SOVREMENNAYA PEDIATRIYA № 6 – 2013
The «Modern pediatrics» journal — is the first in the ranking of the best specialized publications in the field of pediatrics.
Урочиста церемонія нагородження кращих спеціалізованих медичних видань за підсумками 2013 року.
P.l. Shupyk national medical academy of postgraduate education celebrates its 95th anniversary!
Morozova S. V., Mytyuk А. М.
Physiological and clinical aspects nasal breathing.
Stuklov N. I., Semenova Y. N.
Treatment of iron defciency anemia. Which is more important: effciency or tolerance? Is there an optimal decision?
Abstract: Efficiency of iron deficiency therapy is determined not only by bioavailability of iron, it also depends on commitment of the patient to treatment which is greatly influenced by the drug tolerance and cost of treatment. Efficiency of drugs containing ferrous iron is proved in many researches (level of evidence 1A) and doesn't cause doubts. Drugs on the base of ferric iron are better tolerated, but they are not always efficient and require long-term treatment. Due to its unique composition (iron gluconate II +copper gluconate+ manganese gluconate) the Tot'hema drug (manufactured by the French company Laboratory Innotech International) quickly restores the hemoglobin concentration and reserves of iron and has a good tolerance features. Copper and manganese are a part of active centers of proteins which facilitate absorption of iron in intestine, quick utilization of iron by tissues which take part in hemoglobin synthesis, regulate iron supply into mitochondrions, ensure antioxidant protection. Comparison of three meta-analyses showed that Tot'hema is tolerated better than iron sulphate II(34,1% and 20,4%; p<0,005) and to some degree in comparison with ferric iron drugs (iron-hydroxide polymaltose complex III (14,9%; 0,1< p < 0,25), iron protein succinylate III (9,4%; 0,75 < p < 0,9). Moreover, when taking Tot'hema constipations occur 19 times less in comparison with taking iron sulphate II and 10 times less when taking iron-hydroxide polymaltose complex III , which is very important for pregnant women especially in the III semester. At the same time Tot'hema is a drug of average price category, and this makes it an optimal drug for treatment of most patients.
Keywords: treatment of anemia, iron gluconate, iron sulphate, iron-hydroxide polymaltose complex, iron protein succinylate, iron deficiency, copper gluconate, manganese gluconate, Tot'hema.
Бойкова Н. Э.
Современные подходы к терапии патологии верхних отделов дыхательного тракта у курящих подростков.
Статья посвящена серьезной медико-социальной проблеме — подростковому курению. По обобщенным данным статистики, в старших классах курят 50–70% юношей и 30–40% девушек. Курение, помимо прочего, приводит к развитию ЛОР-заболеваний. Авторы статьи провели исследование, целью которого было установить терапевтическую эффективность и переносимость карбоцистеина в лечении воспалительной патологии верхних дыхательных путей у курящих подростков.
Solntseva A. V., Zagrebaeva O. Yu., Konchits E. S.
Early determinants of obesity in children during the puberty.
Summary. Actual direction in the study of childhood obesity is the identification of the determinants of early overweight markers.
Materials and methods: we analyzed retrospectively outpatient cards of 259 children 12–17 years of age in the 8th Paediatric Outpatient Clinic in Minsk. Gestational age, feeding until 4 months of age, anthropometric data at birth, 4–12 months, 1,5, 2–6, 12 years were estimated. Patients were divided into groups according to their BMI in 12 years: G1 — control — normal-weight girls (n=92), G2 — overweight girls (n=20), G3 — obese girls (n=10); B1 — control — normal-weight boys (n=88), B2 — overweight boys (n=17), B3 — obese boys (n=25).
Results: there were the increasing BMI in girls G3 in comparison with control in 4, 5 and 6 years. BMI in B3 were higher than control in 6–8, 10–12 months; 2–6 years. The age of adiposity rebound was 2 years in girls and boys with obesity (p=0,05 and p=0,001 respectively).
Conclusions: Increased BMI levels in infancy and preschool children, early adiposity rebound are risk factors of the development of obesity. Selection of potential early markers of obesity in childhood is important to determine the target point of preventive and therapeutic impact.
