, post-exertional malaise, cognitive problems, muscle pain and can affect different aspects of patient’s life. Aim. The aim of this study was to describe the prevalence and characteristics of persistent symptoms of COVID-19 in non-hospitalized pediatric patients one year after infection. Material and methods. This is a single center case-control study including children and young people (COVID-19 as cases and other acute respiratory infections as controls). A survey using ISARIC Global COVID-19 paediatric follow-up questionnaire was conducted by a pediatrician in person or via telephone interview one year after infection. Post COVID-19 condition was defined using WHO case definition. Results and discussion. 206 cases and 176 controls were analyzed. The mean ages of cases and controls were 8.8 years and 8.4 years accordingly, with 55% and 50% being females. The most frequent persistent symptoms in cases at 1 year were loss of taste – 8.7% [5.3%; 13.1%], fatigue – 8.7% [4.9%; 13.1%], chest pain – 4.9% [1.9%; 7.8%], headache – 2.4% [1.0%; 4.9%], tingling – 2.4% [0.5%; 4.9%]. Controls had similar persistent symptoms, but cases had significantly higher rates of sensory disturbances (taste/smell alterations) and fatigue. There were no statistically significant differences between other groups of symptoms found. Prevalence of post COVID-19 condition in cases group was 1.5% [0.0%; 3.4%]. Conclusion. Prevalence of post COVID-19 condition in children one year after mild infection is low. However, compared to other respiratory infections, COVID-19 may cause persistent taste/smell disturbances and fatigue.
介绍。儿童COVID-19后病情会导致各种持续性症状,如疲劳、运动后不适、认知问题、肌肉疼痛,并可能影响患者生活的不同方面。的目标。本研究的目的是描述感染一年后非住院儿科患者COVID-19持续症状的患病率和特征。材料和方法。这是一项单中心病例对照研究,包括儿童和年轻人(COVID-19为病例,其他急性呼吸道感染为对照)。在感染一年后,由儿科医生亲自或通过电话访谈使用ISARIC全球COVID-19儿科随访问卷进行调查。根据世卫组织病例定义定义COVID-19后病情。结果和讨论。分析206例病例和176例对照。病例和对照组的平均年龄分别为8.8岁和8.4岁,其中55%和50%为女性。在1年的病例中,最常见的持续症状是味觉丧失- 8.7% [5.3%;13.1%],疲劳- 8.7% [4.9%;13.1%]胸痛- 4.9% [1.9%;7.8%],头痛- 2.4% [1.0%;4.9%],刺痛- 2.4% [0.5%;4.9%)。对照组有类似的持续症状,但病例有明显更高的感觉障碍(味觉/嗅觉改变)和疲劳。其他组间发现的症状没有统计学上的显著差异。病例组COVID-19后状态患病率为1.5% [0.0%];3.4%)。结论。在轻度感染一年后,儿童中COVID-19后病症的患病率很低。然而,与其他呼吸道感染相比,COVID-19可能会导致持续的味觉/嗅觉障碍和疲劳。
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引用次数: 0
Evaluating clinical effectiveness and safety of pneumococcal immunization of infants 评价婴幼儿肺炎球菌免疫接种的临床有效性和安全性
Q4 Medicine Pub Date : 2023-11-01 DOI: 10.21518/ms2023-361
T. G. Malanicheva, N. V. Ziatdinova, G. G. Gataullina, L. M. Mukhametzanova
According to WHO, pneumococcal infection (PI) is considered one of the most dangerous of all vaccine-preventable diseases and, before vaccination, led to the death of up to 1.6 million people per year, of which from 0.7 to 1 million were children. In the prevention of PI, specific prevention occupies a special place. For the first time in 2014, vaccination against PI with pneumococcal conjugate vaccine was included in the national calendar of preventive vaccinations. International practice of using pneumococcal vaccine has shown that timely vaccination can produce positive results in the fight against PI. Under observation were 55 children who were vaccinated against PI with the pneumococcal polysaccharide conjugate vaccine (adsorbed), 13 valent according to the national calendar of preventive vaccinations of the Russian Federation. It was revealed that post-vaccination complications after vaccination did not occur in any child. General post-vaccination reactions were observed in the form of a short-term increase in temperature, loss of appetite and sleep disturbances, as well as local reactions in the form of edema, hyperemia, and hardening at the site of vaccine administration. We studied the incidence of community-acquired pneumonia (CAP), acute otitis media and acute respiratory infections among 55 children of the first year of life vaccinated at 2 months and 4.5 months (main group) and 50 children for various reasons not vaccinated against PI (comparison group). A study of the long-term results of 2-fold vaccination in the first year of life and revaccination at 15 months against PV based on observation of children for two years showed that children of the main group, compared with the comparison group, were 3.3 times less likely to suffer from PV, 2.7 times acute otitis and 1.7 times acute respiratory infections, p < 0.05. The data obtained show the high efficiency and safety of vaccinating children against PI with the pneumococcal vaccine.
