Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-2-148-152
L. V. Kim, V. Zhelev, G.V. Slizovsky, T. S. Liulka
Necrotizing enterocolitis (NEC) is one of the most severe diseases in preterm newborns. Despite numerous studies analyzing NEC, many aspects of its etiology, pathogenesis, diagnosis, and treatment are still poorly understood. NEC diagnosis at early stages remains extremely challenging. It is early diagnosis that ensures timely treatment initiation and reduces mortality. There is a clear need for early diagnostic biomarkers of NEC, since it will improve treatment outcomes and expand our understanding of NEC pathogenesis. This literature review summarizes information on laboratory and instrumental diagnostics of NEC, which can facilitate the identification of new biomarkers. Key words: necrotizing enterocolitis, preterm infants, newborn, diagnosis
{"title":"Early diagnosis of necrotizing enterocolitis","authors":"L. V. Kim, V. Zhelev, G.V. Slizovsky, T. S. Liulka","doi":"10.20953/1817-7646-2022-2-148-152","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-2-148-152","url":null,"abstract":"Necrotizing enterocolitis (NEC) is one of the most severe diseases in preterm newborns. Despite numerous studies analyzing NEC, many aspects of its etiology, pathogenesis, diagnosis, and treatment are still poorly understood. NEC diagnosis at early stages remains extremely challenging. It is early diagnosis that ensures timely treatment initiation and reduces mortality. There is a clear need for early diagnostic biomarkers of NEC, since it will improve treatment outcomes and expand our understanding of NEC pathogenesis. This literature review summarizes information on laboratory and instrumental diagnostics of NEC, which can facilitate the identification of new biomarkers. Key words: necrotizing enterocolitis, preterm infants, newborn, diagnosis","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67742812","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-3-128-135
E. Kondratyeva, A. Razumovsky, A. Smirnov, V. V. Kholostova
In this article, we report a case of cystic fibrosis (CF) with untypical manifestations, including obstructive pancreatitis with relative pancreatic insufficiency, complicated by pancreatolithiasis and type 1 diabetes mellitus (DM1). Interestingly, the patient had almost none clinical manifestations of CF in the lower respiratory tract. The first manifestation was abdominal pain associated with chronic obstructive pancreatitis. The patient had only laboratory manifestations of DM1 without any clinical signs. DM1 treatment led to an increase in the child's body weight and increased external respiration, which allowed an operation for pancreatitis. We removed calculi and performed longitudinal pancreaticojejunostomy. The surgery alleviated pain and increased the external secretion of the pancreas. Thus, this case demonstrates difficulties associated with CF diagnosis, as well as effectiveness and feasibility of surgical treatment for obstructive pancreatitis, even in cases when it is believed to be an inherited and incurable disease. Key words: cystic fibrosis, pancreatitis, pancreatic insufficiency, pancreatolithiasis, type 1 diabetes mellitus
{"title":"Congenital concomitant pathology of the pancreas: cystic fibrosis, pancreatitis, and diabetes","authors":"E. Kondratyeva, A. Razumovsky, A. Smirnov, V. V. Kholostova","doi":"10.20953/1817-7646-2022-3-128-135","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-3-128-135","url":null,"abstract":"In this article, we report a case of cystic fibrosis (CF) with untypical manifestations, including obstructive pancreatitis with relative pancreatic insufficiency, complicated by pancreatolithiasis and type 1 diabetes mellitus (DM1). Interestingly, the patient had almost none clinical manifestations of CF in the lower respiratory tract. The first manifestation was abdominal pain associated with chronic obstructive pancreatitis. The patient had only laboratory manifestations of DM1 without any clinical signs. DM1 treatment led to an increase in the child's body weight and increased external respiration, which allowed an operation for pancreatitis. We removed calculi and performed longitudinal pancreaticojejunostomy. The surgery alleviated pain and increased the external secretion of the pancreas. Thus, this case demonstrates difficulties associated with CF diagnosis, as well as effectiveness and feasibility of surgical treatment for obstructive pancreatitis, even in cases when it is believed to be an inherited and incurable disease. Key words: cystic fibrosis, pancreatitis, pancreatic insufficiency, pancreatolithiasis, type 1 diabetes mellitus","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67744581","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-4-110-116
