Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-5-36-42
V. Stupak, E. S. Feduleeva, A. Ishutin, L. S. Zolotareva
The Resolution on Palliative Care (PC) adopted by the World Health Assembly in 2014 implies PC integration into healthcare at all levels. In the Russian Federation, PC management and improvement are regulated by territorial health development programs. Objective. To analyze expert opinions on the quality of PC in various regions of the Russian Federation to optimize pediatric PC. Materials and methods. This prospective cohort study was conducted in 80 regions of the Russian Federation in October–December 2020. We interviewed 276 chief consultants, top healthcare executives, heads of healthcare institutions, pediatric departments, neonatology departments, and gynecological departments. Results. Respondents reported high quality of PC and equipment in healthcare institutions. However, they also marked limited territorial accessibility and volume of PC. They believe that PC in Russia requires better funding and expansion of home care, medical care in day hospitals and regular hospitals, and improvement of legal protection of patients. Conclusion. PC in the Russian Federation is one of the top priorities in healthcare. Several regulatory documents (including orders No 345n/372n and No 348n, resolution No 813, orders for the Moscow Region No 4-r and No 87-r) have been implemented. However, organizational problems still exist in some regions, which requires the improvement of the regulatory framework. Key words: pediatric palliative care, children, hospice and palliative care, medical and organizational measures, quality of life, suffering alleviation
{"title":"Palliative medical care for children at the federal and regional levels: analysis of expert opinions and new challenges to the healthcare system","authors":"V. Stupak, E. S. Feduleeva, A. Ishutin, L. S. Zolotareva","doi":"10.20953/1817-7646-2022-5-36-42","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-36-42","url":null,"abstract":"The Resolution on Palliative Care (PC) adopted by the World Health Assembly in 2014 implies PC integration into healthcare at all levels. In the Russian Federation, PC management and improvement are regulated by territorial health development programs. Objective. To analyze expert opinions on the quality of PC in various regions of the Russian Federation to optimize pediatric PC. Materials and methods. This prospective cohort study was conducted in 80 regions of the Russian Federation in October–December 2020. We interviewed 276 chief consultants, top healthcare executives, heads of healthcare institutions, pediatric departments, neonatology departments, and gynecological departments. Results. Respondents reported high quality of PC and equipment in healthcare institutions. However, they also marked limited territorial accessibility and volume of PC. They believe that PC in Russia requires better funding and expansion of home care, medical care in day hospitals and regular hospitals, and improvement of legal protection of patients. Conclusion. PC in the Russian Federation is one of the top priorities in healthcare. Several regulatory documents (including orders No 345n/372n and No 348n, resolution No 813, orders for the Moscow Region No 4-r and No 87-r) have been implemented. However, organizational problems still exist in some regions, which requires the improvement of the regulatory framework. Key words: pediatric palliative care, children, hospice and palliative care, medical and organizational measures, quality of life, suffering alleviation","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67747624","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: 10.20953/1817-7646-2022-6-121-124
S. Sharkov, O. Shmyrov, A.Yu. Lobach, A. Kulaev, R. V. Surov, M. N. Lazishvili, A. Kovachich
Hydronephrosis is a disease characterized by expansion of the renal pelvis and calyces resulted from improper urine outflow in the pelvic ureter that causes damage to the kidney parenchyma and a progressive decrease in its function. Anderson–Hynes pyeloplasty is a highly effective surgical method for this disease. The recurrence rate after this procedure does not exceed 3–5%. One of the possible causes of relapse is long-term ureteral stenosis, which requires a repeated reconstructive surgery. We report a case of recurrent hydronephrosis associated with long-term ureteral stenosis. The patient has undergone laparoscopic surgery with the formation of pyeloenteroureteroanastamosis. Key words: hydronephrosis, relapse, laparoscopy, pyeloenteroureteroanastamosis, pyeloplasty
{"title":"Formation of pyeloenteroureteroanastamosis in a child with recurrent hydronephrosis caused by long-term ureteral stenosis","authors":"S. Sharkov, O. Shmyrov, A.Yu. Lobach, A. Kulaev, R. V. Surov, M. N. Lazishvili, A. Kovachich","doi":"10.20953/1817-7646-2022-6-121-124","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-121-124","url":null,"abstract":"Hydronephrosis is a disease characterized by expansion of the renal pelvis and calyces resulted from improper urine outflow in the pelvic ureter that causes damage to the kidney parenchyma and a progressive decrease in its function. Anderson–Hynes pyeloplasty is a highly effective surgical method for this disease. The recurrence rate after this procedure does not exceed 3–5%. One of the possible causes of relapse is long-term ureteral stenosis, which requires a repeated reconstructive surgery. We report a case of recurrent hydronephrosis associated with long-term ureteral stenosis. The patient has undergone laparoscopic surgery with the formation of pyeloenteroureteroanastamosis. Key words: hydronephrosis, relapse, laparoscopy, pyeloenteroureteroanastamosis, pyeloplasty","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748051","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: 10.20953/1817-7646-2022-6-17-24