据世卫组织称,肺炎球菌感染被认为是所有疫苗可预防疾病中最危险的疾病之一,在接种疫苗之前,每年导致多达160万人死亡,其中70万至100万是儿童。在PI的预防中,针对性预防占有特殊的地位。2014年,肺炎球菌结合疫苗首次被列入国家预防性疫苗接种日程。使用肺炎球菌疫苗的国际实践表明,及时接种疫苗可以在防治肺炎方面取得积极成果。在观察中,55名儿童接种了肺炎球菌多糖结合疫苗(吸附),根据俄罗斯联邦国家预防性疫苗接种日历接种了13种疫苗。结果显示,所有儿童均未发生疫苗接种后并发症。一般接种后反应表现为短期体温升高、食欲不振和睡眠障碍,以及局部反应,表现为接种部位水肿、充血和硬化。我们研究了55名在2个月和4.5个月时接种疫苗的1岁儿童(主要组)和50名因各种原因未接种PI疫苗的儿童(对照组)的社区获得性肺炎(CAP),急性中耳炎和急性呼吸道感染的发生率。一项基于对儿童2年观察的1岁2次疫苗接种和15个月再次疫苗接种的长期结果研究表明,与对照组相比,主组儿童患PV的可能性降低3.3倍,急性中耳炎降低2.7倍,急性呼吸道感染降低1.7倍,p <0.05. 获得的数据表明,用肺炎球菌疫苗接种儿童预防PI的效率和安全性很高。
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引用次数: 0
Pediatric inflammatory bowel diseases, features of the disease course: a clinical case of complicated course of ulcerative colitis 小儿炎症性肠病病程特点:溃疡性结肠炎合并病程1例
Q4 Medicine Pub Date : 2023-11-01 DOI: 10.21518/ms2023-363
N. K. Shumeyko, O. V. Zaytseva, N. B. Serebrovskaya, I. P. Ostroukhova, A. N. Antonenko, O. Yu. Krasnikova
The article is devoted to one of the urgent problems of pediatric gastroenterology – inflammatory bowel diseases (IBD), which currently include ulcerative colitis (UC) and Crohn’s disease (CD). The prevalence of IBD is inferior to other gastroenterological diseases, but according to the severity of the course, the frequency of complications and the level of mortality, IBD occupy one of the leading places in the structure of diseases of the gastrointestinal tract. The problem of IBD constantly attracts the attention of doctors of various specialties – pediatricians, gastroenterologists, surgeons and others. This is due to an increase in the incidence of this pathology, a variety of clinical manifestations, including extra-intestinal manifestations, faced by doctors of various specialties. In childhood, there is more often a greater prevalence of the lesion, a less specific and erased picture, there is an impact on the physical development of the child. The article provides information on the prevalence, significant factors in the development of the disease; research data revealing the relationship between taking med ications and the risk of IBD onset. The problems of the pathogenesis of the disease, the significance of the genetic status in the development of CD and UC are described. The article presents data on the features of the clinical picture of UC in childhood, recommendations for the primary diagnosis of IBD, including modern laboratory and instrumental research methods. The article also describes the recommended international criteria for assessing the severity of IBD and the problems of differential diagnosis. As a demonstration, the authors’ own observations are presented. The clinical example describes an atypical case of UC in a teenager, occurring with the involvement of the cardiovascular, bronchopulmonary and urinary systems with the development of polyserositis. Early diagnosis of IBD is necessary to prevent disability of patients, ensure further development of the child, improve the quality of life.