K. Ermolenko
Acute gastroenteritis remains one of the relevant health problems causing great economic and social burden both in our country and worldwide. The leading pathogenetic syndromes in gastroenteritis are dehydration, a violation of the qualitative and quantitative composition of the intestinal microbiocenosis, a violation of barrier properties of the intestinal mucosa, and a dysfunction of the apical enzymes of enterocytes. This article presents the main approaches to choosing optimal tactics of pathogenetic therapy, assessing the severity of gastroenteritis dehydration and demonstrates the role of probiotics in therapeutic tactics and the criteria for selecting strains. It was shown that the use of hypo-osmolar solutions in the treatment of dehydration syndrome in children is most appropriate. Complex pathogenetic therapy of gastroenteritis in children should be aimed at correcting the syndromes of dehydration and destabilization of the microbiocenosis system, accelerating the function restoration in apical enzymes of enterocytes, as well as optimizing the protective properties of the mucin layer of the intestinal mucosa. The most reasonable in the treatment of dehydration syndrome in children is the use of hypo-osmolar solutions. Simultaneously with rehydration, enterosorbents and dietary foods may be used to improve the effectiveness of treatment. Probiotic therapy should begin as early as possible and include internationally recommended probiotic strains, among which Lacticaseibacillus rhamnosus GG is one of the most studied and safe and can be successfully used both to relieve the symptoms of gastroenteritis and to prevent their complications. Key words: acute gastroenteritis, dehydration, probiotics, diarrhea, Lacticaseibacillus rhamnosus GG
{"title":"Possibilities of pathogenetic therapy for acute gastroenteritis in children","authors":"K. Ermolenko","doi":"10.20953/1817-7646-2022-4-110-116","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-4-110-116","url":null,"abstract":"Acute gastroenteritis remains one of the relevant health problems causing great economic and social burden both in our country and worldwide. The leading pathogenetic syndromes in gastroenteritis are dehydration, a violation of the qualitative and quantitative composition of the intestinal microbiocenosis, a violation of barrier properties of the intestinal mucosa, and a dysfunction of the apical enzymes of enterocytes. This article presents the main approaches to choosing optimal tactics of pathogenetic therapy, assessing the severity of gastroenteritis dehydration and demonstrates the role of probiotics in therapeutic tactics and the criteria for selecting strains. It was shown that the use of hypo-osmolar solutions in the treatment of dehydration syndrome in children is most appropriate. Complex pathogenetic therapy of gastroenteritis in children should be aimed at correcting the syndromes of dehydration and destabilization of the microbiocenosis system, accelerating the function restoration in apical enzymes of enterocytes, as well as optimizing the protective properties of the mucin layer of the intestinal mucosa. The most reasonable in the treatment of dehydration syndrome in children is the use of hypo-osmolar solutions. Simultaneously with rehydration, enterosorbents and dietary foods may be used to improve the effectiveness of treatment. Probiotic therapy should begin as early as possible and include internationally recommended probiotic strains, among which Lacticaseibacillus rhamnosus GG is one of the most studied and safe and can be successfully used both to relieve the symptoms of gastroenteritis and to prevent their complications. Key words: acute gastroenteritis, dehydration, probiotics, diarrhea, Lacticaseibacillus rhamnosus GG","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67745581","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-4-164-173
L. Ilyenko, T. Garashchenko, N. E. Payganova
