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Vol 4, No 1 (2013)

Articles
MOLECULAR DIAGNOSTICS OF TUBEROUS SCLEROSIS
Yanus G.A., Suspitsyn Y.N., Dorofeyeva M.Y., Imyanitov Y.N.
Abstract
Tuberous sclerosis is a hereditary disease of phakomatoses group, characterized by the development of multiple hamartomas of brain, eyes, skin and visceral organs. Diagnostics of tuberous sclerosis requires identification of pathogenic mutations within TSC1 or TSC2 genes. Here we present a description of clinical case of tuberous sclerosis followed by detection of the causative mutation.
Pediatrician (St. Petersburg). 2013;4(1):3-8
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Clinical implication of the Hydrogen Breath Test for diagnosis of lactose intolerance and overgrows syndrome in infants
Korniyenko Y.A., Kubalova S.S., Dmitriyenko M.A., Dzhagatspanyan I.E.
Abstract
The aim of this study was to estimate the diagnostic value of the Hydrogen Breath Test (HBT) in diagnosis of lactose intolerance (LI) and overgrows syndrome (OS) in infants with functional gastrointestinal disorders (FGD). 102 infants from 1 to 6 months with FGD symptoms were investigated by HBT with lactose, fecal microbiota were examined by culture and real time PCR, fecal calprotectin was measured. LI was found in 37 % FGD infants, OS in 60 %. Calprotectin level was 445 ± 28 mg/g in OS and 195 ± 27 mg/g in infants without OS. Microbiota was altered in all FGD infants with increase of Cl. difficile, St. aureus. Infants with LI got Lactase Baby, infants with OS-L. reuteri in infant formula NAN Comfort or in drops Rela Life. Both were effective in elimination of FGD symptoms. Calprotectin level and microbiota disturbances were better after treatment.
Pediatrician (St. Petersburg). 2013;4(1):9-15
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The functional outcomes stage IVb and V retinopathy of prematurity
Konikova O.A., Diskalenko O.V.
Abstract
The results of the assessment of the functional outcomes of the vision of 142 children with stage IVb and V retinopathy of prematurity after surgical treatment of retinal detachment are represented. The electroretinography objective criteria can serve as evidence of the severity of the morphological changes in the developing retinal detachment. These criteria may also be relevant in the assessment of prognosis and recovery of visual function after surgical treatment of retinopathy of prematurity. Vitreoretinal surgical treatment should be done to the maximum early from the onset of retinal detachment.
Pediatrician (St. Petersburg). 2013;4(1):16-20
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Optimization of dysbiosis prevention and correction in children with gastrointestinal disturbance
Pirogova Z.I.
Abstract
Dysbiosis prevention and correction in children with gastrointestinal disturbance is the most disputable and currently central problem of modern gastroenterology. In the article are summarized studding resultes of liquid probiotics “Bifidumbacterinum “Bifishka” and Narine-forte effectiveness for gastrointestinal disturbance remedial measures optimization.
Pediatrician (St. Petersburg). 2013;4(1):21-25
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Features of the state of health and physical development of school students of St. Petersburg
Suslova G.A., Lvov S.N., Zemlyanoy D.A.
Abstract
In article are given the results of research of a state of health and physical development of school students. It’s revealed that 59.9 % of schoolboy have harmonious physical development. Power opportunities of every third school student lie within values “below an average”. Dependences of physiometric indicators on a sex and age are analyzed.
Pediatrician (St. Petersburg). 2013;4(1):26-32
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Some features of staged treatment of cataract in children
Nikitina T.N.
Abstract
25 patients 5–17 years old after primary and secondary implantation of intraocular lenses were examined. The least reactive course of the postoperative period, in combination with the best functional result, was received using intraocular lenses AcrySof (Alcon). The best functional results (visual acuity and binocularity) were received at secondary implantation of the intraocular lenses, executed to children over 7 years old with aphakia who received active pleoptic treatment before and after operation.
Pediatrician (St. Petersburg). 2013;4(1):33-36
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Efficacy of surgical treatment of traumatic cataract with simultaneous intraocular lens implantation in children
Zakirkhodzhayeva D.A.
