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Vol 6, No 2 (2015)


Nutrition of the preterm infant

Sauer P.J.


Nutrition is of great importance for the preterm infant. It is not only essential for survival, but also makes provision for rapid development of many organs outside the uterus which process normally takes place in the third trimester of pregnancy. It is for future life essential that all factors that might influence the development are as optimal as possible, including nutrition. However, there might also be an upper limit to the intake of some ingredients in the neonatal period. The rate of growth of the preterm infant is five times higher compared to term infants and the breast of the mother delivering preterm might yet be ready to produce the optimal composition of milk. Preterm infants receiving mothers milk only are known to show a lower gain in weight and length than the so called reference fetus. It is therefore at least questionable if preterm human milk can be used to define the nutritional needs of the preterm infant. To define the optimal composition and amounts of nutrients for the preterm infant a factorial approach can be used. The estimated requirements are calculated from the calculated requirements for maintenance and growth. Though some studies have shown that the protein content of milk from mothers who delivered preterm can be higher in the first few weeks after birth compared to milk of term delivering mothers, soon after there is a rapid decline in protein content after which period the content is not different from the term delivered mother. Providing exclusively mothers own milk leads to suboptimal growth and insufficient accretion of minerals. The needs of the preterm infant in energy, protein, lipids, carbohydrates, minerals, pro- and prebiotics to provide optimal nutrition in the first days after birth are discussed in the paper. It is concluded that nowadays early, aggressive nutrition directly after premature birth with the immediate introduction of amino acids and rapid introduction of lipids is advised. Enteral feeding should be started very soon after birth, preferably on the first day of life and increased in the days thereafter. The first choise for enteral feeding is mothers own milk, supplemented from the second week with a fortifier. Special preterm formula might serve as a good alternative in case when breast milk is not available.
Pediatrician (St. Petersburg). 2015;6(2):4-11
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Clinical and psychological characteristics motives of drug use by adolescents

Grechanyi S.V.


The purpose of this study was to investigate the relationship addictive motives, clinical-dynamic characteristics of conduct disorders and adaptation of personality in substance harmful using adolescents. Were studied 293 adolescents with a diagnosis of «Conduct disorder» and comorbid diagnoses «Harmful substance use» (mean age - 15,3 ± 0,1 years). Patients were divided into 4 groups. 1 subgroup comprised 89 patients with comorbid diagnosis of «Harmful opioid use». 2 subgroup comprised 95 patients with comorbid diagnosis of «Harmful inhalant use». 3 subgroup comprised 57 patients with comorbid diagnosis of «Drinking alcohol with harmful consequences». 4 subgroup consisted of 52 patients with comorbid diagnosis of «Harmful stimulant use». Results of the study revealed two groups of patients: patients with motives correction of negative emotional states (CE) and patients with the motives of stimulation emotionally positive state (SE). For patients with motives SE was characterized by the predominance of symptoms antisocial personality, conduct disorders, more expressions of social and legal consequences of substance use and quantity of comorbid alcohol use. Patients with motives CE marked predominance of symptoms of hyperkinetic conduct disorder and organic affective disorders, big quantitative severity of substance use when expressed psychopathology and health consequences. Patients with motives SE compared with patients with motives CE show a more favorable profile protective coping behavior associated with less use of immature and nonadaptive psychological defense mechanisms («regression», «replacement») and non-constructive types of coping («distancing», «self-control», «escape-avoidance»).
Pediatrician (St. Petersburg). 2015;6(2):12-16
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The risk of malignancies in women with long flowing hyperthyroidism in history: a retrospective randomized study

Vlaseva O.V., Glushakov R.I., Sobolev I.V., Proshin S.N., Tapil’skaya N.I.


