Pub Date : 2023-10-13DOI: 10.24110/0031-403x-2023-102-5-252-259
V.V. Gorev, T.A. Tenovskaya, S.I. Valieva, E.E. Petryaykina, I.P. Vitkovskaya, M.S. Savenkova, A.E. Angel, N.V. Buzina
“Turning the complicated problems into the new opportunities and constantly maintaining the confidence in the future” - these are the principles the Morozov Children’s Hospital and its entire large team approach the celebration of its 120th anniversary with. The history of the Morozov Children’s Hospital is a history of the constant movement forward, a history of the highest professionalism and courage of its staff, a history of achievements and victories. As of today, the Morozov Children’s Hospital is one of the largest multidisciplinary hospitals not only in Moscow, but also overall Russia, where patients expect and get the best professional experience coupled with the effective solutions of their health problems with the use of both modern and innovative technologies. “Compassion and Professionalism,” which was a motto for years, sounds more relevant now than ever.
{"title":"MOROZOV CHILDREN’S HOSPITAL. 120 YEARS OF HISTORY BEFORE OUR EYES","authors":"V.V. Gorev, T.A. Tenovskaya, S.I. Valieva, E.E. Petryaykina, I.P. Vitkovskaya, M.S. Savenkova, A.E. Angel, N.V. Buzina","doi":"10.24110/0031-403x-2023-102-5-252-259","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-252-259","url":null,"abstract":"“Turning the complicated problems into the new opportunities and constantly maintaining the confidence in the future” - these are the principles the Morozov Children’s Hospital and its entire large team approach the celebration of its 120th anniversary with. The history of the Morozov Children’s Hospital is a history of the constant movement forward, a history of the highest professionalism and courage of its staff, a history of achievements and victories. As of today, the Morozov Children’s Hospital is one of the largest multidisciplinary hospitals not only in Moscow, but also overall Russia, where patients expect and get the best professional experience coupled with the effective solutions of their health problems with the use of both modern and innovative technologies. “Compassion and Professionalism,” which was a motto for years, sounds more relevant now than ever.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805051","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 : 2023-10-13DOI: 10.24110/0031-403x-2023-102-5-53-58
S.S. Zhukov, V.A. Malievskiy
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. First-line therapy is the prescription of Methotrexate (MTX) though this drug can cause undesirable effects which in its turn dictates the need for the use of diagnostic techniques that would allow early detection of intolerance to MTX. One of such diagnostic approaches is the Methotrexate Intolerance Severity Score (MISS) questionnaire. The purpose of this research was to evaluate the frequency of MTX intolerance in children with JIA using the Russian-language adaptation of the MISS questionnaire. Materials and methods used: a single-center, single-stage study of children aged 3 to 17 y/o with a non-systemic variant of JIA who were prescribed MTX was conducted using the 2011 MISS questionnaire in Russian. The MTX intolerance was determined if the patient scored 6 points and above. Results: 250 patients (78 boys and 172 girls) were included in the study. MTX intolerance using the MISS questionnaire was identified in 30% of patients; the most common complaint was MTX-associated nausea. The cut-off point for the questionnaire was estimated using the ROC analysis. The area under the ROC curve was 0.945. Patients scoring 6 points with a sensitivity of 94% (95% CI 78-97) and specificity of 100% (95% CI 80-100) were intolerant to MTX. The validity of using the questionnaire to identify individuals with MTX intolerance has been demonstrated therefore the questionnaire can be recommended for wider use. Conclusion: MTX intolerance, which was determined by the total score (6 points and above) was identified in 75 patients on MTX therapy.