本文致力于儿科胃肠病学的一个紧迫问题-炎症性肠病(IBD),目前包括溃疡性结肠炎(UC)和克罗恩病(CD)。IBD的患病率低于其他胃肠疾病,但根据病程的严重程度、并发症的发生频率和死亡率水平,IBD在胃肠道疾病结构中占据领先地位。IBD的问题不断吸引着儿科医生、胃肠病学家、外科医生等各专科医生的关注。这是由于这种病理的发病率增加,各种临床表现,包括肠道外的表现,面临着各个专业的医生。在儿童期,往往有更大患病率的病变,一个不太具体和抹去的画面,对孩子的身体发育有影响。文章提供了患病率的信息,疾病发展的重要因素;研究数据揭示了服用药物与IBD发病风险之间的关系。本文就该病的发病机制、遗传状况在CD和UC发展中的意义等问题进行了阐述。文章介绍了儿童UC的临床特征数据,IBD的初步诊断建议,包括现代实验室和仪器研究方法。本文还介绍了评估IBD严重程度的推荐国际标准和鉴别诊断的问题。作为证明,作者提出了自己的观察。临床病例描述了一个非典型的UC在一个青少年,发生累及心血管,支气管肺和泌尿系统与发展多浆液炎。早期诊断IBD对预防患者残疾、保证患儿进一步发育、提高生活质量是必要的。
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引用次数: 0
Current opportunities for glycaemic control in children and adolescents with type 1 diabetes mellitus: the path to achieving a goal 目前1型糖尿病儿童和青少年血糖控制的机会:实现目标的途径
Q4 Medicine Pub Date : 2023-10-31 DOI: 10.21518/ms2023-357
I. L. Nikitina, A. O. Plaksina
Type 1 diabetes is a highly prevalent disorder worldwide and the commonest form of diabetes in children and adolescents. The incidence rates are steadily increasing, despite numerous efforts aimed at finding the possibility to detect and interrupt autoimmune inflammation in the pancreas at preclinical stages. Modern technologies make it possible to set metabolic control goals that are increasingly closer to physiological ones. The article presents recommendations regarding new technologies for glycaemic control and criteria for compensation of T1DM in children and adolescents in accordance with the updated guidelines of the International Society of Diabetes Mellitus in Children and Adolescents (ISPAD, 2022) and the Russian standards for self-monitoring of glycemia using an individual blood glucose meter associated with the use of continuous glucose monitoring technologies to assess the accuracy and/or calibration of monitoring data and address treatment adjustment issues. The possibilities and advantages of modern blood glucose meters are highlighted both in terms of accuracy of readings and functional expandability. Clinical cases demonstrating the importance of using blood glucose meters in decision-making by patients (adolescents) with type 1 diabetes who receive insulin pump therapy are presented. Excessive haste in decision-making by patients resulting in non-target results on glycaemic levels, which could have been avoided with timely measurement of blood glucose levels with a glucose meter was stressed. The great role of continuous education of children and adolescents with T1DM together with assessment and analysis of the significance of new and existing technologies for diagnosis, treatment, and monitoring of this chronic disease is emphasized, so that the patients and their parents can fully and effectively use constantly emerging opportunities.
