No 5S (2018)

Infant formulas based on goat milk serve as a qualitative alternative for the artificial feeding of infants and young children. The purpose of the review: based on the analysis of the physico-chemical composition, to demonstrate the unique properties of goat milk and certain advantages over cow milk. The results of clinical studies on the use of adapted infant formulas based on goat milk for feeding of healthy infants and in a number of diseases of young children are discussed.

Bronchopulmonary dysplasia (BPD) is one of the most significant consequences of perinatal pathology, developing predominantly in premature infants who received respiratory support in the neonatal period. The disease has a regressive course and is characterized, as a rule, by a decrease in respiratory failure as the child grows up; in some cases, a clinical recovery is possible at 3 years of life. Such a course of the disease determines differentiated approaches to patients at different stages of their management. However, the outpatient stage of management of patients in this category has not been enough addressed in the scientific literature. The article presents the management of patients with BPD at an outpatient stage in accordance with the Federal Clinical Recommendations (2014). The safety and efficacy of passive and active immunization of children with BPD against such respiratory pathogens as respiratory syncytial virus infection, pneumococcus, Haemophilus influenza,e are discussed. The necessity of long-term monitoring of the functional parameters of external respiration in children with history of BPD is explained. The verification of the outcomes of the disease at 3 years of life is presented.

Non-Hodgkin’s lymphomas (NHL) occupy the third place in the structure of oncological morbidity in children and are characterized by highly aggressive course. Rapid dissemination and the development of life-threatening complications determine the need to identify the type of lymphoma and tactics of management of a patient as soon as possible. The article concerns the theories of etiology, the features of the clinical picture, examination and treatment of the main morphological variants of NHL. Over the past decades, the approach to diagnosis and treatment of diseases in this group has changed significantly. Currently, special attention is paid to immunohistochemical and cytogenetic characteristics. Modern therapy taking into account these features of the disease has made it possible to achieve distinct successes, which resulted in a significant increase in the survival rate of pediatric patients.

Acute intestinal infections (AIIs) occupy a significant place in the structure of infectious diseases in children. In recent years, there has been a steady trend towards an increase in the incidence rate of AIIs in the Russian Federation. Currently, diarrheal viruses are the main cause of AIIS in children. Assessment of severity of AIIS takes into account the dehydration severity, the degree of lesions of the gastrointestinal tract and intoxication. It is extremely important to evaluate the degree of dehydration and timely initiation of oral rehydration therapy, which requires the use of low osmolar glucose-saline solutions. An important component of AII therapy is a rational diet that is appropriate for the child’s age, the nature of the concomitant diseases and the type of feeding.

Background. Sore throat is one of the most common complaints in pediatric practice. Most often, it is a consequence of inflammation of the mucous membrane of the posterior pharyngeal wall and palatine tonsils in acute tonsillitis (AT) of both bacterial and viral etiology. Objective. Evaluation of the spectrum of diseases accompanied by changes in the pharyngoscopic pattern, the detection of the incidence of ATs in children, their etiology, and the most effective methods of treatment. Methods. The study included 100 children with pharyngoscopic changes: 83 children with known etiology of tonsillitis (3 children with bacterial tonsillitis and 80 children with viral forms of the disease) and 17 with reliably not clear etiology of tonsillitis. All children underwent general clinical examination with pharyngo-, oto- and anterior rhinoscopy, routine blood and urine tests. Some patients additionally underwent detection of serum C-reactive protein and procalcitonin levels, examination of nasopharyngeal swabs for the detection of respiratory viruses and enteroviruses, examination of serum for the presence of IgM antibodies to the nuclear antigen of the Epstein-Barr virus, as well as a swab from the posterior pharyngeal wall and palatine tonsils to determine β-hemolytic streptococcus group A. Treatment methods. Patients with proven streptococcal tonsillitis received both systemic antibacterial therapy and topical treatment for relief of sore throat. With viral forms of tonsillitis, we tried to prescribe only symptomatic treatment, usually used in ARVI, as well as topical therapy for the relief of inflammation and sore throat. As a drug for topical treatment of tonsillitis, benzodamine hydrochloride was used under the trade name Tantum® Verde in dosage forms of spray and orodispersible tablets with an evaluation of efficacy based on subjective sensations of the patient on a visual analogue scale (VAS) equivalent to 100 points, before and after administration of the drug and objective changes in the pharyngoscopic pattern. Results. More than 95% of patients noted a significant reduction in the pain syndrome in the first 60 seconds after the start of use of Tantum® Verde. Regardless of the etiology of ATs, the VAS score first hour after showed that 83.7% of patients had significant pain relief when using both a spray and tablets. At the end of the first day of topical therapy, there was a clear positive dynamics of subjective sensations and improvement of the pharyngoscopic picture in 75% of cases. At the end of the second day, the other 23% of patients stopped complaining of pain. Conclusion. The vast majority of ATs has a viral etiology. Antibacterial etiotropic therapy of streptococcal tonsillitis quickly relieves fever and improves the patient’s condition. With viral infections, it is only possible to improve the patient’s condition with the use of symptomatic drugs, locally stopping the pain syndrome, mainly in tonsillitis. Preparations containing benzydamine, used for a long time and well-proven, not only meet all the basic requirements for the drugs for topical treatment of ATs, but are also possible for use in different dosage forms.

