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Vol 8, No 5 (2017)


Prophylactic thyroidectomy as method of medullary thyroid carcinoma prevention in children from MEN syndrom families

Matveeva Z.S., Romanchishen A.F., Gostimsky A.V., Vabalayte K.V.


The article presents results of diagnostics, surgical treatment and follow-up of patients with rare hereditary-conditioned forms of thyroid cancer – medullary thyroid carcinoma in content of multiple endocrine neoplasia syndrome. Particular attention is paid to the examination and tactics of treatment of children and adolescents with family genetically confirmed Sipple syndrome. The disease is diagnosed in 4 families. Syndrome of multiple endocrine neoplasia 2a type we found in 7 (0.024%) of 29,325 children and adult patients. All the children were from families in which one of the blood relatives suffered medullary thyroid cancer. The family nature of the disease was confirmed by molecular genetic studies that revealed mutations in C634 (T1900C) in the 11 exon of the RET gene. Only in 3 out of 7 cases thyroidectomy was prophylactic. Four children were fond foci of medullary carcinoma in the removed thyroid gland. In total, 22 operations were performed for the members of 4 families suffering from the family syndrome MEN-2a. The article shows that if a patient is diagnosed Sippl's syndrome, all his blood relatives need to be checked for the mutation of the RET gene to identify familial medullary thyroid cancer, adenomas of parathyroid glands and pheochromocytomas. Early removal of the thyroid gland (in children under the age of 5 years) prevents medullary cancer, and timely diagnosis and adequate surgical removal of neoplasms of parathyroid glands and adrenal glands ensure recovery of the patients. Closest relatives should be checked for the level of calcium and calcitonin, catecholamines, vanillylmandelic acid and metanephrine, ACTH, cancer-embryonic antigen.

Pediatrician (St. Petersburg). 2017;8(5):5-11
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Heart rate variability analysis with daily monitoring of electrocardiograms in children with chronic non-obstructive pyelonephritis

Zhuravleva N.S., Buryak V.N., Pokusaeva O.S., Babich V.L.


Condition of the autonomic nervous system reflects the characteristics of the autonomic regulation of the activities of various functional systems. In order to determine possible violations of the autonomic regulation of the functional activity of the urinary system there was held some timing and spectral parameters of heart rate variability of 53 children aged 7 to 14 years old with chronic unobstructive pyelonephritis. The diagnosis of chronic obstructive pyelonephritis was set in accordance with the code N11.0 ICD-10. The control group consisted of 30 almost healthy children. In order to investigate the autonomic regulation of examined children’s urinary system vegetative status was determined using Holter ECG according to a standard procedure. By use of the complex DX-AKM-03ArNika (Kharkiv, Ukraine) registration of bioelectric potentials formed as electrocardiointervals was provided. Based on the results obtained, a database was developed, further analyzed in the computer program ArNika V 2.0 (Medibase). As a result of the survey of children with chronic unobstructive pyelonephritis established the presence of autonomic dysfunction with a predominance of sympathetic over parasympathetic component. This children’s chronic unobstructive pyelonephritis is characterized by initial vegetative tone in form of sympathicotonia, vagotonia and amphotonia, which is a prerequisite for searching for methods of individualizing treatment approaches depending on the vegetative tone.

Pediatrician (St. Petersburg). 2017;8(5):12-19
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Primary hyperparathyroidism in childhood

Gostimsky A.V., Matveeva Z.S., Romanchishen A.F., Karpatskiy I.V., Peredereev S.S., Lisovskiy O.V., Pogorelchuk V.V.