I. Kriulin, E. Alexeeva, Ilia Y. Shilkrot, T. Dvoryakovskaya
Background. Secondary hemophagocytic lymphohistiocytosis (sHLH) is a potentially fatal complication of systemic juvenile idiopathic arthritis (sJIA) characterized by hyperinflammation and a variety of clinical and laboratory manifestations. This condition is also referred to as macrophage activation syndrome (MAS) in patients with rheumatic diseases, including those with sJIA. In this article, we use the term sHLH. Approximately 40% of sHLH cases are asymptomatic, especially in patients who receive biologicals. Thus, the development of a prognostic model and identification of early sHLH markers in sJIA patients will enable timely initiation of anti-inflammatory and immunosuppressive therapy. Objective. To develop a prognostic model and identify early sHLH markers in sJIA patients. Methods. This study included 100 sJIA patients who were examined and treated in the Department of Rheumatology, National Medical Research Center for Children's Health between August 2010 and May 2021. A total of 114 sHLH episodes were registered among study participants. We analyzed medication history, as well as clinical and laboratory parameters reflecting the activity of sHLH and sJIA as potential early markers of sHLH. Multivariate logistic regression analysis was used to assess the predictive value of these markers for sHLH development. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each factor to evaluate its significance. Receiver operating characteristic (ROC) curves were constructed to assess the sensitivity and specificity of the model. Results. We analyzed a number of factors as potential early sHLH markers, including medication history (treatment with oral or injectable glucocorticoids (GCs) before sHLH, immunosuppressants (methotrexate, cyclosporine, or leflunomide), and biologicals (tocilizumab, canakinumab, adalimumab, etanercept)), clinical signs (fever, rash, hepatomegaly, splenomegaly, lymphadenopathy, myalgia, hemorrhagic syndrome, central nervous system (CNS) lesions, kidney lesions, lung lesions, heart lesions), and laboratory parameters (hemoglobin, absolute count of red blood cells (RBCs), white blood cells (WBCs), neutrophils, lymphocytes, and platelets, erythrocyte sedimentation rate (ESR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), creatinine, blood urea, c-reactive protein (CRP), ferritin, triglycerides, procalcitonin (PCT), total protein, albumin, blood electrolytes (sodium, potassium, chlorides, iron), coagulation parameters (Quick prothrombin, thrombin time, prothrombin time, international normalized ratio (INR), partial thromboplastin time (APTT), D-dimer, fibrinogen, fibrin monomer, von Willebrand factor, protein S, and protein C). Our prognostic model demonstrated that the following variables were significant predictors of sHLH in sJIA patients: lymphadenopathy, red blood cell count <4.34 × 106 cells/mL, platelets <208 × 103 c
背景。继发性噬血细胞性淋巴组织细胞增多症(sHLH)是全身性幼年特发性关节炎(sJIA)的一种潜在致命并发症,其特征是过度炎症和多种临床和实验室表现。在风湿病患者,包括sJIA患者中,这种情况也被称为巨噬细胞激活综合征(MAS)。在本文中,我们使用术语sHLH。大约40%的sHLH病例无症状,特别是在接受生物制剂治疗的患者中。因此,sJIA患者预后模型的建立和早期sHLH标志物的鉴定将有助于及时启动抗炎和免疫抑制治疗。目标。目的:建立sJIA患者的预后模型并识别早期sHLH标志物。方法。本研究纳入2010年8月至2021年5月在国家儿童健康医学研究中心风湿病科接受检查和治疗的100例sJIA患者。研究参与者共记录了114例sHLH发作。我们分析了用药史,以及反映sHLH和sJIA活性的临床和实验室参数,作为sHLH的潜在早期标志物。采用多变量logistic回归分析评估这些标志物对sHLH发展的预测价值。计算每个因素的优势比(ORs)和95%置信区间(CIs),以评估其显著性。构建受试者工作特征(ROC)曲线,评估模型的敏感性和特异性。结果。我们分析了许多可能作为sHLH早期标志物的因素,包括用药史(sHLH前口服或注射糖皮质激素(GCs)治疗,免疫抑制剂(甲氨喋呤、环孢素或来氟米特)和生物制剂(托珠单抗、canakinumab、阿达木单抗、依那西普),临床症状(发烧、皮疹、肝肿大、脾肿大、淋巴结病、肌痛、出血性综合征、中枢神经系统(CNS)病变、肾脏病变、肺部病变、心脏病变),和实验室参数(血红蛋白、红细胞(rbc)、白细胞(wbc)、中性粒细胞、淋巴细胞、血小板、红细胞沉降率(ESR)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ -谷氨酰转移酶(GGT)、乳酸脱氢酶(LDH)、肌酐、血尿素、c反应蛋白(CRP)、铁蛋白、甘油三酯、降钙素原(PCT)、总蛋白、白蛋白、血电解质(钠、钾、氯化物、铁)、凝血参数(快速凝血酶原、凝血酶时间、凝血酶原时间、国际标准化比率(INR)、部分凝血活素时间(APTT)、d -二聚体、纤维蛋白原、纤维蛋白单体、血管性血友病因子、蛋白S和蛋白C)。我们的预后模型显示,以下变量是sJIA患者sHLH的显著预测因子:淋巴结病变、红细胞计数412单位/L。模型的特异性为98.0%;总体准确率为95.6%。roc曲线下面积(AUC)为0.954±0.027 (95% CI 0.902 ~ 1.000;< 0.001)。结论。sJIA患者sHLH最可靠的预后指标无疑是原发性(家族性)噬血细胞淋巴组织细胞增多症基因的杂合突变。此外,sJIA患者的淋巴结病变、红细胞和血小板计数减少、血清氯化物水平降低、血清LDH升高可被解释为sHLH的早期标志物,因此可作为加强抗炎和免疫抑制治疗的指征。关键词:继发性噬血细胞淋巴组织细胞增多症,全身性幼年特发性关节炎,早期标志物,预后模型
{"title":"Secondary hemophagocytic lymphohistiocytosis: prognostic model and early markers in patients with systemic juvenile idiopathic arthritis. Results of a cohort retrospective study","authors":"I. Kriulin, E. Alexeeva, Ilia Y. Shilkrot, T. Dvoryakovskaya","doi":"10.20953/1817-7646-2022-6-17-24","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-17-24","url":null,"abstract":"Background. Secondary hemophagocytic lymphohistiocytosis (sHLH) is a potentially fatal complication of systemic juvenile idiopathic arthritis (sJIA) characterized by hyperinflammation and a variety of clinical and laboratory manifestations. This condition is also referred to as macrophage activation syndrome (MAS) in patients with rheumatic diseases, including those with sJIA. In this article, we use the term sHLH. Approximately 40% of sHLH cases are asymptomatic, especially in patients who receive biologicals. Thus, the development of a prognostic model and identification of early sHLH markers in sJIA patients will enable timely initiation of anti-inflammatory and immunosuppressive therapy. Objective. To develop a prognostic model and identify early sHLH markers in sJIA patients. Methods. This study included 100 sJIA patients who were examined and treated in the Department of Rheumatology, National Medical Research Center for Children's Health between August 2010 and May 2021. A total of 114 sHLH episodes were registered among study participants. We analyzed medication history, as well as clinical and laboratory parameters reflecting the activity of sHLH and sJIA as potential early markers of sHLH. Multivariate logistic regression analysis was used to assess the predictive value of these markers for sHLH development. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each factor to evaluate its significance. Receiver operating characteristic (ROC) curves were constructed to assess the sensitivity and specificity of the model. Results. We analyzed a number of factors as potential early sHLH markers, including medication history (treatment with oral or injectable glucocorticoids (GCs) before sHLH, immunosuppressants (methotrexate, cyclosporine, or leflunomide), and biologicals (tocilizumab, canakinumab, adalimumab, etanercept)), clinical signs (fever, rash, hepatomegaly, splenomegaly, lymphadenopathy, myalgia, hemorrhagic syndrome, central nervous system (CNS) lesions, kidney lesions, lung lesions, heart lesions), and laboratory parameters (hemoglobin, absolute count of red blood cells (RBCs), white blood cells (WBCs), neutrophils, lymphocytes, and platelets, erythrocyte sedimentation rate (ESR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), creatinine, blood urea, c-reactive protein (CRP), ferritin, triglycerides, procalcitonin (PCT), total protein, albumin, blood electrolytes (sodium, potassium, chlorides, iron), coagulation parameters (Quick prothrombin, thrombin time, prothrombin time, international normalized ratio (INR), partial thromboplastin time (APTT), D-dimer, fibrinogen, fibrin monomer, von Willebrand factor, protein S, and protein C). Our prognostic model demonstrated that the following variables were significant predictors of sHLH in sJIA patients: lymphadenopathy, red blood cell count <4.34 × 106 cells/mL, platelets <208 × 103 c","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748381","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: 10.20953/1817-7646-2022-6-62-73
A. Kaplina, N. Petrova, V. Nikiforov, T. Pervunina, A. I. Khavkin, Y. Markova, A. Sukhotskaya, T.V. Podgurskaya, S. Sitkin
Necrotizing enterocolitis (NEC) is a serious complication in newborns with critical congenital heart disease (CHD), prolonging hospital stay, worsening neurological prognosis, and increasing mortality. The leading role in the pathogenesis of NEC in these infants is the violation of mesenteric perfusion. A decrease in arterial blood oxygenation may be an additional risk factor for intestinal hypoxia. Objective. To assess the incidence and risk factors for NEC in full-term newborns with CHD born in 2019–2021 at the Perinatal Center of Almazov National Research Medical Center. Patients and methods. The article presents an analysis of the frequency and risk factors of NEC in children with CHD born at the Almazov National Medical Research Centre in 2019–2021. In the group of critical and duct-dependent CHD (n = 264), the overall incidence of NEC was 15.9% (42 cases). The frequency of surgical stages of NEC (IIIA) was 1.1% (3 cases). In the preoperative period, there was a trend towards a higher frequency of inotropic therapy in a subgroup of children who subsequently developed NEC. NEC in newborns with duct-dependent CHD developed mainly in the early postoperative period after cardiac surgery. In children with duct-dependent pulmonary blood flow, a higher incidence of NEC after surgery was noted compared to children with duct-dependent systemic blood flow. Conclusion. Risk factors for NEC in the postoperative period were arterial hypotension and hemodynamically significant cardiac arrhythmias. Dysbiosis of the gut microbiota and changes in microbial metabolism may be additional risk factors for NEC in children with CHD. Key words: necrotizing enterocolitis, risk factors, congenital heart disease, cardiopulmonary bypass, intestinal microbiome, metabolomics
{"title":"Necrotizing enterocolitis in newborns with congenital heart defects: incidence and risk factors","authors":"A. Kaplina, N. Petrova, V. Nikiforov, T. Pervunina, A. I. Khavkin, Y. Markova, A. Sukhotskaya, T.V. Podgurskaya, S. Sitkin","doi":"10.20953/1817-7646-2022-6-62-73","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-62-73","url":null,"abstract":"Necrotizing enterocolitis (NEC) is a serious complication in newborns with critical congenital heart disease (CHD), prolonging hospital stay, worsening neurological prognosis, and increasing mortality. The leading role in the pathogenesis of NEC in these infants is the violation of mesenteric perfusion. A decrease in arterial blood oxygenation may be an additional risk factor for intestinal hypoxia. Objective. To assess the incidence and risk factors for NEC in full-term newborns with CHD born in 2019–2021 at the Perinatal Center of Almazov National Research Medical Center. Patients and methods. The article presents an analysis of the frequency and risk factors of NEC in children with CHD born at the Almazov National Medical Research Centre in 2019–2021. In the group of critical and duct-dependent CHD (n = 264), the overall incidence of NEC was 15.9% (42 cases). The frequency of surgical stages of NEC (IIIA) was 1.1% (3 cases). In the preoperative period, there was a trend towards a higher frequency of inotropic therapy in a subgroup of children who subsequently developed NEC. NEC in newborns with duct-dependent CHD developed mainly in the early postoperative period after cardiac surgery. In children with duct-dependent pulmonary blood flow, a higher incidence of NEC after surgery was noted compared to children with duct-dependent systemic blood flow. Conclusion. Risk factors for NEC in the postoperative period were arterial hypotension and hemodynamically significant cardiac arrhythmias. Dysbiosis of the gut microbiota and changes in microbial metabolism may be additional risk factors for NEC in children with CHD. Key words: necrotizing enterocolitis, risk factors, congenital heart disease, cardiopulmonary bypass, intestinal microbiome, metabolomics","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748747","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: 10.20953/1817-7646-2022-6-45-54