Background. Recent epidemiological and experimental studies indicate that predisposition for obesity and nutrition-related non-infectious diseases can be programmed during prenatal development and early childhood, and it is determined by the state of the mother’s nutrition before and during pregnancy. Epigenetic changes are possible during prenatal development under the influence of exogenous factors, in particular, insufficient or excessive nutrition of the fetus, which in turn can cause changes in metabolic processes, structure and functions of organs and systems, thereby increasing susceptibility to chronic diseases. The model of human eating behavior is formed early in life, when stable taste preferences are established and the attitude to the procedure of food intake (the regimen, the portion volume, the cultural behavior at the table) is fostered. Objective: evaluation of the dietary habits of pregnant women (PW) and breastfeeding women (BW) with normal body weight and obesity and the dietary habits of their children. Methods. The assessment of the actual nutrition by the method of 24-hour reproduction of food and the frequency method in PW and BW with normal and excessive body weight, and feeding habits of children of these mothers and BW with normal body weight. Results. Pregnant women with a body mass index (BMI) of more than 24.9 kg/m2 and carriers of mutant alleles of established polymorphisms have a more frequent intake of a number of foods high in protein and fat and digestible carbohydrates compared to women with normal BMI. In breastfeeding women with a BMI more than 24.9, the same patterns were established, which indicates the preservation of food stereotypes characteristic of the period of pregnancy during the lactation. Differences in the formation of eating behavior in children depending on the nutritional status of the mothers were revealed: early introduction of foods and dishes of complementary feeding to children of mothers with excessive body weight and obesity; after 1.5-2 years of age, mothers are more likely to add salt and sugar to food for children. Conclusion. The study confirmed that the inappropriate eating behavior of pregnant and breastfeeding women with overweight and obesity, leading to excessive consumption of foods containing saturated fats and sugars with a high glycemic index, salt and substances stimulating appetite, contributes to the formation of inappropriate eating behavior in children, because mothers give complementary feeding to their children earlier compared to mothers with BMI=18.5-24.9.

The article discusses the problem of mycoplasmal infection in pediatric practice. Mycoplasma pneumoniae is a fairly common agent of acute respiratory infections in children, which is the second most important etiologic factor in the development of community-acquired pneumonia in children older than 5 years. Mycoplasmal infection can occur in different clinical variants with varying degrees of severity, and the severity of the course and the spectrum of clinical manifestations, both respiratory and non-respiratory, are associated most with the virulence of the pathogen and the immune potential of the infected person. There is still a need to develop an readily accessible test for rapid diagnosis. Antibacterial therapy is recommended for the treatment of pneumonia and severe forms requiring hospitalization.