SOVREMENNAYA PEDIATRIYA №3-2013
Resolution of research and practical symposium with international participation «Current issues of clinical pediatrics» (14–15 march 2013 year).
Research and production company «O.D. Prolisok» is reached 20 years old.
English Werner and Bauer Carl-Peter
Dimethindene maleate during the treatment of pruritus associated with varizella Zoster virus infection in children.
Overview: The efficacy and tolerability of dimethindene maleate (CAS 3614-69-5, DMM, Fenistil®) in the form of drops in the treatment of pruritus in children with varicella, using two different doses of dimethindene maleate and placebo are investigated. In a double-blind, randomized, placebo-controlled, multi-center clinical study was included 128 children aged from 1 to 6 years. Patients had used DMM preparation 0.1 mg / kg / day or 0.05 mg / kg / day or placebo, respectively. All patients applied a commercially available astringent lotion for the topical treatment of cutaneous lesions. The primary criterion of efficacy was the change in the severity of pruritus (in points) for the end of treatment compared to baseline, which was estimated as the area under the baseline (AUB). The statistically significant superiority in reducing the severity of pruritus during the treatment by both doses of DMM preparation in comparison with placebo is shown. Statistically significant differences between the two groups of the treatment by DMM preparation are absent.
Key words: antihistamines, CAS 3614-69-5, varicella, dimethindene maleate, Fenistil® drops, portability, pruritus.
Hostanska Katarina, Melzer Joerg, Amon Annette, Sailer Reinhard
Suppression of interleukin (IL)-8 and human beta defensin-2 secretion in LPS-and/or IL-1 β-stimulated airway epithelial A549 cells by a herbal formulation against respiratory infections (BNO 1030).
Aim of the study: A special ethanolic-aqueous extract from seven traditional medicinal plants (BNO 1030) has been used for several decades to treat recurrent infections of the respiratory tract. Considering the potential role of interleuldn-8 (IL-8) and human beta defensin-2 (h D-2) in inflammation, we investigated the effect of BNO 1030 on lipopolysaccharide (LPS) from Pseudomonas aeruginosa or IL-1-1 -induced inflammatory mediators in А549 human type II alveolar epithelial cells.
Materials and methods: A549 cells were stimulated with LPS (100 g/ml) or IL-1β (50 ng/ml)in the presence of the preparation and the secretion of IL-8 and h D-2 were measured after 18 h and 24 h in cell free supernatants using enzyme-linked immunosorbent assays (ELISA). Cell viability and cell growth was investigated by propidium iodide uptake and WST-1 assay, respectively.
Results: BNO 1030 inhibited the secretion of IL-8 and h D-2 at non-cytotoxic concentrations (0.1-100 g/ml; cell growth inhibitory concentration, 50% (ІС50) =678±87.6 g/ml). Stimulation by IL-1β led to a 7-fold activation of IL-8 secretion, which was reduced by 37.7±4.1% (p<0.05) after incubation with 100 g/ml BNO 1030. Inducible h D-2 was suppressed by 91.8±15,6% (p<0.01) at the same concentration of BNO 1030 (IC50=0.7±0.1 g/ml). The 2-fold increase of IL-8 secretion by LPS-stimulated cells was completely abolished at concentration of 50 ) g/ml BNO 1030 (IC50=5.7±3.6 g/ml).
Conclusion: BNO 1030 suppressed the secretion of IL-8 and h D-2 in cultured epithelial A549 cells. These results support its use as a phytotherapeutic product prepared from traditional remedies in inflammatory diseases, especially those affecting the respiratory tract.
Keywords: Interleukin-8, Human beta defensin 2, Herbal preparation Imupret®, Respiratory А54Э cells, Anti-inflammatory effect.
Henker Jobst ; Laass Martin W. ; Blokhin Boris M.; Maydannik Vitaliy G.; Bolbot Yuriy K. ; Elze Martina ; Wolff Corinna ; Schreiner Armin ; Schulze Jurgen
Probiotic Escherichia coli Nissle 1917 versus placebo for treating diarrhea of greater than 4 days duration in infants and toddlers.
