SOVREMENNAYA PEDIATRIYA № 5 – 2011
Summary. In the article the data about incidence and morbidity among children's population of Ukraine for the period 2006-2010 is presented. The results of study are point at decline of children's population and significant differences of figures in the regional aspect.
Key words: children's population, incidence, morbidity.
Summary. The selective management by prophylactic and health-improving measures is the real way of improvement of the state of health of population. A case frame by a health includes the following blocks: «Kvalymetria of health», «Level of health care», «Purpose of health care», «Medical-preventive measures». Kvalymetria health allows to plan a volume and character of health and prophylactic work.
Key words: kvalymetria of health, selective management.
Summary. Vaccines have long been used to boost the immune system and to confer protection against microbial infections. In contrast, immunotherapy based on ribosomal preparations has been proposed to enhance both specific and nonspecific immune responses (in particular, the mucosal immune defense system) against common respiratory tract pathogenes. Тhe aim of this review is to summarize current knowledge on the ability of a combination of four immunogenic ribosomal fractions from different bacteria species and of the extracted fraction from the membrane of Klebsiella pneumoniae to modulate several immune functions. The immunomodulatory activity of the ribosome component is attributed to the presence of highly purified epitopes from cellular fractions obtained by bacterial lysis. The ribosomal preparation is hypothesized to induce a T-dependent immune response consequent network with proliferation of В lymphocytes and production of secretory high-affinity antibodies (in particular, IgA), as well as the creation of a specific immune memory. Indeed, this agent stimulates the activity of macrophages, polymorphonuclear cells, and natural killer cells. The «ideal» vaccine is a highly purified protein bound to a carrier and an adjuvant that enhances the vaccination effect.
Key words: activation, epitopes, immune system, immunogenicity, immunoglobulin, Klebsiella pneumoniae, natural cytotoxicity, respiratory recurrent infections, ribosome-component immune modulator.
Summary. Under unfavorable environmental conditions formed by environmental disadaptation, which leads to respiratory diseases in children. This article describes a multifaceted effect of combined phytopreparation Sinupret (antiinflammation, antiedematic, secretolytic, antiviral, antibacterial, immunomodulatory, improves mucociliary clearance, drainage and ventilation of the paranasal sinuses), which is realized by a unique phytoniring technology. The expediency of Sinupret in the prevention and etiopathogenetic treatment of infections of upper respiratory tract in children from ecologically unfavorable regions are proved.
Key words: environmental disadaptation, respiratory diseases, combined phytopreparation, phytoniring technology, Sinupret.
Summary. The overview of the literature devoted to the role of vitamin D in the human body, in particular connection between its level and the risk of cardiovascular system diseases is shown. The availability of the body by vitamin D must be an important task of human health care throughout his life that is shown by the way of conclusion in virtue of analysis data.
Key words: vitamin D, vitamin deficiencies, cardiovascular diseases.
Резюме. Рассматриваются причины железодефицитных состояний (ЖДС), включая железодефицитную анемию (ЖДА). Подчеркивается, что в патогенезе ЖДС важную роль могут играть нарушения обмена других эссенциальных микроэлементов, в частности меди и марганца. Таким образом, для успешной терапии ЖДС необходимо учитывать особенности взаимодействия микроэлементов в живом организме и помнить, что железо является не единственным микроэлементом, необходимым для синтеза гемоглобина. В этой связи особое место среди ферропрепаратов занимает препарат Тотема, в состав которого помимо железа входят медь и марганец. Подчеркивается, что Тотема оптимально соответствует физиологии обмена железа и выпускается в чрезвычайно удобной для применения жидкой лекарственной форме. Рассматриваются результаты клинических исследований Тотемы, свидетельствующие о высокой эффективности этого препарата в лечении и профилактике ЖДС и ЖДА у различных категорий больных и его хорошей переносимости.
Summary. Study was aimed to clinical efficacy «Holisal-gel» for the treatment of children with diseases of the oral mucosa. We examined 70 children with diseases of the oral mucosa. Use of the «Holisal-gel» was effective, has reduced the duration of treatment by 60%, a significant reduction of clinical symptoms, early epithelial mucous elements, normalization of the oral cavity.
