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Vol 4, No 3 (2013)

Articles
Current conception of the link of obesity and intestinal microbiota
Korniyenko Y.A.
Abstract
More than 500 million people in the world are overweight, this “epidemic” covers all countries, including Russia, and there is both in adults and in children. This is usually attributed to a change in lifestyle and diet of modern people, that also may influence at intestinal microbiota. Microbiota takes part in the energy and fat metabolism, which has been proven in germ-free animals. Transplantation of microflora from overweight animals to germ-free ones contributed to the development of obesity, regardless of diet. Obesity is accompanied by mild chronic inflammation, it can be a result of changing of intestinal microbiota. Lipopolysaccharides (LPS) of Gram (–) intestinal bacteria via activation of TLR-4 are the main cause of this inflammation. Intestinal microbiota of obese and slim is different. Obesity increases the number of Clostridia and Gram (–) Proteobacteria, reduced number of Bacteroides and Bifidobacteria. Recent works showed the positive influence of probiotics, particularly infant Bifidobacteria strains, on metabolic syndrome, in particular, the level of glucose, insulin, cholestero
Pediatrician (St. Petersburg). 2013;4(3):3-14
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Outcomes for critical conditions in newborns depending on the time of interhospital transportation
Aleksandrovich Y.S., Pshenisnov K.V., Andreyev V.V., Parshin Y.V., Cherevatenko R.I., Nurmagambetova B.K.
Abstract
This article analyzes the influence of interhospital transportation duration of newborns in critical state on the close outcome. The features of intensive care measures, the frequency of seizures, bronchopulmonary dysplasia and open arterial duct were studied regarding the age at which an infant was admitted to a neonatal ICU in a hospital of III level. It was found that transportation of critically ill infants at the age of one day or three days of life was associated with high risk of complications in the neonatal period. It was shown that the optimal time for interhospital transportation of a newborn baby to an intensive care unit of a hospital of III level is the second day after birth.
Pediatrician (St. Petersburg). 2013;4(3):15-23
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Manifestations of rickets in infants with transient lactose intolerance and measures for its prevention
Denisov M.Y., Kochetkova Y.S., Morozova O.N., Alekhno A.A.
Abstract
The frequency and characteristics of clinical symptoms of comorbid diseases — hypovitaminosis D and transient lactose intolerance in infants who were born in the Siberian region. A total of 52 infants living in Novosibirsk, including 32 childs with transient lactose intolerance (61.5 %) and 20 apparently healthy children. Studied natal risk factors. High incidence of rickets in children in both groups, and for lactose intolerance severe disease with significant bone deformities. The fundamentals of preventive measures for patients with lactose intolerance, living in areas with harsh climates.
Pediatrician (St. Petersburg). 2013;4(3):24-28
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New aspects of the mechanisms of development and treatment of irritable bowel syndrome
Tipikina M.Y., Korniyenko Y.A.
Abstract
In 121 children with irritable bowel syndrome (IBS) a complex evaluation of the values of volum threshold sensitivity (VTS) of the rectum, intestinal microbiota according to the findings of feces analysis and lactulose hydrogen test, and also of the activation of inflammation according to endoscopy, histology, stool calprotectin testing and proinflammatory cytokines in the colonic mucosa was performed. The estimation of these parameters before and after treatment with probiotics, trimebutin, combination therapy of pro-and prebiotics, combination therapy trimebutin and probiotics for 1 month. The control group were children receiving placebo. In all patients with IBS enhanced VTS was noted. Signs of inflammation were detected according to the findings of endoscopy in 66.9 %, of histology – in 97.5 %, enhanced levels of calprotectin were found in 27.3 %, enhanced levels of IL-8 — 45 at %, INF-γ — 90 %. In all patients with IBS have disbiotic disorders of the colon, sings of bacterial overgrowth syndrome were detected in 85.1 % of children. Probiotics effective in reducing the VTS, improving of clinical data,microbiological indices, and coping with of inflammatory disorders in the intestines. Are the most effective of treatment with both trimebutin and probiotics, or probiotics and prebiotic lasting at least one month.
Pediatrician (St. Petersburg). 2013;4(3):29-35
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Metabolic syndrome and morphofunctional state of pancreas in children: clinical and pathogenetic relationship
Bokova T.A.