Background: Administering probiotics can prevent or cure some forms of diarrhea. The efficacy of probiotic Escherichia coli Nissle 1917 (EcN) in infants and toddlers with diarrhea >4 days was tested by a double-blind trial.
Methods: One hundred fifty-one children aged 1–47 months with nonspecific diarrhea were randomized to receive either EcN suspension (N=75) or placebo (N=76). Diarrhea had to meet the following definition: >3 watery or loose nonbloody stools in 24 hours of a diarrheal episode persisting for >4 consecutive days but < or =14 days. All children were well nourished or only moderately malnourished, mildly dehydrated, and received oral rehydration at study commencement. They were treated orally with 1–3 mL EcN suspension (1 mL contains 10 viable cells) or placebo daily for 21 days. Primary objective was to confirm a better response rate (reduction of daily stool frequency to < or =3 watery or loose stools over > or =4 days) with EcN.
Results: The 7-day response was higher for the EcN group than placebo (EcN 78.7%, placebo 59.2%). Significant differences were observed on days 14 (EcN 93.3%, placebo 65.8%, P=0.0017) and 21 (EcN 98.7%, placebo 71.1%, P<0.001). Kaplan-Meier survival analysis resulted in a significant difference of 3.3 days between the groups (P<0.0001); median time to response for EcN waas 2.4 and 5.7 for placebo. EcN was safe and well tolerated.
Conclusions: In the conditions of this trial EcN was a suitable remedy for diarrhea >4 days in young children.
Key word: diarrhea, infants and toddlers, probiotic, Escherichia coli Nissle 1917, EcN.
Korneva V. V.
Optimal selection of iron solution for curing hipoferric anemia among children.
Summary: An article represents analysis of the modern approaches to treatment of hipoferric anemia among children of different age. An outcome of a research conducted while drafting an article is a comparative analysis of efficienty and safety of ferrotherapy, in particular: ion ferriferous solutions (saline
ferrum solution) and non-saline solutions, including polymaltosade hydroxide combinations of trivalent ferrum, in particular Maltofer. The article provides outcomes of a research of efficiency and safety of Maltofer's application in pediatric practice,
Key words: hipoferric anemia, children, Maltofer.
Pypa L. V., Murgina M. M.
TNF-α gene polymorphism during the localized and generalized purulent-septic diseases in children.
Objective: To study the effect of one allelic TNF-α gene polymorphism (308 G / A) on the susceptibility to the development of a generalized form of purulentseptic diseases in children.
Patients and methods. The 27 patients with localized and generalized purulent-septic diseases in the age from 8 months to 17 years were examined. Determination of allelic polymorphism of the promoter area of TNF-α gene (-308 G A) was performed using the method of restrictive analysis of the amplification products (PCR-RFLP).
Results. In the localized infection group in 14 (93.3%) children the typical variant of TNF-α alleles of (308G) is defined and in 1 (6.7%) child — an atypical variant TNF-α alleles (308A). In the group of generalized forms of the typical variant of the gene (308 G) is defined in 8 (66%) children, atypical (308 A) — in 4 (34%).
Conclusions. The presence of atypical variant of TNF-α gene (308 A) is a risk factor for generalized form of the infection. To the carriers of the present variant of TNF-α gene during the appearance of a localized bacterial infection should be immediately appointed a powerful antibiotic therapy.
Key words: children, tumor necrosis factor -α, one allelic.
Kozakevich V. K.
The value of nucleotides in the infant's nutrition.
Objective: To estimate the effectiveness of adapted milk formula «Malyutka premium 1» for feeding of the infants from the first month of life.
Patients and methods. The 73 full-term children in the age from 1 to 4 months were under observation. Adapted milk formula «Malyutka premium 1» got 37 children during the 1.5 months. The control group consisted of 36 nursing infants.