M. Savenkova, E. Isaeva, E. Vetrova, G. Kraseva, N. A. Abramova, M. Shabat, R. Dushkin, S. Fadeeva, S. Kontio, M. P. Savenkov
Objective. To evaluate the efficacy of therapy for acute respiratory viral infections (ARVIs) in children with antiviral medications: inosine pranobex (Groprinosin®, Gedeon Richter) and Kagocel (Kagocel®, Niarmedic Pharma LLC) in comparison with symptomatic treatment without etiotropic agents based on clinical and laboratory parameters. Patients and methods. The clinical and laboratory observation was conducted in an outpatient setting in the pre-COVID-19 period between 2018 and 2020. Acute respiratory infections were diagnosed using licensed testing systems by multiplex polymerase chain reaction (PCR) with detection of nucleic acid viral genomes: influenza, rhinovirus, respiratory syncytial virus, metapneumovirus, parainfluenza, seasonal coronaviruses, adenoviruses, and bocavirus). A total of 151 children aged 3 to 15 years were examined and monitored in dynamics, with 78.7% of positive and 21.3% of negative results detected by PCR in the nasopharyngeal and oropharyngeal swabs. The patients were randomized into three groups depending on the antiviral medication prescribed: group 1 (53 children) received Groprinosin®; group 2 (52 children) received Kagocel®; group 3 (control, 46 children) received only symptomatic therapy without antiviral agents. Results. The study demonstrated a significant positive effect in patients in group 1 treated with Groprinosin® (n = 53). At the end of therapy for both mono- and mixed infections, there were 95.8% of negative results (according to PCR diagnosis, that is, the absence of viral genome). In children in group 2 (n = 52) treated with Kagocel®, the absence of viral nucleic acids (NAs) was observed less frequently (in 77.3% of cases). In children in group 3 (n = 46) who did not receive etiotropic antiviral therapy, there were only 40.3% of negative results after the end of treatment, and viral NAs were detected in 59.7% of patients. In this case, a 5-day course of Groprinosin® was prescribed, after which the PCR results became negative in all patients. Therefore, children with recurrent respiratory infections, mixed infections, and herpesvirus infections require longer therapy. Additionally, a high frequency of ARVI complications was noted in group 3 (5 (10.9%) patients, where otitis was observed in 1 case, sinusitis – in 2 cases, bronchitis – in 2 cases), whereas 1 (1.8%) patient taking Groprinosin® had otitis, and 1 (1.9%) patient taking Kagocel® had pneumonia. Conclusion. This study was the first to investigate antibody titers to respiratory viruses in dynamics at 3, 6 and 12 months after the onset of ARVI. It showed that the development of antibodies to respiratory viruses is very unstable and does not occur in all patients. Antibodies almost disappeared by the third month after ARVI and were no longer detectable by the sixth month. After 12 months, patients suffered a new ARVI and developed the corresponding antibodies. This information will be especially relevant in conditions of the rise in the incidence
{"title":"Role of antiviral therapy in respiratory infections in children: analysis of clinical and laboratory observations","authors":"M. Savenkova, E. Isaeva, E. Vetrova, G. Kraseva, N. A. Abramova, M. Shabat, R. Dushkin, S. Fadeeva, S. Kontio, M. P. Savenkov","doi":"10.20953/1817-7646-2022-6-45-54","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-45-54","url":null,"abstract":"Objective. To evaluate the efficacy of therapy for acute respiratory viral infections (ARVIs) in children with antiviral medications: inosine pranobex (Groprinosin®, Gedeon Richter) and Kagocel (Kagocel®, Niarmedic Pharma LLC) in comparison with symptomatic treatment without etiotropic agents based on clinical and laboratory parameters. Patients and methods. The clinical and laboratory observation was conducted in an outpatient setting in the pre-COVID-19 period between 2018 and 2020. Acute respiratory infections were diagnosed using licensed testing systems by multiplex polymerase chain reaction (PCR) with detection of nucleic acid viral genomes: influenza, rhinovirus, respiratory syncytial virus, metapneumovirus, parainfluenza, seasonal coronaviruses, adenoviruses, and bocavirus). A total of 151 children aged 3 to 15 years were examined and monitored in dynamics, with 78.7% of positive and 21.3% of negative results detected by PCR in the nasopharyngeal and oropharyngeal swabs. The patients were randomized into three groups depending on the antiviral medication prescribed: group 1 (53 children) received Groprinosin®; group 2 (52 children) received Kagocel®; group 3 (control, 46 children) received only symptomatic therapy without antiviral agents. Results. The study demonstrated a significant positive effect in patients in group 1 treated with Groprinosin® (n = 53). At the end of therapy for both mono- and mixed infections, there were 95.8% of negative results (according to PCR diagnosis, that is, the absence of viral genome). In children in group 2 (n = 52) treated with Kagocel®, the absence of viral nucleic acids (NAs) was observed less frequently (in 77.3% of cases). In children in group 3 (n = 46) who did not receive etiotropic antiviral therapy, there were only 40.3% of negative results after the end of treatment, and viral NAs were detected in 59.7% of patients. In this case, a 5-day course of Groprinosin® was prescribed, after which the PCR results became negative in all patients. Therefore, children with recurrent respiratory infections, mixed infections, and herpesvirus infections require longer therapy. Additionally, a high frequency of ARVI complications was noted in group 3 (5 (10.9%) patients, where otitis was observed in 1 case, sinusitis – in 2 cases, bronchitis – in 2 cases), whereas 1 (1.8%) patient taking Groprinosin® had otitis, and 1 (1.9%) patient taking Kagocel® had pneumonia. Conclusion. This study was the first to investigate antibody titers to respiratory viruses in dynamics at 3, 6 and 12 months after the onset of ARVI. It showed that the development of antibodies to respiratory viruses is very unstable and does not occur in all patients. Antibodies almost disappeared by the third month after ARVI and were no longer detectable by the sixth month. After 12 months, patients suffered a new ARVI and developed the corresponding antibodies. This information will be especially relevant in conditions of the rise in the incidence","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67749075","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: 10.20953/1817-7646-2022-1-142-149
K. G. Kamalov, A. Arslanbekova, D.A. Arslanbekova, I. M. Magomedova
The study of the physical development of adolescent population in the Republic of Dagestan is insufficient and attracts the attention of endocrinologists. A detailed examination of the features of physical development in this region could help to clarify the general patterns of acceleration or deceleration taking place in this territory of the Russian Federation. Objective. To conduct a comparative analysis of physical development indicators of adolescent boys during puberty in 1970-1990 with similar indicators of 2005-2010. Methods. The physical development of adolescents aged 11-17 years was examined in the mountain, foothill, and plain ecological and geographical zones of the Republic of Dagestan. Results. The physical development of boys aged 11-14 years in all ecological and geographical zones of the Republic of Dagestan in both groups was comparable (p > 0.05). Adolescents in the older age group of 15-16 years (group 1) outperformed their peers (group 2) by an average of 0.6-2.1%. From the age of 16, there was a “crossing” of the centile curves of physical development, and adolescents aged 16–17 years (group 2) already outperformed their peers (group 1) in all ecological and geographical zones of the Republic of Dagestan. This was most evident when comparing the physical development of the boys living in the foothill zone, where this difference was significant at 4.0-7.5% (p < 0.04) when comparing the two age groups (group 1 and 2). Final height by the end of puberty in adolescents in group 1 was in the range of 152.0 ± 2.7 cm and 163.0 ± 1.3 cm and in group 2 – 156.3 ± 0.7 cm and 167.7 ± 0.9 cm. Conclusion. The analysis and general secular trend of physical development indicators of adolescents at the turn of the 20th and 21st centuries on the model of the Republic of Dagestan showed that anthropometric parameters of adolescents in the Russian Federation demonstrate the presence of specific regional features – environmental, socio-economic, and anthropogenic. Key words: anthropometric data, Republic of Dagestan, retrospective indicators of adolescents, secular trend, comparative analysis, physical development
{"title":"Comparative analysis of physical development indicators of adolescent boys in the 20th and 21st centuries (secular trend) on the model of the Republic of Dagestan","authors":"K. G. Kamalov, A. Arslanbekova, D.A. Arslanbekova, I. M. Magomedova","doi":"10.20953/1817-7646-2022-1-142-149","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-1-142-149","url":null,"abstract":"The study of the physical development of adolescent population in the Republic of Dagestan is insufficient and attracts the attention of endocrinologists. A detailed examination of the features of physical development in this region could help to clarify the general patterns of acceleration or deceleration taking place in this territory of the Russian Federation. Objective. To conduct a comparative analysis of physical development indicators of adolescent boys during puberty in 1970-1990 with similar indicators of 2005-2010. Methods. The physical development of adolescents aged 11-17 years was examined in the mountain, foothill, and plain ecological and geographical zones of the Republic of Dagestan. Results. The physical development of boys aged 11-14 years in all ecological and geographical zones of the Republic of Dagestan in both groups was comparable (p > 0.05). Adolescents in the older age group of 15-16 years (group 1) outperformed their peers (group 2) by an average of 0.6-2.1%. From the age of 16, there was a “crossing” of the centile curves of physical development, and adolescents aged 16–17 years (group 2) already outperformed their peers (group 1) in all ecological and geographical zones of the Republic of Dagestan. This was most evident when comparing the physical development of the boys living in the foothill zone, where this difference was significant at 4.0-7.5% (p < 0.04) when comparing the two age groups (group 1 and 2). Final height by the end of puberty in adolescents in group 1 was in the range of 152.0 ± 2.7 cm and 163.0 ± 1.3 cm and in group 2 – 156.3 ± 0.7 cm and 