Abstract
The aim of the study: evaluation of pancreatic morphofunctional state of children with metabolic syndrome (MS). 48 children were examined with different shapes and degrees of obesity, ranging in age from 6 to 15 years old (23 males and 25 females). 2 selected groups: core group-31 child with MS, the comparison group-17 children with obesity without signs of MS. Decrease the postprandial response of the pancreas, which indicates lower adaptive capacity and high risk of development of chronic pancreatitis in children with MS. The interrelation between the overall size of the gland before and after food load with violations of carbohydrate and lipid metabolism. The results indicate the need for in-depth surveys of children with a view to the correction of excretory and endocrine functions of the pancreas decrease in risk of formation of MS
Pediatrician (St. Petersburg). 2013;4(3):36-40
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Mucopolysaccharidosis type I: genetic variants and enzyme replacement therapy experience in Saint-Petersburg
Buchinskaya N.V., Kalashnikova O.V., Dubko M.F., Kostik M.M., Chasnyk V.G.
Abstract
In this article we describe a 5th years experience of enzyme replacement therapy (ERT) of mucopolysaccharidosis (MPS) type I, an autosomal recessive disease caused by deficienty of α-L- iduronidase. ERT by Aldurazyme (BioMarin, Genzyme, USA) used for patients with proved MPS I. The drug was intravenously administered in a dose 100 U/kg or 0,58 mg/kg per week. Also we evaluate the prevalence of genetic variants and first symptoms of the disease on a base of results of clinical examination and therapy children with MPS I in 2007—2012 years in 3rd pediatric department of State Pediatric Medical University. Composed recommendations for early diagnostic MPS I for specialists and parents
Pediatrician (St. Petersburg). 2013;4(3):41-46
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The characteristic of energy metabolism’s infringement and possibilities of its correction in children suffering from celiac disease
Kamilova A.T., Dustmuhamedova D.H., Khushvaktova Z.A., Sirov B.N.
Abstract
The results of study of energy metabolism’s infringement and possibilities of its correction in children suffering from celiac disease are presented in the article. The study was conducted from January 2009 till December, 2012 in department of gastroenterology RSSM of Center of pediatrics. 45 children with CD at the age from 3 till 14 years have been surveyed. The carried out researches have shown at patients with CD processes of energy formation are broken: synthesis АТF and АDF is lowered, their ratio is increased, values of LTT and GТТ are lowered in 4 times. Increment of a ratio laktat/piruvat is detected, that testifies to prevalence at children tissue hypoxia. Treatment of patients suffering from CD application of use phytoecdisteroid ecdisten reduces duration of kliniko-laboratory symptoms and improves values of energy metabolism.
Pediatrician (St. Petersburg). 2013;4(3):47-51
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Correlation of Immunogenicity the different oat varieties from children with celiac disease and expansion gluten-free diet
Vokhmyanina N.V., Gavrilyuk I.P.
Abstract
Most of the recent studies suggest that oats are well tolerated by celiac disease patients. However, it is still possible that different oat cultivars may display different biological properties relevant for celiac disease pathogenesis. The aim of this study was to investigate biological and immunological properties of two oat varieties, in relation to their safety for CD patients. Our data show different immunological properties of two oat varieties for celiac disease patients. It is necessary update on serologic testing for anti-avenin antibodies for individualization gluten-free diet.
Pediatrician (St. Petersburg). 2013;4(3):52-55
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Diagnosis of mixed-forms of persistent infections in children with gastroduodenal pathology
Ryabchuk F.N., Aleksandrova V.A.
Abstract
In recent years more and more frequently when mucosa of the stomach at the same time with Нelicobacter Рylori (HP) in the mucosa of the stomach and duodenum found various persistent pathogens (viruses Gripp, Herpes , HV 1 and 2 tipe, virus Epstein-Barr and Citomegalovirus). The work is devoted to a thorough diagnosis of persistent viruses in children with gastroduodenitis, which was used in the treatment of adequate antiviral therapy, contributing to the disappearance of autoantibodies from the blood, increase the effectiveness of eradication therapy and a significant improvement of the morphological structure of the stomach mucosa in children.
Pediatrician (St. Petersburg). 2013;4(3):56-60
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SOME ASPECTS OF THE MUKOAKTIV THERAPY OF ACUTE RESPIRATORY DISEASES IN THE CHILDREN
Soroka N.D.
Abstract
The article presents the data on acute respiratory infections in children, defined the characteristics of the modern trends, gives a brief clinical characteristics of protracted variants of acute respiratory disease. The reasonability of mykoaktive therapy in the treatment of acute respiratory diseases. Presents data post marketing study of efficacy and safety of mykoaktive preparation Prospan (Manufacturer Engelhard Arzneimittel, Germany). Prospan marked by a high secretolytic, bronchospasmolytic effects and safety of dry extract of leaves of ivy of the treatment of acute respiratory diseases, including children of early age, as well as the opportunity to personalize the application of various medicinal forms preparation and ways of delivery to the organism of a sick child.