Key words: diseases of oral mucosa, Holisal-gel, treatment.
Summary. The article reports the results of a study of factors that influence on development of dyslexia in children of preschool age. Children 6 years of age: 111 children with dyslexia and 75 children without dyslexia have taken part in research. According to results of a study, we came to the conclusion that development of dyslexia depend on influence of group a medicobiologic of factors. The children with dyslexia have most of frequency of burdened factors in comparison with children from reference group.
Key words: dyslexia, children of preschool age, risk factors.
Summary. Under a supervision there were 60 children of patients by a chronic active form Epstein—Barr of viral infection in age from 1 to 18 years. Children, except for base therapy got preparation of flavozid in the age-related doses in the flow of 3-th months. It is rotined as a result of the conducted researches. That flavozid has clinical and laboratory efficiency at treatment of chronic active form Epstein—Barr of viral infection for children.
Key words: children, Epstein-Barr virus, infectious mononucleosis, chronic active form of Epstein-Barr of viral infection, Flavozid, treatment.
Summary. In children with a recurrent bronchitis or bronchial asthma take place the changes of bone metabolism indexes, characterizing both strengthening of bone resorption and relative weakening of physiological processes of bone tissue formation on a background the enhanceable agerelated requirement in substrates for the skeleton construction in research was set. In children with a recurrent bronchitis takes place the reliable decline of concentration of total serum and urine calcium, increase of alkaline phosphatase activity, osteocalcin, parathormone and products of collagen 1 type degradation levels. In patients with bronchial asthma the higher percent of children with the decrease serum and urine calcium level, enhanceable osteocalcin, and products of collagen 1 type degradation levels was set.
Key words: children, osteogenesis, bronchitis, bronchial asthma, bone metabolism.
Summary. Magnesium plays an important role in the vital functions of people. Child's organism is sensible to violations of magnesium homoeostasis and it causes certain interest in connection with information about prevalence of deficit of magnesium in populaion and features of growth and development of child's organism. Article have information on the exchange of magnesium for children and possibility of correction of magnesium deficit in pediatric practice.
Key words: magnesium, correction of magnesium deficit, Магне-В6.
Summary. In this article given a data about the mechanisms of cough development in children, its differential diagnostics, approaches to therapy. An important place in therapy of cough is occupied by phytotherapeutic medicines which shown to be of high-efficiency and safety.
Key words: children, phytotherapy.
Summary. The in!depth study of the children's health status living in the region with a high fluoride concentration drinking water is conducted. According to the results of study the high level of morbidity, in structure of which the anemia of the I–II deg. is dominates as an independent disease (25.4%) so in various combinations with other related and chronic diseases (cardiopathy, nephropathy, bronchial asthma, BPD, chronic tonsillitis, chronic gastritis, chronic gastroduodenitis, dysbacteriosis of the I–II degree, food and drug allergies) is established. The complex of therapeutic and preventive measures is proposed, which allow reducing the number of sickly children from 53% to 9.5% (p <0.001).
Key words: sickly children, drinking water, fluoride, therapeutic and preventive measures.
Summary. Article represents modern aspects of the methodology of the quality of life estimation in pediatrics, the specifics of using this methods in children. The study assessed the quality of life for children with cerebral palsy using a questionnaire of PedsQLтм «Cerebral Palsy Module» (J. Varni, 2006), studied the effect of normobaric hypoxic training on quality of life of children with cerebral palsy.
Key words: cerebral palsy, quality of life, questionnaire of PedsQLтм «Cerebral Palsy Module», normobaric hypoxic training, rehabilitation.
Summary. It is found that the use of Pikovit-syrup in the complex treatment of infants (1–3 years) years with acute pneumonia allowed increasing the effectiveness of pathogenetic therapy, contributed to the elimination of hypovitaminosis symptoms. It is proved a good tolerability of preparation by infants, its low sensitizing activity.
Key words: children, acute pneumonia, hypovitaminosis, Pikovit-syrup.