1型糖尿病是世界范围内非常普遍的疾病,也是儿童和青少年中最常见的糖尿病形式。发病率正在稳步上升,尽管许多努力旨在发现在临床前阶段检测和中断胰腺自身免疫性炎症的可能性。现代技术使人们有可能设定越来越接近生理的代谢控制目标。本文根据国际儿童和青少年糖尿病学会(ISPAD)的最新指南,提出了关于血糖控制新技术和儿童和青少年T1DM补偿标准的建议。2022)和俄罗斯使用个人血糖仪自我监测血糖的标准,并结合使用连续血糖监测技术来评估监测数据的准确性和/或校准,并解决治疗调整问题。现代血糖仪的可能性和优势在读数的准确性和功能的可扩展性方面都得到了强调。临床病例证明了使用血糖仪对接受胰岛素泵治疗的1型糖尿病患者(青少年)决策的重要性。强调患者决策过于匆忙导致血糖水平非目标结果,这可以通过使用血糖仪及时测量血糖水平来避免。强调对儿童和青少年T1DM患者进行持续教育的重要作用,并评估和分析新技术和现有技术对这一慢性疾病的诊断、治疗和监测的意义,使患者及其家长能够充分有效地利用不断出现的机会。
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引用次数: 0
Experience of using an interferon inducer in the prevention of influenza and acute respiratory viral infections in children 使用干扰素诱导剂预防儿童流感和急性呼吸道病毒感染的经验
Q4 Medicine Pub Date : 2023-10-31 DOI: 10.21518/ms2023-315
O. V. Borisova, N. M. Bochkareva, N. S. Polezhaeva, O. N. Yashkina, N. G. Tsareva, D. M. Gadelshina
Introduction. Taking into account the changeable viral landscape of pathogens, the persistence of seasonal morbidity at a high level, and the refusal of a number of parents to be vaccinated against influenza, the interest of scientists and practitioners in the use of endogenous interferon inducers is increasing. Studies by domestic authors have proven that Kagocel® is highly effective in the prevention and treatment of influenza and other ARIs. Aim. Evaluation of the efficacy and safety of Kagocel® for the prevention of influenza and ARIs in children aged 3–18 years old on an outpatient basis during the epidemic rise of respiratory viral infections in 2022–2023. Materials and methods. A prospective comparative analysis of cases of prevention of influenza and ARIs by Kagocel® in children was carried out: group 1 – main (n = 32). Kagocel® was prescribed according to the scheme for a month. The comparison group consisted of patients vaccinated against influenza, who did not receive drugs for the prevention of acute respiratory viral infections: group 2 – comparison (n = 28). Results and discussion. The index of preventive efficacy of Kagocel® was 3.0, the efficiency ratio was quite high – 66.7%. The elimination of the main clinical symptoms of the disease was noted on average by the 2nd–3rd day of illness. Prophylactic administration of the drug allowed to reduce the incidence of influenza and ARIs by 3 times; reduce the number of complications from these diseases by 4 times. The economic feasibility of prophylaxis with Kagocel® has been proven, direct costs for the treatment of one patient have decreased by 3.6 times. The interferon inducer was well tolerated, no side effects of the drug were detected. Conclusion. Endogenous interferon inducer Kagocel® can be used for prophylactic purposes during the seasonal rise in the incidence of influenza and ARIs.