Sore throat is one of the most common reasons for going to a primary care doctor and at the same time self-medicating with antibiotics. The main task of a pediatrician at an outpatient appointment is first of all to understand how to help a child (that is, to reduce pain) in order to improve his quality of life. Determining the streptococcal nature of the disease for the appointment of antibacterial therapy is a matter of prescribing systemic antibacterial therapy. In the treatment of acute tonsillopharyngitis, it is relevant to use safe and effective means as part of complex therapy to shorten the duration of the disease, reduce the risk of complications, prevent relapses and improve the quality of life. The integration of homeopathic medicines into complex treatment regimens makes it possible to increase their effectiveness and reduce the drug load. The use of homeopathy in the Russian Federation is permitted and regulated by law. Of the complex homeopathic preparations intended for the treatment of acute and chronic inflammatory diseases of the lymphopharyngeal ring, Tonsilotren is the most studied. The drug is organotropic, because its composition includes components that have maximum tropicity to the lymphoid tissue of the tonsils. Tonsilotren® is a highly effective and safe drug that can be used as part of the complex therapy of both acute tonsillopharyngitis and exacerbations of chronic tonsillitis. The drug has a pronounced positive effect on the relief of local signs of tonsillitis, as well as on improving the general condition of patients with pathology of the lymphopharyngeal ring, which has been proven both in experiment and in a series of clinical studies. Key words: tonsillar pathology, acute tonsillopharyngitis, targeted drugs
{"title":"Current trends in the treatment of acute tonsillophayngitis in children","authors":"L. Ilyenko, T. Garashchenko, N. E. Payganova","doi":"10.20953/1817-7646-2022-4-164-173","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-4-164-173","url":null,"abstract":"Sore throat is one of the most common reasons for going to a primary care doctor and at the same time self-medicating with antibiotics. The main task of a pediatrician at an outpatient appointment is first of all to understand how to help a child (that is, to reduce pain) in order to improve his quality of life. Determining the streptococcal nature of the disease for the appointment of antibacterial therapy is a matter of prescribing systemic antibacterial therapy. In the treatment of acute tonsillopharyngitis, it is relevant to use safe and effective means as part of complex therapy to shorten the duration of the disease, reduce the risk of complications, prevent relapses and improve the quality of life. The integration of homeopathic medicines into complex treatment regimens makes it possible to increase their effectiveness and reduce the drug load. The use of homeopathy in the Russian Federation is permitted and regulated by law. Of the complex homeopathic preparations intended for the treatment of acute and chronic inflammatory diseases of the lymphopharyngeal ring, Tonsilotren is the most studied. The drug is organotropic, because its composition includes components that have maximum tropicity to the lymphoid tissue of the tonsils. Tonsilotren® is a highly effective and safe drug that can be used as part of the complex therapy of both acute tonsillopharyngitis and exacerbations of chronic tonsillitis. The drug has a pronounced positive effect on the relief of local signs of tonsillitis, as well as on improving the general condition of patients with pathology of the lymphopharyngeal ring, which has been proven both in experiment and in a series of clinical studies. Key words: tonsillar pathology, acute tonsillopharyngitis, targeted drugs","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67745757","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-4-13-16
L. V. Kim, V. Zhelev, G.V. Slizovsky
Objective. To determine the diagnostic value of fatty acid binding protein (I-FABP) in premature infants with necrotizing enterocolitis (NEC). Patients and methods. A prospective study was conducted that included 38 premature infants. The children were divided into 2 groups. Group I included 18 children with NEC, 20 premature infants were included in control group II. Patients underwent clinical and laboratory examination, radiography of the abdominal cavity and measurement of the level of I-FABP in serum. Results. Serum I-FABP levels were significantly higher in children from the main group at all stages of the study: at birth, at the beginning of enteral feeding and at the time of diagnosis of NEC (p < 0,001). There is a correlation between the I-FABP level and the NEC stage. Conclusion. Sequential measurements of serum I-FABP levels can be a useful marker for early diagnosis and prediction of disease severity in NEC. Key words: necrotizing enterocolitis, early diagnosis, biomarker, premature, newborns