167.7 ± 0.9 cm. Conclusion. The analysis and general secular trend of physical development indicators of adolescents at the turn of the 20th and 21st centuries on the model of the Republic of Dagestan showed that anthropometric parameters of adolescents in the Russian Federation demonstrate the presence of specific regional features – environmental, socio-economic, and anthropogenic. Key words: anthropometric data, Republic of Dagestan, retrospective indicators of adolescents, secular trend, comparative analysis, physical development","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67741129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The etiology, pathogenesis, and characteristics of neonatal colic are being actively explored by clinicians and researchers. The impact of nutrition on colic in newborns is still not fully understood and requires further investigations. This article discusses the role of functional nutrients of infant formulas (including prebiotics and probiotics) in the prevention and correction of colic in newborns and their impact on the formation of the intestinal microbiota. It also focuses on the effect of prebiotics in the diet on the intestinal microbiome composition, severity of colic in newborns, and association between the presence of probiotic cultures in the diet and development of colic. We emphasize the importance of studying microbiome composition and metabolites produced by intestinal commensals, including short-chain fatty acids. We also describe possible prebiotic and probiotic effects of infant formula containing goat milk. Key words: infantile colic, infant formula, prebiotics, prebiotics, oligosaccharides 2'-FL, GOS, Bifidobacterium lactis, gut microbiota, goat milk
{"title":"Functional gastrointestinal disorders in infants: is it possible to treat them with infant formulas?","authors":"I.N.Kholodova I.N.Kholodova, E.S.Kiseleva E.S.Kiseleva","doi":"10.20953/1817-7646-2022-1-157-166","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-1-157-166","url":null,"abstract":"The etiology, pathogenesis, and characteristics of neonatal colic are being actively explored by clinicians and researchers. The impact of nutrition on colic in newborns is still not fully understood and requires further investigations. This article discusses the role of functional nutrients of infant formulas (including prebiotics and probiotics) in the prevention and correction of colic in newborns and their impact on the formation of the intestinal microbiota. It also focuses on the effect of prebiotics in the diet on the intestinal microbiome composition, severity of colic in newborns, and association between the presence of probiotic cultures in the diet and development of colic. We emphasize the importance of studying microbiome composition and metabolites produced by intestinal commensals, including short-chain fatty acids. We also describe possible prebiotic and probiotic effects of infant formula containing goat milk. Key words: infantile colic, infant formula, prebiotics, prebiotics, oligosaccharides 2'-FL, GOS, Bifidobacterium lactis, gut microbiota, goat milk","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67741289","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: 10.20953/1817-7646-2022-1-185-189
V. Lyakh, S. Levushkin, N. Skoblina
The investigation of changes in the parameters reflecting physical development of children, adolescents, and youth under the influence of genetic, environmental, social, and other factors has both scientific and practical value. Objective. To analyze changes in the body mass index (BMI) of children, adolescents, and youth in the late 20th century and early 21st century in different countries. We used the information form the Scopus database and Russian citation databases. We observed global secular trends demonstrating increasing BMI index and the number of overweight and obese children, adolescents, and youth. The last 40 years were characterized by particularly worrying trends with the proportion of overweight and obese children and adolescents reaching 25.0%. From pathophysiological point of view, this leads to a number of metabolic diseases. In countries with a well-developed industrial sector, the secular trends in height of children, adolescents, and youth weakened in the last decade of the 20th century and in the beginning of the 21st century. By contrast, their body weight continued to increase during this period. Conclusion. Overweight and obesity have become so widespread globally that many researchers are currently talking about an obesity epidemic. Key words: children, body mass index, physical development
{"title":"Changes in the body mass index of children, adolescents, and youth: trends observed in the end of the 20th century and beginning of the 21st century","authors":"V. Lyakh, S. Levushkin, N. Skoblina","doi":"10.20953/1817-7646-2022-1-185-189","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-1-185-189","url":null,"abstract":"The investigation of changes in the parameters reflecting physical development of children, adolescents, and youth under the influence of genetic, environmental, social, and other factors has both scientific and practical value. Objective. To analyze changes in the body mass index (BMI) of children, adolescents, and youth in the late 20th century and early 21st century in different countries. We used the information form the Scopus database and Russian citation databases. We observed global secular trends demonstrating increasing BMI index and the number of overweight and obese children, adolescents, and youth. The last 40 years were characterized by particularly worrying trends with the proportion of overweight and obese children and adolescents reaching 25.0%. From pathophysiological point of view, this leads to a number of metabolic diseases. In countries with a well-developed industrial sector, the secular trends in height of children, adolescents, and youth weakened in the last decade of the 20th century and in the beginning of the 21st century. By contrast, their body weight continued to increase during this period. Conclusion. Overweight and obesity have become so widespread globally that many researchers are currently talking about an obesity epidemic. Key words: children, body mass index, physical development","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67741610","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: 10.20953/1817-7646-2022-1-24-35
