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No 11 (2017)
- Year: 2017
- Articles: 18
- URL: https://journals.eco-vector.com/2073-4034/issue/view/7047
Articles
OT REDAKTsII
Pharmateca. 2017;(11):3-3
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NEWS OF MEDICINE
Pharmateca. 2017;(11):4-5
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SAFETY OF APPLICATION OF SHORT COURSES OF GLUCOCORTICOSTEROIDS: LITERATURE REVIEW
Abstract
The literature review is devoted to the safety of short courses of glucocorticosteroids (GCS) in children. An analysis of the literature has shown that short courses of treatment with GCS are characterized by a satisfactory safety profile in general. The most common side effects of GCS when used from 7 to 14 days include dyspepsia (nausea, vomiting), behavioral and sleep disorders. In most cases, these side effects cause withdrawal of GCS in children. The most dangerous, in terms of prognosis, can be the use of systemic GCS at the prodromal stage of varicella. Long-term use of GCS (courses more than 2 months) is associated with both suppression of adrenal cortex function and immunosuppression. Studies show that treatment with short courses of systemic GCS (orally 1 to 2 mg/ kg/day of prednisolone or prednisone for 3-7 days) does not cause these effects, even if they are used several times in one year. However, an increase in the duration of treatment with systemic GCS beyond 7 days, according to several studies, increases the risk of serious side effects.
Pharmateca. 2017;(11):6-13
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PRACTICAL APPROACHES TO THE OPTIMIZATION OF MICROBIAL ECOLOGY OF THE DIGESTIVE TRACT IN CHILDREN
Abstract
This review article provides information on clinical studies on the evaluation of normal intestinal microbiota, its formation and positive functions. Particular attention is focused on the controlling role of the mucin layer. The issues of the ability of probiotics to exert a protective effect on the intestinal barrier, antagonistic effect on conditionally pathogenic microorganisms and stimulating effect on immunity are discussed. The master seed species and strains that are part of the probiotic preparations, the most studied from the point of view of evidence-based medicine are considered.
Pharmateca. 2017;(11):14-21
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ADVERSE DRUG REACTIONS IN CHILDREN
Abstract
Currently, adverse drug reactions (ADRs) are a big problem due to the high prevalence and the potential severity of their outcomes. There are type A (dose-dependent, more common) and type B (unpredictable, often more severe and clinically problematic) ADRs. The children’s population is more vulnerable to the development of ADRs due to the immaturity of the systems involved in the absorption, metabolism, transport and elimination of drugs, which should be taken into account during prescription of pharmacotherapy in children.
Pharmateca. 2017;(11):22-27
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CONSTIPATIONS IN CHILDREN: DIAGNOSIS AND TREATMENT AT THE PREHOSPITAL STAGE
Abstract
Constipation is a common pathology, especially in young children. The leading causes of constipation include hypodynamia, unhealthy diet, changes in the intestinal biocenosis; psychological, iatrogenic and other factors are also important. The Roman criteria are advisable to use in diagnosing constipation. The key to successful treatment of functional constipation lies in its early diagnosis and complex therapy, including dietary and behavioral aspects. Laxatives are an important element in the treatment of constipation, and oligosaccharides with a prebiotic effect are the most physiological. The data presented in the article demonstrate the optimal safety profile and high efficacy of lactitol as a laxative, as well as its prebiotic properties.
Pharmateca. 2017;(11):28-33
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ANTI-INFLAMMATORY THERAPY OF BRONCHITIS IN CHILDREN
Abstract
The article discusses the problem of bronchitis, which refers to the diseases most frequently encountered in pediatric practice; therefore it has not only medical but also social significance. Classification, etiology, clinical manifestations, and principles of treatment of this disease are presented. The problem of bronchitis in children should be studied in terms of functional disorders, etiology, with providing the ability to the choice of sparing methods of treatment that do not require special inhalation equipment.
Pharmateca. 2017;(11):34-40
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THE PLACE OF METABYOTICS IN PREVENTION AND TREATMENT OF ANTIBIOTIC-ASSOCIATED DIARRHEA
Abstract
To date, there are many cases of irrational use of antibacterial drugs (ABDs): prescription without indications, «just in case», violation of schemes of their use, a broad assignment of reserve ABDs. Antibiotic-associated diarrhea is one of the significant side effects associated with the therapy with ABDs. To date, one of the most promising areas in the therapeutic correction of microbiocenosis disorders is metabiotic therapy.