{"title":"Diagnostic value of fatty acid-binding protein in newborns with necrotizing enterocolitis","authors":"L. V. Kim, V. Zhelev, G.V. Slizovsky","doi":"10.20953/1817-7646-2022-4-13-16","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-4-13-16","url":null,"abstract":"Objective. To determine the diagnostic value of fatty acid binding protein (I-FABP) in premature infants with necrotizing enterocolitis (NEC). Patients and methods. A prospective study was conducted that included 38 premature infants. The children were divided into 2 groups. Group I included 18 children with NEC, 20 premature infants were included in control group II. Patients underwent clinical and laboratory examination, radiography of the abdominal cavity and measurement of the level of I-FABP in serum. Results. Serum I-FABP levels were significantly higher in children from the main group at all stages of the study: at birth, at the beginning of enteral feeding and at the time of diagnosis of NEC (p < 0,001). There is a correlation between the I-FABP level and the NEC stage. Conclusion. Sequential measurements of serum I-FABP levels can be a useful marker for early diagnosis and prediction of disease severity in NEC. Key words: necrotizing enterocolitis, early diagnosis, biomarker, premature, newborns","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67746015","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-5-60-65
O. Tretyakova, I. Sukhareva, N. V. Efremova, T. E. Girich
Objective. To determine the influence of social factors on the desire among adolescents from different countries to correct their appearance. Materials and methods. A survey of 1040 respondents (with an average age of 17 ± 1.0 years) was conducted. Of the respondents, 540 (51.9%) were high school students and 500 (48.1%) were medical university students. Of them, 566 (54.4%) were girls and 474 (45.6%) were boys. All respondents were divided into 2 groups: students from Russia (260 (52%)) and students from other countries (240 (48%)). Results. Every second teenager (50.9%) had complaints about appearance, and regardless of sex, the majority (56.3%) of them wanted to look like their idols. Media imposition of physical appearance standards caused respondents of both sexes to feel dissatisfied with their bodies (p = 0.08). Unsatisfactory evaluation of teenagers' appearance by relatives formed the desire for its correction, regardless of sex (p = 0.8). At the same time, the opinion of friends was more significant for girls than for boys (p = 0.04). Russian students were significantly more often dissatisfied with their body image compared to international students (p = 0.006). For them the negative assessment of their appearance by peers (p = 0.0001) and the inconsistency with the standards of physical attractiveness promoted by the media (p = 0.0000001) were of greater importance in the perception of their appearance. Conclusion. The most significant factors influencing the desire of adolescents to change their appearance were unsatisfactory evaluation by peers and inconsistency with the media’s standards of physical attractiveness. Key words: appearance correction; body image; teenagers; social factors
{"title":"Social influence on the desire to correct appearance among adolescents in Russia and other countries","authors":"O. Tretyakova, I. Sukhareva, N. V. Efremova, T. E. Girich","doi":"10.20953/1817-7646-2022-5-60-65","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-60-65","url":null,"abstract":"Objective. To determine the influence of social factors on the desire among adolescents from different countries to correct their appearance. Materials and methods. A survey of 1040 respondents (with an average age of 17 ± 1.0 years) was conducted. Of the respondents, 540 (51.9%) were high school students and 500 (48.1%) were medical university students. Of them, 566 (54.4%) were girls and 474 (45.6%) were boys. All respondents were divided into 2 groups: students from Russia (260 (52%)) and students from other countries (240 (48%)). Results. Every second teenager (50.9%) had complaints about appearance, and regardless of sex, the majority (56.3%) of them wanted to look like their idols. Media imposition of physical appearance standards caused respondents of both sexes to feel dissatisfied with their bodies (p = 0.08). Unsatisfactory evaluation of teenagers' appearance by relatives formed the desire for its correction, regardless of sex (p = 0.8). At the same time, the opinion of friends was more significant for girls than for boys (p = 0.04). Russian students were significantly more often dissatisfied with their body image compared to international students (p = 0.006). For them the negative assessment of their appearance by peers (p = 0.0001) and the inconsistency with the standards of physical attractiveness promoted by the media (p = 0.0000001) were of greater importance in the perception of their appearance. Conclusion. The most significant factors influencing the desire of adolescents to change their appearance were unsatisfactory evaluation by peers and inconsistency with the media’s standards of physical attractiveness. Key words: appearance correction; body image; teenagers; social factors","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67747181","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-6-112-120
