No 14 (2016)

The article presents data on the effectiveness of pharmacogenetic markers of treatment efficacy in children with atopic bronchial asthma. Variability in response to treatment with glucocorticosteroids, leukotriene receptor antagonists and ß2-adrenergic agonists in children with bronchial asthma is disclosed. The association of Gly/Gly16 genotype of ß2-adrenergic receptor gene with insufficient effect of the therapy with short-acting ß2-agonists is demonstrated. The involvement of Gly16 allele, CYP2D6*1934GGd, in development of phenotype with severe asthma tolerant to therapy with ß2-agonists and inhaled corticosteroids is emphasized.

Cough in children is one of the most common complaints that make parents to seek medical care. It is known that a healthy child suffers from acute respiratory viral infections, accompanied by fever, running nose and almost always cough, 5 or, according to some data, up to 8 times a year. At the same time, at the outpatient stage, without mentioning hospital treatment, systemic antibiotic therapy is assigned in most cases. Cough itself cannot be the reason for the appointment of antibacterial drugs. The article describes the main causes of cough in children, the distinctive features of its types, the methods of differential diagnosis techniques and principles of treatment of cough in various diseases.

Based on fundamental research data and own clinical experience, the authors describe the basic properties of mycoplasma, epidemiology, clinical manifestations of the different variants of the mycoplasmosis and treatment in children. It is noted that the mycoplasma infection in children is accompanied by long-term antigenemia that cause relapses and autoimmunization. All above mentioned is the rationale for the optimization of causal and pathogenetic therapy of mycoplasmosis, aimed at correcting the significant disturbances in the immunoresistance of the organism and endothelial function in children suffering from mycoplasmosis.

Acute gastroenteritis (AGE) is one of the most frequent causes of hospitalization of children under 5 years of age worldwide. Oral rehydration is first-line therapy in AGE due to the main symptoms of the disease: diarrhea and vomiting resulting in dehydration. In accordance with WHO guidelines, children with mild to moderate dehydration require exclusively oral rehydration therapy, while severe dehydration is an absolute indication for parenteral rehydration. Some children with mild dehydration, however, may require parenteral rehydration due to uncontrollable vomiting, refusal of drinking and/or ongoing diarrhea, which is not always possible to predict at the time of the child’s admission to hospital, and to evaluate by available scales. The article presents the results of study aimed to the development of predictive scale for assessing the need for parenteral rehydration in AGE. The previously created Vesikari scale for the retrospective assessment of the AGE severity was basis for this tool. The developed rating scale for need for parenteral rehydration in acute period produced satisfactory results in the selection of the method of rehydration, especially in children with moderate dehydration. The use of this scale will help to reduce the duration of hospitalization due to timely appointment of parenteral rehydration.

Nosocomial pneumonia (NP) is one of the most common infectious diseases in the hospital, and a leading pathology in patients of resuscitation units and intensive care units (ICUs). The clinical consequences of the disease are very important, especially for patients receiving mechanical ventilation (MV). Currently, MV-associated NP is the main cause of mortality of patients in the ICUs, with high attributive mortality rates. Adequate antibiotic therapy plays the decisive role in the favorable outcome in pneumonia. The carbapenems are recommended as first-line therapy for late NP and/or in the presence of risk factors for multiresistant micro flora. Doripenem - new parenteral 1-ß-methyl-carbapenem that has appeared on the Russian pharmaceutical market in 2008. The purpose of this survey - to generalize the results on the effectiveness of doripenem in the treatment of NP accumulated to date.