Primary hyperparathyroidism is a disease caused by excessive production of parathyroid hormone by the parathyroid glands. Most often, sporadic cases of the disease occur. In the family form of hyperparathyroidism, as well as in the syndrome of multiple endocrine neoplasia, the disease is caused by genetic changes. In manifest forms of the disease, hyperparathyroidism leads to destruction and deformation of bone tissue, osteoporosis, urolithiasis, cholelithiasis, pancreatitis, peptic ulcer disease, and disorders of mineral and electrolyte metabolism. Bone manifestations of the disease can lead to disability of the child. The article presents the experience of surgical treatment of 15 children, patients with primary hyperparathyroidism, aged from 6 to 18 years old, 10 of them girls and 5 boys operated in the period from 1973 to 2017. The main methods of diagnosis of the disease, the difficulties of timely diagnostic are discussed. The features of laboratory indicators of clinical manifestations of the disease are clearly shown. The clinical manifestations of primary hyperparathyroidism in children differed from adults more heavily damage of bone tissue with the development of gross deformities of the limbs. In 8 (57.3%) of 15 children, manifest forms of the disease were diagnosed. In 7 (46.7%) children, parathyroid adenomas were detected and removed during surgery for various thyroid diseases. In two patients, parathyroid adenomas were removed during operations performed for a genetically confirmed syndrome of multiple endocrine neoplasia of type IIa. In this study, the features of adenoma localization of the parathyroid gland, the possibility of surgical treatment and the dynamics of clinical manifestations after surgery are discussed. Proper treatment allowed to achieve full recovery.

Pediatrician (St. Petersburg). 2017;8(5):20-24
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Assessment of the results of treatment of children with amblyopia associated with strabismus

Kononova N.E., Somov E.E.


Treatment of amblyopia in children with strabismus is still a difficult problem, especially in cases of disruption of binocular vision. There are also classification differences, reflected in the proposals, coming from professors E.S. Avetisov (1968) and E.E. Somov (1997). The question is how to assess the severity of amblyopia and the result of its treatment. The first author has chosen as the primary measure visual acuity, the second – binocular function. This indicator is integral and really reflects the level of functional status of the organ of vision of any child. This is a really important point, because the essential symptom of strabismic and of other origin amblyopia is impairment, detected in binocular vision. In addition, we should keep in mind the fact, that the “maturation” of central visual acuity in children is gradual and closely related to their age. After we have examined 50 children systematically attending a specialized kindergarten, we found out, that according to the criteria of E.S. Avetisov their cure is 39.8%, and according to the criteria of E.E. Somov – 12,5%. In the first case, it is a significantly inflated figure due to children with really high visual acuity and lack of binocularity. But daily practice shows that the results of high visual acuity after pleoptic therapy, not supported by the re-establishment of binocular vision, are not durable and gradually, or sometimes rapidly decrease. The study also showed that the existing methods of orthoptic treatment are not effective enough and must be improved.

Pediatrician (St. Petersburg). 2017;8(5):25-29
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Morphological characteristic and assessment of changesin the main structural components of the histohematological barrier of the thyroid tissue in cases of the sudden cardiac death from alcoholic cardiomyopathy

Sokolova O.V., Yagmurov O.D., Nasyrov R.A.


A retrospective analysis of acts of forensic medical autopsies from the archive of St. Petersburg GBUS BSME and a histological study of thyroid gland tissue in 188 cases (95 women and 93 men) were carried out with statistical processing of the obtained results for the purpose of studying and assessing the morphological changes in the main components of the histohematological barrier of thyroid gland tissue in cases of the sudden cardiac death from alcoholic cardiomyopathy. The decrease in the weight of the thyroid gland in the investigated cases and the revealed morphological signs, indicative of a decrease in the memory function of the thyroid gland were found and can be caused by the prolonged toxic effect of ethanol and its metabolites. Morphological changes in the endothelial lining of the vessels of the microcirculatory bed are caused both by the direct cytotoxic action of ethanol and its metabolites and by the action of mediators, the release of which occurs as a result of stimulation of the reactive cells, which leads to swelling, deformation and increased activity of endothelial cell membranes with the expansion of intercellular spaces and the development of increased permeability of the endothelial lining, which, in its turn, contributes to disruption of electrolyte transport and nutrients transport with changes trophism thyroid gland tissue, which is a substrate for the appearance of dystrophic and necrobiotic processes in main structural components of the histogematogenous barrier of the thyroid gland. The revealed morphological changes in thyroid gland tissue in cases of death from alcoholic cardiomyopathy have a non-specific nature and should be considered in conjunction with other visceral manifestations that are a reflection of alcohol intoxication during the chronic alcoholism.