Summary. In the article information about the use of peroral cephalosporins (Lexin, Cefutil, Cefodox) in pediatric practice is presented, for treatment of the pulmonary diseases at children. These literatures and own researches about clinical efficiency and safety of peroral cephalosporins are presented.
Key words: pulmonary diseases, antibiotic treatment, peroral cephalosporins.
Summary. From the standpoint of system analysis about provision of mechanisms of general nonspecific adaptive reactions in organism the clinical efficacy of phyto-immuno-preparation «Bіoaron C» in the complex rehabilitation of children with recurrent respiratory infections is investigated. Safety and clinical efficacy of the drug, immunomodulatory and adaptogenic effect are indentified.
Key words: immune system, homeostasis, adaptation reactions, phytopreparations, Bioaron C.
Summary. The fuction of external breathing has been studied in 154 children ill with complicated pneumonia at the age of 6–18 years. In children with manifestations of undifferentiated connective tissue dysplasia certain more restrictive violations and generalized obstruction have been revealed which are still kept after finishing in – patient treatment. In children without connective tissue dysplasia manifestations renovation of majority spirometry indices has been achieved.
Key words: children, pneumonia, connective tissue dysplasia, the fuction of external breathing.
Summary. Тhis article descrides new pathogenic mechanisms atherosclerotic lesions vessels in children with juvenile rheumatoid arthritis, communication between chronic inflammation, treatment and development of atherosclerosis in this class patient. Possible ways of prevention vessels injury was presented.
Key words: juvenile rheumatoid arthritis, atherosclerosis, inflammation.
Sammary. Treatment of adolescents with primary arterial hypertension (PAH) with antihypertensive medicines of the front line in the course of 6 and 12 months` therapy, even in the absence of blood pressure normalization, contributed to some reduction of the left ventricle myocardium weight index, normalization of the blood lipid spectrum, and to a lowered level decrease. There was establishes a low inclination to the long$term treatment of adolescents with PAH with antihypertensive medicines. There was singled out the group of patients (30,0%) in which there was observed AH progress during the course of observation. The necessity of long-term prescription of antihypertensive medication of the front live to adolescents with PAH for prevention of AH stabilization was proved in the study.
Key words: arterial hypertension, adolescents, blood pressure 24-hours monitoring, target organs, treatment.
Summary. Objective: determining the impact of treatment complexes (of pathogenetic and cardiometabolic action) on the heart remodeling processes and on central hemodynamics in children with initial stages of chronic cardiac insufficiency. 20 children with myocardial pathology (myocardiofibrosis, cardiac connective tissue dysplasia, and cardiac rhythm disorders) which were treated with pathogenetic agents (inhibitor of angiotensin resolving ferment and/or β"blocker), and 20 patient that had periodical treatment courses with -cardiometabolic agents (thiotriasolin, trimetazidin, L-carnitin or mildronat) were examined in the study. It has been established that in children with a boundary decrease level of the LV ejection fraction (55–61%) against the background of pathogenetic therapy there were registered certain improvements of morphofunctional cardiac characters: decreased LV dimensions and some rise of the pumping and contractile myocardium capabilities, normalization of correlations of general hemodynamics features. Cources of cardiometabolic theatment do not result in such changes, and general hemodynamics change tends to take up hypokinetic variant.
Key words: chronic cardiac insufficiency, systolic dysfunction, children, pathogenetic therapy, cardiometabolic therapy, structural and functional cardiac parameters, hemodynamics.
Summary. In the present literature review examined the process of becoming and understanding new approaches to monitoring of juvenile rheumatoid arthritis. Much attention is paid to the methods of assessment of disease activity as a clue line monitoring of rheumatoid arthritis. The possibility of using the concept of quality of life in the system of comprehensive monitoring of the disease explained.
Key words: juvenile rheumatoid arthritis, activity of process, quality of life, children.
Summary. The problem of rational enzyme therapy of exocrine pancreatic insufficiency in children with prolonged enterocolitis remains complex and important one in medical and social aspects. The current protocols suggest the complex correction of morphofunctional disorders of alimentary organs influencing the main causes of the disease. The use of high-effective and safe drug Panzinorm 10 000 is one of the potential therapeutic direction.