幼年特发性关节炎(JIA)是儿童期最常见的风湿性疾病。一线治疗是甲氨蝶呤(MTX)的处方，尽管这种药物可能引起不良反应，这反过来又要求使用诊断技术，以便及早发现对甲氨蝶呤的不耐受。其中一种诊断方法是甲氨蝶呤不耐受严重程度评分(MISS)问卷。本研究的目的是使用俄语版MISS问卷评估JIA患儿MTX不耐受的频率。使用的材料和方法:一项单中心、单阶段的研究，对3至17岁患有非系统性JIA变异的儿童进行研究，这些儿童服用MTX。如果患者得分在6分及以上，则确定MTX不耐受。结果:250例患者(男78例，女172例)纳入研究。使用MISS问卷在30%的患者中发现MTX不耐受;最常见的症状是甲氨蝶呤相关的恶心。使用ROC分析估计问卷的分界点。ROC曲线下面积为0.945。敏感度为94% (95% CI 78-97)，特异性为100% (95% CI 80-100)的6分患者为甲氨蝶呤不耐受患者。使用问卷来识别甲氨蝶呤不耐受个体的有效性已被证明，因此可以推荐更广泛地使用问卷。结论:75例接受MTX治疗的患者出现MTX不耐受，以总分(6分及以上)判断。
{"title":"METHOTREXATE INTOLERANCE IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS ACCORDING TO THE METHOTREXATE INTOLERANCE SEVERITY SCORE (MISS) QUESTIONNAIRE: A SINGLE-STAGE STUDY","authors":"S.S. Zhukov, V.A. Malievskiy","doi":"10.24110/0031-403x-2023-102-5-53-58","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-53-58","url":null,"abstract":"Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. First-line therapy is the prescription of Methotrexate (MTX) though this drug can cause undesirable effects which in its turn dictates the need for the use of diagnostic techniques that would allow early detection of intolerance to MTX. One of such diagnostic approaches is the Methotrexate Intolerance Severity Score (MISS) questionnaire. The purpose of this research was to evaluate the frequency of MTX intolerance in children with JIA using the Russian-language adaptation of the MISS questionnaire. Materials and methods used: a single-center, single-stage study of children aged 3 to 17 y/o with a non-systemic variant of JIA who were prescribed MTX was conducted using the 2011 MISS questionnaire in Russian. The MTX intolerance was determined if the patient scored 6 points and above. Results: 250 patients (78 boys and 172 girls) were included in the study. MTX intolerance using the MISS questionnaire was identified in 30% of patients; the most common complaint was MTX-associated nausea. The cut-off point for the questionnaire was estimated using the ROC analysis. The area under the ROC curve was 0.945. Patients scoring 6 points with a sensitivity of 94% (95% CI 78-97) and specificity of 100% (95% CI 80-100) were intolerant to MTX. The validity of using the questionnaire to identify individuals with MTX intolerance has been demonstrated therefore the questionnaire can be recommended for wider use. Conclusion: MTX intolerance, which was determined by the total score (6 points and above) was identified in 75 patients on MTX therapy.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805059","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}
Optimal vitamin D supplementation is necessary for the normal course of growth and develop-ment processes, bone formation, prevention of stress fractures, improvement of recovery after injuries and physical exertion in young athletes. There is a high prevalence of vitamin D deficien-cy in children and adolescents in Russia currently. The number of studies on the prevalence of vitamin D metabolic disorders in young athletes is insufficient. The purpose of this research was to assess the vitamin D availability in young athletes. Methods used: cross-sectional, single-center study included young athletes from 24 kinds of sports who underwent medical examination in March to July, 2022. Serum 25-hydroxycalciferol (25(OH)D3) was measured in all athletes using the chemiluminescence analysis. Results: 527 young athletes (254 (48.2%) boys/273 (51.8%) girls) aged 10 to 17 years and 11 months old (average 15.2 [14.2; 16.5] y/o) were examined. Vit-amin D deficiency (25(OH)D3 <20 ng/ml) was detected in 226 (42.9%) athletes, of which severe deficiency (25(OH)D3 <10 ng/ml) was in 5 (2%). Vitamin D insufficiency was diagnosed in 219 (41.6%), and the optimal level of 25(OH)D3 (>30 ng/ml) was detected only in 82 (15.5%). There were no statistically significant gender differences in the frequency of occurrence of vitamin D insufficiency (p=0.561) and deficiency (p=0.673). Conclusion: extremely low vitamin D availa-bility in young athletes was revealed. Conducting further research on the prevalence of vitamin D deficiency and ways to correct it in young athletes is necessary to start working on recommended optimizing and preventive and therapeutic approaches to correcting of the vitamin D levels in high-performance youth sports.