P. V. Morozov, S.V. Novoseltsev
Objective. To improve rehabilitation of infants who received respiratory support at birth. Patients and methods. This prospective comparative study was conducted in the Children's City Polyclinic No 13 of Yekaterinburg and included 131 infants who received different types of artificial lung ventilation (ALV) for some respiratory disorders. All patients were followed up by a pediatrician, neurologist, pulmonologist, and an infectious disease specialist; all of them received appropriate therapy. The experimental group comprised 99 infants who additionally received a course of osteopathic (manual) correction for 8–10 weeks, whereas the control group included 32 infants who received standard therapy only. Patients in the experimental and control groups were matched for all parameters. In addition to chest X-ray, all study participants underwent an assessment of their neurological, somatic, and biomechanical statuses. Osteopathic treatment (4 to 6 sessions lasting 30–40 minutes each) was performed by one osteopathic doctor. Statistical analysis was conducted using the SPSS Statistics.26 software; we calculated Pearson's linear correlation coefficient and used Fisher's exact test and McNemar's test. Differences were considered significant at p < 0.05. Results. Seventy-nine infants (79.8%) initially had both neurological and somatic disorders. Ten patients (10.1%) had either somatic disorders (such as labored nasal breathing, regurgitation, constipation, thermoregulation disorder) or neurological disorders (weather sensitivity, sleep disorders, delayed motor and/or neuropsychiatric development, impaired blood and cerebrospinal fluid dynamics) alone. We identified three groups of major somatic dysfunctions (SDs) in the biomechanical status: local (levels: С0–СI, sternum, thoracoabdominal diaphragm, sacrum); regional (cervical spine–level СII–СVI, laryngopharyngeal complex, lungs, abdominal cavity, skull); and global dysfunction of the dura mater. After treatment, the frequency of all neurological and somatic disorders, as well as the frequency of all SDs reduced in the experimental group (p < 0.001). Pathological changes on chest X-rays (elevated diaphragm, low mobility of the thoracic diaphragm, bullae, pleurodiaphragm atic adhesions, etc.) were detected in 89 patients (67.9%), including 66 infants from the experimental group (66.7%) and 23 infants from the control group (71.8%). Osteopathic (manual) treatment significantly reduced the number of patients with abdominal diaphragm dysfunction (56.6% vs. 26.3%), bullae (35.3% vs. 11.1%), and middle lobe syndrome (8.1% vs. 2%) (p < 0.001). The number of patients with thoracoabdominal diaphragm dysfunction in the control group did not change (n = 18; 56.2%). Positive radiological dynamics was observed in 90.9% of patients from the experimental group and 43.5% of patients from the control group. Moreover, only infants from the control group demonstrated negative radiological dynamics (17.4%). Conclusion. Newb
{"title":"Infants after artificial lung ventilation. New approaches to rehabilitation","authors":"P. V. Morozov, S.V. Novoseltsev","doi":"10.20953/1817-7646-2022-1-24-35","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-1-24-35","url":null,"abstract":"Objective. To improve rehabilitation of infants who received respiratory support at birth. Patients and methods. This prospective comparative study was conducted in the Children's City Polyclinic No 13 of Yekaterinburg and included 131 infants who received different types of artificial lung ventilation (ALV) for some respiratory disorders. All patients were followed up by a pediatrician, neurologist, pulmonologist, and an infectious disease specialist; all of them received appropriate therapy. The experimental group comprised 99 infants who additionally received a course of osteopathic (manual) correction for 8–10 weeks, whereas the control group included 32 infants who received standard therapy only. Patients in the experimental and control groups were matched for all parameters. In addition to chest X-ray, all study participants underwent an assessment of their neurological, somatic, and biomechanical statuses. Osteopathic treatment (4 to 6 sessions lasting 30–40 minutes each) was performed by one osteopathic doctor. Statistical analysis was conducted using the SPSS Statistics.26 software; we calculated Pearson's linear correlation coefficient and used Fisher's exact test and McNemar's test. Differences were considered significant at p < 0.05. Results. Seventy-nine infants (79.8%) initially had both neurological and somatic disorders. Ten patients (10.1%) had either somatic disorders (such as labored nasal breathing, regurgitation, constipation, thermoregulation disorder) or neurological disorders (weather sensitivity, sleep disorders, delayed motor and/or neuropsychiatric development, impaired blood and cerebrospinal fluid dynamics) alone. We identified