Pediatrician (St. Petersburg). 2017;8(5):30-34
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Measures in assessment of pediatric systemic lupus erythematosus: an experience of retrospective observational study

Kuchinskaya E.M., Chasnyk V.G., Kostik M.M.


Systemic lupus erythematosus in children (juvenile-onset SLE, jSLE) is a multisystemic disease with an unpredictable course and a more severe phenotype compared to adults. The patterns of jSLE are extremely heterogeneous, so an enrollment to controlled studies may be rather complicated. Due to this problem and some additional ones, there are no standards for treatment of jSLE yet. The attending physician is fully responsible for the induction and maintenance therapeutical options including durability and aggressiveness.

Objectives: finding of jSLE individual course’s features prognostically connected with the disease outcome.

Methods: 45 children admitted to the SPbGPMU hospital with the systemic lupus erythematosus diagnosed at the age of 4-17 years were enrolled in this retrospective study. Primary SLE manifestations, the activity of disease according to SELENA-SLEDAI and ECLAM scales during initial treatment period and flares after it, the fact of remission achievement in 6 months were evaluated in each patient.

Results: a few organ involvements were considered to be connected with outcome’s characteristics, for example lupus nephritis and early disease oncet are unfavorable predictive factors. The positive connection of favorable outcome with cyclophosphamide, intravenous methylprednisolone and mycophenolate mofetil was found; the negative connection between initial disease activity and flares after induction treatment was also noticed.

Conclusion: the patient with initially high disease activity treated aggressively with high cumulative doses of cyclophosphamide, intravenous methylprednisolone and mycophenolate mofetil has more chances of the favorable outcome (the achievement of remission without further flares).

Pediatrician (St. Petersburg). 2017;8(5):35-43
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Recurrent bronchitis as a clinical variant of functional changes of the respiratory system in children

Nesterenko Z.V.


Background. The high prevalence of acute respiratory infections in children, recurrent episodes of acute bronchitis remain to be one of the hot topics of pediatrics. The causes of recurrent exacerbations of bronchitis in children, despite the numerous research works on this issue, are not completely clear.

Aim: to study the features of the clinic in children with recurrent bronchitis.

Methods. There were 58 patients aged 3 to 12 years with recurrent bronchitis. A study demonstrated the close relationship between recurrent episodes of acute bronchitis not only with pre-preschool and preschool age (when bronchopulmonary tissue is not completely differentiated), with the influence of negative environmental factors, with bacterial, viral infection, but also with signs of connective tissue disorders (CTD) in them.

Results. Revealing connective tissue insufficiency explains the causes of disorders of bronchial cartilage and connective tissue, that lead to the development of bronchial dyskinesia thus exacerbating the vulnerability of immature bronchopulmonary tissue along with autonomic dysfunction, typical for CTD. Involvement of several organs and systems in the CTD process changes the course of clinical symptoms of recurrent bronchitis. Probably by the main differentiation of tissues of organs at this age, including connective tissue, can be explained the fact that in 2/3 of the children observed by the age of 7 the manifestations of exacerbations of the disease ceased. In the half of the patients with recurrent episodes, who had bronchial obstruction in the first year of life, a allergy history, paroxysms of respiratory dyspnoea after an additional examination, – asthma was diagnosed; in one patient an aneurysm of the lung vessels was revealed.

Conclusions. Basing on the conducted study, the use of the term “recurrent bronchitis” is advisable in children of the first seven years of life. In patients with continuing episodes of bronchitis bronchopulmonary pathology should be excluded; in patients with allergy history and symptoms of bronchial obstruction, spasmodic cough in previous episodes of bronchitis asthma should be excluded. The presence of symptoms of connective tissue disorders in children with recurrent bronchitis requires a careful examination of patients for the detection of comorbid diseases.

Pediatrician (St. Petersburg). 2017;8(5):44-48
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Vitamin sufficiency of children visiting preschool educational institutions from different regions (Moscow region, Yekaterinburg)

Vrzhesinskaya O.A., Kodentsova V.M., Pereverzeva O.G., Leonenko S.N.