O. Kozhevnikova, P. Khramtsov, N. O. Berezina, E. Abashidze, A. Fisenko, E. Antonova, S. A. Chekalova, A. M. Kurgansky, V. Lebedev
Objective. To determine the spectrum and prevalence of sleep and sleep-related breathing disorders and the daytime/nighttime patterns associated with them in elementary school children. Patients and methods. A questionnaire was administered to parents of 262 schoolchildren aged between 7 and 10 years (142 boys and 120 girls). It comprised 76 questions on the features of nighttime sleep, factors influencing its disorders, as well as on complaints about various sleep and sleep-related breathing disorders. Signs of sleep disorders were assessed through verbal communication with children or were recorded by parents during their nighttime sleep. The questionnaire provided “yes”/”no”/”do not know” response options. Statistical analysis included the frequency analysis of sleep disorders and sleep complaints. The analysis was performed using Python software libraries: pandas 1.4.3, scipy.stats 1.8.1. Results. According to the results of the questionnaire, 46% of elementary school children had from 2 to 11 different complaints about sleep, and these were mainly 9-10-year-old children. The most frequent complaints were difficulty falling asleep (19%), sleep talking (18%), and nightmares (12%). Short sleep duration was noted in every fifth child due to late bedtime (р < 0.001) and early awakening (р < 0.001). It was significantly associated not only with fatigue, irritability, reduced cognitive performance, but also with indirect signs of sleep-disordered breathing: excessive morning thirst (р = 0.019) and morning dry mouth (р = 0.04). Complaints of nocturnal snoring (12% of children) and short sleep duration showed a strong correlation with frequent ARIs per year (р < 0.001, р = 0.003, respectively). Daily screen time of more than four hours was registered in 13% of children, and 51% used electronic devices predominantly before bedtime. The following waking patterns were found to be the most significant for sleep disorders: late bedtime (р = 0.004), using gadgets at night (р = 0.028), and finishing using gadgets before bedtime (р < 0.001). In addition, 31% of children took a meal before bedtime, which was significantly correlated with nightmares (р = 0.049) as one of the most frequent signs of sleep disturbance. Conclusion. Questioning elementary school children and their parents for early detection of signs of sleep disorders, prevention of ARIs, identification of children with sleep-disordered breathing and timely treatment of their causes, control over compliance with hygienic requirements for waking and sleeping regimes, especially with the recommended sleep duration, restriction of meals and using gadgets before going to bed are a set of measures for sleep normalization, promoting the development of a personalized approach to prevent a whole range of socially significant pathologies. Key words: sleep disorder, elementary school children, comorbidity, snoring, prevention
{"title":"Effect of sleep on schoolchildren’s health","authors":"O. Kozhevnikova, P. Khramtsov, N. O. Berezina, E. Abashidze, A. Fisenko, E. Antonova, S. A. Chekalova, A. M. Kurgansky, V. Lebedev","doi":"10.20953/1817-7646-2022-6-112-120","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-112-120","url":null,"abstract":"Objective. To determine the spectrum and prevalence of sleep and sleep-related breathing disorders and the daytime/nighttime patterns associated with them in elementary school children. Patients and methods. A questionnaire was administered to parents of 262 schoolchildren aged between 7 and 10 years (142 boys and 120 girls). It comprised 76 questions on the features of nighttime sleep, factors influencing its disorders, as well as on complaints about various sleep and sleep-related breathing disorders. Signs of sleep disorders were assessed through verbal communication with children or were recorded by parents during their nighttime sleep. The questionnaire provided “yes”/”no”/”do not know” response options. Statistical analysis included the frequency analysis of