No 1 (2016)

Myofascial pain syndrome (MFPS) is one of the main sources of musculoskeletal pain in adults and children. The presence of musculoskeletal back pain impacts on the performance efficiency and education of children, which leads to the social, habitable and working maladjustment of the patients, as well as a violation of their quality of life. The main reasons for the development of MFPS include stretching the muscles (bad jump, turn); repeated microtrauma (chronic overexertion, long-term work of untrained muscles); postural overexertion (prolonged exposure to non-physiological position); muscle hypothermia; emotional stress. Correct diagnosis depends largely on the completeness of the information, medical history, detailed analysis of the patient’s complaints and on careful clinical examination, which, in addition to the traditional neurological examination, should include methods of manual diagnostics, evaluation of muscle condition and paraclinical methods. So far, all these questions about the pathogenesis, diagnosis and treatment of MFPS in children are not well understood and require further discussion.

The review is dedicated to the analysis of clinical guidelines for the treatment of cough in children. The need for differentiation of cough during the diagnostics, such as type of cough and its duration and etiology, is emphasized. The results of randomized controlled, and observational studies in children with acute respiratory tract infections are presented. The main groups of antitussives are discussed, and the feasibility of use of fenspiride for the treatment of respiratory diseases of viral, bacterial and intracellular etiology in infants and older children, accompanied by an inflammatory reaction and obstruction at the level of the upper and lower respiratory tract, is shown.

The article systematizes vitamin D effects on the nervous system. The results of numerous studies showed the need for vitamin D in order to maintain homeostasis of neurotransmitters, hippocampus functioning, the development and functioning of the cerebral cortex. Clinical studies have shown that adequate supply of vitamin D supports sustainable psycho-emotional background, cognitive ability, memory, fine motor skills, fluency - essential components of successful learning.

Purpose: Palivizumab, a humanized, respiratory syncytial virus (RSV)-specific monoclonal antibody, is safe and effective in reducing RSV-associated hospitalizations of infants and children at high risk for RSV disease. The purpose of this study was to assess the safety and efficacy of palivizumab in subjects in the Russian Federation who participated in three studies. Patients and Methods: Infants and children with risk factors for serious RSV disease (prematurity [gestational age <35 weeks], bronchopulmonary dysplasia, congenital heart disease) were administered up to 5 monthly doses ( 15 mg/kg) of palivizumab during the RSV season. RSV-associated hospitalizations and adverse events (AEs) among Russian participants in the 3 studies were pooled and assessed. Results: Of the subjects in the combined trials (n=176), there were 7 discontinuations (4.0%). Most subjects (78.4%) received 5 doses of palivizumab. No RSV-associated hospitalizations occurred. Ninety-three subjects (52.8%) experienced an AE. Most AEs were mild or moderate in severity. AEs considered at least possibly related to study drug occurred in five subjects (2.8%). Serious AEs occurred in 29 subjects (16.5%). One subject died due to an AE not considered related to study drug. Conclusion: The safety and efficacy of palivizumab in children in the Russian Federation at high risk for severe RSV disease appear similar to that demonstrated in other studies conducted with palivizumab elsewhere.

The article presents the results of studies of the functional disorders of the gastrointestinal tract (GIT), and changes in intestinal microbiota in 120 children who had acute intestinal infection caused by rotaviruses and noroviruses. It was shown that functional gastrointestinal pathology realized at 18.3% of convalescents after viral gastroenteritis. Changes of microbiota in viral gastroenteritis of different etiologies have a number of specific features: reducing the quantitative content of Faecalibacterium prausnitzii, raising of Bacteroides thetaiotaomicrion in rotavirus infection, pronounced inhibition of growth of Lactobacillus spp. and Bifidobacterium spp., the excessive growth of opportunistic bacteria in norovirus infection.

The evaluation of the results of prolonged follow-up (5 years after diagnosis) for 32 children aged from 6 months to 9 years old, suffering from functional constipation, was performed. The analysis of the following parameters was implemented: characteristics of appetite and variability of child nutrition; the character of the stool according to the Bristol stool scale, and subjective feelings during the act of defecation; continuity of rehabilitation measures after the primary treatment, including the use of drugs. Within the first 6 months, positive results were achieved due to having gained persistent medical effect in 78.6% of patients. Later, however, the therapeutic effect faded; the parents have lost the skills and refused mandatory aspects of the maintenance of health (healthy nutrition, physical activity, etc.). As a result, there were 57.7% of recovered children after 5 years of follow-up. In other cases, the clinical picture of constipation has persisted.

Respiratory diseases occupy first place in the structure of morbidity in children, among them the largest proportion belongs to acute respiratory infections (ARI), which have predominantly viral etiology. The pathogenesis of ARI is an inflammation in the mucosal lining caused by the action of various cytokines and mediators. Anti-inflammatory drug fenspiride affects simultaneously on various links of the inflammatory process that has been established in numerous experimental studies. High efficiency and safety of fenspiride in children with ARI has been shown in several comparative clinical studies. The data collected allow to recommend this drug for widespread use in pediatric patients.