The syndrome of thyrotoxicosis is the second occurrence in endocrine diseases giving way to the only diabetes. The most common cause of hyperthyroidism is Graves' disease. Nodular toxic goiter is following Graves' disease. Then more rare causes are solitary toxic adenoma and thyroiditis. Epidemiological studies carried out at the turn of XX-XXI centuries in the developed countries of Europe and North America have shown that a history of hyperthyroidism episode increases the relative risk of development of ovarian cancer by 80 % and breast cancer by 45-60 %. It has been shown that hyperthyroidism including subclinical one is a risk factor for morbidity and mortality from malignant neoplasms of different localizations as breast cancer, thyroid cancer, pancreatic cancer and lung cancer. In this case, drew the fact that significant differences in the risk of morbidity by specific disease forms depends on the ethnic composition of the population. In Russian Federation the similar epidemiological studies have not been carried out yet. We obtained the results of an epidemiological retrospective multicenter randomized clinical simultaneous analytical comparative study of the “case-control” among women treated for diffuse toxic goiter and nodular toxic goiter in 1999-2009. The study involved 1135 patients with hyperthyroidism in anamnesis. The comparison group included 953 patients with eu- and hyperthyroid status. The risk of malignancies in women with hyperthyroidism in anamnesis was 2.36 (95 % CI 1.63-3.42, p < 0.01). The risk of hormone-dependent tumors was 2.65 ( 95 % CI 1.7-4.13, p < 0.01). The aim: to evaluate the risk of malignancies in women with long flowing hyperthyroidism.
Pediatrician (St. Petersburg). 2015;6(2):17-21
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Normosmic hypogonadotropic failure

Boyarskiy K.Y., Reznik V.A.


Currently, mutations have been described in a number of genes encoding proteins that control the release of LH-RH by hypothalamus. One such protein is itself LH-RH (gene GNRH1), its receptor (GNRH1-R), the controller allocation hypothalamus LH-RH protein Kisspeptin (KISS1), receptor Kisspeptin (KISS1-R), another regulator of release of LH-RH neurokinin B gene (TAC3) and its receptor neurokinin B (TAC3-R). In infertility clinic were admitted two patients with isolated hypogonadotropic hypogonadism form. Both patients were observed during the lifetime of low-levels of FSH and LH and primary amenorrhea. At the same time indicators of ovarian reserve, as measured by the AMH were sufficient for ovarian stimulation Patients are at lifelong hormone replacement therapy. In order to induce the growth of follicles patients received preparations containing exogenous FSH and LH. Given the presence of male factor infertility, in both patients was used intracytoplasmic sperm injection (ICSI ) as a method of fertilization. In both patients were received 5 and 8 eggs, and 4 and 6 embryos, respectively. In each patient were transferred two embryos. In both patients were achieved clinical pregnancies. In the first patient pregnancy stopped at 8th week for an unknown reason, the other patient delivered a full-term baby girl alive. These data demonstrate the high efficiency of the treatment of infertility in women with normosmic hypogonadotropic failure. In genetic analysis revealed that the first patient is a carrier of a mutation in the gene receptor LH-RH (GNRH1-R) in both alleles, whereas the second patient is a heterozygous for this gene variant.
Pediatrician (St. Petersburg). 2015;6(2):22-24
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Analysis of gynecological morbidity in girls suffering from chronic decompensated extragenital diseases

Zernyuk A.D., Gurkin Y.A., Polikarpova A.Y., Medvedeva I.V., Atamova E.M.


In recent years the Russian Federation among the causes of maternal mortality extragenital diseases occupy the first place (37.7 % in 2012). There is an increasing group of children with chronic diseases. Objective: to make an analysis of the gynecological pathology in girls with decompensated chronic extragenital pathology. Methods. A total of 1682 patients aged under 18 years who are treated in the Saint Petersburg State Pediatric Medical University’s multidisciplinary clinic and directed clinicians to consult a gynecologist. We used anamnestic, clinical and laboratory methods of investigation and analysis of medical records. Results. As a result of analysis, we found that the structure of gynecological pathology identified in patients with decompensated extragenital diseases, 44 % are menstrual disorders, 37.9 % - an inflammatory disease, 14.2 % - non-inflammatory problems, 12.7 % - other. In this case, gynecological pathology, of course, is associated with somatic. So, the girls suffering from connective tissue, often recorded long and heavy menstruation (38.9 %), diseases of the gastrointestinal tract and urinary system - painful (45.9 and 55 %, respectively), endocrine pathology often accompanied by rare, scanty menses (56.8 %). Conclusions. Given the importance of extragenital pathology in the implementation of fertility, it is important to pay particular attention to: a) development of an algorithm for monitoring, treatment, rehabilitation of girls suffering from extragenital pathology, which should include a compulsory inspection gynecologist; b) the participation of gynecologist in the regular medical check observation girls with chronic extragenital pathology in the case of existing combinations with gynecological diseases. Such an approach should be further consolidated when transferring patients under the supervision of an adult network.
Pediatrician (St. Petersburg). 2015;6(2):25-31
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Comparative characteristic of clinical and laboratory indicators of congenital herpes virus infection in children and the course of mother’s pregnancy