Key words: children, pancreas, exocrine secretion.
Summary. In the article data about clinical and paraclinical pecularities in 484 children with diseases of pancreas in combination with chronic cholecystocholangitis was described. Prevalence of asthenic and abdominal pain syndrome in 98,1% and 86,7% children was estimated. Due to laboratory and instrumental data mild violations of exocrine function of pancreas took place in 78,8% of patients. In 82,6% sick children prevalence of sympathetic nervous system and suprasegmental regulation was estimated which determines adaptation and prognosis of the disease.
Key words: diseases of pancreas, chronic cholecystitis, children.
Summary. The basic approaches to purposeful influence on intestinal microflora are presented. With this aim the possibilities of use of milk functional foods with lactulose are shown.
Key words: intestinal microflora, prebiotics, lactulose.
Summary. The article reflects the main morpho-functional features of cell component inflammatory infiltrat of the stomach in dependence of children’s age. It was established that most of the examined children had the inflammatory of the limphaciticus infiltraticus. According to the results, the level of the inflammatory changes and the character of the cell component of the stomach depends on the children`s age that have to be kept in mind during research.
Key words: children, chronic gastroduodenitis, limphaciticus infiltraticus, microcirculation of the stomach.
Summary. In the article the results about the use of «Omez D» combined preparation of proton pump inhibitor of omeprazole and domperidone produced by «Dr. Reddy 's Laboratories Ltd» in the complex of combined therapy of inflammatory gastroduodenal diseases in children are presented. Analysis of the results of Omez D in the condition of anti-helicobacter therapy in children with inflammatory and erosive and ulcerative lesions of gastric and duodenal ulcer associated with Helicobacter pylori, proved its efficacy and safety in children of older age groups.
Key words: older age children, gastroduodenitis, peptic ulcer disease, Helicobacter pylori, proton pump inhibitors, domperidone, Omez D.
Summary. Clinical observation of 131 children in the age from 4 to 22 months with functional dyspepsia syndrome is conducted. It is established that the most significant risk factors for functional dyspepsia development in infants are bottle-feeding and early introduction of complementary foods. Age differences in the clinical manifestations of functional dyspepsia were not observed. The best treatment results were achieved in the case of combination of traditional preparations and phyto-correction.
Key words: functional dyspepsia, infants, phyto-correction.
Summary. The article discusses current views on functional disorders of the hepatobiliary system, in particular, biliary dyskinesia, as well as problems of diagnosis and treatment of these disorders in young children. Provided data using the preparation Chophytol as choleretic breakfast during the ultrasound examination and in treatment of infants with biliary tract dyskinesia.
Key words: functional disorders of the hepatobiliary system, biliary tract dyskinesia, infants, Chophytol.
Summary. In 150 children with chronic viral hepatitis B and C in the phase of the replication study gender-age structure, clinical manifestations, patient factors and factors of the virus, the level of proinflammatory cytokines (for example, TNF-α and its soluble receptors) mechanisms of endotoxemia, especially hepatic hemodynamics, metabolism of connective tissue. Clinical and paraclinical differences of chronic viral hepatitis B and C in children was found, the correlation between the breach processes collagen, endothelial damage, formation of endotoxemia and the degree of active hepatitis was established.
Key words: children, chronic virus hepatites, clinic, pathogenesis.
Summary. The analysis of efficiency of Brulium (domperidon 10 mg) in treatmen of the gastroesophageal reflux desease in children with bronchial asthma was traced. it was shown that the use of Brulium decreases clinical signs of gastroesophageal reflux desease and symptoms of bronchial asthma. It was proved that Brulium is an effective and safe medicine and can be recommended in treatment of the gastroesophageal reflux desease in children with bronchial asthma.
Key words: bronchial asthma, gastroesophageal reflux, Brulium (domperidon).