Results. In the setting of application of milk formula «Malyutka premium 1» was observed a decrease in symptoms of minimal dysfunction of the gastrointestinal tract (decrease in the frequency and intensity of regurgitation and colic) and good dynamic mass-height indicators. It is marked good organoleptic properties of the milk formula and satisfactory nutritional value of the product.
Conclusions. Milk formula «Malyutka premium 1» can be recommended for mixed and artificial feeding of healthy infants of the first year of life.
Key words: children, artificial feeding, adapted milk formula, nucleotides.
Starets E. A., Malinovskaya N. A., Movlyanova N. V.
Risk factors of «breast feeding» jaundice development.
Objective: To identify risk factors of «breast feeding» jaundice by assessing of physical development and clinical course of the disease in children in the first months of life.
Patients and methods. The main group included 37 children in the age of 1 month, who were under the treatment with a diagnosis of «Conjugational jaundice»; the control group included 30 healthy children of similar age with physiological jaundice in anamnesis, who were exclusively nursing. Inclusion criteria were certifications about the presence of hyperbilirubinemia (due to indirect bilirubin), the absence of an inflammatory pathology, lack of concomitant somatic pathology, exclusive breast feeding and birth in time. The general clinical research methods, evaluation of physical development with the help of the WHO Anthro, blood chemistry were used.
Results. Sex differences in the frequency of «breast feeding» jaundice are not observed. In children of both sexes at birth presented significantly low body weight (less than -2 standard deviations) at normal body length. Significant risk factor for the «breast feeding» jaundice development is the child's weight gain in the first month of life on 600 g and less. A weak positive correlation between the level of total bilirubin and ALT levels and also between total bilirubin level and the level of thymol are found.
Conclusions. The main etiologic factor of «breast feeding» jaundice should be considered not reduction of bilirubin conjugation in the liver but the lack of breast feeding which is leads to a relative starvation and increased reabsorption of unconjugated bilirubin.
Key words: «breast feeding» jaundice, indirect bilirubin, children.
Marushko Yu. V., Iovitsa T. V.
Features of diagnosis and treatment of intestinal colic in infants associated by lactase deficiency.
Objective: To determine the role of lactase deficiency in the occurrence of colic in infants, to evaluate the clinical value of hydrogen breath test for the diagnosis of intestinal colic.
Patients and methods. A total of 149 children aged 1–6 months with intestinal colic and symptoms of diarrheal disorders were under observation. All of them were nursing infants and lose in weight in the psychomotor development was not marked; common blood and urine tests were without pathological changes. To investigate lactase deficiency the hydrogen breath test was carried out with a load of food lactose (1.5 g / kg). In the treatment of children is used Mamalak (1 capsule — 3000 DU lactase) or Koliprev (1 drop — 150 DU lactase). Results. For nursing infants of the first six months of life at presents of intestinal colic and dyspeptic disorder were common transient lactase deficiency and excess lactose dependent bacterial overgrowth in the intestinal tract. The use of lactase allows correcting the state of the intestinal tract microflora and maintaining breast feeding.
Conclusions. The hydrogen breath test — is an informative method of diagnosis of intestinal colic in infants caused by lactase deficiency. The inclusion of lactase in the complex treatment of intestinal colic has pronounced therapeutic effect that is confirmed by the results of the hydrogen breath test in the dynamics of the observations. The use of lactase allows saving breastfeeding.
Key words: intestinal colic, children, lactase deficiency, hydrogen breath test, treatment.
Kovalchuk T. A.
Experience of subcutaneous administration of immunoglobulin drugs in children with primary immunodeficiency.
Summary. The article is devoted to the formation of the modern trends of treatment of primary immunodeficiency in historical perspective from intramuscular to intravenous and subcutaneous injections of gamma globulin. There are presented scientific facts that confirm the advantages of using subcutaneous forms of intravenous immunoglobulin. It was reproduced clinical case of diagnosis Bruton's disease in two years old boy and the effectiveness of five years therapy of subcutaneous gamma globulins. Methods of subcutaneous immunoglobulin preparations are described in children with primary immunodeficiency.
Keywords: primary immunodeficiency, subcutaneous injections of immunoglobulin, children.