介绍。考虑到病原体多变的病毒格局、季节性高发病率的持续存在以及一些家长拒绝接种流感疫苗,科学家和从业人员对使用内源性干扰素诱导剂的兴趣正在增加。国内作者的研究证明,Kagocel®在预防和治疗流感和其他急性呼吸道感染方面非常有效。的目标。在2022-2023年呼吸道病毒感染流行上升期间,Kagocel®预防3-18岁儿童流感和急性呼吸道感染的门诊疗效和安全性评估材料和方法。对Kagocel®预防儿童流感和急性呼吸道感染的病例进行前瞻性比较分析:第1组-主组(n = 32)。Kagocel®按照方案处方一个月。对照组由接种流感疫苗的患者组成,他们没有接受预防急性呼吸道病毒感染的药物:第二组-比较(n = 28)。结果和讨论。Kagocel®的预防效能指数为3.0,有效率高达66.7%。疾病的主要临床症状平均在发病第2 - 3天消除。预防性用药可使流感和急性呼吸道感染的发病率降低3倍;将这些疾病的并发症数量减少4倍。使用Kagocel®进行预防的经济可行性已得到证实,治疗一名患者的直接成本降低了3.6倍。干扰素诱导剂耐受性良好,未发现药物副作用。结论。内源性干扰素诱导剂Kagocel®可用于流感和急性呼吸道感染发病率季节性上升期间的预防目的。
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引用次数: 0
Actual nutrition of young children: how to make what you want real 幼儿的实际营养:如何让你想要的成为现实
Q4 Medicine Pub Date : 2023-10-31 DOI: 10.21518/ms2023-316
M. M. Gurova, E. A. Protsenko
Introduction. The nutrition of young children determines the vector of the physical and neuro-psychological development of the child, forms the characteristics of eating behavior. Aim. To study the features of the nutritional practice of young children living in Belgorod, and to evaluate the success of the implementation of the Program for optimizing the nutrition of children aged 1 to 3 years in the Russian Federation in pediatric practice. Materials and methods. We interviewed 307 women with young children born at 38–41 weeks of gestation with an Apgar score of at least 8 points. In addition, we developed a questionnaire that allows retrospectively assessing the regime and diet of young children. Results. We identified the following problems of young children nutrition: non-compliance with the diet – only 18.1% of the respondents strictly adhered to the regime, the use of confectionery and sweets as snack products in almost a third of children (27%) which were introduced into the diet in 44% of children aged 1–2 years, and in 43% of children after 2 years. According to the survey data, 38.2% of respondents used industrial food products for young children in the form of milk-based drinks, but the duration of their use was limited to the second year of life. 14% of children used other industrial food products for young children. Discussion. The presented dietary habits of children lead to the formation of incorrect eating habits, aggravating the imbalance of the diet, increasing the risk of health problems. Conclusion. The results of the study show the need for further work on the active implementation of the existing recommendations for optimizing the nutrition of young children. The FrutoNyanya brand includes a wide selection of industrially produced baby food products, allowing you to achieve a wide variety, but also healthy food products.
介绍。幼儿的营养状况决定了儿童身体和神经心理发育的载体,形成了饮食行为的特点。的目标。研究别尔哥罗德地区幼儿营养实践的特点,评估俄罗斯联邦1 - 3岁儿童营养优化方案在儿科实践中的实施效果。材料和方法。我们采访了307名妇女,她们的孩子在妊娠38-41周出生,阿普加评分至少为8分。此外,我们还开发了一份问卷,可以回顾性地评估幼儿的饮食习惯。结果。我们确定了幼儿营养的以下问题:不遵守饮食-只有18.1%的受访者严格遵守该制度,几乎三分之一的儿童(27%)使用糖果和糖果作为零食产品,在44%的1-2岁儿童中被引入饮食,在2岁后的儿童中占43%。调查数据显示,38.2%的受访者以牛奶饮料的形式使用工业食品,但其使用时间仅限于2岁。14%的儿童使用其他工业食品供幼儿食用。讨论。儿童所呈现的饮食习惯导致不正确饮食习惯的形成,加剧了饮食的不平衡,增加了出现健康问题的风险。结论。研究结果表明,需要进一步开展工作,积极实施优化幼儿营养的现有建议。FrutoNyanya品牌包括多种工业生产的婴儿食品,让您实现品种繁多,又健康的食品。
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引用次数: 0
Modern adapted infant formulas: problem status and prospects for solving 现代婴儿配方奶粉:问题现状和解决前景
Q4 Medicine Pub Date : 2023-10-31 DOI: 10.21518/ms2023-336
A. V. Dmitriev, R. A. Gudkov, V. I. Petrova, N. V. Fedina, A. L. Zaplatnikov
According to the World Health Organization report, in 2019 47 million children under 5 were wasted, of which 14.3 million were severely wasted. In most cases, the main reason for nutritional deficiencies in the world is a child’s diet low in calories, dietary protein deficiency and inferiority, as well as inadequate intake of vitamins and minerals. The article presents a modern literature review devoted to the main problems in creating adapted formulas for infants who are deprived of the opportunity of getting breastfeeding. Among the most pressing problems are: difficulties in bringing the total protein concentration in the formula to the breast milk level while keeping an adequate amino acid profile, the high risk of animal milk protein allergies in infants, unfulfilled hopes for the preventive effect of partially hydrolysed formulas in relation to the development of allergic diseases, as well as the high prevalence of functional gastrointestinal diseases in children who are formula-fed. At the same time, it was emphasized that the use of goat’s milk as a protein base for basic infant formulas may in the future help solve some of the above problems. The protein component of goat’s milk compares favourably with cow’s milk, and the amino acid composition helps reduce protein concentration in the finished formula enriched with whey fraction to the recommended level. The article stresses that there is a need to continue studies on the effectiveness and safety of adapted goat’s milk formulas in infants to give definite answers to the questions posed.