Key words. Obesity, puberty, risk factors, early determinants, adiposity rebound.
Uniform clinical protocol of medical care for children with chronic gastro-duodenitis.
Uniform clinical protocol of medical care for children with chronic cholecystitis.
Abaturov A. E., Gerasimenko O. N., Zavgorodnyaya N. Yu.
Beta- defensin 2 synthesis induction by probiotic bacterium during the treatment of hilicobacter infection in children.
Purpose: To determine the effect of a probiotic preparation with Escherichia coli Nissle 1917 strain on factors of local anti-Helicobacter protection by the way of estimation of the β-defensin 2 ( HBD -2) concentration in the gastric juice of children with chronic H. pylori- associated gastroduodenal pathology in acute stage.
Patients and methods. A total of 30 children aged from 8 to 17 years were under observation. The main group consisted of 15 children, to the seven-day scheme of «triple» anti-Helicobacter eradication therapy of which was included Mutaflor ® preparation with E. coli Nissle 1917 probiotic strain. The comparison group included 15 children who had received only basic «triple» anti-Helicobacter therapy. The effectiveness of treatment was evaluated at 7 and 28 days of therapy with a mandatory control bacteriological examination of feces, the definition of hemogramm indicators and biochemical hepato-and renogram. The effectiveness of H. pylori eradication and redefinition of HBD -2 in gastric juice was performed after 6 weeks for the end of completing of anti-Helicobacter therapy.
Results. The use of E. coli Nissle 1917 probiotic strain in the scheme of «triple» anti-Helicobacter therapy in children allowed increasing the efficiency of eradication, to reduce the severity of side effects of the basic treatment and to characterize it by good individual tolerability.
Conclusions. Treatment by probiotic preparation «Mutaflor ®» reduces the vulnerability of the gastric mucosa to the effect of H. pylori that is proving the feasibility of its use in the eradication treatment regimen of Helicobacter infection in children.
Key words. H.pylori- infection, beta -defensins, Escherichia coli Nissle 1917 probiotic strain, Mutaflor ®.
Nadraga A. B., Kasyanenko Yu. V., Tokarev P. V., Talalay L. I., Potseluyko N. M., Tomashevskaya I. E.
Effectiveness of use of Humana Electrolyt in the complex treatment of children with acute intestinal infections.
Objective: To determine the efficacy of the use of Humana Electrolyt for oral rehydration in the complex treatment of children with acute intestinal infections (AII).
Patients and methods. A total of 40 children hospitalized with acute intestinal infections were under observation. For all children were ordered conduction of general clinical laboratory and instrumental examinations; determination of electrolytes in the blood serum; for estimation of severity of dehydration was used Performance Status Scale; severity of gastroenteritis course was evaluated by Vesikari scale. For patients of the main group (20 children) in the complex treatment was included Humana Electrolyt oral rehydration solution. Children of the comparison group (20 children) with the same purpose had received other commercial solutions or home-cooked solutions for drinking.
Results. Application Humana Electrolyt for children of the first three years of life contributed to a more rapid normalization of violations of water and electrolyte balance did not result in the process of rehydration to lower levels of potassium in the blood serum and in general contributed to the healing process. This was reflected in the duration of infusion therapy and duration of stay in the hospital. It is also marked good organoleptic properties of the mixture.
Conclusions. The high efficiency of the Humana Electrolyt mixture and commitment to children to the proposed treatment is found.
Key words: acute intestinal infections, young children, disorders of water and electrolyte balance, mixture of oral rehydration, Humana Electrolyt.
Korniychuk O. P., Burova L. M., Lavrik G. S., Ferents N. M., Maksimov N. I.
Biosporin antimicrobial activity: study in vitro.
Objective: To study the antagonistic activity of «Biosporin — Biopharma» in vitro according to the standard cultures of enteric pathogens Shigella sonnei, Salmonella typhimurium, Escherichia coli of the reference strain and clinical isolates Escherichia coli, Proteus vulgaris, Citrobacter koseri, Staphylococcus saprophyticus, Staphylococcus aureus, Enterococcus faecalis and Candida.