Lezhenko G. A., Pashkova E. E., Pantyushenko L. I.
Microbiological characteristics of the respiratory tract in children with recurrent bronchitis.
Objective: choice of rational antibiotic therapy of children with recurrent bronchitis (RB) on the basis of the study of the microbial landscape of the respiratory tract.
Patients and methods. A comprehensive examination and treatment of 74 children with RB in the age from 5 to 16 years (mean age — 10,4±1,3 years) is conducted. Microbial spectrum of sputum prior to the appointment of antibiotic therapy is studied in all patients.
Results. The main causative agents in patients with RB were gram-negative microorganisms (47 children — 63.5%), almost in four times less common coccal flora (12 patients — 16.2%), in 14 (18.9%) patients were found cryptococcus. In one case (1.3%) was found enterococcus and pseudomonas aeruginosa. Taking into account the data of bacteriological examination and the sensitivity of the isolated microorganisms to antibiotic therapy of RB was included preparation cefuroxime axetil (Cefutil) in the form of tablets twice a day in the age-dependent dosage. Positive dynamics of the clinical picture was observed from the first days of therapy in the setting of the application of preparation. Cefutil was well tolerated by all patients.
Conclusions. In patients with RB microbial landscape characterized by the dominance of sputum gram-positive microorganisms, primarily due to bacteria of the genus Haemophillus. Application of cephalosporin of the II generation cefuroxime axetil in the treatment of RB in children has shown high efficacy and safety.
Key words: recurrent bronchitis, respiratory tract microflora, cefuroxime axetil, children.
Kokorkin D. N., Zheltov A. Ya
Experience of the use of «Meralis» combined nasal spray in the treatment of secretory otitis.
Objective: To study the effectiveness of various schemes of the pre-and postoperative management of patients with secretory otitis (SO) using a saline solutions, nasal steroids and decongestants (nasal spray Meralis).
Patients and methods. Examination of 70 children with SO is conducted. The irrigation treatment (IT) of the nasal cavity and nasopharynx by isotonic solution in combination with antiseptics is used as a basic therapy during the 5 days before surgery procedure. Regimen is supplemented by: Meralis nasal spray, nasal steroids (mometasone furoate) and the placebo group (cold saline).
Results. Due to the significant improvement in well-being consolation from future operations were in 21 patients, in 16 (22.8%) from which were with spontaneous recovery of SO noted on the 7th day of treatment. The use of IT and Meralis spray in children with nasal pathology and SO had shown significantly better result of treatment than in the placebo group, and according to the effectiveness was comparable to topical nasal steroids. During the outpatient therapy by IT in combination with Meralis nasal spray allowed achieving spontaneous healing of secretory otitis in 20% of cases.
Conclusions. The use of Meralis spray and irrigation of the nasal cavity with an antiseptic solution allow restoring nasal breathing and eliminating the dryness of the nasal mucosa significantly faster than placebo and also effective as nasal steroids. Meralis combined nasal spray is differ by its rapid and prolonged vasoconstrictor effect.
Key words: secretory otitis, irrigation therapy, nasal spray, Meralis.
Using symbiotic Fluvir® for acute respiratory diseases prophylaxis in children.
Flue and acute respiratory viral infections prophylaxis is the most efficient measure for prevention of their morbidity and complications. Fluvir allows decrease flue and acute respiratory viral infections morbidity, time of their course and severity due to its immunomodulatory effect. It can be recommended for flue and acute respiratory viral infections prevention in children.
Key words: acute respiratory diseases, children, prophylactics.
Tokarchuk N. I., Garlinskaya Yu. V., Antonets T. I., Starinets L. S., Savitskaya T. V., Lagoda V. V.
Diagnostic value of procalciton determination during the pneumonia in infants.
Purpose: To set the mean of the level of procalcitonin as a marker of bacterial infection in community-acquired pneumonia in infants.
