Pub Date : 2022-01-01DOI: 10.20953/1817-7646-2022-2-55-64
M. Zhuravleva, Yu. V. Gagarina, T. V. Marin, G. Asmolova, Yu. A. Sigova, I. Krsheminskaya, D. Ovsyannikov
Objective. To assess the impact of preventive therapy with palivizumab against respiratory syncytial viral (RSV) infection on the indicator of the implementation of the Unified plan to achieve national goals of the Russian Federation and on the infant mortality rate. Patients and methods. Preterm infants born prior to 35 weeks gestation were considered as target population for immunization with palivizumab. We modeled an increase in palivizumab coverage to 25% by 2024 and calculated the expected number of deaths and hospitalizations that can be prevented using palivizumab. We also calculated targeted values of infant mortality reduction (for the entire country and individual regions) that can be achieved by increasing palivizumab coverage. Results. Annual increase of RSV prophylaxis coverage will prevent 49, 63 and 76 deaths in Russia in 2022, 2023, and 2024, respectively. This will ensure a 36.3%, 48.4%, and 60.5% reduction in infant mortality in 2022, 2023, and 2024, respectively, which will facilitate the achievement of targeted indicators specified in the National development goals of the Russian Federation. Moreover, it will prevent 904, 1142, and 1381 hospitalizations due to RSV in 2022, 2023, and 2024, respectively. Conclusion. Wider use of palivizumab will decrease the hospitalization rate and will facilitate the achievement of the targeted indicator ‘reduction of infant mortality’ within the Federal Project ‘Improvement of children's healthcare.’ Key words: infant mortality, preterm infants, palivizumab, prevention, respiratory syncytial virus infection
{"title":"Expected effect of palivizumab on the reduction of infant mortality and hospitalizations rates due to respiratory syncytial virus infection","authors":"M. Zhuravleva, Yu. V. Gagarina, T. V. Marin, G. Asmolova, Yu. A. Sigova, I. Krsheminskaya, D. Ovsyannikov","doi":"10.20953/1817-7646-2022-2-55-64","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-2-55-64","url":null,"abstract":"Objective. To assess the impact of preventive therapy with palivizumab against respiratory syncytial viral (RSV) infection on the indicator of the implementation of the Unified plan to achieve national goals of the Russian Federation and on the infant mortality rate. Patients and methods. Preterm infants born prior to 35 weeks gestation were considered as target population for immunization with palivizumab. We modeled an increase in palivizumab coverage to 25% by 2024 and calculated the expected number of deaths and hospitalizations that can be prevented using palivizumab. We also calculated targeted values of infant mortality reduction (for the entire country and individual regions) that can be achieved by increasing palivizumab coverage. Results. Annual increase of RSV prophylaxis coverage will prevent 49, 63 and 76 deaths in Russia in 2022, 2023, and 2024, respectively. This will ensure a 36.3%, 48.4%, and 60.5% reduction in infant mortality in 2022, 2023, and 2024, respectively, which will facilitate the achievement of targeted indicators specified in the National development goals of the Russian Federation. Moreover, it will prevent 904, 1142, and 1381 hospitalizations due to RSV in 2022, 2023, and 2024, respectively. Conclusion. Wider use of palivizumab will decrease the hospitalization rate and will facilitate the achievement of the targeted indicator ‘reduction of infant mortality’ within the Federal Project ‘Improvement of children's healthcare.’ Key words: infant mortality, preterm infants, palivizumab, prevention, respiratory syncytial virus infection","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":"67743395","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: 10.20953/1817-7646-2022-3-109-112
V. Shadrina, Y. Melyanovskaya, E. Furman
We report a case of cystic fibrosis (CF) in a 9-year-old child with the rare c.3140-16T>A (3272-16T>A) variant of the CFTR gene in homozygous state. CF was suspected at neonatal screening. The results of the sweat test (Nanoduct) were 88 and 84 mmol/L. Since the age of 1.5 months, the patient received inhalation of dornase alfa, kinesitherapy, pancreatic enzymes (only in case of abundant intake of fatty foods), and vitamin therapy. The boy early developed cough with sputum; at the age of 5 years, he also developed chronic sinusitis. At the age of 3 years, his level of fecal pancreatic elastase 1 was 597 μg/g, which indicated preserved exocrine function of the pancreas. At the age of 9 years, the boy demonstrated normal physical development and lung function (examined using spirometry). Computed tomography showed no bronchiectasis. X-ray revealed radiological signs of chronic sinusitis. The assessment of intestinal current measurement (ICM) demonstrated a reduced CFTR function typical of mild genetic variants. Thus, the patient with the c.3140-16T>A (3272-16T>A) variant in homozygous state has developed only chronic rhinosinusitis by the age of 9 years. Measurement of ICM confirmed the diagnosis of mild CF genotype. Key words: c.3140-16T>A (3272-16T>A) genetic variant, cystic fibrosis, mild phenotype