Materials and methods. In the examination the classical method of deferred antagonism is used.
Results. It is proved the high activity of «Biosporin — Biopharma» to the opportunistic Enterobacteriaceae — the main factors of intestinal bacterial diseases and, most importantly, with regard to Salmonella and Shigella sonnei. Most Biosporin activity is set with respect to Staphylococcus aureus. An important advantage of Biosporin compared to other biopreparations is eliminating effect to Candida.
Conclusions. The antimicrobial action of «Biosporin — Biopharma» and the presence of other medical properties allow recommending its use during the intestinal diseases, diseases of the upper respiratory tract and pathological processes in the mucous membranes, reduced local immunity and urinary system diseases. The use of Biosporin as an antifungal preparation in dysbiotic conditions in children and adults can avoid or reduce the chemotherapeutic stress on the body.
Key words: antimicrobial activity, study in vitro, probiotic Biosporin.
Marushko R. V.
Randomised clinical trial: the effectivness of immunonutrients in infants with inflammatory bowel diseases.
Background: At present, there are considered new approaches in treatment of IBD in infants. The mail goal is to contribute to therapeutic benefit with rational, physiologic, and nontoxic approach. Recently, probiotics, prebiotics and n-3 LC PUFA were found to have a potential relationship with IBD pathophysiology. As immunonutrients, their simultaneous application can enhance the therapeutic effect; contribute in reducing the severity of IBD, achievement of favorable course of inflammation and maintenance remission. So far few studied were perform in this way.
Goals: To assess the effectiveness of simultaneous application of immunonutrients (probiotics, prebiotics and n-3 LC PUFAs) in the treatment of chronic non-specific non-ulcerative colitis in infants.
Methods: A total of 92 infants (mean age 1.6 years, range 1–3 years, female/male 10/13) with chronic non-specific non-ulcerative colitis (CNNC) were randomized into two groups: 50 infants (main group) received иммуннонутриенты, and other 42 children were control group in conjunction with conventional therapy. Clinical evaluation, endoscopic investigations as well as expression levels of pro-and anti-inflammatory interleukins and microbiologic analyses of faecal samples (Bifidobacteria, Lactobacilli) were evaluated at the beginning and at the end of the trial.
Results: Summarising the results of the study, the Disease Activity Index (DAI) score decreased significantly in the main group (3.4±1.2 versus baseline 8.6±0.8, P < 0.01) compared to control group (7.1±1.1 versus baseline 8.7±0.7, P > 0.05). All patients of the main group and 25 of 42 (59,5 %) infants of control group had a clinical response (P < 0.05), whereas remission was reached in 47 of 50 (95 %) infants of the main group and in 22 of 42 (52,4 %) infants of control group (P < 0.05). In both groups no exacerbation occurred. There were no clinical adverse events related to immunonutrient applications. , were observed interleukine and significant imbalance of indigenous intestinal microflora. At the post-trial evaluation significant improvement of immunologic and bacteriologic paramiters was observed only in infats of the main group (P < 0.01).
Conclusions: The data of the study document the efficacy of application of immunonutrients (probiotics, prebiotics and n-3 LC PUFAs) as an accompanying treatment in improving clinical manifestation of the disease, redusing disease activity and mucosal inflammation in infants with chronic non-specific non-ulcarative colitis as well as positive changes in the expression levels of pro- and anti-inflammatory cytokines involved in the mechanisms of IBD and increasing indigenous bacteria. This clinical randomized trial demonstrated the role of immuninutrients in maintenance of remission chronic inflammatory deseases in infants.
Keywords: inflammatory bowel diseases, infants, immunonutrients.
Kozakevich V. K.
Khorol dairy canning plant for baby food (review).
Proposing the baby food review of PJSC «KHOROL DAIRY CANNING PLANT for BABY FOOD». Extensive assortment of domestic powdered baby milk Malutka, Malytka premium, Malysh and porridges Malyshka allows to decide a lot of canning problems both healthy children and children with special needs in nutrition.