Ushakova G.M., Vasiliev V.V., Osipova Z.A., Kuyoumchan S.H., Tuktarova A.Y.


The work summarizes the results of the investigations made by the researchers of Scientific Research Institute of Children’s Infections in Saint Petersburg. There are presented comparative characteristics of congenital Herpes virus infection accompanied by a course of the mother’s pregnancy. Etiologic interpretation of congenital Herpes virus infection was based on the identification of specific antibodies of M and G class immunoglobulins against CMV, HSV and EBV by fluorescence immunoassay, virus DNA by PCR in different biological environment (blood, sputum, urine). The results of the tests were filled into the created individual electronic block-cards and processed further by the methods of parametric and nonparametric statistics in the licensed version of “Windows Vista Professional” operational environment “Statistica 7.0” program (correlated, regressive, cluster, discriminant tests) with the confidence level p < 0,05. There are described two our clinical observations of those children who have survived after generalized Herpes virus infection. There are framed the risks of congenital infection revealing depending on the pregnancy course in the form of the algorithm. There are also given the practical recommendations on the interpretation of the laboratory data found. The clinical presentation of congenital Herpes infections (HSV, CMV and EBV) is extremely polymorphic and doesn’t allow definite suspecting of the disease etiology. In the case of congenital infection suspicion the method of choice is the indication of causative genome in the biological samples available. The determination of specific IgM in the first-year children is less informative in these cases. The system of laboratory follow up of the pregnancy to assess the risk of congenital infection needs further improvement (it needs monitoring, current recommendations on interpretation).
Pediatrician (St. Petersburg). 2015;6(2):32-38
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Atomoxetine, thioridazine, pipophezine in treatment adolescents with ADHD

Glushchenko V.V.


Analysis of published data on the diagnostic criteria used in the qualification of hyperkinetic syndrome found that along with the data on residual-organic failure CNS causes the development of hyperkinetic syndrome expanded range of studies on the endogenous nature of this syndrome. Thus the international “Genomics Consortium psychiatric” (Psychiatric Genomics Consortium) identify common loci in hyperkinetic disorder and schizophrenia which are located on the short arm of the 3rd chromosome (3r21) and on the long arm of chromosome 10 (10q24) and revealed single nucleotide substitutions (SNPs) in the two genes (CACNA1C and CACNB2) which encode proteins that are part of the channels regulating calcium transport into brain cells. Hyperactivity disorder (GR) as a mental disorder (F90) is multifactorial in nature, which requires consideration of clinical symptom in different planes with the release of endogenous and exogenous forms the primary etiological factor for differentiation therapy. Were studied 231 adolescents with a diagnosis of “Attention-Deficit hyperactivity Disorder” (mean age - 17,7 years). The main components of adolescents AHHD are given by BPRS: arousal (3,63 ± 0,06); cognitive (2,94 ± 0,06) and emotional (2,64 ± 0,06) disorder. Patients were split into threatment group: group 1 (n = 23) received Atomoxetine 25mg/day; group 2 (n = 20) received thioridazine 25mg/day, group 3 (n = 22) - pipophezine 50 mg/day. The positive dynamics of disregulatory-motor typeractivity, cognitive and emotional components of ADHD was observed. The aim: to evaluate the influence of Atomoxetine, Thioridazine, Pipophezine on the main psychopatological clinical-components of adolescents AHHD.
Pediatrician (St. Petersburg). 2015;6(2):39-44
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Prevalence of mutations nt656g and V281L in indigenous children of Russian Far North

Yakovleva S.Y., Burtseva T.E., Shadrin V.P., Sinel’nikova E.V., Avrusin S.L., D’yachkov A.N., Kononova O.A., Yur’yeva V.V., Nikolaeva L.A., Chasnyk V.G.


Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders which is most often caused by deficiency of steroid 21-hydroxylase (CYP-21). High level of inbreeding in the populations of indigenous people of Russian Far North was the reason to assess the prevalence of CYP21-inactivating mutations nt656g (classical sodium wasting phenotype of CAH) and V281L (non-classical CAH) and the genotype-phenotype relationship in children-inhabitants of Yakutia and Yamal-Nenets Autonomous Region (YNAR). We examined children living in 9 settlements of Yakutia and in 4 settlements of YNAR: 65 Russians, 206 Sakha, 344 Evens, 88 Evenks, 34 Yukagirs, 7 Chukchi, 99 Dolgans, 41 Nenets, 137 Selkups, 21 others. Blood samples were drawn from 315 children living in Yakutia and from 176 children living in YNAR. Allele specific PCR was used (primers In2ns, In2ms, In2cs for mutation in intron 2 (656) A/C → G and primer Ex7ma for mutation in exon 7 (V281L)) with positive control DNA. In cases of positive reaction the procedure was repeated and if it was again positive sequencing was performed. We didn’t find homozygotes. Twelve heterozygotes have been revealed with mutations at CYP21 gene. Of them splicing mutation in intron 2 (nucleotide 656) was revealed on 1 chromosome, mutation in exon 7 (V281L) - on 11 chromosomes. Prevalence of mutation nt656g in Evens was 1:41 (2,4 : 100). In other ethnic groups it was not revealed. Hence on average for the whole studied group of children the prevalence of mutation nt656g was 0,4 : 100. The prevalence of mutation V281L was the highest in Chukchi (5,1 : 100) and Yukagirs (5 : 100) with average prevalence for the whole studied group 2,4 : 100. The prevalence of heterozygotes for the V281L mutation in whole studied group was found to be almost similar to the prevalence of heterozygotes for non-classical CAH in non-Ashkenazi population (1 : 60, Speiser P.W. et al., 1985). In Nenets and Selkup children living in YNAR the prevalence was half as high as the average for Native children in Yakutia.
Pediatrician (St. Petersburg). 2015;6(2):45-54
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Investigation of LTF and GDF-9 gene polymorphism and in mammals (Bos Taurus L) by PCR-RFLP analysis for pharmacogenetics

Proshin S.N., Usenbekov E.S., Shakibaev E.B., Bimenova Z.Z., Zhumakhanova R.M., Glushakov R.I., Dement’eva N.V.


It has been established the close relationship between gene polymorphism of lactoferrin (LTF) with an incidence of mastitis and somatic cell counts in milk of mammals. Lactoferrin gene products are associated with resistance to several diseases, and particularly for mastitis. Lactoferrin (LTF) is a multifunctional small glycoprotein of milk. Its main function is to protect the breast. It is considered that genetic variants of DNA lactoferrin could be used as a marker for the prediction of somatic cells in milk and mastitis incidence. Allele A of LTF gene is associated with the incidence of mastitis in mammals such as cows. It has also been established that the polymorphism of BMP15 and GDF9 genes of sheep influence the number and rate of ovulation. Thus the alleles of Bone morpho-genetic protein (BMR15) gene influence the process of folliculogenesis in sheep. Sheep heterozygous on this locus ovulate two or three oocytes. The authors of this study recommend the use of polymorphism BMP15 gene as DNA markers to increase fertility in sheep. It is well known that products of GDF9 gene control the process of growth and development of follicles in cows. Polymorphisms of the gene is well studied in medicine. Women who have a mutation in the coding region of the gene GDF9 found signs of premature ovarian failure. The study of lactoferrin gene polymorphism has theoretical and practical importance since there is a positive correlation between the content in milk of somatic cells and genetic variants of lactoferrin. Thus, the authors suggest the use of GDF9 gene polymorphism in cows as a DNA marker for the prediction of reproductive function in mammals. The aim: to study DNA polymorphism of genes LTF, GDF9 and identified animals (Bos Taurus L) with the desired genotype for the studied loci to build model for searching new pharmacological agents.
Pediatrician (St. Petersburg). 2015;6(2):55-58
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Protective effects of antihypoxic substances of metaprot and etomerzol in model ethylene glycol intoxication

Vorob’eva V.V., Zarubina I.V., Shabanov P.D., Proshin S.N.