Pharmateca. 2017;(11):41-45
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THE ROLE OF SYMPTOMATIC THERAPY OF RESPIRATORY TRACT INFECTIONS IN CHILDREN IN PREVENTING AND OVERCOMING OF DRUG RESISTANCE OF MICROORGANISMS
Abstract
The problem of treatment of acute respiratory tract infections (ARTI) is discussed. Excessive use of antibiotic therapy in children with ARTI requires a revision of approaches to the treatment of this group of diseases. In particular, it is necessary to use the adequate symptomatic therapy of ARTI in pediatric patients. Combined drug containing bromhexine hydrochloride, guaifenesin and salbutamol sulfate, effectively affects the manifestations of ARTI - cough and bronchial obstruction. Clinical studies have shown that the use of this drug significantly reduces the duration of the disease. This suggests that the use of this combined drug reduces the use of antibiotics in children with ARTI. It is advisable to conduct clinical studies on the impact of pathogenetic and symptomatic drugs on the frequency of use of antibiotic therapy in children.
Pharmateca. 2017;(11):46-51
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THE USE OF METHYLPREDNISOLONE ACEPONATE IN THE COMPLEX THERAPY OF ATOPIC DERMATITIS IN CHILDREN
Abstract
The article presents an analysis of literature data on the experience of the use of methylprednisolone aceponate (Advantan, BAYER) in the treatment of children with atopic dermatitis. The study was aimed to the evaluation of the efficacy and safety of methylprednisolone aceponate in the treatment of children with atopic dermatitis. In different countries, studies on the use of various dosage forms of this drug have been conducted. The efficacy and safety of methylprednisolone aceponate is shown.
Pharmateca. 2017;(11):52-56
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PRINCIPLES OF THERAPY OF ACUTE INTESTINAL INFECTIONS IN CHILDREN AT THE PRESENT STAGE
Abstract
Acute intestinal infections are widespread in the world, and the incidence and frequency of poor outcomes in children, especially in the first years of life, is much higher than in the adult population. From modern positions, the approach to diagnosis and treatment should be comprehensive and personified. The article presents literature data and own authors’ research dats on the effectiveness of the applied methods of treatment. The issue of etiotropic therapy of invasive diarrhea is discussed separately. Nonabsorbable intestinal antiseptics are the drugs of choice in pediatric practice in most cases of invasive diarrhea.
Pharmateca. 2017;(11):57-62
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THE USE OF MUSCLE RELAXANTS IN COMPLEX REHABILITATION OF CHILDREN WITH SPASTIC-DYSKINETIC FORMS OF CEREBRAL PALSY
Abstract
The article considers the mechanisms of action of two muscle relaxants - botulinum toxin type A (BoTN-A) and baclofen, and analyzes their effectiveness in complex rehabilitation of children with spastic-dyskinetic forms of infantile cerebral palsy (ICP). It was noted that BoTN-A is the most effective drug for correcting motor disorders in this category of patients. The following conclusion is made: in complex rehabilitation, muscle relaxants of peripheral (BTTA) and central (baclofen) actions can have a positive effect on the development of motor functions in children with spastic-dyskinetic forms of cerebral palsy; however, the use of botulinotherapy allows accelerating the formation of motor skills, improving coordination and posture, and preventing occurrence of secondary biomechanical complications in severe motor disorders.
Pharmateca. 2017;(11):63-66
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VNIMANIYu AVTOROV!
Pharmateca. 2017;(11):66-66
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IMMUNOLOGICAL FEATURES OF VIRAL INTESTINAL INFECTIONS IN CHILDREN
Abstract
The article presents the results of evaluation of features of the immunological parameters in 41 children in the acute period and during period of recovery after norovirus, rotavirus and combined rotavirus-norovirus infections. It has been shown that various components response participate in the immune response in viral intestinal infections, and their roles vary depending on the period of the infectious process. The acute period of intestinal infection is characterized by an increase in the interferon-γ levels, as well as a decrease in the average content of T-helpers and cytotoxic lymphocytes, more pronounced in rotavirus than in norovirus infection. During the period of recovery, normalization of the level of the main subpopulations of lymphocytes and interferon status are noted, against a background of moderate increase in mature B-lymphocytes and serum immunoglobulin A levels, which reflects the involvement of the immune system in the antiviral response.