Key words: formula feeding, prebiotics, oligosaccharides. GOS/FOS, infant milk formula, infants.
Voznyak A. V.
Effectiveness of «Noofen®» in the complex treatment of vegetative dysfunction in children.
Objective: to improve the treatment program of vegetative dysfunction (VD) in school-aged children.
Patients and methods. A prospective clinical and instrumental examination of 57 children aged 7–14 years old who were hospitalized with VD diagnosis is conducted. The diagnostic algorithm included: clinical history, the complaints of parents and children; the definition of the main clinical manifestations of VD; instrumental methods of examination; analysis of heart rate variability and features of vegetative homeostasis. The psychological state of the children was assessed by WAM questionnaire; for evaluation of the level of anxiety were used Spielberger test and Hamilton scale. To the complex standard therapy of th main group was added «Noofen®».
Results. In children with VD was observed strain of both parts of the VNS. Also was marked a high level of anxiety, frequent complaints of head pain. Comparative evaluation of the effectiveness of treatment regimens had shown «Noofen®» activity that is indicating about the complex action (nootroic, antihypoxic, mild sedative, analgesic and vegetostabilizing) preparation.
Conclusions. In children with VD were observed imbalance of the vegetative regulation and disorders of vegetative provision of heart rate, stress of adaptation mechanisms of the organism in the whole and the prevalence of central influence on heart rate. The efficiency of the proposed scheme of complex treatment including «Noofen®» preparation is proved.
Key words: children, vegetative dysfunction, «Noofen®».
Shatilo V. I.
Prophylaxis of posture disorders in children and adolescents.
Objective: To analyze the problem of posture disorders in children and adolescents, to identify promising approaches for it solution.
Patients and methods. Information-analytical, clinical and statistical methods are used. The data of the state medical statistics and statistics of the Zhytomyr region, the results of the survey of health workers of educational institutions are analyzed.
Results. Untimely revealed pathology of the musculoskeletal system, the lack of appropriate interventions for improvement of children's health and primary prevention at the earliest stages of their growth contributes to the growth of advanced forms of posture disorders and scoliosis. In condition of timely diagnosis of early clinical manifestations and preventive and therapeutic measures we can be prevented and influence on development of posture disorders in children. The functional and organizational model of posture disorders prevention in children in the general educational institutions is proposed.
Conclusions. The main task of health care professionals concerning the prevention of the musculoskeletal system diseases in children is the allocation of the risk groups in developing and implementing appropriate preventative measures.
Key words: musculoskeletal system diseases, posture disorder, the health care professional, prevention.
Yankovskiy D. S., Shirobokov V. P., Moiseenko R. A., Krivopustov S. P., Dyment G. S.
New generation of enterosorbents and complex probiotics for human microbial ecosystem improvement.
The article is devoted to the human microbial ecology and the use of probiotics in medicine. The characteristic of domestic enterosorbents based on smectite and multi-functional complex probiotics on its based is presented.
Key words: microbial ecology, microbiota, probiotic, smectite, enterosorbent, multiprobiotic, «Smektovit ®», «Simbiter ® forte.»
Mokiya—Serbinа S. A., Chechel V. V.
Cognitive disorders and their correction in children of preschool age, which had iron deficiency in early age.
Objective: To study the efficacy and safety of the preparation «Kindinorm» in the treatment of preschool children which had iron deficiency (ID) in early age, on the basis of a comprehensive assessment of indicators of cognitive functions.
Patients and methods. The study included 30 preschool children with ID at an early age. All children underwent clinical, laboratory and psychological examination. The observation was carried out in the dynamics before treatment, after 28 days during treatment and after 56 days — after the course of therapy. The 30 children of the main group were treated «Kindinorm» along with ferrotherapy «Aktiferrin».
Results. A reduction in the performance of perception, memory, attention, thinking, speech in children with ID at an early age. The treatment «Kindinorm» marked improvement in indicators that characterize the level of attention, auditory perception, auditory and visual memory, verbal and logical thinking. Adverse effects with «Kindinorm» not revealed.