The analysis of the reasons for the children to the intensive care unit indicates that the poisoning is one of the most important cause of life-threatening conditions in childhood. The poisoning by drugs and ethanol dominates among other poisoning factors. Multiple drug poisoning is not so rare case as well as intentional self-poisoning among teenagers. It is dangerous not only toxigenic phase of poisoning by various chemical compounds but also their long-term effects. The symptoms of cerebroasthenia, minimal dysfunction of brain, vascular disorders, violation of thermoregulation, convulsions, visual impairment, hepatopathy, nephropathy, adrenal dysfunction are discussed as the effects of acute poisoning in children. Above-mentioned facts indicate the need to improve the toxicological assistance not only during resuscitation but also in a phase of long-term effects. The as early as possible elimination of the effects of acute poisoning leaves the possibility of development of the child according to age. The study of the general laws of chemical and biological interaction of poison with organs and tissues of animals in the experiment can detect adaptive and compensatory mechanisms to ensure stability of the basic functions of the organism to the damaging effects of xenobiotics. The study of the molecular and cellular mechanisms of action of exogenous chemical factors elucidates the target points to the impact of pharmacological agents. Taking into account that the mandatory pathogenetic component of the process of intoxication is hypoxia we used the ethylene glycol poisoning model to test direct antihypoxants 2 etiltiobenzimidazola hydrobromide (metaprot) and 5-ethoxy-2-etiltiobenzimidazol (etomerzol). Aim: to estimate antihypoxic and antioxidant effects of actoprotective substances as metaprot and etomerzol in the model of ethylene glycol poisoning.
Pediatrician (St. Petersburg). 2015;6(2):59-65
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Treatment of inflammatory and degenerative damages of the smooth parodont tissue with tooth pastes in rats

Mokrenko E.V., Shabanov P.D.


A rat model of inflammatory and degenerative damages of the smooth parodont tissue by means of administration of 2 % formal-dehyde water solution into the smooth parodont tissues was described. The oxidative status of rats including lipid peroxidation and antioxidant defense system indexes was assessed because of their high sensitivity to inflammation process. The lipid peroxidation indexes (malonic dialdehyde and dienic conjugates level) were 2-3-fold higher in the blood serum and parodont tissue in 7 days after inflammation beginning. The system of antioxidant defense (recovered glutatione level and activity of superoxide dismutase) was more sensitive in comparison with lipid peroxidation. The recovered glutation content in the blood serum was decreased from 2.02 ± 0.09 till 0.88 ± 0.21 µM/ml, and superoxide dismutase activity was reduced from 0.78 ± 0.10 till 0.28 ± 0.04 А/mg protein, that was these indexes were decreased in 2.5-3 times. The same regularity was observed in the smooth tissues of the parodont. The recovered glutation level was decreased in 2.1 times and superoxide dismutase activity was reduced in 7 times. Therefore, the curative and prevention action of tooth pastes and stomatologic drugs could be assessed with this model of inflammation. In particular, the tooth pastes lesmin-dent > clamin-dent > zhemchug (in order of descending activity) attenuate or abolish signs of inflammatory and degenerative damages of the smooth parodont tissue in rats assessed on lipid peroxidation and antioxidant defense system indexes.
Pediatrician (St. Petersburg). 2015;6(2):66-70
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The influence of sex and age upon response of white rats to hypoxic hypoxia

Khaytsev N.V., Vasiliev A.G., Trashkov A.P., Kravtsova A.A., Balashov L.D.