Patients and methods. A total of 40 patients with community-acquired pneumonia in children aged from one month to 3 years were under observation. According to the severity of the disease the children were divided into two groups: the first group consisted of 27 patients with the III severity level of disease, the second — 13 children with IV severity level. The clinical examinations, white blood cell count, C-reactive protein were estimated. The determination of the level of procalcitonin in the venous blood during the first days after admission to the hospital was conducted to all children.
Results. The elevated level of procalcitonin in 34 (85%) patients with community-acquired pneumonia was found. A significant increase in the severity of procalcitonin was absorbed in all patients with pneumonia of the IV severity, the average level of which was 3,25 ± 0,05 ng / ml. Procalcitonin on the average level was 1,8 ± 0,02 ng / ml in 21 (62%) of children with III severity level of disease. Thus, the most significant for the diagnosis of bacterial pneumonia in children in the first year of life is the value of procalcitonin test > 2 ng / ml.
Conclusions. The diagnostic value of procalcitonin as an early marker of bacterial infection in community-acquired pneumonia in infants is found.
Key words: community-acquired pneumonia, infants, procalcitonin.
Синусит у дітей: сучасні концепції.
Ovcharenko L. S., Tkachenko V. Yu.
Effective antibiotic therapy of the recurrent bacterial bronchitis in children with hyperlasia of pharyngeal lymphoid tissue ring.
Objective: To establish the clinical efficacy of 5-day oral administration of «Cefodox» preparation in the treatment of children with recurrent forms of acute bacterial bronchitis in the setting of hypertrophy of pharyngeal lymphoid tissue ring and its effect on the composition of the microflora of respiratory tract, the course of systemic bacterial inflammatory process; to establish the safety and tolerability of the preparation.
Patients and methods. A total of 30 children in the age from 2 to 10 years with acute bacterial bronchitis for the third time during the last year in the setting of the hypertrophy pharyngeal lymphoid tissue ring were under observation. Cefodox was administered orally in the form of a suspension during ingestion in the dosage 10 mg / kg body weight twice a day with an interval of 12 hours. Concomitant therapy included the use of mucotropic means, antipyretics in the age dosages.
Results. Statistically significant improvement in all control parameters and the general condition of the patients was marked on the fifth day of treatment. Microbiological examination had demonstrated a statistically significant reduction in the number of CFU of isolated pathogens. Allergic reactions, adverse events and occurrences of side effects of the preparation are not found.
Conclusions. The use of Cefodox during 5 days is a highly effective method of treatment of recurrent bacterial bronchitis in children in the setting of hyperplasia of pharyngeal lymphoid tissue ring.
Key words: children, bronchitis, treatment, cefpodoxime proxetil.
Marushko Yu. V., Gischak T. V.
Effect of combined magnesium preparation on asthenic signs and sleep quality in children with essential hypertension.
Objective: To increase the effectiveness of treatment of asthenic symptoms and disorders of the night sleep in children with primary arterial hypertension (PAH) by including «Magne-B6» preparation to the treatment regimen.
Patients and methods. A total of 109 children (52 girls and 57 boys) in the age from 10 to 17 years with the presence of increase in blood pressure and excluded secondary character of hypertension were observed. The main group formed 82 children in the complex treatment of which was included Magne B6 by 1 tablet per 4 times a day during one month. The comparison group included 27 children who did not receive magnesium preparations. Studies were conducted in the dynamics at the beginning, after month and for the end of three months of prescribed treatment.
Results. Including of combined preparation of magnesium and pyridoxine to the treatment regimen of PAH on the setting of basic therapy (antihypertensive preparations, sedative means, diet and exercise stress) led to better results with regard to the correction of asthenic symptoms and lack of night-time reduction of AT. The resulting data is indicates about the effectiveness of a complex preparation Magne-B6 in children with PAH against the AS.
Conclusions. Application of Magne-B6 for one month is enough for children with minor manifestations of asthenia. Children with more severe manifestations of asthenia for the elimination of asthenic manifestations require extension of the treatment course with magnesium up to 3 months.
Key words: primary hypertension, children, treatment, magnesium preparation.
Boyarchuk O. R., Banadyga N. V., Sagal' I. R.