Сonclusions. The results of the study allow us to recommend the use of the preparation «Kindinorm» in children with ID at an early age to improve the effectiveness of treatment of cognitive impairment.
Key words: children, iron deficiency, cognitive disorders, tests, Kindinorm.
Banadyha N. V.
The essence of diselementozis in children with iron deficiency anemia.
Objective: examine the contents of some trace elements and metal containing compounds in the blood of children with iron deficiency anemia.
Patients and methods. The study involved 100 children aged 1 month to 3 years, which was diagnosed with iron deficiency anemia of varying severity. Analyzed the features of intra- and postnatal stages of child development, as nutrition, major clinical manifestations of anemia. For all patients despite the general clinical examination, we determined serum levels of copper, zinc, iron, metal containing compounds (catalase, ceruloplasmin). The control group consisted of 20 children of similar age, which is not revealed acute and chronic diseases.
Results. In the examined group was set associated diselementozis which manifested with a low content of copper and zinc in serum, combined with significantly high in catalase, ceruloplasmin. It was established that there is an inverse correlation between total serum iron-fixing ability and level: iron (r = -0,659; p < 0,05); catalase (r = -0,382; p<0,05); zinc (r = -0.248, p < 0,05). However, there was a direct relationship between the content of serum iron and zinc (r = 0,271; p < 0,05); between the copper and zinc content (r = 0,461; p < 0,05); That all seems the importance of polietiology of occurence of iron deficiency anemia in infants.
Conclusions. Associated diselementozis diagnosed in children with iron deficiency anemia, justifying the need to expand the diagnostic algorithm, targeted correction of nutritional and therapeutic recommendations.
Key words: children of early age, trace elements, iron deficiency anemia, diagnostics.
Ghdanovich O. I., Kolomiichenko T. V.
Major problems of modern neonatal pharmacotherapy.
The actual problems of modern neonatal pharmacotherapy are discussed. Emphasis is placed on the need for better information on the use of medical drugs in children, for what need to create a national drug formulary for children. Difficulties in clinical trials of new drugs in children, especially infants, are noted. The basic ways of solving the problems of modern neonatal pharmacotherapy are identified.
Key words: neonatology, drug treatment, drugs, clinical trials.
Symptomatic treatment respiratory diseases in children: report under the scientific-practical seminar Problem questions of pediatrics in the practical medicine.
Drynov G. I.
Clinical and immunological characteristics and effectiveness of conservative treatment of chronic tonsillitis in children.
Objective: To determine the effectiveness of Imupret as a means of ARVI and acute chronic tonsillitis (CT) prevention during prolonged therapy.
Patients and methods. Treatment with «Imupret» was carried out in 162 children with chemotherapy in the age from 3 to 15 years by 6 month course. Patients were examined by the general clinical program which is included: general and biochemical blood analysis, bacteriological smears palatal arches and the posterior pharyngeal wall, sputum, X-ray examination and respiratory function assessment. Additionally was evaluated the immune status.
Results. During the year of observation in 55 patients was revealed high efficiency of treatment by « Imupret » preparation; in 76 patients treatment was effective, in 23 effect was moderate and only in 8 patients positive changes were not found or marked as anabatic. Established positive changes in the immune status after treatment by Imupret were persistent and correlated with the effectiveness of therapy.
Conclusions. «Imupret» preparation has a pronounced therapeutic, preventive and disease-modifying effect during the upper respiratory tract infections of as viral so bacterial etiology. Long-term use of Imupret allows restoring the work of the immune system and reduces the number of surgical interventions.
Key words: upper respiratory tract infections, chronic tonsillitis, prevention and treatment, Imupret.
Bobrysheva A. V., Kruger H. A., Vyaltseva Y. V., Pung K. V.
Differencial diagnosis of the brain tumor case in the time of increased morbidity with acute respiratory viral infectiouns.
Summary. Described clinical case diagnostics tumor of the brain in patients 15-year-old boy in the period of the epidemic of influenza.
Key words: seasonal infections, influenza, children, a tumor of the brain.
Filonenko G. V., Salamanina A. A.