{"title":"ASSESSMENT OF VITAMIN D SUFFICIENCY IN YOUNG ATHLETES","authors":"S.A. Stolyarova, P.L. Okorokov, I.V. Zyabkin, E.P. Isaeva","doi":"10.24110/0031-403x-2023-102-5-216-221","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-216-221","url":null,"abstract":"Optimal vitamin D supplementation is necessary for the normal course of growth and develop-ment processes, bone formation, prevention of stress fractures, improvement of recovery after injuries and physical exertion in young athletes. There is a high prevalence of vitamin D deficien-cy in children and adolescents in Russia currently. The number of studies on the prevalence of vitamin D metabolic disorders in young athletes is insufficient. The purpose of this research was to assess the vitamin D availability in young athletes. Methods used: cross-sectional, single-center study included young athletes from 24 kinds of sports who underwent medical examination in March to July, 2022. Serum 25-hydroxycalciferol (25(OH)D3) was measured in all athletes using the chemiluminescence analysis. Results: 527 young athletes (254 (48.2%) boys/273 (51.8%) girls) aged 10 to 17 years and 11 months old (average 15.2 [14.2; 16.5] y/o) were examined. Vit-amin D deficiency (25(OH)D3 <20 ng/ml) was detected in 226 (42.9%) athletes, of which severe deficiency (25(OH)D3 <10 ng/ml) was in 5 (2%). Vitamin D insufficiency was diagnosed in 219 (41.6%), and the optimal level of 25(OH)D3 (>30 ng/ml) was detected only in 82 (15.5%). There were no statistically significant gender differences in the frequency of occurrence of vitamin D insufficiency (p=0.561) and deficiency (p=0.673). Conclusion: extremely low vitamin D availa-bility in young athletes was revealed. Conducting further research on the prevalence of vitamin D deficiency and ways to correct it in young athletes is necessary to start working on recommended optimizing and preventive and therapeutic approaches to correcting of the vitamin D levels in high-performance youth sports.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805447","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 : 2023-10-13DOI: 10.24110/0031-403x-2023-102-5-18-26
M.A. Karpenko, A.A. Stolov, M.T. Maigadzhieva, D.A. Kravchuk, I.V. Krsheminskaya, A.M. Bolibok, T.I. Grishina, V.N. Larina, T.I. Eliseeva, N.I. Kubysheva, L.V. Pushko, N.I. Kolganova, E.V. Schepkina, A.I. Kuznetsov, Yu.A. Sigova, A.V. Zholinsky, Z.I. Emurzieva, M. Khaled, D.Yu. Ovsyannikov
Frequency of development and characteristics of the course of bronchial asthma (BA) in premature infants with bronchopulmonary dysplasia (BPD) remains controversial problem as yet. In particular, there is insufficient data on predictors of the development of BA in children with BPD. The purpose of this research was to find the predictors for the development of BA in children with BPD. Materials and methods used: a single-center retrospective (2004 to 2023) cohort study of 1724 records of pediatric patients aged 3 months to 18 years old with BA and a history of BPD. The study used a clinical anamnestic method, determination of the number of eosinophils, concentrations of total and specific IgE to allergens in the blood, examination of external respiratory function, a bronchodilation test for the diagnosis of BA and univariate regression analysis. Results: BA developed in 174 (10%) of the 1724 BPD cases. The chance for the BA development in children with BPD is statistically significantly increased by late prematurity (OR 2.257; 95% CI 1.02-4.99; p=0.044), familiar BA history (OR 18.765; 95% CI 11.46-30, 70; p<0.001), concomitant atopic dermatitis (AD) (OR 26.709; 95% CI 13.38-53.31; p<0.001) and allergic rhinitis (AR) (OR 126.849; 95% CI 61.66-260.7; p<0.001), the presence of episodes of wheezing in the first 3 years of life (OR 3.589; 95% CI 2.60-4.94; p<0.001). In patients with BPD, each episode of wheezing in the second year of life increases the risk for the BA development by 1.804 times (95% CI 1.57-2.06; p<0.001) and by 3.425 times (95% CI 2.63-4.44; p<0.001) if it was in the third year of life. Conclusion: predictors for the BA development in children with BPD are late prematurity (gestational age 34 to 36 weeks), familiar BA history, presence of concomitant AD and AR, episodes of wheezing during the first 3 years of life, especially after reaching the age of 1 year old.