我们报告一例囊性纤维化(CF)在一个9岁的儿童与罕见的c.3140-16T> a (3272-16T> a) CFTR基因纯合状态变异体。新生儿筛查时怀疑CF。汗液试验(Nanoduct)结果分别为88和84 mmol/L。从1.5个月大开始，患者开始吸入dornase alfa、运动疗法、胰酶(仅在大量摄入脂肪食物的情况下)和维生素治疗。男孩早期出现咳嗽伴痰;5岁时，他也患上了慢性鼻窦炎。3岁时粪便胰腺弹性酶1水平为597 μg/g，提示胰腺外分泌功能保留。9岁时，男孩表现出正常的身体发育和肺功能(使用肺活量测定法检查)。计算机断层扫描未见支气管扩张。x光片显示慢性鼻窦炎的影像学征象。肠电流测量(ICM)的评估表明，CFTR功能降低是轻度遗传变异的典型特征。因此，纯合状态的c.3140-16T>A (3272-16T>A)变异体患者在9岁时仅发展为慢性鼻窦炎。ICM测定证实为轻度CF基因型。关键词:c.3140-16T>A (3272-16T>A)基因变异，囊性纤维化，轻度表型
{"title":"Phenotypic manifestations of the CFTR c.3140-16T>A (3272-16T>A) variant in homozygous state in a child with cystic fibrosis","authors":"V. Shadrina, Y. Melyanovskaya, E. Furman","doi":"10.20953/1817-7646-2022-3-109-112","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-3-109-112","url":null,"abstract":"We report a case of cystic fibrosis (CF) in a 9-year-old child with the rare c.3140-16T>A (3272-16T>A) variant of the CFTR gene in homozygous state. CF was suspected at neonatal screening. The results of the sweat test (Nanoduct) were 88 and 84 mmol/L. Since the age of 1.5 months, the patient received inhalation of dornase alfa, kinesitherapy, pancreatic enzymes (only in case of abundant intake of fatty foods), and vitamin therapy. The boy early developed cough with sputum; at the age of 5 years, he also developed chronic sinusitis. At the age of 3 years, his level of fecal pancreatic elastase 1 was 597 μg/g, which indicated preserved exocrine function of the pancreas. At the age of 9 years, the boy demonstrated normal physical development and lung function (examined using spirometry). Computed tomography showed no bronchiectasis. X-ray revealed radiological signs of chronic sinusitis. The assessment of intestinal current measurement (ICM) demonstrated a reduced CFTR function typical of mild genetic variants. Thus, the patient with the c.3140-16T>A (3272-16T>A) variant in homozygous state has developed only chronic rhinosinusitis by the age of 9 years. Measurement of ICM confirmed the diagnosis of mild CF genotype. Key words: c.3140-16T>A (3272-16T>A) genetic variant, cystic fibrosis, mild phenotype","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":"67743778","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: 10.20953/1817-7646-2022-3-120-127
A. Voronkova, E. Kondratyeva, E. Nikolaeva, E. Pasnova, I. R. Fatkhullina, N. Odinaeva
The pancreas is one of the main organs affected by the dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Pancreatitis can be a symptom of cystic fibrosis (CF) or a CFTR-related disorder. Genetic variants of the CFTR gene causing CF or having varying clinical significance are observed in 32–48% of patients. Approximately 20% of patients with mild genotypes are expected to develop pancreatitis. We report three cases of pancreatitis in children with CF and preserved pancreatic function. We focus on the challenges associated with the assessment of pancreatic insufficiency grade, suffering of children with recurrent acute and chronic pancreatitis, difficulties associated with the diagnosis and interpretation of laboratory parameters, problems of prognosis of pancreatitis development and progression in patients with pathogenic variants of the CFTR gene. Patients with mild pathogenic variants of the CFTR gene can have their pancreatic elastase-1 level reduced over time, which necessitates its annual monitoring. Patients with mild pathogenic variants should be routinely tested for pancreatic amylase, lipase, and diastase; and undergo examination using visualization methods. All CF patients require complete genotype verification to identify those with a mild genotype. Patients with recurrent pancreatitis should be checked for heterozygous pathogenic variants of the CFTR gene or CF verification. Key words: CFTR gene, cystic fibrosis, mild genotype, pancreas, pancreatitis, pancreatic elastase