Periodic 3-hour daily exposition of white rats to hypoxic hypoxia (standard altitude 8250 m) for 10 days have revealed males and females of both very young and extremely old age groups (“young” - 0,5 months old and “old” - 26 months old) to be more sensitive to chronic hypoxic hypoxia than mature middle-aged animals (“mature” - 3 months old). Their increased sensitivity was apparent in body mass dynamic changes, oxygen consumption, peripheral blood hemoglobin concentration, and red blood cells’ count and peroxidase activity. Parallel to these parameters hypophysis-adrenal system functional activity was assessed according to blood eosynophils’ amount, ascorbic acid adrenals’ concentration, hypophysis and adrenals relative masses changes and “resistance index”. Both male and female rats of “young” and “old” age groups demonstrated variability of different parameters however those characteristic of hypophysis-adrenals system functional activity were practically always involved. Granted non-specific universal adaptation reactions like general adaptation syndrome are of special importance during exposure to any chronic influence, the “young” and “old” animals demonstrated insufficient capacity of hypophysis-adrenals system. However “old” female rats were much more resistant to chronic hypoxic impact revealing the lowest level of hypophysis-adrenals system functional activity.
Pediatrician (St. Petersburg). 2015;6(2):71-77
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Minilaparoskopy (Mini Site) in surgical treatment of childbearing age patients

Gurkin J.A., Plekhanov A.N.


Nowadays gynecologists try to find less traumatic and more effective variants of surgical treatment. Minilaparoscopic surgery is a resultant achievement of developments in gynecology since the beginning of the 20th century. It is a novel real-time surgical method. During the last decade the authors have accomplished 270 minilaparoscopic operations. The present paper sums up our experience in minilaparoscopic operations involving the uterus, Fallopian tubes, ovaries (salpingolysis, decortication, endometriosis sites excision, gonadectomy, etc.). The advantages of this kind of surgical operation especially promising in infantile gynecology are disclosed. Among the advantages of minilaparoscopic approach in infantile gynecology the authors emphasize the decrease of preoperational period, optimization of diagnostics during the operation, sparing techniques, reduction of post-operational complications. The aforementioned features of laparoscopic surgery suggest breakthroughs in normalizing nature of treatment in gynecology improving reproductive well-being of females and reproductive potential of girls. As a result we expect better demographic and reproductive prospects in future.
Pediatrician (St. Petersburg). 2015;6(2):78-84
pages 78-84 views

Skin wounds’ healing basic problems and the use of skin substitutes

Konstantinova M.V., Khaytsev N.V., Kravtsova A.A., Balashov L.D.


Kin substitutes present a heterogenous group of substances that aid in temporary or permanent covering of wounds of various types. Although they can not replace surgical debridement or standard methods of treatment they proffer an alternative to standard methods of treatment whenever the latter are ineffective. Skin substitutes require less wound vascularization, they increase the wound’s cutaneous component, decrease or eliminate inhibitory factors, decrease inflammatory process and grant quick and safe wound closing. Mast cells besides regulating vascular reactions in trauma zone also boost immune, defensive and reparative processes in the wound. Stimulatory influence of mast cells upon fibrosis depend on activation of fibroblasts rather than direct collagen production by mast cells. Attention is focused at studies of autologous adult stem-cells’ stimulation in various organs and tissues as well as at intercellular matrix (ICM). ICM besides being cells’ fastening substrate also controls proliferation, differentiation, migration, apoptosis cells’ functions. Collagen, fibronectin, laminin, proteoglycanes, cytokines and chemokynes are important ICM components. Microcirculation plays a substantial role in wound healing process. Cultivated fibroblasts due to their ability for long-term synthesis of ICM components can effectively correct wound healing process. Allogenic fibroblasts can be successfully used as skin substitutes’ components in the treatment of skin wounds and burns. Unlike autologous fibroblasts the allogenic cells may be obtained in advance and freeze-stored in large quantities.
Pediatrician (St. Petersburg). 2015;6(2):85-95
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Immunological changes accompanying the development of experimental neoplastic process

Dementeva E.A., Gurina O.P.