支气管肺发育不良(BPD)早产儿支气管哮喘(BA)的发生频率和病程特点是一个有争议的问题。特别是，关于BPD患儿BA发展的预测因素的数据不足。本研究的目的是寻找BPD患儿BA发展的预测因素。使用的材料和方法:一项单中心回顾性队列研究(2004年至2023年)，纳入了1724例3个月至18岁的BA和BPD病史的儿科患者。本研究采用临床记忆法，测定嗜酸性粒细胞数量、血液中对过敏原的总IgE和特异性IgE浓度、检查外呼吸功能、支气管扩张试验诊断BA并进行单因素回归分析。结果:1724例BPD中有174例(10%)发生BA。BPD患儿发生BA的几率在晚早产儿中显著增加(OR 2.257;95% ci 1.02-4.99;p=0.044)，熟悉BA史(OR 18.765;95% ci 11.46- 30,70;p<0.001)，伴有特应性皮炎(AD) (OR 26.709;95% ci 13.38 ~ 53.31;p < 0.001)和变应性鼻炎(AR) (OR 126.849;95% ci 61.66-260.7;p<0.001)，生命前3年出现喘息发作的风险(OR 3.589;95% ci 2.60-4.94;术中,0.001)。在BPD患者中，生命第二年每发作一次喘息使BA发展的风险增加1.804倍(95% CI 1.57-2.06;p<0.001)和3.425倍(95% CI 2.63-4.44;p < 0.001)，如果是在生命的第三年。结论:BPD患儿BA发展的预测因素有:晚期早产(胎龄34 ~ 36周)、熟悉BA病史、伴有AD和AR、3岁前(尤其是1岁后)有喘息发作。
{"title":"PREDICTORS FOR THE BRONCHIAL ASTHMA DEVELOPMENT IN CHILDREN WITH BRONCHOPULMONARY DYSPLASIA","authors":"M.A. Karpenko, A.A. Stolov, M.T. Maigadzhieva, D.A. Kravchuk, I.V. Krsheminskaya, A.M. Bolibok, T.I. Grishina, V.N. Larina, T.I. Eliseeva, N.I. Kubysheva, L.V. Pushko, N.I. Kolganova, E.V. Schepkina, A.I. Kuznetsov, Yu.A. Sigova, A.V. Zholinsky, Z.I. Emurzieva, M. Khaled, D.Yu. Ovsyannikov","doi":"10.24110/0031-403x-2023-102-5-18-26","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-18-26","url":null,"abstract":"Frequency of development and characteristics of the course of bronchial asthma (BA) in premature infants with bronchopulmonary dysplasia (BPD) remains controversial problem as yet. In particular, there is insufficient data on predictors of the development of BA in children with BPD. The purpose of this research was to find the predictors for the development of BA in children with BPD. Materials and methods used: a single-center retrospective (2004 to 2023) cohort study of 1724 records of pediatric patients aged 3 months to 18 years old with BA and a history of BPD. The study used a clinical anamnestic method, determination of the number of eosinophils, concentrations of total and specific IgE to allergens in the blood, examination of external respiratory function, a bronchodilation test for the diagnosis of BA and univariate regression analysis. Results: BA developed in 174 (10%) of the 1724 BPD cases. The chance for the BA development in children with BPD is statistically significantly increased by late prematurity (OR 2.257; 95% CI 1.02-4.99; p=0.044), familiar BA history (OR 18.765; 95% CI 11.46-30, 70; p<0.001), concomitant atopic dermatitis (AD) (OR 26.709; 95% CI 13.38-53.31; p<0.001) and allergic rhinitis (AR) (OR 126.849; 95% CI 61.66-260.7; p<0.001), the presence of episodes of wheezing in the first 3 years of life (OR 3.589; 95% CI 2.60-4.94; p<0.001). In patients with BPD, each episode of wheezing in the second year of life increases the risk for the BA development by 1.804 times (95% CI 1.57-2.06; p<0.001) and by 3.425 times (95% CI 2.63-4.44; p<0.001) if it was in the third year of life. Conclusion: predictors for the BA development in children with BPD are late prematurity (gestational age 34 to 36 weeks), familiar BA history, presence of concomitant AD and AR, episodes of wheezing during the first 3 years of life, especially after reaching the age of 1 year old.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805052","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 : 2023-10-13DOI: 10.24110/0031-403x-2023-102-5-116-123
E.A. Khuzina, E.G. Furman
Electronic consumer products (devices, systems) made to delivering of nicotine-containing products are very popular among teenagers and children nowadays. There is a large amount of scientific research data and clinical cases describing the negative effects of electronic cigarettes on the respiratory system, primarily on the lungs. The components of e-liquids can cause inflammation, oxidative stress, infectious complications and disrupt the genetic apparatus of cells in the mucous membrane of the respiratory tract. Awareness and vigilance regarding the possibility of lung injury in heavy e-cigarette users is extremely important because, unfortunately, there are currently no effective ways to limit the distribution and the use of such kind of devices. The article represents bibliographical data on the pathogenesis, diagnostic capabilities and approaches to treatment of lung injuries associated with vaping.