Introduction. The deficiency of vitamins is a factor that has a negative impact on the growth and development of the child, it leads to a decrease in nonspecific resistance of the organism, a decrease in the adaptive potential, acts as a risk factor for the development of nutritional disorders, aggravates the process and makes it difficult to treat any disease.

The purpose of the study. Assessment of the vitamin status of children attending pre-school educational institution by means of non-invasive methods for urinary excretion of ascorbic acid and metabolites of B vitamins.

Materials and methods. 49 children (26 boys and 23 girls) aged 4 to 7 years living in Moscow region, and 51 children (26 boys and 25 girls) 2-7 years old living in Ekaterinburg were examined in 2015-16 years (winter-spring period). Сhildren received the main nutrition in kindergarten. In the evening time on weekdays children additionally received separate foods or ready meals at home, on weekends (2 of 7 days) children ate at home. The supply with vitamins C, B1, B2 and B6 was evaluated by its hour urinary excretion.

Results. The picture of vitamin status of children from different regions turned out to be almost identical. The lack of vitamin B2 was found in about one third of the children, vitamin B1 and B6 insufficiency took place significantly 2 fold more often (in 61.2-76.5%). Decreased vitamin C excretion took place in 34.7% of children from the Moscow region. Only every fifth child was provided with all studied vitamins. A significant number of children showed multivitamin deficiency. Children who received multivitamin supplements were better supplied with these micronutrients.

Conclusion. The results indicate the need for correction of multimicronutrient insufficiency in children by including in the diet of fortified food products, the use of baby specialized products enriched with micronutrients, and vitamin-mineral supplements intake.

Pediatrician (St. Petersburg). 2017;8(5):49-53
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The influence of vital stress experienced by women in pregravidarum period on sexual development of their daughters

Temirkhanova K.T., Tsikunov S.G., Pyatibrat E.D., Pyatibrat A.O.


Comparative evaluation of sexual development among adolescent girls whose mothers experienced and did not experience psychological trauma associated with life-threatening was conducted. The physiological features of sexual development in girls in the Republic of Dagestan, whose mothers experienced a high risk of terror threat in pregravidarum period were identified. It was determined that in pre-pubertal period the concentration of luteinizing and follicle-stimulating hormone in peripheral blood in girls whose mothers experienced stress associated with life-threatening was significantly higher than in girls of the control group. In prepubertal period in girls whose mothers experienced a vital stress, the earlier decrease in the activity of the adrenal cortex in the transition from prepuberty to puberty was observed. Girls whose mothers experienced a vital stress can be characterized by an earlier menarche, at the age of 10-12 the menarche occurred significantly more often than in the control group. The anthropometric data show an earlier maturation of these girls under the age of 12. In the prepubertal period the formation of breast and pubic hair growth were ahead of girls in the control group. Thus, girls whose mothers experienced vital stress are characterized by an earlier and at the same time disharmonious puberty. They are characterized by earlier menarche, delayed rhythm of the menstrual cycle and some changes in humoral regulation rhythm. Thus, it is vital the stress suffered by women before pregnancy causes changes in hormonal regulation in pregnancy that leads to long-term damage of physiological homeostasis of the offspring.

Pediatrician (St. Petersburg). 2017;8(5):54-60
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Staghorn stones’ composition analysis features

Andryukhin M.I., Golovanov S.A., Polikarpova A.M., Prosiannikov M.Y., Nersisyan L.A., Gadzhiev N.K., Tagirov N.S., Obidnyak V.M., Solh R.M.