根据世界卫生组织的报告,2019年有4700万5岁以下儿童被浪费,其中1430万儿童被严重浪费。在大多数情况下,世界上营养缺乏的主要原因是儿童的饮食热量低,饮食蛋白质缺乏和自卑,以及维生素和矿物质摄入不足。这篇文章提出了一个现代的文献综述,致力于在创造适应配方婴儿谁被剥夺了获得母乳喂养的机会的主要问题。其中最紧迫的问题是:很难将配方奶粉中的总蛋白质浓度提高到母乳的水平,同时保持足够的氨基酸含量;婴儿对动物奶蛋白过敏的风险很高;部分水解配方奶粉对过敏性疾病的预防作用的希望未能实现;以及配方奶粉喂养的儿童中功能性胃肠道疾病的高发率。同时,有人强调,使用羊奶作为基础婴儿配方奶粉的蛋白质基础,可能有助于解决上述一些问题。羊奶的蛋白质成分优于牛奶,氨基酸组成有助于将富含乳清部分的成品配方中的蛋白质浓度降低到推荐水平。文章强调,有必要继续研究婴儿适应羊奶配方的有效性和安全性,以对所提出的问题给出明确的答案。
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引用次数: 0
Acute sore throat in frequently ill children: potential of topical therapy 经常生病的儿童的急性喉咙痛:局部治疗的潜力
Q4 Medicine Pub Date : 2023-10-31 DOI: 10.21518/ms2023-337
I. M. Kirichenko, V. I. Popadyuk, N. S. Kozlova, A. I. Chernolev
Sore throat is the most common reason for visiting primary care doctors, pediatricians, and ENT doctors. Acute sore throat, as a rule, is not an independent disease and most often accompanies tonsillopharyngitis caused by respiratory viral infections. In childhood, the share of acute respiratory viral infections among other infectious diseases can reach up to 90%, and the proportion of frequently ill children ranges from 30 to 50%. A feature of frequently ill children is a high incidence of illness, regardless of seasonality, and a tendency to a protracted course of the inflammatory process. Uncontrolled systemic antibiotic therapy for acute sore throat in frequently ill children leads to the development of dysbacteriosis and a decrease in mucosal immunity. The use of the topical antibacterial drug Faringazon for sore throat in children reduces inflammation in both viral and bacterial infections and reduces the need for systemic antibiotic therapy. The active substance of Ambazon has a bacteriostatic effect when is kept in the mouth until it resorbs and is effective against Streptococcus haemolyticus , Streptococcus pneumoniae , Streptococcus viridans , and also has antifungal effects against Candida albicans yeast fungus, which is a saprophyte, but exhibits pathogenic properties in decreased body’s immune defence and dysbiosis. The use of topical antimicrobial therapy helps reduce inflammation and speed up the recovery of patients without prescription of systemic antibiotics, and also ensures the preservation of microbiome, reducing the probability of emergence of antibiotic resistant strains to the minimum.