{"title":"LUNG DAMAGE ASSOCIATED WITH THE USE OF ELECTRONIC CIGARETTES AND VAPING IN CHILDREN AND ADOLESCENTS","authors":"E.A. Khuzina, E.G. Furman","doi":"10.24110/0031-403x-2023-102-5-116-123","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-116-123","url":null,"abstract":"Electronic consumer products (devices, systems) made to delivering of nicotine-containing products are very popular among teenagers and children nowadays. There is a large amount of scientific research data and clinical cases describing the negative effects of electronic cigarettes on the respiratory system, primarily on the lungs. The components of e-liquids can cause inflammation, oxidative stress, infectious complications and disrupt the genetic apparatus of cells in the mucous membrane of the respiratory tract. Awareness and vigilance regarding the possibility of lung injury in heavy e-cigarette users is extremely important because, unfortunately, there are currently no effective ways to limit the distribution and the use of such kind of devices. The article represents bibliographical data on the pathogenesis, diagnostic capabilities and approaches to treatment of lung injuries associated with vaping.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805055","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}
Juvenile arthritis with systemic onset (sJIA) is one of the most difficult tasks of differential diagnosis and selection of therapy for a rheumatologic practitioner as yet. The presence of a systemic hyperinflammatory response, the development of macrophage activation syndrome (MAS) and sepsis determine the severity of sJIA. Pulmonary involvement coupled with the development of interstitial lung disease and/or pulmonary arterial hypertension is a relatively new, potentially life-threatening complication of sJIA. The purpose of this research was to characterize patients with sJIA who had respiratory lesions (RL) at the onset of the disease. Methods used: a retrospective cohort study included the data from the case histories of 85 pediatric patients with sJIA who were divided into 2 groups: G1 with RL (dyspnea, pleurisy, interstitial lung disease, acute respiratory distress syndrome); and G2 of those who’ve had no such complaints. Results: 18 (21.1%) had RL associated with female gender, heart lesions (OR=6.4 (2.1; 19.7), p=0.0006), macrophage activation syndrome (72.2%; OR=6.6 (2.1; 21.0), p=0.0006), hemorrhagic syndrome, CNS disorders (OR=6.1 (1.2; 30.3), p=0.015), decreased levels of hemoglobin, platelets, prothrombin, fibrinogen, albumin, total protein and sodium as well as the higher levels of ferritin, lactate dehydrogenase, aspartate aminotransferase, triglycerides. Patients with lung involvement had tended to have higher C-reactive protein levels and were more likely to have transient proteinuria in the active phase of the disease. Multivariate analysis identified two criteria associated with the respiratory damage: heart damage (β=0.18, p=0.039) and hypoalbuminemia <26 g/l (β=0.73, p=0.0000001). Conclusion: the presence of macrophage activation syndrome, damage to the cardiovascular system requires targeted monitoring of respiratory damage in patients with sJIA.
{"title":"MANIFESTATIONS PECULIARITIES OF JUVENILE ARTHRITIS WITH SYSTEMIC ONSET IN PATIENTS WITH THE RESPIRATORY LESIONS’ DEVELOPMENT AT THE ONSET OF THE DISEASE. RESULTS OF A SINGLE-CENTER RETROSPECTIVE COHORT STUDY AND A BIBLIOGRAPHICAL REVIEW","authors":"K.E. Belozerov, N.M. Solomatina, N.N. Abramova, E.A. Isupova, E.V. Gaidar, M.A. Kaneva, T.L. Kornishina, V.V. Masalova, O.V. Kalashnikova, I.A. Chikova, V.G. Chasnyk, A.A. Kuznetsova, M.M. Kostik, D.O. Ivanov","doi":"10.24110/0031-403x-2023-102-5-44-53","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-44-53","url":null,"abstract":"Juvenile arthritis with systemic onset (sJIA) is one of the most difficult tasks of differential diagnosis and selection of therapy for a rheumatologic practitioner as yet. The presence of a systemic hyperinflammatory response, the development of macrophage activation syndrome (MAS) and sepsis determine the severity of sJIA. Pulmonary involvement coupled with the development of interstitial lung disease and/or pulmonary arterial hypertension is a relatively new, potentially life-threatening complication of sJIA. The purpose of this research was to characterize patients with sJIA who had respiratory lesions (RL) at the onset of the disease. Methods used: a retrospective cohort study included the data from the case histories of 85 pediatric patients with sJIA who were divided into 2 groups: G1 with RL (dyspnea, pleurisy, interstitial lung disease, acute respiratory distress syndrome); and G2 of those who’ve had no such complaints. Results: 18 (21.1%) had RL associated with female gender, heart lesions (OR=6.4 (2.1; 19.7), p=0.0006), macrophage activation syndrome (72.2%; OR=6.6 (2.1; 21.0), p=0.0006), hemorrhagic syndrome, CNS disorders (OR=6.1 (1.2; 30.3), p=0.015), decreased levels of hemoglobin, platelets, prothrombin, fibrinogen, albumin, total protein and sodium as well as the higher levels of ferritin, lactate dehydrogenase, aspartate aminotransferase, triglycerides. Patients with lung involvement had tended to have higher C-reactive protein levels and were more likely to have transient proteinuria in the active phase of the disease. Multivariate analysis identified two criteria associated with the respiratory damage: heart damage (β=0.18, p=0.039) and hypoalbuminemia <26 g/l (β=0.73, p=0.0000001). Conclusion: the presence of macrophage activation syndrome, damage to the cardiovascular system requires targeted monitoring of respiratory damage in patients with sJIA.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805445","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}
This systematic bibliographical review has a purpose of summarizing the current data on the presence of main cardiovascular risk factors, including the metabolic syndrome (MS) components, in children and adolescents with juvenile idiopathic arthritis (JIA). PubMed was searched for the keywords as follows: “juvenile arthritis,” “rheumatoid arthritis” and “cardiovascular risk factors,” “metabolic syndrome,” “dyslipidemia,” “arterial hypertension,” “obesity.” Thus, 90 original studies, meta-analyses, case series and clinical guidelines were included for analysis. The Authors’ own publications previously published on the topic were also in the list. The connection between the cardiac disorders and the MS in childhood, in particular, with the development of cardiovascular complications in adulthood is shown. The diagnostic criteria for MS and the prevalence of the complete MS signs (obesity, arterial hypertension, dyslipidemia, disorders of carbohydrate metabolism and insulin resistance) both in the general population and among adults and children with chronic inflammatory joint diseases are discussed. In addition to the traditional ones, the specific risk factors for cardiovascular diseases in patients with JIA are also considered, such as: rheumatoid cachexia, high inflammatory activity of the disease, side effects of antirheumatic drugs etc. The pathogenesis of metabolic disorders in JIA and the tactics for managing patients with an emphasis on non-drug methods of treatment are discussed as well.