sleep disorders and sleep complaints. The analysis was performed using Python software libraries: pandas 1.4.3, scipy.stats 1.8.1. Results. According to the results of the questionnaire, 46% of elementary school children had from 2 to 11 different complaints about sleep, and these were mainly 9-10-year-old children. The most frequent complaints were difficulty falling asleep (19%), sleep talking (18%), and nightmares (12%). Short sleep duration was noted in every fifth child due to late bedtime (р < 0.001) and early awakening (р < 0.001). It was significantly associated not only with fatigue, irritability, reduced cognitive performance, but also with indirect signs of sleep-disordered breathing: excessive morning thirst (р = 0.019) and morning dry mouth (р = 0.04). Complaints of nocturnal snoring (12% of children) and short sleep duration showed a strong correlation with frequent ARIs per year (р < 0.001, р = 0.003, respectively). Daily screen time of more than four hours was registered in 13% of children, and 51% used electronic devices predominantly before bedtime. The following waking patterns were found to be the most significant for sleep disorders: late bedtime (р = 0.004), using gadgets at night (р = 0.028), and finishing using gadgets before bedtime (р < 0.001). In addition, 31% of children took a meal before bedtime, which was significantly correlated with nightmares (р = 0.049) as one of the most frequent signs of sleep disturbance. Conclusion. Questioning elementary school children and their parents for early detection of signs of sleep disorders, prevention of ARIs, identification of children with sleep-disordered breathing and timely treatment of their causes, control over compliance with hygienic requirements for waking and sleeping regimes, especially with the recommended sleep duration, restriction of meals and using gadgets before going to bed are a set of measures for sleep normalization, promoting the development of a personalized approach to prevent a whole range of socially significant pathologies. Key words: sleep disorder, elementary school children, comorbidity, snoring, prevention","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67747920","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-5-83-89
E.B. Milner, N. Evdokimova, V. Novikova, A. Khavkin
The problem of overweight in young people is highly relevant now, because the prevalence of obesity-related complications, including cardiovascular risks, is rapidly increasing. The most common complication of overweight is metabolic syndrome, when obesity is often associated with essential hypertension (EH), dyslipidemia and insulin resistance. Objective. To analyze the risks of cardiovascular disorders in obese adolescents. This is a literature review, where we used theoretical methods, such as analysis, classification, systematization, and generalization of data. In all age groups, the first clinical complication of obesity is EH, the degree and course of which significantly affect the obesity prognosis and determine the probability of early cardiovascular complications. Up to 80% of obese children and adolescents are found to have high blood pressure (BP). Each extra kilogram increases systolic BP by 0.36 mmHg and diastolic BP by 0.1 mmHg. The prevalence of EH increases with increasing body weight. Obese people are 2 to 3 times more likely to develop coronary heart caused by atherosclerotic lesions in the coronary arteries with subsequent fatal cardiovascular events. Higher incidence of cardiovascular diseases in obese patients is presumably associated with endothelial dysfunction and subclinical inflammation. Cardiovascular disorders became more prevalent in young people over the last decade. They are often diagnosed in adolescence. Conclusion. Despite the significance of this healthcare problem, no universal clinical and metabolic markers of cardiovascular damage have been identified so far. The structural and geometric rearrangement of the myocardium in obese patients have not been sufficiently studied. Key words: cardiovascular risks, cardiovascular pathology, obesity, metabolic syndrome, adolescence, puberty, essential hypertension