喉咙痛是去看初级保健医生、儿科医生和耳鼻喉科医生的最常见原因。一般来说,急性喉咙痛不是一种独立的疾病,通常伴有由呼吸道病毒感染引起的扁桃体咽炎。在儿童时期,急性呼吸道病毒感染在其他传染病中所占的比例可高达90%,经常患病的儿童所占比例为30%至50%。经常生病的儿童的一个特点是发病率高,不考虑季节性,并倾向于一个长期的炎症过程。对经常生病的儿童急性咽喉痛不加控制的全身抗生素治疗导致菌群失调和黏膜免疫力下降。使用局部抗菌药物法林加松治疗儿童喉咙痛可减少病毒和细菌感染引起的炎症,并减少对全身抗生素治疗的需要。Ambazon的活性物质含于口腔直至吸收时具有抑菌作用,对溶血链球菌、肺炎链球菌、绿光链球菌有效,对白色念珠菌酵母菌也有抗真菌作用,白色念珠菌是一种腐生菌,但在机体免疫防御下降和生态失调中表现出致病性。使用局部抗菌治疗有助于减轻炎症,加快患者的恢复,而无需全身抗生素处方,也保证了微生物组的保存,将抗生素耐药菌株的出现概率降至最低。
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引用次数: 0
Paracetamol and ibuprofen in the treatment of pain and fever in children: modern views on the choice of a drug 扑热息痛和布洛芬治疗儿童疼痛和发烧:对药物选择的现代观点
Q4 Medicine Pub Date : 2023-10-31 DOI: 10.21518/ms2023-367
I. N. Zakharova, I. V. Berezhnaya, V. V. Pupykina, A. D. Gostyukhina, N. F. Dubovets
Paracetamol (acetaminophen) and ibuprofen are commonly used to relieve fever and pain in children. Their effects are similar, but differ in strength and mechanisms of action on the body. Acetaminophen, a para-aminophenol derivative, has antipyretic and analgesic properties. Despite the fact that paracetamol has been officially used as a drug for more than 75 years, its mechanism of biological action has not been sufficiently studied. In paediatric practice, paracetamol is more often used as an antipyretic, but in recent years, with the development of technology and emergence of new dosage forms on the market, it came into common use as an analgesic in many diseases, including oncological, rheumatological, etc. Ibuprofen is the most commonly used non-steroidal anti-inflammatory drug with pronounced analgesic and antipyretic properties. Ibuprofen, a non-selective inhibitor of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), affects the hypothalamic thermoregulatory center via inhibition of prostaglandin synthesis. In the paediatric population, the most common indications for the use of ibuprofen are fever, sore throat, ear pain, headache and toothache, post-traumatic and musculoskeletal pain, and inflammatory joint diseases. Paracetamol and ibuprofen are safe for use in paediatric practice, if dosing rules are observed, and are approved for use by the World Health Organization, FDA and other expert organizations. In addition, the emergence of new presentation forms of these drugs is most important in paediatrics.
扑热息痛(对乙酰氨基酚)和布洛芬通常用于缓解儿童的发烧和疼痛。它们的作用是相似的,但在强度和作用于身体的机制上有所不同。对乙酰氨基酚是一种对氨基酚衍生物,具有解热和镇痛作用。尽管扑热息痛作为一种药物正式使用已超过75年,但其生物作用机制尚未得到充分研究。在儿科实践中,扑热息痛更多地被用作解热药,但近年来,随着技术的发展和市场上新剂型的出现,扑热息痛被普遍用作许多疾病的镇痛药,包括肿瘤、风湿病等。布洛芬是最常用的非甾体抗炎药,具有明显的镇痛和解热作用。布洛芬是环氧化酶-1 (COX-1)和环氧化酶-2 (COX-2)的非选择性抑制剂,通过抑制前列腺素合成影响下丘脑热调节中枢。在儿科人群中,使用布洛芬最常见的适应症是发烧、喉咙痛、耳痛、头痛和牙痛、创伤后和肌肉骨骼疼痛以及炎症性关节疾病。如果遵守剂量规则,扑热息痛和布洛芬在儿科实践中使用是安全的,并已得到世界卫生组织、FDA和其他专家组织的批准使用。此外,这些药物的新表现形式的出现在儿科是最重要的。
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引用次数: 0