Abstract
Background: eye injury is often accompanied by lens damage. Aim: To evaluate the efficacy of surgical treatment of traumatic cataract with simultaneous IOL implantation in children. Material and methods: The results of surgical treatment of traumatic cataract with simultaneous IOL implantation in 62 children were analyzed: in 48 boys (77.4%) and 14 girls (22.6%) with a mean age 8.1 years. Results: visual acuity after surgery gradually increased from 0.09 to 0.22 by the end of the first month, 0.43 in 6 months and 0.47 in one year of follow-up. In 85.5% of the operated children visual acuity in the late post-op period was accounted 0.3–1.0, and in 82.2% of cases binocular vision was recovered. In the early postoperative period following complications were observed: exudative iridocyclitis — 16.1%; deposits of fibrin in the pupil — 8%; pigment deposits on surface of the IOL — 19%; secondary cataract — 12%; IOL or its haptics dislocation — 3% cases. Conclusions: Early IOL implantation during traumatic cataract surgery in children is suitable. Use of viscoelastics allows minimizing the severity of postoperative inflammation and reducing a risk of complications. Intraocular injection of Gemasa during surgery is effective to resolve hyphema, intraocular hemorrhages and fibrinoid exudate.
Pediatrician (St. Petersburg). 2013;4(1):37-40
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Prognostic Impact of MYCN Amplification, 1p Deletion and 11q Deletion in Neuroblastoma Patients
Druy A.Y., Tsaur G.A., Shorikov Y.V., Popov A.M., Savelyev L.I., Tsvirenko S.V., Fechina L.G.
Abstract
Neuroblastoma is characterized by wide clinical heterogeneity from tumors prone to spontaneous regression to highly aggressive disease that requires multimodal chemotherapy with autologous stem cells transplantation. Patient’s age and stage of the disease were described as prognostic factors. Different genetic aberrations were analyzed as potential predictive signs of poor outcome. MYCN gene amplification, 1p and 11q deletions are associated with aggressive tumor behavior, advanced stage of the disease and unfavorable outcome. In current report we analyzed molecular mechanisms and prognostic significance of indicated genetics abnormalities.
Pediatrician (St. Petersburg). 2013;4(1):41-48
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Methods of breast reconstruction after cancer
Bit-Sava E.M., Belogurova M.B., Akhmedov R.M., Monogarova M.A.
Abstract
More women are diagnosed and treated for breast cancer today than at any time in the past. New technologies in the treatment of breast cancer and breast reconstruction are changing morbidity and mortality realities for women diagnosed with breast cancer. This article reviews information on own experience in different methods of breast reconstruction after cancer.
Pediatrician (St. Petersburg). 2013;4(1):49-52
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Сomparative effect of artificial tear drug usage in patients with «dry eye» syndrome and chronic blepharitis
Prozornaya L.P., Brzheskiy V.V.
Abstract
During recent years, the problem of treatment «dry eye» syndrome in patients with chronic blepharitis is very important. But until there are no rational standards how to treat such patients. We investigated group of 44 adults with the chronic blepharitisand concomitant dry eye syndrome. In present article, рresented are the treatment results of artificial tear drug usage in patient with «dry eye» syndrome and chronic blepharitis.
Pediatrician (St. Petersburg). 2013;4(1):53-57
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Characteristics of clinical manifestations of Marfan syndrome in childrenand complications of surgical treatment of lens luxation
Toshpulatova A.Z.
Abstract
The most common ocular clinical signs of Marfan syndrome are lens luxation (46.16 %) and cataract (26.92 %), which during their progression are complicated by secondary glaucoma, lenticular myopia and strabismus. Discussed information indicates to the need to improve the traditional methods of surgery in children with ocular manifestations of Marfan syndrome in order to reduce the risk of intraand postoperative complications.
Pediatrician (St. Petersburg). 2013;4(1):58-61
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INCREASING OF SURGICAL EFFICACY OF CYSTIC ECHINOCOCCOSIS OF LIVER IN PEDIATRIC SURGERY
Minaev S.V., Gerasimenko I.N., Bykov N.I.