{"title":"Cardiovascular risks in obese adolescents","authors":"E.B. Milner, N. Evdokimova, V. Novikova, A. Khavkin","doi":"10.20953/1817-7646-2022-5-83-89","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-83-89","url":null,"abstract":"The problem of overweight in young people is highly relevant now, because the prevalence of obesity-related complications, including cardiovascular risks, is rapidly increasing. The most common complication of overweight is metabolic syndrome, when obesity is often associated with essential hypertension (EH), dyslipidemia and insulin resistance. Objective. To analyze the risks of cardiovascular disorders in obese adolescents. This is a literature review, where we used theoretical methods, such as analysis, classification, systematization, and generalization of data. In all age groups, the first clinical complication of obesity is EH, the degree and course of which significantly affect the obesity prognosis and determine the probability of early cardiovascular complications. Up to 80% of obese children and adolescents are found to have high blood pressure (BP). Each extra kilogram increases systolic BP by 0.36 mmHg and diastolic BP by 0.1 mmHg. The prevalence of EH increases with increasing body weight. Obese people are 2 to 3 times more likely to develop coronary heart caused by atherosclerotic lesions in the coronary arteries with subsequent fatal cardiovascular events. Higher incidence of cardiovascular diseases in obese patients is presumably associated with endothelial dysfunction and subclinical inflammation. Cardiovascular disorders became more prevalent in young people over the last decade. They are often diagnosed in adolescence. Conclusion. Despite the significance of this healthcare problem, no universal clinical and metabolic markers of cardiovascular damage have been identified so far. The structural and geometric rearrangement of the myocardium in obese patients have not been sufficiently studied. Key words: cardiovascular risks, cardiovascular pathology, obesity, metabolic syndrome, adolescence, puberty, essential hypertension","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748132","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-5-90-100
YU. P. Vasilieva, N. Skripchenko, A. Klimkin, M. Bedova, O. Levina
Objective. To develop an algorithm of structural and functional non-invasive diagnosis of different stages of intracranial hypertension (ICH) in children with acute meningitis and encephalitis. Patients and methods. We examined 115 patients aged 1 month to 17 years. We used neurosonography (NSG), transcranial duplex scanning (TCD), ultrasound examination of the optic nerve (ON), and fundus examination by an ophthalmologist. We have developed a comprehensive structural and functional diagnostic algorithm for different ICH stages in children with suspected neuroinfections. This algorithm should be applied within a day upon admission to the intensive care unit and includes NSG, TCD, ON ultrasound, and fundus examination by an ophthalmologist. The exact diagnostic criteria were developed for each method. NSG: clear contours of the brain stem; lateral ventricles between 12 and 16 mm in size; bone-brain diastasis between 1 and 4 mm. TCD: systolic flow rate in the middle cerebral artery between 60 and 180 cm/s; systolic flow rate in the veins of Rosenthal between 10 and 20 cm/s; arterial resistance index up to 0.8; venous resistance index up to 0.5. ON ultrasound: ON thickness up to 5.5 mm in children aged 1 month to 5 years and up to 5.8 mm in children aged 5–17 years. Fundus examination: dilated veins in the fundus. Decompensated ICH: deformed brain stem pattern; lateral ventricles up to 11 mm, bone-brain diastasis <1 mm; systolic flow rate in the middle cerebral artery up to 60 mm/s; systolic flow rate in the veins of Rosenthal up to 10 mm/s; reverberation pattern; ON thickness 6.5 ± 0.43 mm with unclear ON contours; stagnant disk of the optic nerve. We provide clinical examples that illustrate the effectiveness of the new algorithm, as well as the effectiveness of comprehensive therapy with cytoflavin during acute disease. Cytoflavin has multiple effects on the organism, improves cerebral hemodynamics and metabolism. Key words: intracranial hypertension, children, duplex, optic nerve, meningitis, neurosonography, ultrasound, encephalitis, cytoflavin
{"title":"Novel approach to comprehensive diagnosis of intracranial hypertension in children with neuroinfections","authors":"YU. P. Vasilieva, N. Skripchenko, A. Klimkin, M. Bedova, O. Levina","doi":"10.20953/1817-7646-2022-5-90-100","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-90-100","url":null,"abstract":"Objective. To develop an algorithm of structural and functional non-invasive diagnosis of different stages of intracranial hypertension (ICH) in children with acute meningitis and encephalitis. Patients and methods. We examined 115 patients aged 1 month to 17 years. We used neurosonography (NSG), transcranial duplex scanning (TCD), ultrasound examination of the optic nerve (ON), and fundus examination by an ophthalmologist. We