The key immunology problem remains the understanding of the mechanisms for the effective protection of the body against various pathogens with simultaneous suppression of the immune response to autoantigens. The pathogenesis of neoplastic pathological processes includes violations of the mechanisms of normal cell growth and cell proliferation. Antitumor immune response is a complex event, involving many different cell types. But despite the ability of the immune system to recognize and respond to a variety of tumor-associated antigens, the neoplastic process overcomes the protective forces of the organism, grows and spreads. For cancer cells characterized by independence from antiproliferative signals, autocrine stimulation of growth disturbances in the system, induction of apoptosis and control of genome stability. As a result of accumulation of genetic and epigenetic changes in tumor cells differ significantly from the normal range and the level of expression of genes involved in the transformation process, the accumulation of mutations in key genes promoters and suppressors of tumorigenesis. This creates the opportunity for recognition by cells of the immune system. The study of changes in value and operation of the various elements of the immune system in the development of experimental neoplastic process allows you to identify the mechanisms of interaction in the system «malignant tumor-immune system, to assess patterns of interaction with other organs and tissues, to create a theoretical pathogenetically reasonable premise for the development of anticancer therapy.
Pediatrician (St. Petersburg). 2015;6(2):96-108
pages 96-108 views

To the problem of the organization of independent study of students in medical school (on the example of the network project)

Zinkevich E.R.


In article the problem of the organization of independent work of students is considered. From the basic pedagogical point of view, independent study is such type of educational activity at which a certain level of independence of a student in all its structural components is supposed - from statement of the purpose to the control, the self-control and correction which carries out gradual transition from performance of the elementary types of work to more difficult ones, having exploratory nature. From the point of view of the author, independent study of students is a development tool of their cognitive interests and abilities, formations of special abilities for continuous self-education. In the article such conditions of the organization of independent study of students are described: mastery of the methods of organization and reflection of own educational cognitive activity; existence of necessary educational and methodical and special literature; scientific-methodical and information-methodical support of this type of educational activity, etc. The organization of independent work of students is possible on the basis of design training. Design training assumes creation of a process of assimilation of knowledge in the logic of an integrated approach to educational cognitive activity of students which has to make for them personal sense. The author considers the network educational project as one of the ways of the organization of independent work of students. In this connection, functions of the network educational project, conditions of its organization and the didactic requirements imposed to its organization are described. The option of the organization of independent work of students within the network educational project is offered on the example of the educational discipline “Pedagogical psychology”.
Pediatrician (St. Petersburg). 2015;6(2):109-113
pages 109-113 views

Contribution of N. P. Kravkov to development of the general, aged, evolutionary and clinical pharmacology (in memoriam to 150 years from the birth)

Shabanov P.D.


In the paper, the life and scientific achievements of Nikolai Pavlovich Kravkov (1865-1924), a founder of the Russian pharmacology, head of the Department of Pharmacology, Military Medical Academy, St. Petersburg, were described. N. P. Kravkov carried out significant investigations in pharmacology of gas metabolism, drug toxicology, aged and evolutionary pharmacology, clinical pharmacology (discovery of intravenous and combined narcosis). The main achievement of N. P. Kravkov became the cycle of investigations on isolated organs (ear, heart, lung, spleen, pancreatic gland, thyroid gland, adrenal gland, uterus of the mammalians, head and gills of pike, human fingers, heart and spleen). In these investigations, the rhythmic oscillation of the vascular tonus was proved, the theory of phasic action of pharmacological drugs on tissues, presentations on sensitiveness limits of living protoplasma, possibilities of animation of mummified tissues were postulated. N. P. Kravkov created a large scientific school (S. V. Anichkov, M. I. Gramenitskii, G. L. Shkavera, M. N. Nikolaev, A. I. Kuznetsov, B. S. Sentyurin, V. V. Zakusov, V. A. Valdman). For 25 years (1899-1924) N. P. Kravkov headed the Department of Pharmacology of Military Medical Academy. Commission for awarding the prize V. I. Lenin for scientific work which included the most prominent scientists of our country (O. J. Schmidt was Chairman), A. N. Bach, P. P. Lazarev, S. G. Navashin and M. N. Pokrovsky decided to award the prize to N. P. Kravkov for proceedings in 1926 year.
Pediatrician (St. Petersburg). 2015;6(2):114-125
pages 114-125 views

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