{"title":"Pancreatitis in children with cystic fibrosis and preserved pancreatic exocrine function","authors":"A. Voronkova, E. Kondratyeva, E. Nikolaeva, E. Pasnova, I. R. Fatkhullina, N. Odinaeva","doi":"10.20953/1817-7646-2022-3-120-127","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-3-120-127","url":null,"abstract":"The pancreas is one of the main organs affected by the dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Pancreatitis can be a symptom of cystic fibrosis (CF) or a CFTR-related disorder. Genetic variants of the CFTR gene causing CF or having varying clinical significance are observed in 32–48% of patients. Approximately 20% of patients with mild genotypes are expected to develop pancreatitis. We report three cases of pancreatitis in children with CF and preserved pancreatic function. We focus on the challenges associated with the assessment of pancreatic insufficiency grade, suffering of children with recurrent acute and chronic pancreatitis, difficulties associated with the diagnosis and interpretation of laboratory parameters, problems of prognosis of pancreatitis development and progression in patients with pathogenic variants of the CFTR gene. Patients with mild pathogenic variants of the CFTR gene can have their pancreatic elastase-1 level reduced over time, which necessitates its annual monitoring. Patients with mild pathogenic variants should be routinely tested for pancreatic amylase, lipase, and diastase; and undergo examination using visualization methods. All CF patients require complete genotype verification to identify those with a mild genotype. Patients with recurrent pancreatitis should be checked for heterozygous pathogenic variants of the CFTR gene or CF verification. Key words: CFTR gene, cystic fibrosis, mild genotype, pancreas, pancreatitis, pancreatic elastase","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":"67744340","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: 10.20953/1817-7646-2022-5-66-74
A. Khavkin, V. Novikova, A. Vashura, T. Kovtun
The discovery of the gut-bone axis promoted the development of treatment strategies aimed to preserve bone mineral density. Probiotics and probiotic complexes in combination with bone mineral matrix are gradually becoming a new treatment method for osteoporosis. This literature review aims to explore the role of gut microbiota in osteoclastogenesis, bone healing, mechanisms of its effects, and possible ways to modify the microbiota in order to improve bone metabolism. Key words: gut microbiota-bone axis, osteogenesis, osteoporosis, microbiota, nutritional support, baby formula, inulin
{"title":"Gut-bone axis: current concepts of interactions","authors":"A. Khavkin, V. Novikova, A. Vashura, T. Kovtun","doi":"10.20953/1817-7646-2022-5-66-74","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-66-74","url":null,"abstract":"The discovery of the gut-bone axis promoted the development of treatment strategies aimed to preserve bone mineral density. Probiotics and probiotic complexes in combination with bone mineral matrix are gradually becoming a new treatment method for osteoporosis. This literature review aims to explore the role of gut microbiota in osteoclastogenesis, bone healing, mechanisms of its effects, and possible ways to modify the microbiota in order to improve bone metabolism. Key words: gut microbiota-bone axis, osteogenesis, osteoporosis, microbiota, nutritional support, baby formula, inulin","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":"67747247","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: 10.20953/1817-7646-2022-4-76-83
Vladimir Perfilyev, A. G. Miroshnichenko, V. Zhelev, E. V. Devald
The approaches to pharmacotherapy of neonatal seizures are always empirical and vary across the globe. There is still no consensus on this issue because of the highly variable efficacy of anticonvulsants traditionally used in newborns. Currently, none of these drugs has sufficient evidence to make an unambiguous conclusion on their efficacy and safety. Therefore, the search for new anticonvulsants for newborns is highly relevant. This review aims to summarize existing literature surrounding anticonvulsants that can potentially be used in newborns. It discusses advantages and disadvantages, as well as their utility in neonatal care. It also summarizes the latest information on neonatal seizures and outlines future directions of research to create new therapeutic strategies for neonatal seizures. Key words: anticonvulsant, treatment, neonatal seizures, newborns, anticonvulsant therapy, anticonvulsants, seizures
{"title":"Alternative anticonvulsants in neonatology","authors":"Vladimir Perfilyev, A. G. Miroshnichenko, V. Zhelev, E. V. Devald","doi":"10.20953/1817-7646-2022-4-76-83","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-4-76-83","url":null,"abstract":"The approaches to pharmacotherapy of neonatal seizures are always empirical and vary across the globe. There is still no consensus on this issue because of the highly variable efficacy of anticonvulsants traditionally used in newborns. Currently, none of these drugs has sufficient evidence to make an unambiguous conclusion on their efficacy and safety. Therefore, the search for new anticonvulsants for newborns is highly relevant. This review aims to summarize existing literature surrounding anticonvulsants that can potentially be used in newborns. It discusses advantages and disadvantages, as well as their utility in neonatal care. It also summarizes the latest information on neonatal seizures and outlines future directions of research to create new therapeutic strategies for neonatal seizures. Key words: anticonvulsant, treatment, neonatal seizures, newborns, anticonvulsant therapy, anticonvulsants, seizures","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":"67747472","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: 10.20953/1817-7646-2022-5-20-27