three groups of major somatic dysfunctions (SDs) in the biomechanical status: local (levels: С0–СI, sternum, thoracoabdominal diaphragm, sacrum); regional (cervical spine–level СII–СVI, laryngopharyngeal complex, lungs, abdominal cavity, skull); and global dysfunction of the dura mater. After treatment, the frequency of all neurological and somatic disorders, as well as the frequency of all SDs reduced in the experimental group (p < 0.001). Pathological changes on chest X-rays (elevated diaphragm, low mobility of the thoracic diaphragm, bullae, pleurodiaphragm atic adhesions, etc.) were detected in 89 patients (67.9%), including 66 infants from the experimental group (66.7%) and 23 infants from the control group (71.8%). Osteopathic (manual) treatment significantly reduced the number of patients with abdominal diaphragm dysfunction (56.6% vs. 26.3%), bullae (35.3% vs. 11.1%), and middle lobe syndrome (8.1% vs. 2%) (p < 0.001). The number of patients with thoracoabdominal diaphragm dysfunction in the control group did not change (n = 18; 56.2%). Positive radiological dynamics was observed in 90.9% of patients from the experimental group and 43.5% of patients from the control group. Moreover, only infants from the control group demonstrated negative radiological dynamics (17.4%). Conclusion. Newb","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67741667","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: 10.20953/1817-7646-2022-2-109-116
S. Gribanova, V. Yankova, O. Gobyzov, M. Ryabov, A. Karpova, S. Kedik, I. Udyanskaya, V. Grigorieva, I. I. Krasnyuk (jr.), T. Slonskaya, A.A. Zhukova
Objective. To compare spraying characteristics of two nasal sprays containing framycetin – Isofra and Tramicent Materials and methods. We used a silicone model of the nasal cavity (Koken Co. Ltd., Tokyo, Japan) to assess dose distribution of the drug inside the nose. Shadow photography was applied to analyze dynamic characteristics of spraying and the dispersed composition of spray particles. Results. Using a silicone model, we evaluated the dose distribution of the spray inside the nasal cavity. We compared dose distribution of two nasal sprays containing framycetin (Isofra and Tramicent) with full and half-full bottles. Shadow photography was applied to evaluate dynamic characteristics of these sprays, including total duration of spraying, duration of its individual phases, spraying angle, as well as dispersion characteristics, such as average particle size and particle size distributions. Conclusion. The experiments with a silicone nose model demonstrated that Isofra ensured a larger distribution area inside the nasal cavity compared to Terramycin, which suggests a better coverage of the nasal mucosa with Isofra. Comparison of dynamic spraying characteristics (including duration of spraying phases, spraying angle, and shape of the cone) between Isofra and Tramicent using shadow photography showed that Isofra ensured a more homogenous spraying coverage with fine particles. Comparison of the dispersion composition of the two sprays showed that most of the Isofra dose was sprayed with smaller drops than Tramicent, which indicates a better dispersion of Isofra. Our findings suggest that Isofra ensured high quality spraying and effective delivery of the medicine into the nasal cavity. Key words: framycetin, spray, silicone nose model, shadow photography, spray characteristics
{"title":"Assessment of spraying characteristics of two nasal sprays containing framycetin","authors":"S. Gribanova, V. Yankova, O. Gobyzov, M. Ryabov, A. Karpova, S. Kedik, I. Udyanskaya, V. Grigorieva, I. I. Krasnyuk (jr.), T. Slonskaya, A.A. Zhukova","doi":"10.20953/1817-7646-2022-2-109-116","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-2-109-116","url":null,"abstract":"Objective. To compare spraying characteristics of two nasal sprays containing framycetin – Isofra and Tramicent Materials and methods. We used a silicone model of the nasal cavity (Koken Co. Ltd., Tokyo, Japan) to assess dose distribution of the drug inside the nose. Shadow photography was applied to analyze dynamic characteristics of spraying and the dispersed composition of spray particles. Results. Using a silicone model, we evaluated the dose distribution of the spray inside the nasal cavity. We compared dose distribution of two nasal sprays containing framycetin (Isofra and Tramicent) with full and half-full bottles. Shadow photography was applied to evaluate dynamic characteristics of these sprays, including total duration of spraying, duration of its individual phases, spraying angle, as well as dispersion characteristics, such as average particle size and particle size distributions. Conclusion. The experiments with a silicone nose model demonstrated that Isofra ensured a larger distribution area inside the nasal cavity compared to Terramycin, which suggests a better coverage of the nasal mucosa with Isofra. Comparison of dynamic spraying characteristics (including duration of spraying phases, spraying angle, and shape of the cone) between Isofra and Tramicent using shadow photography showed that Isofra ensured a more homogenous spraying coverage with fine particles. Comparison of the dispersion composition of the two sprays showed that most of the Isofra dose was sprayed with smaller drops than Tramicent, which indicates a better dispersion of Isofra. Our findings suggest that Isofra ensured high quality spraying and effective delivery of the medicine into the nasal cavity. Key words: framycetin, spray, silicone nose model, shadow photography, spray characteristics","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67742225","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}