{"title":"CARDIOVASCULAR RISK FACTORS IN JUVENILE IDIOPATHIC ARTHRITIS","authors":"A.V. Krasnopolskaya, L.A. Balykova, E.S. Samoshkina, A.A. Shirokova, O.M. Soldatov, N.V. Shchekina, E.N. Tyagusheva","doi":"10.24110/0031-403x-2023-102-5-135-144","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-135-144","url":null,"abstract":"This systematic bibliographical review has a purpose of summarizing the current data on the presence of main cardiovascular risk factors, including the metabolic syndrome (MS) components, in children and adolescents with juvenile idiopathic arthritis (JIA). PubMed was searched for the keywords as follows: “juvenile arthritis,” “rheumatoid arthritis” and “cardiovascular risk factors,” “metabolic syndrome,” “dyslipidemia,” “arterial hypertension,” “obesity.” Thus, 90 original studies, meta-analyses, case series and clinical guidelines were included for analysis. The Authors’ own publications previously published on the topic were also in the list. The connection between the cardiac disorders and the MS in childhood, in particular, with the development of cardiovascular complications in adulthood is shown. The diagnostic criteria for MS and the prevalence of the complete MS signs (obesity, arterial hypertension, dyslipidemia, disorders of carbohydrate metabolism and insulin resistance) both in the general population and among adults and children with chronic inflammatory joint diseases are discussed. In addition to the traditional ones, the specific risk factors for cardiovascular diseases in patients with JIA are also considered, such as: rheumatoid cachexia, high inflammatory activity of the disease, side effects of antirheumatic drugs etc. The pathogenesis of metabolic disorders in JIA and the tactics for managing patients with an emphasis on non-drug methods of treatment are discussed as well.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805450","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}
Peculiarities of the course of bronchial asthma (BA) in adolescents from the standpoint of the influence of age and gender on it cannot be considered fully studied as yet. Materials and methods used: the data were obtained from 367 patients’ records of atopic BA aged 10 to 17 years old (73,6% boys) who were treated for atopic BA at the Nizhny Novgorod City Children’s Clinical Hospital No. 1 (Nizhny Novgorod, Russia). The patients were divided into two age groups: early adolescence (EA, 10 to 14 y/o, 239 patients) and middle adolescence (MA, 15 to 17 y/o, 128). All patients underwent spirometric studies with an assessment of the forced vital capacity of the lungs (FVC), the ratio of forced expiratory volume in one second (FEV1) to FVC (FEV1/FVC), the average volume velocity of forced exhalation, averaged in the exhalation interval from 25 to 75% FVC (FEF25-75). Spirometric parameters were evaluated using the z-criteria of the Global Lung Initiative. Results: in the general group of patients, the zFVC index was statistically significantly lower in MA compared to EA (p=0,001), and the indicators of zFEV1/FVC and zFEF25-75 were statistically significantly higher in MA (p=0,020, p=0,022 respectively). In the cohort of boys, there were similar differences in spirometric parameters in EA and MA (p=0,009, p=0,002, p=0,002, respectively). In girls, the values of FVC in MA were statistically significantly lower than in EA (p=0,0310, as in the general cohort and the cohort of boys). At the same time, in girls, the indicators of zFEV1/FVC and zFEF25-75, reflecting bronchial permeability, were slightly lower in MA than in EA, but the differences were not statistically significant. Conclusion: in boys, but not in girls, the spirometric parameters reflecting bronchial patency in MA were statistically significantly higher than in EA. At the same time, in both boys and girls, the indicators of FVC decrease in MA compared to EA, remaining above the population median values of indicators.