H. Youssef, A. R. Rezk, A. Mohamed, A. Salem, Asim A Mohamed
Objective. Screening of palatopharyngeal incoordination in infants who required mechanical ventilation. Patients and methods. This study included 51 patients admitted to the pediatric intensive care unit (PICU), Faculty of Medicine, Ain Shams University. The study was conducted during the period from February 2021 to February 2022. All patients were divided into five groups according to the results of the Fiberoptic Flexible Endoscopic Evaluation of Swallowing (FEES) postintubation, FEES post-extubation, Videofluoroscopic Swallow Study (VFSS) post-extubation, and dye study: group 1 – not affected infants, group 2 – infants with palatopharyngeal incoordination, group 3 – infants with palatopharyngeal incoordination and gastroesophageal reflux, group 4 – infants with reflux, group 5 – infants with congenital upper air way anomalies. Results. Palatopharyngeal incoordination was detected in 16 (31.3%) patients, congenital upper airway anomalies – in 12 (23.5%) patients, and gastroesophageal reflux – in 10 (19.6%) patients. After three months, palatopharyngeal incoordination was resolved in 92.3% of patients, and 7.7 % had silent aspiration. Conclusion. Palatopharyngeal incoordination is a multifactorial process with the important implications for early diagnosis and interventions to treat this condition in pediatric patients. Key words: silent aspiration, mechanical ventilation, infants, palatopharyngeal incoordination
{"title":"Screening of palatopharyngeal incoordination in mechanically ventilated critically ill infants","authors":"H. Youssef, A. R. Rezk, A. Mohamed, A. Salem, Asim A Mohamed","doi":"10.20953/1817-7646-2022-5-20-27","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-20-27","url":null,"abstract":"Objective. Screening of palatopharyngeal incoordination in infants who required mechanical ventilation. Patients and methods. This study included 51 patients admitted to the pediatric intensive care unit (PICU), Faculty of Medicine, Ain Shams University. The study was conducted during the period from February 2021 to February 2022. All patients were divided into five groups according to the results of the Fiberoptic Flexible Endoscopic Evaluation of Swallowing (FEES) postintubation, FEES post-extubation, Videofluoroscopic Swallow Study (VFSS) post-extubation, and dye study: group 1 – not affected infants, group 2 – infants with palatopharyngeal incoordination, group 3 – infants with palatopharyngeal incoordination and gastroesophageal reflux, group 4 – infants with reflux, group 5 – infants with congenital upper air way anomalies. Results. Palatopharyngeal incoordination was detected in 16 (31.3%) patients, congenital upper airway anomalies – in 12 (23.5%) patients, and gastroesophageal reflux – in 10 (19.6%) patients. After three months, palatopharyngeal incoordination was resolved in 92.3% of patients, and 7.7 % had silent aspiration. Conclusion. Palatopharyngeal incoordination is a multifactorial process with the important implications for early diagnosis and interventions to treat this condition in pediatric patients. Key words: silent aspiration, mechanical ventilation, infants, palatopharyngeal incoordination","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":"67747597","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: 10.20953/1817-7646-2022-5-75-82
E. Degtyareva, A. Gorelov, H. Simonovskaya, E. P. Isaeva, M. A. Kufa, M. Kantemirova, A.S. Aleksandrova, V. Barskiy, A.S. Zakrevskij
Approximately 5–15% of children develop post-COVID-19 syndrome after SARS-CoV-2 infection, which manifests itself with various pathological symptoms for more than 12 weeks. Cardiovascular symptoms range from serious myocardial inflammation, manifestations of essential hypertension to signs of autonomic dysfunction with a tendency to hypersympathicotonia, which negatively affects the quality of life of children. We report a case of subacute myocarditis in a patient with long-COVID after a low-symptomatic acute disease. This case illustrates high clinical significance of timely diagnosis of long-COVID using gadolinium-enhanced magnetic resonance imaging, which was performed in our country for the first time in pediatric practice. We developed criteria for early diagnosis of autonomic dysfunction specific for children and adolescents. We also developed treatment recommendations, including behavioral therapy, drug, and non-drug treatments. Key words: long-COVID, autonomic dysfunction, hypersympathicotonia, myocarditis, behavioral therapy, non-drug treatment