The features of erysipeloid diagnosis in children: clinical case.
Summary. In the article the etiology and pathogenesis, diagnostic direction finding and treating Erysipeloid are shown. The clinical case of the disease in the young child is presented.
Key words: infectious diseases, diagnosis, treatment, erysipeloid, children.
Marushko Yu. V., Movchan O. S., Zelyonaya N. A., Іovitsa T. V.
Experience of the use of synbiotic Fluvir® in children on the stage of rehabilitation after acute respiratory diseases.
Objective: To examine the level of secretory immunoglobulin A in saliva of children with an acute respiratory disease and correction of found disorders with the use of synbiotics Fluvir®.
Patients and methods. A total of 30 children in the age from 2 till 12 years who had acute respiratory disease of different types of severity were under observation. Children from the I group ( 20 patients ) had received a course of synbiotics «Fluvir® for children» 1 sachet per day for 25-30 days; children from the II group (10 patients) had not received Fluvir®. Analysis of the level of secretory IgA in saliva was carried out on 10th -15th day of the disease and after 30-35 days.
Results. The Reduction of sIgA concentration was found in the saliva of children who had an acute respiratory disease, which can lead to reduced resistance of the body to infectious diseases. The use of symbiotic «Fluvir® for children» has allowed reducing the appearance of the ethnic syndrome after acute respiratory disease and dyspeptic syndrome after antibiotic treatment. Use of the preparation during one month resulted to improvement and normalization of secretory IgA concentrations in saliva of patients. Within 6 months in the group of children who received a monthly course of symbiotic «Fluvir® for children» was marked significantly lower incidence of acute respiratory infections in comparison with children who had not uses symbiotic
Conclusions. Synbiotic «Fluvir® for children» is an effective and safe for use in pediatric patients for the prevention of acute respiratory infections and correction of the reduction of sIgA level after respiratory diseases.
Key words: children, acute respiratory diseases, secretory IgA, Fluvir®.
Pan'ko N. A.
Prognosis of juvenile arthritis evolution in the first year of the process.
Objective: The development of predicting criteria of evolution of juvenile, rheumatoid and reactive arthritis.
Patients and methods. A total of 49 children with signs of early arthritis (up to 6 months from the debut) were under observation. In the process of refining of the nosological entity of articular pathology were used clinical, conventional laboratory and instrumental studies; antibodies were determined to cyclic citrullinated peptide and citrullinated vimentin; also was conducted Wald's -Genkin sequential procedure.
Results. It is found that for predicting the future JRA evolution significant importance has mainly such clinical signs: joints debut, pairing and symmetry of articular syndrome, as soon as possible involvement of other joints in the inflammatory process. Among laboratory parameters the most important is increase of the content of glycoproteins. In predicting of the chronic course of ReA the leading role belongs to the symptoms that are characterize the intensity of inflammation in the joint apparatus, echosonographic connections of synovitis with benign and the growths of synovial membrane, and seropositive status by a-MCV on the initial stages of the disease.
Conclusions. In the study were presented the most informative clinical signs and laboratory parameters for predicting the course of juvenile rheumatoid arthritis and reactive arthritis in the first months of the disease. The algorithms for predicting of unfavorable clinical course of juvenile arthritis in the early stages of the disease are found.
Key words: juvenile rheumatoid arthritis, prognosis, clinic, antibodies to citrullinated proteins.
Dudnik V. M., Vyzhga Yu. V.
Evaluation of the functional deficiency in children with juvenile rheumatoid arthritis.
Objective: To determine the criteria of functional deficiency based on the study of the features of the clinical course and JRA activity in children.
Patients and methods. The study included 149 children with JRA in the age from 1 to 17 (12,0 ± 3,9) years. On the period of study all children had clinical and laboratory signs of disease exacerbation. The complex of examination included a clinical and laboratory methods; evaluation of articular syndrome by Ritchie index, assessment of pain syndrome with the use of visual analog scale; assessment of the JRA activity by the use of integral indices of disease activity scale. Questioning of patients with JRA has been conducted by the CHAQ method specially adapted for the child's age.