Abstract
From 1990 until 2010 retrospective study was carried out to investigate the occurrence of cystic echinococcosis (CE) of liver in children at Stavropol Regional children hospital in clinical wards of Stavropol State Medical Academy. We treated 60 children from 3 to 15 years with hepatic CE. In 22 (36.7%) patients had hepatic CE, in 38 (63.3%) — combines CE of the liver and lungs. Patients were divided into two equal groups: main and control. In the main group was used omentoplastiсa of residual cavity after closed echinococсectomy. In the control group — capitonage. In main group performed pre-and postoperative chemotherapy with nemozol at a dose of 10–15mg/kg/day and wobenzym in the dose of 1 tablet per 6 kg of body weight three times per day. In the main group complications occurred in 6.7% of children. In the control group, the complication rate was 23.2%. The number of relapses in the control group was 6 cases, in the main group is not mentioned. Accordingly the combined use of omentoplastiсa of residual cavity after closed echinococсectomy with nemozol and polyenzyme therapy to avoid recurrence of the CE, as well as shorten the duration of hospitalization and number of postoperative complications in children.
Pediatrician (St. Petersburg). 2013;4(1):62-64
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CHARACTERISTICS OF RESPIRATORY SUPPORT IN ANESTHESIA OF ENDOLARYNGEAL OPERATIONS
Kolotilov L.V., Pavlov V.Y.
Abstract
The article presents the practical aspects of jet ventilation (JV) methods usage during the anesthesiological support of endolaryngeal operations. The recommendations for the selection of JV methods and regimes subject the form of pathologic object, degree of its manifestation, localization, and also mode of endosurgical operation are given. The possibilities of JV complications prevention are discussed.
Pediatrician (St. Petersburg). 2013;4(1):65-70
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Otsenka effektivnosti metodov dissektsii pri pankreatoduodenal'noy rezektsii
Pavelets K.V., Kashintsev A.A., Kokhanenko N.Y., Imyanitov Y.N.
Abstract
Панкреатодуоденальная резекция является методом выбора при лечении рака поджелудочной железы. Эта операция технически трудно выполнима, обязательно дополняется широкой регионарной лимфодиссекцией и требует затраты большого количества времени. В работе выполнено сравнение методик диссекции — классической и с использованием ультразвукового скальпеля и Ligasure™. Было доказано, что использование современного оборудование позволяет полноценно выполнить регионарную лимфодиссекцию и мобилизацию панкреатодуоденального комплекса, уменьшить время операции, снизить частоту послеоперационных осложнений.
Pediatrician (St. Petersburg). 2013;4(1):71-73
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THE EFFECT OF ADVANCE HYPOXIC TRAINING UPON TISSUE OXYGEN TENSION IN THE TUMOR DURING AQUTE HYPOXIA OF DIFFERENT TYPES
Khaytsev N.V., Vasilyev A.G., Trashkov A.P.
Abstract
The tumors of rats who had not been acclimated to hypoxia subjected to acute hypoxic hypoxia (altitude chamber) as well as blood hypoxia (carbon monoxide) decreased tissue oxygen tension while histotoxic hypoxia (NaCN) on the contrary increased tissue oxygen tension. The tumor acclimated to hypoxia seems to select compensatory mechanisms mostly associated with increased tissue oxygen tension thus taking advantage of lower extent of tissue oxygen tension when subject to acute hypoxic hypoxia than in femoral muscle. All types of acute hypoxias caused a decrease of tissue oxygen tension in the malignancy.
Pediatrician (St. Petersburg). 2013;4(1):74-77
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Singularities of haemorrhagic syndrome in children with native and acquired deficiencies of von Willebrand factor
Pshenichnaya K.I., Lyugayev Y.V., Golovina O.G.
Abstract
Deficiencies of content in blood and activity of von Willebrand factor can be inborn or acquired with diseases of different nature. Acquired deficiencies of von Willebrand factor or acquired von Willebrand syndrome in children have been described in several clinical studies. This research paper contains data on clinical manifestation and dynamics of haemorrhagic syndrome in 30 children between 13 months and 18 years of age with acquired von Willebrand factor, suffering from different types of pathology. Similarly, clinical manifestations and dynamics of angiostaxis have been studied in 33 children with von Willebrand disease. It has been determined that clinical manifestations of microcirculatory angiostaxis are the same for children from both groups; however, children with acquired von Willebrand syndrome showed dominating limited numbers of haemorrhagical symptoms that were shorter in duration and less intense. Besides, hematomic component of haemorrhagic syndrome was absent. Eventually, accompanied by positive dynamic of the underlying disease, relapses of haemorrhagic syndrome cease, which does not happen in case of the patients with von Willebrand disease.