{"title":"Cardiac and vegetative manifestations of long-COVID in children","authors":"E. Degtyareva, A. Gorelov, H. Simonovskaya, E. P. Isaeva, M. A. Kufa, M. Kantemirova, A.S. Aleksandrova, V. Barskiy, A.S. Zakrevskij","doi":"10.20953/1817-7646-2022-5-75-82","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-75-82","url":null,"abstract":"Approximately 5–15% of children develop post-COVID-19 syndrome after SARS-CoV-2 infection, which manifests itself with various pathological symptoms for more than 12 weeks. Cardiovascular symptoms range from serious myocardial inflammation, manifestations of essential hypertension to signs of autonomic dysfunction with a tendency to hypersympathicotonia, which negatively affects the quality of life of children. We report a case of subacute myocarditis in a patient with long-COVID after a low-symptomatic acute disease. This case illustrates high clinical significance of timely diagnosis of long-COVID using gadolinium-enhanced magnetic resonance imaging, which was performed in our country for the first time in pediatric practice. We developed criteria for early diagnosis of autonomic dysfunction specific for children and adolescents. We also developed treatment recommendations, including behavioral therapy, drug, and non-drug treatments. Key words: long-COVID, autonomic dysfunction, hypersympathicotonia, myocarditis, behavioral therapy, non-drug treatment","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":"67748204","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: 10.20953/1817-7646-2022-6-97-105
A. Khavkin, M. Gurova, V. Novikova, A. Vashura
This article outlines current concepts of probiotic drugs and probiotic foods for children, provides the list of gastrointestinal disorders in children that can be considered as indications for probiotics, as well as their mechanism of action. Particular attention is paid to probiotic use according to the criteria of evidence-based medicine. The review also focuses on the positive role of the probiotic strain Bifidobacterium animalis subsp. lactis in the treatment and prevention of gastroenterological disorders in children, both as part of pharmacotherapy and enriched food products. Key words: intestinal microbiota, dysbiosis, Bifidobacterium animalis subsp. lactis, probiotics, probiotic foods for children
{"title":"Probiotics and probiotic products for children with intestinal disorders","authors":"A. Khavkin, M. Gurova, V. Novikova, A. Vashura","doi":"10.20953/1817-7646-2022-6-97-105","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-97-105","url":null,"abstract":"This article outlines current concepts of probiotic drugs and probiotic foods for children, provides the list of gastrointestinal disorders in children that can be considered as indications for probiotics, as well as their mechanism of action. Particular attention is paid to probiotic use according to the criteria of evidence-based medicine. The review also focuses on the positive role of the probiotic strain Bifidobacterium animalis subsp. lactis in the treatment and prevention of gastroenterological disorders in children, both as part of pharmacotherapy and enriched food products. Key words: intestinal microbiota, dysbiosis, Bifidobacterium animalis subsp. lactis, probiotics, probiotic foods for children","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":"67749320","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: 10.20953/1817-7646-2022-1-95-112
E. Krekhova, E. Alexeeva, T. Dvoryakovskaya, K. Isaeva, R. Denisova, A.L. Chomakhidze, O. Lomakina, A. Mamutova, A. Fetisova, M. Gautier, K. Chibisova, I. Kriulin, I. Tsulukiya
Therapy with biologicals at the onset of systemic juvenile idiopathic arthritis (sJIA) ensures faster achievement of inactive disease or remission in more patients compared to standard treatment. Identification of predictors of early response to biologicals is necessary to increase treatment efficacy in children with sJIA. Objective. To develop a model for predicting treatment outcomes with different biologicals in sJIA patients. Materials and methods. We analyzed medical records of sJIA patients who received tocilizumab or canakinumab and were admitted to the Department of Rheumatology between July 2009 and February 2021. Predicted outcomes included inactive disease after 12 months of therapy with biologicals (according to C. Wallace criteria and JADAS71) and drug-free