编号 1 (2018)

Juvenile myoclonic epilepsy is the most common form of idiopathic generalized epilepsy. The rehabilitation of patients with this pathology is based on balanced antiepileptic therapy using effective drug without side effects. The clinical case of aggravation of acute psychosis and Stevens-Johnson syndrome against the background of irrational pharmacotherapy in a teenage girl with juvenile myoclonic epilepsy is discussed.

The nature of the fever depends not only on the pathogenicity, pyrogenicity of the pathogen and the massivity of its invasion or the severity of aseptic inflammation, but also on the individual characteristics of the child, so, this fact should be considered in the choice of tactics of management of a sick child. The use of non-steroidal anti-inflammatory drugs in fever represents a symptomatic treatment. Given the dual nature of the effect of fever on the body, the question of the use of antipyretic drugs is debatable.

Allergic rhinitis is one of the most common allergic diseases. The article presents information on prevalence, etiology, pathogenesis and principles of treatment of this disease.

Purpose. To evaluate the clinical and immunological efficacy of use of ultrasound in combination with autoserotherapy in children with atopic bronchial asthma (BA). Material and Methods. The study included 64 children with atopic asthma aged 6 to 18 years. Group A received ultrasound in combination with autoserotherapy in addition to the background therapy. Group B received background therapy only. During the study, the level of disease control, the use of background therapy, and basophil phenotypes were assessed. Results. In both groups, the disease control has increased in children aged over 12 years; the results of the ACT test at 1 and 3 months were significantly higher in Group A than in Group B (P <0.05). When comparing the results of the test in children aged 6-12 years, the results of the C-ACT test at 1 month were statistically significantly higher in Group A than in Group B (P <0.05), indicating an earlier achievement of control in the group of children who received ultrasound with autoserotherapy in addition to background therapy. After 6 months from the start of treatment, the number of children in need of background therapy was significantly higher in Group B than in Group A (P <0.05). When studying the basophil phenotypes, it was found that in patients receiving ultrasound with autoserotherapy, the relative and absolute levels of basophils carrying CD203c +, CD203c+CD63 + receptor have decreased. In this group of children, the absolute level of CD203c+IgE+ basophils was statistically significantly lower (P <0.05). When comparing the parametres in two groups, it was revealed that the relative level of CD203c + CD63 + basophils was statistically significantly lower in group A than in group B at 82-90 days (P <0.05). Conclusions. The use of ultrasound in combination with autoserotherapy in children with atopic BA contributes to a faster achievement of disease control, shorter use of background therapy, and changes the basophil phenotype, reducing proallergic indicators.

Background. The results of a pilot project on the formation of criteria for the detection of mucopolysaccharidosis type I (MPS-I) in the routine pediatric clinical practice are presented. Methods. The integration of the program of molecular and genetic screening of the disease in the territory of the Russian Federation, as well as screening of medical records of patients with established diagnosis and suspected MPS-I, contribute to the formation of criteria. Results. As a result of the study, it was possible to group the most important signs allowing to suspect the MPS-I in a particular patient. Conclusions. Using a scoring system for each group of signs and symptoms, it is possible to objectively assess the likelihood of diagnosing MPS-I in patients at an early age.

Purpose. To determine the significance of unfavorable parameters of premorbid background in the formation of functional gastrointestinal disorders (FGIDs) in children with viral acute intestinal infections (VAII) based on the evaluation of anamnestic data. Methods. A comprehensive clinical and laboratory examination of 143 children aged 1 to 7 years who suffered from VAII of rotavirus, norovirus and combined rotanoroviral etiology was carried out. The examination was performed at the height of the disease, at the period of early convalescence, as well as during the follow-up for 12 months with visits every 3 months. Results. During the follow-up, among children who suffered from VAII, FGIDs were diagnosed in 30 (21.0%) of them. In the older age group (4-7 years), FGIDs were more common (26.5%) than in the younger age group (17.3%, p=0.32). In order to form a more accurate prognosis for the development of post-infectious FGIDs, a stepwise discriminant analysis was conducted; it was possible to identify an informationally significant combination of isolated anamnestic factors studied, predicting the high probability of the risk of FGIDs formation in children within a year after VAII. Conclusions. Based on the results of study using the methods of mathematical and statistical modeling, a set of prognostic factors of the premorbid background, which determine the formation of FGIDs in children after VAII, was established. They include early adoption of artificial feeding, the presence of background allergic pathology, diseases of the digestive system in first-degree relatives, and a number of other factors.