Pharmateca. 2017;(11):67-71
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ANALYSIS OF INFLAMMATORY MARKER LEVELS IN ACUTE RESPIRATORY VIRAL INFECTIONS
Abstract
An increase in the inflammatory marker levels is usually associated with the bacterial etiology of the disease, leading to the appointment of antacterial therapy. The study was aimed to the analysis the inflammatory markers levels - C-reactive protein (CRP) and procalcitonin -in a viral disease, because incorrect interpretation of their increased levels can serve as the basis for the unjustified use of antibacterial drugs. A retrospective analysis of250 case histories of children aged 12 days to 17 years 11 months hospitalized with acute respiratory viral disease in the Department of Diagnosis and Rehabilitation of the SCCH in 2016. Leukocytosis more than 15x109/l was detected in 13% of children, more often - in children with adenoviral tonsillitis (29%) and mononucleosis-like syndrome (23%). The CRP levels more than 30 mg/l was also more frequent in adenoviral tonsillitis (57% of cases) and tonsillitis caused by the Ebstein-Barr virus (50%). Among remaining ARVIs, an increase in the CRP levels was observed only in 10% of cases. The increase in the procalcitonin levels more than 2 ng/ml occurred only in 10% of the patients. In the clinic, antibacterial therapy was carried out only in 25 patients, including due to the increase in inflammatory marker levels against the background of fever (13 patients) and with the duration of fever more than 5 days (9 patients). The course of the disease in children who were prescribed and not prescribed an antibacterial drug was similar. Thus, in children with viral diseases, an increase in the inflammatory marker levels is possible, most often in the presence of tissue inflammation (tonsillitis). In case of a viral disease, the appointment of antibacterial drugs according to the indices of leukocytosis and CRP levels is ineffective.
Pharmateca. 2017;(11):72-75
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APPROACHES TO THE COMBINED TREATMENT OF ACUTE MAXILLARY SYNCUSITIS ASSOCIATED WITH CHLAMIDIAL INFECTION IN CHILDREN
Abstract
A complex examination of 58 children with acute sinusitis, hospitalized in the ENT department, was carried out. Verification of chlamydial structures was performed by polymerase chain reaction and direct immunofluorescence, the presence of antichlamydia antibodies was determined by enzyme immunoassay. A high frequency of detection of chlamydia in children with sinusitis (48% of cases) is shown. The features of clinical manifestations and immunopathological disorders accompanying acute sinusitis are presented. A scheme for the complex treatment of children with acute inflammation of the paranasal sinuses associated with chlamydial infection, which is based on the use of cyclic polyantibiotic therapy with macrolide drugs, is proposed. The most significant advantage of this therapy is a high degree of eradication of the chlamydia (87.5%), which allows for high-quality antichlamydial treatment, prevents chronic inflammation and dissemination of infection, and and helps to reduce the number of complications. High operational characteristics of the scheme determine the appropriateness of its use for the treatment of acute sinusitis associated with chlamydial infection in children. It is recommended for use in practical healthcare by otorhinolaryngologists.
Pharmateca. 2017;(11):76-82
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EXPERT EVALUATION OF QUALITY OF INPATIENT MEDICAL CARE FOR CHILDREN WITH RESPIRATORY PATHOLOGY IN ROSTOV REGION
Abstract
Low quality of medical care can not only impede the achievement of targeted health indicators, but also lead to unjustified direct and indirect costs of the health system as a whole. The article presents the results of the analysis of the quality of medical and diagnostic care for acute respiratory diseases in children hospitalized in pediatric hospitals (based on the example of the Rostov Region), and its conformity with the clinical guidelines approved in the Russian Federation. It was revealed that low quality of medical care for children with ARI was caused by unjustified hospitalization (66%), excessive chest x-ray in the absence of indications (49%), unreasonable prescription of antibacterial therapy (70%) and antihistamines (59%), irrational antiviral and immunomodulatory therapy (51%), inadequate administration of inhalation therapy (29%). Overdiagnosis of pneumonia occurred in 71% of cases, mainly due to incorrect interpretation of the results of X-ray examination. Irrational antibiotic therapy for community-acquired pneumonia was noted in 69% of cases, and polypharmacy - in 63% of cases. The results of the expert evaluation point out the directions for improving the quality of medical care for children: training and attestation of physicians in accordance with the Federal clinical recommendations for diagnosis and treatment of respiratory diseases; control over the use of antibiotics and other medicines in hospitals; internal and external audit of radiological services of hospitals; regular internal and external audit of quality of inpatient medical care.
Pharmateca. 2017;(11):83-90
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EVALUATION OF THE COMPETENCE OF PRIMARY CARE PHYSICIANS IN ORGANIZING MEDICAL AID TO CHILDREN WITH ORFAN DISEASES IN MOSCOW
Abstract
The article presents the results of a sociological research of the readiness of Moscow primary care physicians to provide assistance to children with orphan diseases (ODs). The study was conducted using a specially developed questionnaire. Deficiency of knowledge about ODs, their symptomatology, diagnostics, treatment and rehabilitation of patients was revealed; lack of familiarity with the existence of legislative frameworks that determine the destination routing of children with this pathology in Moscow; lack of methodological materials, including the issues of organization of medical aid and its extent, and insufficient information support for doctors were detected. Based on the results obtained, recommendations aimed at increasing the competence of physicians in providing medical care to children with ODs were developed.
Pharmateca. 2017;(11):91-95
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