remission (without biologicals) for at least 6 months. Potential predictors comprised patient demographic and clinical characteristics, such as sJIA activity, CHAQ index, concomitant therapy, treatment outcomes after 1 and 3 months of therapy, etc. (115 parameters in total). Independent predictors were chosen using multivariate binary logistic regression. Results. This study included 250 patients receiving tocilizumab and 73 patients receiving canakinumab. After 12 months of tocilizumab therapy, 179 patients (76%) achieved inactive disease according to C. Wallace criteria and 170 patients (72%) achieved remission according to JADAS71 index. Drug-free remission (for at least 6 months without biologicals) was registered in 51 patients (20%) from the tocilizumab group. In the canakinumab group, inactive disease according to C. Wallace criteria, remission according to JADAS71, and drug-free remission were achieved in 58 (79%), 58 (79%), and 10 (14%) patients, respectively. Duration of morning stiffness at sJIA onset, dynamics of the duration of morning stiffness after 1 and 3 months of treatment, disease activity evaluated by a physician using the 100-mm visual analog scale (VAS) after one month of therapy, and patientreported overall well-being evaluated using VAS after 3 months of therapy were found to be the predictors of achieving remission according to C. Wallace criteria in the tocilizumab group. The following factors were significantly associated with remission according to JADAS71 index: duration of morning stiffness at sJIA onset and upon treatment initiation, VAS score evaluated by a physician after 1 and 3 months, and number of painful joints after 3 months. We also found several predictors of achieving drug-free remission, including lymphocyte count at disease onset, therapy with glucocorticoids (GCs) and its duration by the time of biological initiation, ESR upon treatment initiation, 50% improvement according to ACR pediatric criteria after 1 month, administration of systemic GCs after 1 month, ESR dynamics by 3 months, and number of joints with limited motion after 3 months. In the canakinumab group, the following factors were associated with remission according to C.Wa
{"title":"Predictors of remission in children with systemic juvenile idiopathic arthritis receiving biologicals (tocilizumab and canakinumab): a cohort study","authors":"E. Krekhova, E. Alexeeva, T. Dvoryakovskaya, K. Isaeva, R. Denisova, A.L. Chomakhidze, O. Lomakina, A. Mamutova, A. Fetisova, M. Gautier, K. Chibisova, I. Kriulin, I. Tsulukiya","doi":"10.20953/1817-7646-2022-1-95-112","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-1-95-112","url":null,"abstract":"Therapy with biologicals at the onset of systemic juvenile idiopathic arthritis (sJIA) ensures faster achievement of inactive disease or remission in more patients compared to standard treatment. Identification of predictors of early response to biologicals is necessary to increase treatment efficacy in children with sJIA. Objective. To develop a model for predicting treatment outcomes with different biologicals in sJIA patients. Materials and methods. We analyzed medical records of sJIA patients who received tocilizumab or canakinumab and were admitted to the Department of Rheumatology between July 2009 and February 2021. Predicted outcomes included inactive disease after 12 months of therapy with biologicals (according to C. Wallace criteria and JADAS71) and drug-free remission (without biologicals) for at least 6 months. Potential predictors comprised patient demographic and clinical characteristics, such as sJIA activity, CHAQ index, concomitant therapy, treatment outcomes after 1 and 3 months of therapy, etc. (115 parameters in total). Independent predictors were chosen using multivariate binary logistic regression. Results. This study included 250 patients receiving tocilizumab and 73 patients receiving canakinumab. After 12 months of tocilizumab therapy, 179 patients (76%) achieved inactive disease according to C. Wallace criteria and 170 patients (72%) achieved remission according to JADAS71 index. Drug-free remission (for at least 6 months without biologicals) was registered in 51 patients (20%) from the tocilizumab group. In the canakinumab group, inactive disease according to C. Wallace criteria, remission according to JADAS71, and drug-free remission were achieved in 58 (79%), 58 (79%), and 10 (14%) patients, respectively. Duration of morning stiffness at sJIA onset, dynamics of the duration of morning stiffness after 1 and 3 months of treatment, disease activity evaluated by a physician using the 100-mm visual analog scale (VAS) after one month of therapy, and patientreported overall well-being evaluated using VAS after 3 months of therapy were found to be the predictors of