The lack of standards in the analysis of the chemical composition of the staghorn stones leads to a decrease in the effectiveness of metaphylaxis, and especially in those cases where the volume of the stone is much larger than the volume of the stone fragment being studied. The aim of this study was to develop standards in order to determine the composition of the staghorn calculi. In the Institute of urology from 2015 to 2016, we identified patients with urolithiasis, staghorn-stone nephrolithiasis who were eventually hospitalized. All patients underwent percutaneous nephrolithotripsy, and fragments of the stone were taken in order to analyze its chemical composition. An analysis of the composition of various fragments taken from different zones of the same calculus was made. Patients were divided into 4 groups depending on the composition of the stone. The first group included patients with a predominance of phosphate in the internal layer of the pelvic fragment of the stone, the second group – with a predominance of oxalates, the third – with a predominance of urates, the fourth – with cystine stones. Our experience, while doing stone analysis, showed that the composition did not coincide in 77% of cases, and in 41,6% of cases a new component in the chemical composition of the stone appeared. Complete coincidence of the composition in the cortical and internal layer of the stone was detected in 35% of the cases, and component coincidence in 58% of cases. In the cortical and internal layers of the pelvic fragments, the total and component coincidence of the composition was 38% and 58%, respectively. Thus, we show the importance of chemical analysis of stones and that the composition of the stone may vary, depending on its location. Timely detection of changes in the nature of the stone allows an adequate treatment of urolithiasis.

Pediatrician (St. Petersburg). 2017;8(5):61-66
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Gender differences in the normative dimensions of internal organs of 17-years teenagers with differentsomatotypic characteristics

Erkudov V.O., Pugovkin A.P., Volkov A.J., Musaeva O.I., Lytaev S.A.


Individualization of approaches in preventive and clinical medicine requires individualization of normative indexes for the protocols in measurement of dimensions of internal organs. At the same time the constitutional principle for the establishment of personal protocols for supersonic morphometry of liver, gall bladder, spleen, pancreatic and thyroid glands are discussed. At the same time the age quantitative age and gender group differences remain unsufficiently studied. The purpose of the study was the investigation of specific constitutionally-dependent differences in the size of internal organs in concern with their possible somatotypic correlates. 49 female and 52 male 17-years old teenagers were studied during regular prophylactic medical inquiry using somatotypic identification and supersonic morphometry of the pancreatic and thyroid glands, liver, gall bladder, spleen, lenic and portal veins. The study revealed statistically significant larger size of liver and gall bladder in leptosomic and mesosomic males in comparison to the females of corresponding somatic types. In addition, mesososomic males possessed increased lumens of splenic and portal veins together with increased dimensions of pancreas and spleen. The reported data s can be used in clinical practice for prevention of erroneous conclusions about hyper- or hypertrophy of internal organs. The results of the study give opportunities for the establishment of anatomical standards of morphometric measurement of internal organs in concern with constitutional characteristics. The revealed somatotypic correlations can serve as markers of individual morphometric characteristics of internal organs.

Pediatrician (St. Petersburg). 2017;8(5):67-73
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Hemodynamic monitoring on the background of intensive therapy in newborns

Boronina I.V., Aleksandrovich Y.S., Popova I.N., Oshanova L.S.


The article deals with the problem of early neonatal and infant mortality. It is pointed out that recent advances in emergency and intensive care therapy have provided decline in early neonatal and infant mortality. Hemodynamic disorders are reported to be associated with any severe pathology in patients of all age groups including newborns, significantly influence quality of life of patients having experienced a critical condition. Clinical manifestations of hemodynamic disorders in infants are not considered to be specific; they are critically delayed and are not timely recognized. The article describes peculiarities of the cardio-vascular system of newborns that are responsible for the necessity of thorough hemodynamic profile monitoring in order to provide detection of vital function alterations at the early stages, ensure timely onset of intensive therapy and its qualitative performance. Special attention is paid to current methods of determination of central hemodynamic parameters, which are stated to be divided into invasive and non-invasive. The paper also highlights some peculiarities of evaluation of hemodynamic findings using specific monitoring methods and factors influencing the outcome. The article specifies increased interest towards non-invasive monitoring tools of hemodynamic profile in recent years; their relevance is stated to be doubtless in both pediatric and neonatal practice. The main task of any monitoring procedure is reported to be hemodynamic findings analysis, “trend tracking” in the process of monitoring a patient and intensive therapy performance.

Pediatrician (St. Petersburg). 2017;8(5):74-82
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The regional anesthesia for surgical correction of the malformation of upper extremities in pediatric

Manokhina J.A.