Glycemic control parameters in children with type 1 diabetes treated with fast-acting insulin aspart domestic biosimilar by continuous subcutaneous infusion 持续皮下输注速效aspart国产生物仿制药治疗1型糖尿病儿童的血糖控制参数
Q4 Medicine Pub Date : 2023-10-31 DOI: 10.21518/ms2023-329
V. V. Platonov, T. A. Dubinina, E. M. Patrakeeva, A. A. Taraikovich
Introduction. Type 1 diabetes (T1D) is a chronic autoimmune disease requiring constant insulin therapy under regular continuous monitoring of glycemic parameters. The use of domestic insulin bioanalogues in CSII therapy is currently not sufficiently covered in the literature. Aim. To evaluate glycemic control parameters in children with T1D treated with the domestic fast-acting insulin aspart biosimilar by CSII. Materials and methods. Retrospective study was carried out on the basis of K.A. Raukhfus center St. Petersburg State Medical and Biomedical Center VMT. Fifty-five children with T1D aged 6 to 17 years (mean age 12 ± 4) were examined, including 29 boys (52.7%, mean age 11 ± 3 years) and 26 girls (47.3%, mean age 13 ± 4 years). Insulin therapy was carried out by systems of CSII Glycemic parameters were monitored by continuous and flash glycemic monitoring systems. The center visits frequency was once a month. Results . During dynamic follow-up after 3 and 6 months, children showed statistically significant (p < 0.05) improvement in glycemic control parameters–decrease in HbA1c level from 8.0 ± 1.8% to 7, 1 ± 1.2% and 6.8 ± 0.6%, increase in TIR from 60.4 ± 20.6% to 71.5 ± 13.0% and 75.9 ± 9.4%, decrease in TAR from 31.1 ± 22.1% to 23.0 ± 12.8% and 20.3 ± 9.3%, decrease in TBR from 9.1 ± 8.2% to 5.8 ± 4.3% and 4.1 ± 1.8%, and decrease in CV from 40.0 ± 9.1% to 33.7 ± 6.7% and 32.5 ± 5.6%. Discussion. The use of domestic biosimilar insulin aspart in insulin pumps iis associated with significant improvement in glycemic control in children and adolescents with T1D. Dynamic observation together with therapeutic education contribute to the maintenance of the achieved parameters at a high level. Conclusions. Therapy with the domestic fast-acting insulin aspart biosimilar by CSII allows achieving target glycemic control in children with T1D.
介绍。1型糖尿病(T1D)是一种慢性自身免疫性疾病,需要在定期连续监测血糖参数的情况下持续胰岛素治疗。国产胰岛素生物类似物在CSII治疗中的应用目前在文献中还没有得到充分的报道。的目标。通过CSII评估国产速效天冬胰岛素生物仿制药治疗T1D患儿的血糖控制参数。材料和方法。回顾性研究在K.A. Raukhfus中心圣彼得堡国立医学和生物医学中心VMT的基础上进行。本组共检查T1D患儿55例,年龄6 ~ 17岁,平均年龄12±4岁,其中男孩29例(52.7%,平均年龄11±3岁),女孩26例(47.3%,平均年龄13±4岁)。胰岛素治疗由CSII系统进行,血糖参数由连续血糖监测系统和瞬时血糖监测系统监测。中心访问频率为每月一次。结果。在3个月和6个月的动态随访中,儿童的差异有统计学意义(p <0.05)改善血糖控制parameters-decrease糖化血红蛋白浓度从8.0±1.8%到7日1±1.2%和6.8±0.6%,增加行动从60.4±20.6%至71.5±13.0%和75.9±9.4%,减少焦油从31.1±22.1%至23.0±12.8%和20.3±9.3%,下降为9.1±8.2%至5.8±4.3%和4.1±1.8%,并减少简历从40.0±9.1%到33.7±6.7%和32.5±5.6%。讨论。在胰岛素泵中使用国产生物仿制药aspart与T1D儿童和青少年血糖控制的显著改善相关。动态观察结合治疗性教育有助于将已达到的参数维持在较高水平。结论。CSII公司的国产速效胰岛素分离生物类似药治疗可使T1D患儿达到目标血糖控制。
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Meditsinskiy Sovet
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