have developed a comprehensive structural and functional diagnostic algorithm for different ICH stages in children with suspected neuroinfections. This algorithm should be applied within a day upon admission to the intensive care unit and includes NSG, TCD, ON ultrasound, and fundus examination by an ophthalmologist. The exact diagnostic criteria were developed for each method. NSG: clear contours of the brain stem; lateral ventricles between 12 and 16 mm in size; bone-brain diastasis between 1 and 4 mm. TCD: systolic flow rate in the middle cerebral artery between 60 and 180 cm/s; systolic flow rate in the veins of Rosenthal between 10 and 20 cm/s; arterial resistance index up to 0.8; venous resistance index up to 0.5. ON ultrasound: ON thickness up to 5.5 mm in children aged 1 month to 5 years and up to 5.8 mm in children aged 5–17 years. Fundus examination: dilated veins in the fundus. Decompensated ICH: deformed brain stem pattern; lateral ventricles up to 11 mm, bone-brain diastasis <1 mm; systolic flow rate in the middle cerebral artery up to 60 mm/s; systolic flow rate in the veins of Rosenthal up to 10 mm/s; reverberation pattern; ON thickness 6.5 ± 0.43 mm with unclear ON contours; stagnant disk of the optic nerve. We provide clinical examples that illustrate the effectiveness of the new algorithm, as well as the effectiveness of comprehensive therapy with cytoflavin during acute disease. Cytoflavin has multiple effects on the organism, improves cerebral hemodynamics and metabolism. Key words: intracranial hypertension, children, duplex, optic nerve, meningitis, neurosonography, ultrasound, encephalitis, cytoflavin","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748227","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}
Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-6-106-111
A. Kudryavtseva, O. Svitich, V. Soboleva, E. Bystritskaya
Atopic dermatitis (AD) is a multifactorial disease. The onset of AD is associated with the skin and intestinal barrier failure and impaired balance of the innate immunity. Inadequate innate immune reactions and decreased production of antimicrobial peptides (AMPs) by epithelial cells allow the passage of foreign proteins and bacterial toxins into the organism resulting in sensitization and local inflammation. Breast milk can act as a source of AMPs. The improper antimicrobial protection can be enhanced by stimulating the epithelial cells with probiotics. Objective. To evaluate the effect of a probiotic containing Lactobacillus acidophilus on the level of β-defensin-2 in breast milk of mothers of infants with AD. Materials and methods. We analyzed the effect of a probiotic containing Lactobacillus sp. strain n.v. Ер 317/402 «NARINE» on the level of β-defensin-2 in breast milk of mothers of infants with AD. The experimental group (n = 26) included mothers of infants with AD. They were further divided into two groups: Group 1 (n = 17) received 2 capsules of probiotic (180 mg in one capsule) twice a day for 20 days, whereas Group 2 (n = 9) received 2 capsules of placebo twice a day for 20 days. The control group comprised mothers of healthy infants (n = 11). The level of β-defensin-2 in breast milk was measured using the ELISA Kit for Defensin Beta 2 (DEFb2) as per the manufacturer's instructions. The differences were evaluated using the unpaired Student's T test and Welch's t-test. Microsoft Excel was used for statistical analysis. Results. The proposed dosage regimen of the probiotic analyzed caused a 5.2-fold increase in the level of β-defensin-2 in breast milk of mothers of infants with AD (p < 0.05) (6.67 vs 1.29) and alleviation of skin inflammation in infants. Conclusion. Administration of Lactobacillus sp. strain n.v. Ер 317/402 «NARINE» may affect the level of β-defensin-2 in breast milk. Therefore, the probiotic can be used for the prevention and treatment of AD. Key words: atopic dermatitis, infants, defensins, breast milk
特应性皮炎(AD)是一种多因素疾病。阿尔茨海默病的发病与皮肤和肠道屏障功能衰竭及先天免疫平衡受损有关。先天免疫反应不足和上皮细胞抗菌肽(AMPs)的产生减少允许外来蛋白质和细菌毒素进入生物体，导致致敏和局部炎症。母乳可以作为抗菌肽的来源。用益生菌刺激上皮细胞可以增强不适当的抗菌保护。目标。探讨一种含嗜酸乳杆菌的益生菌对阿尔茨海默病婴儿母乳中β-防御素-2水平的影响。材料和方法。我们分析了含有乳酸菌菌株n.v. Ер 317/402«NARINE»的益生菌对阿尔茨海默病婴儿母亲母乳中β-防御素-2水平的影响。实验组(n = 26)包括患有AD婴儿的母亲。他们进一步分为两组:1组(n = 17)每天两次服用2粒益生菌胶囊(每粒180毫克)，持续20天，而2组(n = 9)每天两次服用2粒安慰剂，持续20天。对照组由健康婴儿的母亲组成(n = 11)。根据制造商的说明，使用防御素β 2 (DEFb2) ELISA试剂盒检测母乳中β-防御素-2的水平。使用未配对的学生T检验和韦尔奇T检验来评估差异。采用Microsoft Excel进行统计分析。结果。所分析的益生菌的建议剂量方案使患有AD的婴儿的母亲的母乳中β-防御素-2水平增加5.2倍(p < 0.05) (6.67 vs 1.29)，并减轻了婴儿的皮肤炎症。结论。乳杆菌sp.菌株n.v. Ер 317/402«NARINE»可能会影响母乳中β-防御素-2的水平。因此，益生菌可用于AD的预防和治疗。关键词:特应性皮炎，婴儿，防御素，母乳
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