The article presents an analysis of the publications devoted to the problems of anesthesia to surgical procedures at the malformations of the upper extremity in children. The article reviews the questions of epidemiology, classification of upper extremity malformation, safety of anesthesia and the role of regional blockades in the structure of intraoperative and postoperative analgesia to surgical procedures at the malformations of the upper extremity in children. Children are more likely than adults to experience stress in the operating room and early postoperative period. Children are almost impossible to prepare psychologically for the upcoming anesthesia, surgical intervention, a sense of pain after it. Surgical correction of malformations of the upper limbs in children is characterized by multistage and high traumatism, which requires the search for adequate methods of anesthesia, capable of ensuring not only the absence of pain, but also the negative impact on the nervous system of little patients. The key to the application of regional anesthesia in young children is the need for sedation or general anesthesia. The use of ultrasound navigation and electrostimulation of peripheral nerves significantly increases the level of safety and success of their realization. At present, the questions about the duration of postoperative analgesia with the use of peripheral nerve blocks and the need for additional anesthesia in the early postoperative period have been little studied. The influence of the applied anesthesia technique on the state of young children in the postoperative period are requires further investigation.

Pediatrician (St. Petersburg). 2017;8(5):83-90
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Modern concepts of thymus morphology

Breusenko D.V., Dimov I.D., Klimenko E.S., Karelina N.R.


The latest scientific data of the development, structure and cellular composition of thymus are studied and presented. Both widely known sources and new literature were used. This article is reporting external features of the structure of the thymus, internal structure, cellular composition. In particular, attention is paid to the description of the thymus zones, because there has been no consensus among morphologists in this matter. Embryonic development is described, as well as morphometric parameters in different periods of prenatal development. This article will be useful in writing scientific and certificating work, books and dissertation dealing the development of thymus, because there is more actually information about this theme.

Pediatrician (St. Petersburg). 2017;8(5):91-95
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Combined minimaly invasive surgery of pancreaticolithiasis in combination with congenital stricture of the terminal sections of the pancreatic ducts

Korolev M.P., Fedotov L.E., Avanesyan R.G., Mikhailova E.A., Lepekhin G.M., Turyanchik M.M.


Chronic pancreatitis with pancreatic hypertension is extremely rare in childhood. Chronic pancreatitis in this age is usually always associated with a сongenital defect of the pancreatic duct system. The article describes the case of long-term clinical observation and minimally invasive treatment of chronic calculous pancreatitis, first diagnosed in a girl at the age of 16 years. Despite the fact that clinical manifestations were observed from the age of 3 years, the correct diagnosis could be made only at the age of 16, by joint application of ultrasound, Magnetic Resonance Imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP). The cause of chronic pancreatitis were concrements and strictures of the main and additional pancreatic ducts that caused pancreatic hypertension. Attempt of endoscopic retrograde lithoextraction from the pancreatic ducts was impossible because of the presence of severe stricture. Therefore, it was decided to apply a combined approach using percutaneous access under ultrasound navigation. The patient underwent series of minimally invasive combined procedures including the lithoextraction, balloon dilatation and transcutaneous drainage of the pancreatic ducts with the endoscopic and percutaneous access with ultrasound and radiologic control. For the prevention of restenosis, the antegrade stenting of the main pancreatic duct with self-expanding coated nitinol stent was used with further removal of the stent. Due to the treatment, there was no pancreatitis within 5 years after stent removal.

Pediatrician (St. Petersburg). 2017;8(5):96-102
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Emotional aspects of self-attitude of adolescents with Pectus excavatum (PE) before and after surgery (pilot study)

Malkova E.E., Komolkin I.A., Pakhomova M.A., Vitenberg M.V.