achieving remission according to C. Wallace criteria in the tocilizumab group. The following factors were significantly associated with remission according to JADAS71 index: duration of morning stiffness at sJIA onset and upon treatment initiation, VAS score evaluated by a physician after 1 and 3 months, and number of painful joints after 3 months. We also found several predictors of achieving drug-free remission, including lymphocyte count at disease onset, therapy with glucocorticoids (GCs) and its duration by the time of biological initiation, ESR upon treatment initiation, 50% improvement according to ACR pediatric criteria after 1 month, administration of systemic GCs after 1 month, ESR dynamics by 3 months, and number of joints with limited motion after 3 months. In the canakinumab group, the following factors were associated with remission according to C.Wa","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":"67742190","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: 10.20953/1817-7646-2022-2-164-166
P. Ostadrahimi, M. Sheikh, Elham Safaryzadeh
Acute hemorrhagic edema of childhood, also called acute hemorrhagic edema of infancy (AHEI) or Finkelstein-Seidlmayer disease is a vasculitis of small blood vessels. The etiology of the disease is unknown, but various reports in the literature indicate precursor triggers including a preceding infectious disease. This article presents a clinical observation of an 8-month-old boy with ecchymotic skin lesions on legs and ears as well as genital edema, with a history of mild upper respiratory infection two weeks before referral. Laboratory findings were normal. After a few days, he was discharged without particular treatment. Despite the low prevalence of this disease, it is important to consider it during examinations due to the clinical nature of the diagnosis. Based on clinical and laboratory findings, a diagnosis of AHEI was made. We decided not to perform any therapy, and after about two weeks lesions had a self-limited resolution. The child was monitored clinically for about six months, and he did not present any relapse of the disease during the follow-up period. This patient was admitted to the hospital, underwent important laboratory tests, and was evaluated by multiple subspecialty services prior to diagnosis. While keeping in mind more worrisome diagnoses, physicians should consider the diagnosis of AHEI in well-appearing young children with purpuric lesions on the face and ears and non-pitting edema of the extremities. Awareness and early recognition of AHEI may prevent hospital admission, invasive workup, and parental and physician concern. Key words: acute hemorrhagic edema of infancy, Finkelstein-Seidlmayer disease, vasculitis
{"title":"Acute hemorrhagic edema of infancy","authors":"P. Ostadrahimi, M. Sheikh, Elham Safaryzadeh","doi":"10.20953/1817-7646-2022-2-164-166","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-2-164-166","url":null,"abstract":"Acute hemorrhagic edema of childhood, also called acute hemorrhagic edema of infancy (AHEI) or Finkelstein-Seidlmayer disease is a vasculitis of small blood vessels. The etiology of the disease is unknown, but various reports in the literature indicate precursor triggers including a preceding infectious disease. This article presents a clinical observation of an 8-month-old boy with ecchymotic skin lesions on legs and ears as well as genital edema, with a history of mild upper respiratory infection two weeks before referral. Laboratory findings were normal. After a few days, he was discharged without particular treatment. Despite the low prevalence of this disease, it is important to consider it during examinations due to the clinical nature of the diagnosis. Based on clinical and laboratory findings, a diagnosis of AHEI was made. We decided not to perform any therapy, and after about two weeks lesions had a self-limited resolution. The child was monitored clinically for about six months, and he did not present any relapse of the disease during the follow-up period. This patient was admitted to the hospital, underwent important laboratory tests, and was evaluated by multiple subspecialty services prior to diagnosis. While keeping in mind more worrisome diagnoses, physicians should consider the diagnosis of AHEI in well-appearing young children with purpuric lesions on the face and ears and non-pitting edema of the extremities. Awareness and early recognition of AHEI may prevent hospital admission, invasive workup, and parental and physician concern. Key words: acute hemorrhagic edema of infancy, Finkelstein-Seidlmayer disease, vasculitis","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":"67742786","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}
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