Results. In 40.9 % of the child's disease characterized by rapid progression, the mean number of affected joints was 2,55 ± 0,2, Richie index — 5,4 ± 0,4 points and was accompanied by a moderate activity of the inflammatory process according to the integral index of the disease activity scale based on the C -reactive protein (2,4 ± 0,01 points). The high rate of subjective sensations of pain and disease is set, especially among girls that is greatly affected on their psycho emotional state and reduce the quality of life. According to the CHAQ questionnaire, in children with JRA significantly affected the ability to perform a minimum household physical activity (71.8 % of patients), especially reduced mobility and daily activities that make them vulnerable and requires constant assistance.
Conclusions. The presence of a direct correlation connection between the individual clinical parameters (the number of affected joints, Ritchie articular index, an indicator of the integral index of disease activity scale) and indicators of subjective experiences of children (the results of the CHAQ questionnaire and a visual analogue scale) indicates the significant negative impact of the disease on the health and functional status of children with JRA.
Key words: juvenile rheumatoid arthritis, functional deficiency, children.
Volokha A. P.
Treatment and prophylaxis of bacterial meningitis in children.
Bacterial meningitis is a medical emergency. The highest frequency of bacterial meningitis (about 75% cases) registered in children younger than five years of age. Approximately 10% children with bacterial meningitis die, 40% have sequelae including hearing impairment and other neurologic sequelae. Early diagnostic and adequate antimicrobial therapy is the key aspects of managements of patients with bacterial meningitis. Effective immunoprophylaxis with conjugate vaccine against main pathogens of bacterial meningitis (N. menigitidis, H. іnfluenzae type b and S. pneumoniae) is crucial in preventing bacterial meningitis.
Key words: bacterial meningitis, children, antibacterial therapy, vaccination against N. menigitidis, H. іnfluenzae typ b and S. pneumoniae.
Chernyshova L. I., Bondarenko A. V., Starenkaya S. Ya.
Manifestations of primary combined immunodeficiency in the neonatal period.
Summary. Primary immunodeficiencies are severe congenital genetically determined diseases of immune system. Children with primary immunodeficiency usually have no clinical signs of immunodeficiency at the time of birth. However, there are some primary immunodeficiencies that can be suspected at the neonatal period due to phenotype. This article demonstrates author's observation of rare primary combined immunodeficiency (Omen syndrome) in a newborn girl which manifested from birth. The features of the case was manifestation of autoimmunity before infectious syndrome. Omen syndrome accompanied with graft versus host disease due to numerous plasma transfusions worsened patient's condition and prognosis.
Key words: primary immunodeficiency, combined immunodeficiency, Omen syndrome, neonates, transplantation.
Kolibaeva T. F., Markovsky V. D., Sorokina I. V., Myroshnychenko M. S., Podvalnaya N. A.
Structure of urinary system pathology in children: regional aspect.
The authors investigated the urinary system pathology in children of Kharkiv region over the last six years. It was established that in the structure of urinary system pathology in children of Kharkiv region a significant number of cases occur in infections of kidneys and urinary tract, dysmetabolic nephropathy, vesicoureteral reflux and abnormalities of the urinary system, glomerulonephritis, urinary bladder dysfunction, hydronephrosis.
Key words: pathology, urinary system, children.
Leading Government institution «Scientific-practical medical center of pediatric cardiology and cardiac surgery Ministry of health of Ukraine» celebrates its 10th anniversary.
Boyko E. P., Rudenko N. N., Kuzmenko Yu. L., Dovgalyuk A. A., Maksimenko A. V., Emets I. N.
Surgical treatment of pulmonary atresia with intact ventricular septum.
Objective: To analyze the efficacy of surgical treatment of patients with pulmonary atresia with intact ventricular septum (PAIVS).
Patients and methods. A total of 58 patients with a PAIVS diagnosis at the age from 6 hours to 14 days have been examined at the Center of Pediatric Cardiology and Cardiac Surgery for the period from January 2003y. to May 2013y. In 40 patients (68.9 %) from 58 was marked normal-sized or small hypoplastic of the right heart, in 9 (15.5 %) patients diagnosed moderate and in 9 ( 15.5 %) – severe hypoplasia of the right heart.