Summаry. Chronical gastroduodenitis is an important medical and social problem of child Gastroenterology. In recent decades, opinions about etiology and pathogenesis of this disease are changing, in particular, great attention is paid microcirculation and violation of its regulation. In the article data on clinical and laboratory features of chronical gastroduodenitis in children are generalized, the state and nature of disorders NO system are presented for children different age.
Key words: children, chronical gastroduodenitis, oxide of nitrogen, general nitrite.
Summary. The comparative analysis of clinical manifestations dynamics, results of urine bacteriological test and the markers of local mucosal immunity of the urinary tract during the acute pyelonephritis in children associated with an application of accepted therapeutic complex with / without inclusion of CANEPHRON ® N is presented. Both ways of treatment allow eliminating of clinical symptoms of disease, total bacteriological urine sanitation. In the group of patients who had received CANEPHRON ® N, was observed normalization of the local mucosal immunity urinary tract figures, while patients who had not received this preparation, these figures were pathologically changed. The conclusion about the advisability of KANEFRONA N introducing to the complex therapy of children with acute pyelonephritis as a way of immune reactivity of urinary tract normalizing was done, which is important for the prevention of chronic disease.
Key words: acute pyelonephritis, children, local immunity, CANEPHRON ® N, pathogenetic therapy.
Summary. The main clinical and laboratory manifestations of chronic glomerulonephritis depending on the form of the disease in children Podillya region were investigated. The leading signs of hematuriс form of glomerulonephritis were hypertension, varying degrees of hematuria, minimal proteinuria, nephrotic form: еdema, hypertension and proteinuria, isolated urinary syndrome: proteinuria and moderately expressed erytrotsyturiya without ekstrarenal manifestations.
Key words: chronic glomerulonephritis, hematuric form, nephrotic form isolated urinary syndrome, clinical features.
Summary. The types of metabolic disorders and the ways of their correction during the various kidney diseases in children are considered. For the purpose of correction of metabolic disorders and including the modern pharmacological abilities at tubulopathy, chronic renal failure, glomerulonephritis, acute and chronic pyelonephritis and tubulo$interstitial nephritis the inclusion Stimol® in the complex treatment is reasonable and pathogenetically expedient.
Key words: kidney diseases, metabolic acidosis, metabolic disorders correction, Stimol®.
Summary. Efficiency of application of pancreatic enzymes in complex therapy of an atopic dermatitis at children was investigated. The most effective method notes complex therapy of an atopic dermatitis with including of preparation «Pangrol 10000».
Key words: children, atopic dermatitis, pancreatic enzymes, Pangrol 10000.
Hyperreactivity to the most common aeroallergens in infants with repeated episodes of bronchial obstruction against the treatment of H1-by antihistaminic preparation of the III generation desloratadine.
Summary. In the article the results of the survey of 71 patients aged 2-5 years with recurrent episodes of bronchial obstruction in the formation of which the main role belonged to fungal sensitization are presented. Investigation of the level of specific IgE to non-communicable and fungal allergens (Cladosporium herbarum, Alternaria tenuis, Aspergillus niger) and dynamics of these indicators against the inclusion in the complex therapy of H1-antihistamine preparation of the III generation desloratadine (Edem) is conducted. Positive clinical dynamics and decrease of the level of sensitization to non-infectious and fungal allergens during the treatment by desloratadine is proved.
Key words: recurrent bronchial obstruction, non-infectious and fungal sensitization, desloratadine, children of the first 5 years of life.
Summary. The 150 overweight and obese adolescents' metaboyc syndrome criteria according the IDF and other institutions' recommendations data are in the article. Increasing the BMI is associated with the abdominal adipose tissue predisposition with insulinresistance and dyslipidemia in overweight children with the further additional hyperinsulinism, hypertriglyceridemia and decreasing LDL concentration in obese. The number of normotensive individuals among overweight and obese adolescents are reduced depending on BMI. The high percentage of labile forms of hypertension and «white coat hypertension» requires analizing of 24-hours blood pressure monitoring parameters on addition to office ones. So ror the real cardiovascular risk assesment in overweight and obese adolescents needs more sensitive criteria than IDF Metabolic syndrome components evaluation.
Key words: metabolic syndrome, adolescents, obesity, overweight.