The course of reumatic heart disease in children in the setting of reactivation of Epstein—Barr virus infection.
Objective: To study the frequency of Herpesviridae infection in children with chronic rheumatic heart disease (CRHD) and to set its influence on the course of disease.
Patients and methods. The 62 patients with CRHD in the age from 12 to 17 years were under observation. CRHD was diagnosed in the presence of heart disease or heart valve lesions in the form of postinflammatory marginal fibrosis of valvular leaflet. The control group consisted of 25 apparently healthy children. Generally accepted clinical and laboratory examination, electrocardiography and doppler echocardiography were conducted for all children. The frequency of infection and reactivation by Herpesviridae was investigated by enzyme-linked immunosorbent assay.
Results. Reactivation of Epstein—Barr virus (EBV) is more often observed in patients with CRHD as evidenced by the presence of anti'VCA IgM (37,1% of children). Reactivation of chronic EBV infection causes more frequent manifestations of toxic and arthralgic syndromes, hypertrophy, tonsils dyshesion and changes in the hepatobiliary system.
Conclusions. The effect of Epstein-Barr virus infection on the clinical course of rheumatic heart disease and indicators of specific immunity to the high antibody formation is found.
Key words: Herpesviridae, Epstein-Barr virus, rheumatic heart disease, children.
Letyago A. V.
Features of the autonomic nervous system functioning during the forming of osteoarthrosis in girls-adolescents.
The goal — to clarify the mechanisms of osteoarthritis (OA) development based on studying of the features of vegetative support and responsiveness in girls-patients depending on the source type of autonomic tone.
Patients and methods. A total of 41 girls aged 15–18 years with osteoarthritis were observed. Vegetative state regulation was studied by the method of heart rate variability (HRV) in a horizontal position and quiet breathing. The type of original autonomic tone is determined by the data of sympathetic-vagal balance (LF / HF), depending on the values of which (vagotonia, normotoniya, sympathicotony) patients were divided into three groups. Radiographic changes in the joints were evaluated according to the Kellgren classification.
Results. The focus of neurohumoral regulation in patients with OA depends on the activity of units VNS. The most commonly diagnosed domination of the power of the energy spectrum SNA. In the group of girls with sympathicotonic fields where observed low functional capacity of autonomous regulatory mechanisms against the domination of the influence of the central contour. First of all, it was shown by insufficient contribution of HF to the overall power of neurohumoral spectrum at rest. Active orthostatic test revealed a decrease in reactivity of sympathetic component of the spectrum in such patients. During the vagotonia in girls were observed slightly better values of HRV than during the sympathic, especially TP, that is point on a great opportunity of neurohumoral support due to activity of the lower levels of government. But there was a significant instability of the neuro-humoral regulation.
Conclusions. The features of neuro-humoral regulation depending on the activity of units of the autonomic nervous system are found. In girls the most frequently diagnosed domination of power energy spectrum of the sympathetic nervous system with severe abnormalities in heart rate variability, as in rest so during the active orthostatic test.
Key words: osteoarthritis, adolescents, vegetative regulation.
Marushko Y., Polkovnichenko L.
Rational choice of antihistamines in pediatrics.
Summary. The paper represents latest views on antihistamine drugs use in pediatrics. For today, the most essential at acute and chronic allergic diseases in children is use of new antihistamine drug — levocetirizine.
Key words: allergy, children, levocetirizine.
Bobrova V. I., Vorobienko J. I., Voronina S. S., Ruban T. V.
The prognosis of the recurrent course of chronic gastroduodenitis in children.
Summary. The article presents main clinical signs of chronic gastroduodenitis that are valuable for the analysis of the disease. The proposed grade system that shows outcomes of chronic gastroduodenitis in children, allows us to personalize the choice of optimal treatment for children with certain pathology.
Keywords: chronic gastroduodenitis, risk factors, prognosis, children.
Mosienko A. P.
The features of pituitary-gonadal system changes in adolescents with functional diseases of digestive system in the setting of autonomic dysfunction.