Results. Overall mortality during the treatment of the defect was 22.4 %. An alternative to surgical method of treatment in patients with three-piece formed right ventricle and normal coronary anatomy is balloon valvuloplasty (BVP). BVP was conducted for 31 patients with a mortality rate of 9.6%. The 27 patients underwent surgery. The mortality rate was 37%. Risk factors for surgery in the neonatal period were marked dysplasia of the right ventricle and tricuspid valve, Ebstein's anomaly and also anomalies of the coronary arteries.
Conclusions. Pulmonary atresia with intact ventricular septum is a rare malformation with various morphological patterns and only surgical treatment can be effective in these categories of patients.
Key words: pulmonary atresia, balloon valvuloplasty, Ebstein's anomaly.
Doronin A., Khanenova V., Meshkova M.
Cardiac arrhythmias treatment in infants and young children.
Purpose: The aim of our study was to appreciate our own experience of arrhythmia treatment in children with body weight less than 15 kg.
Patients and methods: The study group consisted of 61 consecutive patients weighing less than 15 kg, aged from 1day to 4.5 years. They were treated on the various types of heart rhythm disturbances in Ukrainian Children's Cardiac Center in the period from 04.2011 to 04.2013. The follow-up was from 2 months to 2 years. Depending on the received treatment, all patients were divided into 3 groups: medications (37 patients — 60,7%), catheter interventions (7 patients — 11.5%) and pacemaker implantations ( 17 patients — 27,8%).
Results: In the group of medications in all patients antiarrhythmic therapy was effective. In catheter intervention group except one electrophysiological study in all patients we performed catheter ablations, which have all been effective. In the group of pacemaker implantations we implanted eight pacemakers with endocardial leads, 5 — with epicardial leads, 4 patients underwent pacemaker replacement. No complications of treatment were observed.
Conclusion: Treatment of arrhythmias in children with the weigh up to 15 kg in a specialized center is quite effective and safe. Antiarrhythmic therapy allows postpone the need for catheter degradation in young children.
Key words: children, arrhythmias, treatment, catheter destruction.
Immune reactivity of neonates with complex congenital heart disease after autologic umbilical cord blood transfusion.
Surgical correction of critical congenital heart disease using cardiopulmonary bypass usually requires homologous blood transfusion. It's associated with risk of transmissible infections and immunological complications, especially in neonates. Autologous umbilical cord blood (AUCB), which contains biologically active substances, is an alternative source of blood. But using of AUCB in open cardiac surgery has not been applied. An important task is to find markers of safety and effectiveness of AUCB transfusion in neonatal cardiac surgery. Recently, much attention has been devoted to the role of molecular chaperones especially heat shock protein 60 (Hsp60) and antibodies to Hsp60 in the pathogenesis of cardiovascular diseases. It was shown that anti-Hsp60 antibodies can increase the inflammatory response induced by extracellular Hsp60, including the production of proinflammatory cytokines. Our preliminary results suggest that homologous blood transfusion is accompanied by the reduction of regulatory and protective activity of the organism. We did not identify any immunosuppression after autologous umbilical cord blood transfusion.
Key words: cord blood, anti-Hsp60 antibody, congenital heart disease.
Emets G. V., Kuzmenko S. A., Zhovnir V. A.
Heart failure in children.
Heart failure (HF) — a syndrome during which cardiac output is not able to provide the metabolic needs of the body. The most common mechanisms of its occurrence are increased pre-and after load, arrhythmias and myocardial damage. In children with heart failure often occurs in the setting of congenital heart disease or cardiomyopathy. Current approaches to the treatment of heart failure include the elimination of the underlying disease, surgical correction of congenital or acquired heart disease and drug therapy. The problem of heart failure in children does not lose its relevance and requires further study with large-scale evidence-based research.
Key words: heart failure, heart failure in children.
Gudzenko Prokopіy Mikitovich (on the centenary of the birth of).
ICP: one and a half centuries of truth searching.