The present study deals with preliminary assessment of adolescents’ with Pectus excavatus (PE) personal emotional characters of selt-attitude prior to and after surgical treatment. PE is a congenital defect manifesting in retraction of sternum and cartilaginous portions of the ribs into the rib-cage. It constitutes about 90% of the entire number of cases of congenital pathology of the chest, its rate as high as 1-8 per 1000 neonates. The only method of treatment for this pathology is surgical operation for conservative measures can’t stop progressive deformation of the chest. The peak of this pathology coincides with adolescent period which is particularly sensitive for forming of personality. The goal of the present study is the assessment of emotional and personality features of adolescents with PE that are manifesting in peculiarities of cognitive, affective and behavioral reactivity. 26 adolescent patients aged 13 to 17 years with PE hospitalized at surgical clinic of St. Petersburg State Pediatric Medical University for subsequent primary operative elimination of this defect or recurring operation – ablation of the implant (1-4 years after the primary surgery) took part in the present study. High level of anxiety and depression associated with negative perception of their bodies prior to surgery was revealed. Urgent need for psychological assistance of these adolescents is evident as well as extension of further studies associated with peculiarities of emotional self-perception and its correlation with children-parents relationship character.

Pediatrician (St. Petersburg). 2017;8(5):103-109
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The Relationship of Hardiness and Self-attitude in Adolescents with Acne

Yaurova A.S.


Acne (acne vulgaris) is a chronic inflammatory skin disease resulting from the overproduction of sebum and blockage hyperplastic sebaceous glands with subsequent inflammation. The disease most commonly occurs in puberty and affects more than half of the adolescent population. The aim of this investigation was to study the specificity of such psychological characteristics such as hardiness and self-attitude of adolescents suffering from acne moderate and severe stages. The research subjects were 107 adolescents with acne (57 males and 50 females) undergoing treatment at the dermatological Department SPbSPMU (St. Petersburg State Pediatric Medical University), the comparison group included 100 apparently healthy adolescents (50 male, 50 female). The study used the Test of hardiness S. Maddi adaptation D.A. Leontiev and E.I. Rasskazova and research technique of self-attitude by S.R. Pantileev and V.V. Stolin. We found that self-doubt, dissatisfaction with oneself as a personality, expectation of negative attitude from others are detected in adolescents with acne and cosmetic defect in this study. Low level of the hardiness is associated with the inability to resist circumstances, to see themselves as the source of activity and with negative emotional position to themselves. On the other hand, adolescents with acne with a high level of indicators of hardiness are characterized by the lack of internal tensions, self-confidence, willingness to be proactive and positive expectations from the surrounding reality, including the relationship to them of other people.

Pediatrician (St. Petersburg). 2017;8(5):110-116
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The contribution of N.F. Filatov the national pediatrics (to the 170 anniversary from the birthday of N.F. Filatov) (1847-1902)

Morgoshiia T.S.


It was noted that during 25 years of scientific and teaching activity N.F. Filatov has made a significant contribution to the development of world Pediatrics. He is the author of over 70 scientific works, including “a Short textbook of pediatric diseases” (1893), aged 12 editions, and “Clinical lectures” (1900). His monograph “Lectures on acute infectious diseases” (1885) through 4 editions, “Semiotics and diagnosis of childhood diseases” (1890) – 9 editions, it is translated into German, Czech, Italian, Hungarian and French. In the monographs and manuals N.F. Filatov studied many of pokoleniya-pediatricians. He described the infectious disease named Filatov scarlatinal rubella. She was later described by the British physician Duxom; one of the presently used names of the disease – a disease Filatov-Dukes. In the first edition of "Lectures on infectious diseases" N.F. Filatov described is not known until the time of infectious mononucleosis, which he called idiopathic inflammation of the cervical lymphatic glands. The disease is now often called a disease Filatov. In 1895 N.F. Filatov, described an important diagnostic sign of measles is the appearance of catarrhal period of illness 1-2 days before appearance of rash spot grayish-white lesions on the mucosa of lips and cheeks. As was established later, this sign was first described by A.P. Belsky in 1890, then regardless of him F. Filatov, and in 1896 Koplik. In the literature, this symptom is known as spots Belsky-Filatova-Koplik. N.F. Filatov described the pathogenesis of some forms of edema syndrome in children, published works on prolonged afebrile forms of the flu. N.F. Filatov developed a clinical-physiological direction in Pediatrics. He created a large school of domestic pediatricians. Among his students were V.I. Molchanov and G.N. Speransky.

Pediatrician (St. Petersburg). 2017;8(5):117-120
pages 117-120 views

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