Objective: To determine the role of gonadotropins in the genesis of autonomic disorders in adolescents with functional diseases of digestive system.
Patients and methods. A total of 164 persons, 76 boys (46.3%) and 88 girls (53.7%) were under observation. The baseline autonomic tone has been studied with the use of tables and forms. The functional state of the autonomic nervous system was assessed by analysis of heart rate variability by the method of cardiointer-valography. Vegetative support (ensuring adequate vegetative behavior) was determined by ortoclinostatic sample. The functional state of the pituitary-gonadal system was evaluated according to the somatic-sexual development, the level of gonadotropins (FSH and luteinizing hormones) and peripheral function of the gonads.
Results. According to the study the gastroesophageal reflux disease was diagnosed in 54 (32.9%) patients, functional dyspepsia — in 58 (35.4%), gallbladder dysfunction — in 52 (31.7%). All of the surveyed revealed the presence of autonomic dysfunctions. Functional disorders of the digestive system against autonomic dysfunction were accompanied by disorders of the hypothalamic-pituitary-gonadal system that is manifested primarily by the changes of gonadotropin-releasing hormone concentrations in blood plasma.
Conclusions. Pituitary-gonadal system is actively involved in the system of neuroendocrine regulation. During the different clinical forms of functional lesions of the digestive system in adolescents revealed the single-type of vector changes in hormonal status that is shown the dominant role of neuroendocrine mechanisms in the pathogenesis of these diseases.
Key words: adolescents, functional diseases of the digestive system, autonomic dysfunctions, pituitary-gonadal system.
Bobrova V. I.
Priorities of nitrofuran preparations management during the treatment of chronic gastroduodenitis in children.
The role of Helicobacter pylori infection and opportunistic pathogenic microflora in the development of chronic gastroduodenitis in children are shown. The need of rational choice of means in the eradication therapy is emphasizes. The use of nitrofuran preparations («Makmiror») in the schemes of antihelicobacter therapy can significantly improve the effectiveness of the treatment of helicobacteriosis and significantly reduce its toxicity.
Key words: chronic gastroduodenitis, Helicobacter pylori, opportunistic pathogenic microflora, antihelicobacter therapy, nitrofuran preparations.
Borshch S. K.
The differential use Biosporin for antagonistic elimination grampositive bacterium for treatment intestinale diseases.
Summary. The principles of the differential use biosporin with compoused strains microorganisms which belong to different taxonomical groups are determined in the article. The bacillus probiotics can be used for elimination grampositive agents.
Key words: irritable bowel syndrome, microbial antagonistic, biosporin, probiotic medicines.
Maydannik V. G., Burlaka E. A., Bagdasarova I. V., Lavrenchuk O. V.
Cellular hypoxia as a mechanism of renal disorders during the chronic pyelonephritis in children.
Objective: To study the markers of chronic hypoxia and oxidative stress as a criterion of microbial activity of inflammation and its course in children with chronic pyelonephritis.
Patients and methods. In the hospital were examined 23 children aged from 1 year to 17 years with various forms of chronic pyelonephritis, the 14 of which were in the stage of clinical and laboratory remission and 9 — in the stage of acute condition and received antibiotic therapy. The examination included a general analysis of blood and urine tests, Nechiporenko's urine test, biochemical blood assay, ultrasound examination of the kidneys, 24-hour monitoring of blood pressure, voiding cystography. State of kidney function was evaluated by the way of calculating the glomerular filtration rate by the Schwartz formula and the conduct of renoscintigraphy.
Results. It is found that the development of the disease accompanied by increased generation rate of superoxide radicals Nox2 neutrophils, increased levels of hypoxia-induced factor HIF-1α and decreased activity factor of anti-apoptotic protection Bcl-xL. The dependence of the degree of disorders of the levels of the studied parameters on the stage of the disease is found and proved the feasibility of their use as predictors of an unfavorable course of pyelonephritis.