Pediatrician (St. Petersburg). 2013;4(3):61-64
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RESULTS OF EARLY SURGICAL TREATMENT OF OSTEOCHONDRITIS DISSECANS OF THE KNEE JOINT IN CHILDREN
Baindurashvili A.G., Sergeev S.V., Moskalenko A.V., Pozdeeva N.A.
Abstract
The results of surgical treatment of osteochondritis dissecans (OCD) of a knee joint in children were studied. Three groups of monitoring were formed: arthroscopic treatment of early stages — 31 children, arthroscopic treatment of late stages — 14 children, arthrotomic treatment of late stages — 14 children. Immediate results are comparable in all the groups. The best long-term results were observed in groups of arthroscopic treatment, especially in early stages. Simultaneous application of bone marrow stimulation techniques and symptomatic treatment is more effective.
Pediatrician (St. Petersburg). 2013;4(3):65-69
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Diseases of a neurotic range at children with night enuresis
Chutko L.S., Surushkina S.Y., Nikishena I.S., Yakovenko Y.A., Anisimova T.I., Bykova Y.L.
Abstract
The article is devoted to the study of nocturnal enuresis and frequency of comorbid anxiety disorders in children with this disease. The authors present the results of a survey of 70 children aged 7 to 10 years with primary enuresis. In the study, anxiety disorders were found in 44 children with this pathology (62.9 %). Analysis of the identified symptoms showed that more of the study group are generalized anxiety disorder (31.8 %) and phobic anxiety disorder (40.9 %).
Pediatrician (St. Petersburg). 2013;4(3):70-73
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Clinical interpretation of acetonemic vomiting in pediatries
Reshetnik L.A., Parfenova Y.O., Krivickaya N.S.
Abstract
Acetonemic vomiting is a syndromic condition that occurs in 4–7-year-old children more often than in the other age groups (t = 53,5; p(0,001). Girls are more exposed to acetonemia (t = 55,5; p(0,001), but its severity is more expressed in boys (the average duration of ketoacidosis for boys is 1,58 days, for girls — 1,17 days (t = 3,8; p(0,001). There is also more expressed ketoacidosis in pre-school children as compared with toddlers (t = 2,9; p(0,01) and compared with school-age children (t = 2,8; p(0,01). There are no reliable gender differences in ketoacidosis’ severity. Now the number of children hospitalized to Ivano-Matreninskaya state pediatric hospital with cyclic vomiting syndrome (CVS) has increased by 8 times in the last 10 years.
Pediatrician (St. Petersburg). 2013;4(3):74-76
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PROGNOSTICATION OF BILATERAL NEPHROLITHIASIS DEVELOPMENT RISK
Tagirov N.S., Vasilyev A.G., Gadzhiev N.K., Lihtshangof A.Z.
Abstract
The study involved 653 patients with nephrolithiasis. A multivariate based on discriminant analysis model predicting the risk of bilateral nephrolithiasis development was constructed. Clinical testing revealed high ability of the proposed mathematical model for predicting the development of bilateral nephrolithiasis. The relative risk criterion is highly informative to predict the risk of bilateral nephrolithiasis development. The signs of the high-risk are: urine pH rise over 6.1, concentration of the urine magnesium decrease under 2.26 mmole/l, level of the urine saturation with calcium oxalate over 3.27 and the relative tubular reabsorption under 97.5 %.
Pediatrician (St. Petersburg). 2013;4(3):77-81
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The differential diagnosis algorithms of hypertrophic cardiomyopathy and hypertrophic cardiomyopathy syndromes
Turalchuk M.V., Novik G.A., Goodkova A.Y.
Abstract
The differential diagnosis in HCM patients is discussed. Literature data and results of 98 hypertrophic cardiomyopathy patients examination are given. The differential diagnosis algorithms for HCM and HCM syndromes are proposed.
Pediatrician (St. Petersburg). 2013;4(3):82-85
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Assessment of changes in heart rate variability at different stages of burnout in Emergency Doctors
Revina N.E., Vasilyev A.G.
Abstract
Emergency medical professionals as an object of physiological investigation took part in this study. Important changes in heart rate variability during “burnout” syndrome stages were postulated. Various possible mechanisms of disturbances in central-peripheral relationship during “burnout” syndrome development are discussed.