{"title":"IMPACT OF AGE AND GENDER ON SPIROMETRIC PARAMETERS IN ADOLESCENTS WITH BRONCHIAL ASTHMA","authors":"K.V. Gorbunova, R.N. Khramova, T.I. Eliseeva, D.Yu. Ovsyannikov, S.V. Krasilnikova, E.V. Tush, N.I. Kubysheva, O.V. Khaletskaya","doi":"10.24110/0031-403x-2023-102-5-8-13","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-8-13","url":null,"abstract":"Peculiarities of the course of bronchial asthma (BA) in adolescents from the standpoint of the influence of age and gender on it cannot be considered fully studied as yet. Materials and methods used: the data were obtained from 367 patients’ records of atopic BA aged 10 to 17 years old (73,6% boys) who were treated for atopic BA at the Nizhny Novgorod City Children’s Clinical Hospital No. 1 (Nizhny Novgorod, Russia). The patients were divided into two age groups: early adolescence (EA, 10 to 14 y/o, 239 patients) and middle adolescence (MA, 15 to 17 y/o, 128). All patients underwent spirometric studies with an assessment of the forced vital capacity of the lungs (FVC), the ratio of forced expiratory volume in one second (FEV1) to FVC (FEV1/FVC), the average volume velocity of forced exhalation, averaged in the exhalation interval from 25 to 75% FVC (FEF25-75). Spirometric parameters were evaluated using the z-criteria of the Global Lung Initiative. Results: in the general group of patients, the zFVC index was statistically significantly lower in MA compared to EA (p=0,001), and the indicators of zFEV1/FVC and zFEF25-75 were statistically significantly higher in MA (p=0,020, p=0,022 respectively). In the cohort of boys, there were similar differences in spirometric parameters in EA and MA (p=0,009, p=0,002, p=0,002, respectively). In girls, the values of FVC in MA were statistically significantly lower than in EA (p=0,0310, as in the general cohort and the cohort of boys). At the same time, in girls, the indicators of zFEV1/FVC and zFEF25-75, reflecting bronchial permeability, were slightly lower in MA than in EA, but the differences were not statistically significant. Conclusion: in boys, but not in girls, the spirometric parameters reflecting bronchial patency in MA were statistically significantly higher than in EA. At the same time, in both boys and girls, the indicators of FVC decrease in MA compared to EA, remaining above the population median values of indicators.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135804901","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}
Article represents the first use of fluorescence-guided surgery in pediatric patients and demonstrates procedures that can be recommended for use in children. Materials and methods used: medical records of 28 pediatric patients who underwent laparoscopic and thoracoscopic procedures under fluorescence guidance were studied. Surgical procedures were performed using Rubina® endovideosurgical system by KARL STORZ, Germany. The most frequently performed surgical procedure in childhood was laparoscopic varicocelectomy, with 10 cases where ICG navigation was used to identify testicular lymphatic vessels. This was followed by: cholecystectomy - 6, resection of mature ovarian teratoma - 5, fenestration of a kidney cyst - 3, resection of a non-functioning segment of a horseshoe kidney - 1, removal of ganglioneuroblastoma of intrathoracic localization - 1, laparoscopic relocation of an aberrant lower polar renal vessel with hydronephrosis – 1, and resection of colon enterocystoma - 1. Results: the average age of patients at the time of surgery was 13.2±3.3 y/o (median 14.0 [12.0; 15.0] y/o). The average weight of patients at the time of surgery was 64.1±18.8 kg (median 68.0 [58.0; 78.0] kg). Most often, the drug was administered during surgery - 10 cases, 10 hours before surgery (cholecystectomy) - 6 cases, and one day before surgery - removal of enterocystoma of the colon. Methods of administration were distributed as follows: intravenous administration of the drug was used in 16 cases, intratesticular (varicocele) - 10, intraluminal (for vasorenal hydronephrosis) - 1, and intramural using endoscopy - 1 (for enterocyst of the colon). In all cases, the surgical interventions proceeded without intraoperative complications and without conversions into open inteventions. The duration of surgical intervention averaged 63.9±44.0 minutes (median 40.0 [31.3, 98.8] minutes). The duration of stay in the intensive care unit averaged 10.2±19.9 minutes (median 2.5 [2.0, 15.5] minutes). The duration of hospitalization averaged 3.6±1.0 days (median 3.0 [3.0, 4.0] days). No information was provided on the side effects of ICG administration, nor was there any convincing evidence for the occurrence of early or late postoperative complications. Conclusion: results support the conclusion that laparoscopic procedures performed in children using ICG navigation are beneficial, as the primary goal of safely providing visual guidance of the target surgical anatomy was achieved.