Conclusions. Determination of markers of chronic hypoxia and oxidative stress will help to choose pathogenesis-based treatment preparations and thus slow down the progression of the pathological process in the kidneys, and their monitoring in dynamics will assess the effectiveness of therapy.
Key words: chronic pyelonephritis, children, cellular hypoxia, inflammation, apoptosis, Bcl-xL.
Korenev N. M., Bessonova I. N.
Features of the kidney function in adolescents with various forms of hypertension and hyperuricemia.
Objective: To study the features of kidney functional condition and early signs of endothelial dysfunction of glomerular apparatus of the kidneys in adolescents with arterial hypertension (AH) taking into account the weight and hyperuricemia presence.
Patients and methods. The study included 50 young boys in the age of 14–18 years with arterial hypertension. The first subgroup consisted of 12 (24%) young boys with arterial hypertension and normal body weight, the second one- 9 (18%) patients with arterial hypertension and overweight, and in the third group were 29 (56%) of patients with arterial hypertension and obesity. Medical history and life, taking into account risk factors were studied in all patients; also were evaluated anthropometric parameters, determined body mass index; were conducted clinical studies, office measurement and 24-hour monitoring of blood pressure; the determination of levels of serum uric acid and microalbuminuria, the values of blood creatinine, glomerular filtration rate and tubular reabsorption.
Results. There are found peculiarity of functional kidney condition in patients with arterial hypertension as follows: a higher level of serum uric acid (26.0%), most often in obese (31,0%); significantly greater data of filtration and nitrogen-eliminative kidney functions in patients with primary arterial hypertension than in the group with arterial hypertension and obesity; changes in tubular kidney function in young boys with arterial hypertension and obesity, especially at presence of hyperuricemia.
Conclusions. In adolescents with arterial hypertension identified violations of purine metabolism in the form of increased serum uric acid concentrations, as well as changes of functional kidney condition with the advent of the early signs of endothelial dysfunction of its glomerular apparatus.
Key words: adolescents, arterial hypertension, hyperuricemia, obesity, kidney.
Shipelik T. V., Chuprikov A. P.
Adolescent stage of the formation of personal maturity in boys and girls.
Objective: To study the effect of gender factor on the formation of personal maturity of adolescents.
Patients and methods. The study included 273 adolescents: 130 girls and 143 boys — the pupils of senior classes of the high school in the Kiev. Were used the following methods of psycho-diagnostics: D.A. Leontiev test life orientations, K. Rogers and R. Diamond scale of social and psychological adaptation, a package of techniques «Harmony» by O.I. Motkova, which includes the methodic «Basic desire» and «Purpose in life»; personal and situational anxiety was studied by the use of Ch. Spielberger methodic in Yu. Hanin adaptation, sociometric status of adolescents was measured using the method of «Choice». To characterize the personal development used the questionnaire of the Russian Academy of Education, which allow revealed the features of the emerging life experiences of adolescents.
Results. It is found that personal maturity in the age group of 14–15 years in girls is earlier than in boys, they are ahead boys in psychological development, which manifests itself in the processes of self-realization, self-determination and self-empowerment. Girls are better adapted to the society, due to the flexibility of the emotional, cognitive and motivational spheres.
Conclusions. According to the study the gender differences in the formation of the psychological maturity of adolescents are revealed.
Key words: personal maturity, harmony of person, personal education, personal potential, self-actualization, meaning of life, system of values, quality of life, life purpose, life perspective, spiritual development.
Stetsenko T. I., Konoplyanko T. V.
Hallervorden—Spatz disease. Modern view on etiology, pathogenesis and clinic in children and adults.
Summary. The review of the literature in the modern data about dehenerathion of nervous system with the accumulation of iron in exstrapiramidnyh structures. In modern foreign literature the concept of «disease-Hallevorden—Spatz» replaced by «neurodegeneration of brain with iron accumulation (NBIA)», which clearly reflects the pathogenesis and pathologic data group. Described various types and subtypes of neurodegenerative diseases with iron accumulation, including in childhood.
Keywords: neurodegeneration, Hallevorden—Spatz disease, children.
Doodle: not just words.