Pediatrician (St. Petersburg). 2013;4(3):86-88
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The results of using automated system of prophylactic examination of children in Yakutsk
Yevseyeva S.A., Dranaeva G.G., Kontorusova S.V., Chasnykh V.G., Burtseva T.E., Shadrin V.P., Avrusin S.L.
Abstract
In this article the results of introduction of technology AKDO are presented to out-patient and policlinic service and possibilities of optimum use of this technology in school and preschool offices, in an office of the school doctor are offered.
Pediatrician (St. Petersburg). 2013;4(3):89-93
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Evaluation of different methods of iodine prophylaxis in infants in the region of mild iodine deficiency
Belykh N.A., Mamenko M.Y.
Abstract
Aim: To evaluate of the effectiveness of different methods of iodine prophylaxis in infants. Materials and Methods: The dynamic monitoring of pregnant and lactating mothers and their infants with iodine supplementation (potassium iodine, iodized salt) and without it. Results: Lack of antenatal iodine supplementation leads to a complicated course of the perinatal period, an increase of frequency of gestational hypothyroxinemia and neonatal hyperthyrotropinemia. Infants without iodine prophylaxis have higher levels of TSH and lower content of fT4. Conclusion: The most effective method of iodine supplementation in infants is individual iodine prophylaxis with potassium iodide in pregnant and lactating mother.
Pediatrician (St. Petersburg). 2013;4(3):94-100
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Giardiasis in children: the modern state of problem
Privorotskiy V.F., Luppova N.Y.
Abstract
Giardiasis is a serious problem of modern pediatrics. The urgency is due to both its high prevalence of this type of simple and polymorphism of clinical manifestations, diagnosis and complexity of mixed approaches to treatment. This review examines current aspects of diagnostic and therapeutic possibilities of searching for giardiasis in children.
Pediatrician (St. Petersburg). 2013;4(3):101-110
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About the diseases associated with impaired barrier functionof the skin
Gorlanov I.A., Leina L.M., Milyavskaya I.R., Kulikova S.Y.
Abstract
The article presents data on diseases with impaired barrier function of the skin. A description of the rare disease ichthyosiform — Netherton syndrome.
Pediatrician (St. Petersburg). 2013;4(3):111-114
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The ultrasound evaluation of muscle changes in fibrodysplasia ossificans progressiva: case overview
Sinelnikova Y.V., Chasnyk V.G., Nasyrov R.A., Dubko M.F., Imelbayev A.I., Zinkina A.V., Sulika Y.V., Akinshin I.I., Gorbunova T.O.
Abstract
The review and description of two cases ultrasound observations of changes in the muscle tissue at different periods of the flow of fibrodysplasia ossificans progressiva presented in the article.
Pediatrician (St. Petersburg). 2013;4(3):115-121
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Rare outcome yersiniosis at the teenager
Bekhtereva M.K., Purin V.I., Panova T.F., Dutova Y.P., Ivanova V.V.
Abstract
Yersiniosis — infectious pathology which demands broad diagnostic search in various phases of infectious process, since banal sharp respiratory and enteric infections and, finishing system diseases. In the publication the outcome Yersiniosis in a gemofagotsitarny syndrome is described.
Pediatrician (St. Petersburg). 2013;4(3):122-125
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Adaptation and value — motivational characteristics of modern students
Kozina N.V.
Abstract
This article allows to characterize the dynamics of formation of individual psychological characteristics of students at different stages of training in higher educational institutions.
Pediatrician (St. Petersburg). 2013;4(3):126-129
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The All-Russian Motherhood and Infancy Charity: Continuity in Ideas(to the 100th Anniversary)
Mikirtichan G.L.
Abstract
The present article is concerned with the basic strategies and achievements of The All-Russian Motherhood and Infancy Charity. The Charity was founded in 1913 by a renowned Russian pediatrician K. A. Rauchfuss and was aimed to unite both physicians, charities and community institutions in order to challenge the high infant and child mortality in Russia. The experience of the The All-Russian Motherhood and Infancy Charity concerning methods and principles of organization and work of different children institutions, care of mothers and babies, sanitary education was considered as useful after the October revolution in 1917. Many ex-members of the Charity took part in developing the Soviet National Health Service System. The materials concerning the project of the Charity Institute which were not fulfilled by 1917, were incarnated in the Leningrad Institute of motherhood and childhood protection (nowadays St. Petersburg State Pediatric Medical University ).
Pediatrician (St. Petersburg). 2013;4(3):130-137
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