{"title":"FLUORESCENCE-GUIDED SURGERY. THE FIRST USE IN CHILDREN","authors":"Yu.A. Kozlov, S.S. Poloyan, A.A. Marchuk, A.P. Rozhanskiy, A.A. Byrgazov, S.A. Muravjev, K.A. Kovalkov, V.M. Kapuller, A.N. Narkevich","doi":"10.24110/0031-403x-2023-102-5-222-230","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-222-230","url":null,"abstract":"Article represents the first use of fluorescence-guided surgery in pediatric patients and demonstrates procedures that can be recommended for use in children. Materials and methods used: medical records of 28 pediatric patients who underwent laparoscopic and thoracoscopic procedures under fluorescence guidance were studied. Surgical procedures were performed using Rubina® endovideosurgical system by KARL STORZ, Germany. The most frequently performed surgical procedure in childhood was laparoscopic varicocelectomy, with 10 cases where ICG navigation was used to identify testicular lymphatic vessels. This was followed by: cholecystectomy - 6, resection of mature ovarian teratoma - 5, fenestration of a kidney cyst - 3, resection of a non-functioning segment of a horseshoe kidney - 1, removal of ganglioneuroblastoma of intrathoracic localization - 1, laparoscopic relocation of an aberrant lower polar renal vessel with hydronephrosis – 1, and resection of colon enterocystoma - 1. Results: the average age of patients at the time of surgery was 13.2±3.3 y/o (median 14.0 [12.0; 15.0] y/o). The average weight of patients at the time of surgery was 64.1±18.8 kg (median 68.0 [58.0; 78.0] kg). Most often, the drug was administered during surgery - 10 cases, 10 hours before surgery (cholecystectomy) - 6 cases, and one day before surgery - removal of enterocystoma of the colon. Methods of administration were distributed as follows: intravenous administration of the drug was used in 16 cases, intratesticular (varicocele) - 10, intraluminal (for vasorenal hydronephrosis) - 1, and intramural using endoscopy - 1 (for enterocyst of the colon). In all cases, the surgical interventions proceeded without intraoperative complications and without conversions into open inteventions. The duration of surgical intervention averaged 63.9±44.0 minutes (median 40.0 [31.3, 98.8] minutes). The duration of stay in the intensive care unit averaged 10.2±19.9 minutes (median 2.5 [2.0, 15.5] minutes). The duration of hospitalization averaged 3.6±1.0 days (median 3.0 [3.0, 4.0] days). No information was provided on the side effects of ICG administration, nor was there any convincing evidence for the occurrence of early or late postoperative complications. Conclusion: results support the conclusion that laparoscopic procedures performed in children using ICG navigation are beneficial, as the primary goal of safely providing visual guidance of the target surgical anatomy was achieved.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805201","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}
Article represents analysis of domestic and foreign publications on the peculiarities of the meta-bolic syndrome in adolescent females and its impact on their reproductive function. Numerous dysfunctions of the endocrine system, from puberty to menopause, are closely associated with obesity. The high significance of diseases associated with obesity that manifest themself in child-hood determines the relevance of the research in the field. A clear understanding of the further tactics and strategy for managing girls with metabolic syndrome who are threatened by the de-velopment of polycystic ovary syndrome (PCOS), the need for an interdisciplinary approach with close cooperation between the endocrinologist, the gynecologist and the pediatric physician are the important factors for the successful implementation of reproductive function in the future. Keywords: obesity, hyperandrogenism, adolescents, girls, polycystic ovary syndrome, PCOS, ovarian dysfunction.
{"title":"PRE- AND PUBERTAL OBESITY AS A POTENTIAL PREDICTOR FOR POLYCYSTIC OVARY SYNDROME","authors":"A.V. Moskovkina, O.Z. Puzikova, V.A. Popova, E.V. Churyukina, L.V. Kravchenko","doi":"10.24110/0031-403x-2023-102-5-167-174","DOIUrl":"https://doi.org/10.24110/0031-403x-2023-102-5-167-174","url":null,"abstract":"Article represents analysis of domestic and foreign publications on the peculiarities of the meta-bolic syndrome in adolescent females and its impact on their reproductive function. Numerous dysfunctions of the endocrine system, from puberty to menopause, are closely associated with obesity. The high significance of diseases associated with obesity that manifest themself in child-hood determines the relevance of the research in the field. A clear understanding of the further tactics and strategy for managing girls with metabolic syndrome who are threatened by the de-velopment of polycystic ovary syndrome (PCOS), the need for an interdisciplinary approach with close cooperation between the endocrinologist, the gynecologist and the pediatric physician are the important factors for the successful implementation of reproductive function in the future. Keywords: obesity, hyperandrogenism, adolescents, girls, polycystic ovary syndrome, PCOS, ovarian dysfunction.","PeriodicalId":39654,"journal":{"name":"Pediatriya - Zhurnal im G.N. Speranskogo","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805199","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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