编号 11 (2015)

Headache remains one of the most common complaints in children and adolescents. Tension-type headache (TTH) and migraine are the two most common causes of headache in children. Over recent decades, there has been an increase in the prevalence of tensiontype headache and comorbid psycho-emotional disorders in the pediatric population, especially among teenagers. Despite the high prevalence and social significance, the number of new studies on the TTH is still limited. It is known that about 36% of parents are not aware of the presence of repetitive headaches in their children, and about 50% of doctors do not use the international classification of headaches in their practice. These facts explain the existing difficulties in timely diagnosis, detection and correction of risk factors for chronic TTH. Treatment and prevention of TTH is a comprehensive multi-disciplinary task which should not be restricted only to pharmacotherapy. To achieve success in TTH management, correction of the child’s daily activity and school-family relationship is required, involving psychological support by a psychologist, and, if necessary - by a psychiatrist and a psychotherapist.

Acute respiratory tract infections are the most common reason for seeking medical help. Recurrent respiratory infections and their complications in children are a significant burden for their families and society. The problem of effective and safe treatment and prevention of acute respiratory infections (ARI) is one of the most relevant in clinical pediatrics. The article considers the potentials for the use of possibility of use of immunostimulatory agent with antiviral effect, inosine pranobex, in the treatment of ARI. The data on the mechanism of combined (immunomodulatory and antiviral) action of the drug, its efficacy and tolerability in children are presented. The literature data and the results of own author’s studies suggest that inosine pranobex suppresses the symptoms of ARI, prevents complications, and restores compromised immunity, reduces the need for other drugs and pharmaceutical burden. The properties of the drug expand potentials for the pharmacotherapy of acute respiratory viral infections in children. Analysis of publications on the evaluation of the effectiveness of this drug and own author’s research data allow to recommend the drug inosine pranobex for the treatment of acute respiratory infections in children who are prone to frequent incidence of respiratory infections, patients with chronic disorders, including allergic respiratory diseases and intercurrent acute respiratory infections.

The article is devoted to an actual problem of modern pediatrics and neurology - comprehensive rehabilitation of children after stroke, traumatic brain injury, perinatal lesions of the central nervous system (CNS). The etiological aspects, pathophysiological mechanisms and clinical features of these conditions in children are discussed. The modern directions of comprehensive rehabilitation, including the use of innovative technologies of regenerative treatment, are considered. It is shown that the diagnosis and rehabilitation of the consequences of stroke, traumatic brain injury and cerebral palsy in children is a complex problem that requires a differentiated integrated approach to improve the effectiveness of treatment and quality of life of patients.

Epilepsy in patients with Down syndrome is detected in 8-9% of cases, with West syndrome in half of all cases of epilepsy. A total of 8 patients with Down syndrome and West syndrome were examined. Middle debut of epileptic spasms occurred in the age of 5.6 months. In general, the nature of attacks (epileptic spasms), the electroencephalogram characteristics (EEG) (hypsarrhythmia or modified hypsarrhythmia), and EEG - pattern of paroxysms did not differ from symptoms of West syndrome of other etiology. Antiepileptic therapy resulted in a significant improvement in 87.5% of cases of West syndrome in Down's syndrome, and the remission was achieved in 50% of patients. In this study, tetracosactide, valproates, topiramate, lamotrigine, ethosuximide, and vigabatrin were used. The high efficiency of combination of valproates with topiramate was demonstrated.

The article provides an overview of the frequency and diagnostic features of mycoplasma and chlamydia infections in children. The importance of clinical diagnosis of pneumonia and bronchitis of these ethiologies is emphasized, because the high frequency of carriers of pathogens and delayed growth of antibody titers impede the early diagnosis of the disease. Clinical manifestations of mycoplasmal pneumonia and bronchitis are sufficient for proper selection of empirical antibiotics; lack of effect of β-lactam drug in the treatment of pneumonia has importance for diagnosis. The drugs of choice for the treatment of «atypical» infections are macrolides.

The article presents the results of evaluation of the preventive efficacy and pharmacoeconomic analysis of use of the drug oxodihydroacridinylacetate sodium (Neovir) in acute respiratory infections (ARI) and influenza in a large industrial enterprise. The case-control study included 156 people (main group) expirienced ARI or influenza in the first quarter of 2015 and 300 people (control group) without cases of ARI or influenza during study period and randomly selected according to pre-established procedures. Neovir was prescribed to 30 people of control group, and to 6 people of main group. The risk of acute respiratory disease or influenza within 28 days after a single prophylactic use Neovir was 2,778 times less compared with no use of drug. Pharmacoeconomic analysis showed that prophylactic use of Neovir in company with personnel number of 2,000 people would save 2543.9 thousand rubles for 3 months. The results indicate a high preventive efficacy of Neovir and economic feasibility of its use as a prophylactic agent of nonspecific acute respiratory infections and influenza.

Eukabal® cough syrup - herbal expectorant drug with mucolytic and bactericidal action. The most common cause of cough is infectious and inflammatory diseases of upper respiratory tract, and in this case treatment with Eukabal® is indicated. Besides of that, Eucabal® can be used in bronchitis.