Pediatrician (St. Petersburg). 2013;4(1):78-85
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Psychological features of patients with GB II stage
Sidorova Y.I., Biletskaya M.P.
Abstract
In the work of the Yu. I. Sidorova and M. P. Biletskaya with the aim of studying the psychological features of patients with GB of stage II has been investigated 90 people: 45 people with essential hypertension II stage of the age from 30 to 40 years; 45 people (30–40 years) without chronic somatic For patients GB is characterized by a broad range of emotional experience with a predominance of negative emotions. Installed gender differences in the expression of ways of expression of aggression. Fears of patients GB are polymorphic in nature, linked to non-adaptive protective-сoping behavior, the leading role of which belongs to the fear of death. For patients GB have such personal qualities as: a tendency to depressive feelings, dominance, self-criticism, incredulity.
Pediatrician (St. Petersburg). 2013;4(1):86-88
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Factors associated with women’s sexual-erotic satisfaction
Sayev D.D., Subkevich D.I.
Abstract
The biological, psychological and socio-cultural preconditions affecting sexual-erotic satisfaction of women are discussed. 80 women in the age of from 20 to 40 years were tested. The role of sexual constitution, partnerships, marital status and personal characteristics are presented.
Pediatrician (St. Petersburg). 2013;4(1):89-91
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INCIDENCE AS THE MOST IMPORTANT INDICATOR OF HEALTH
Mayorova Y.K.
Abstract
Incidence should be considered as one of the most important indicators of health of the population. Since the 90’s of the last century, there is a number of negative trends in the health of children and teenagers such as the the steady increase in incidence rates of children in the Russian Federation, the increase in the number of chronic diseases and combined forms, increasing the number of children with disabilities. Growth of incidence is noted practically on all classes of diseases. The number of absolutely healthy children doesn’t exceed now 2–4%. In article the analysis of incidence of the children’s population according to negotiability to out-patient and polyclinic establishments of St. Petersburg is carried out.
Pediatrician (St. Petersburg). 2013;4(1):92-94
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Cytomegalovirus infection in the patients with inflammatory bowel disease
Markova D.O., Nasyrov R.A., Revnova M.O.
Abstract
Cytomegalovirus infection of the gastrointestinal tract is a relatively common occurrence in patients receiving immunosuppressive drugs, those infected with HIV, or those who are transplantant recepients. CMV infection may be diagnosed if typical intranuclear inclusion bodies are seen on standard hematoxylin and eosin (H&E) stain. However, the sensitivity of H&E exam for CMV infection is low. Immunohistochemistry (IHC) exam performed on colon biopsy specimens is more sensitive than routine histologic exam and has excellent specificity. Currently IHC is considered the gold standard for detecting CMV CMV infection in patients with refractory or complicated IBD should be ruled out before aggressive immunosuppressive therapy for treatment-resistant disease to decrease morbidity and mortality.
Pediatrician (St. Petersburg). 2013;4(1):95-99
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Aortic aneurysm in a Marfan’s syndrome patient
Priyma N.F., Popov V.V., Komolkin I.A., Afanasyev A.P.
Abstract
Presents a case of diagnosis and successful surgical treatment of youth of 15 years with Marfan syndrome. The patient was diagnosed with aortic sinus of Valsalva and the ascending aorta, atrioventricular valve prolapse, as well as severe funnel chest. After a thorough diagnosis was made simultaneous surgery including a prosthetic aortic valve-containing conduit, suture annuloplastics atrioventricular valves, and surgical correction of the funnel chest.
Pediatrician (St. Petersburg). 2013;4(1):100-108
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The role of egocentrism in development of centration and the decentration features of the physician’s personality
Menshchikova A.L.
Abstract
Egocentrism as personal feature is defined by social -psychological conditions of formation of the personality and carries out stabilizing functions in structure of ego-system. Egocentrism is defined by a position occupied with the subject in system social-psychological, first of all — interpersonal relations. The centration and the decentration are the mechanisms allowing during dialogue to support a feedback, not breaking thus integrity and uniqueness of the person. Formation of correct representation about a role of the egocentrizm and value a centration of persons, i. e. concentration of consciousnesses on itself, own experiences, is the important stage of increase of social psychological competence of physicins. Overcoming the centration of contents includes formation of skills of coordination of the points of view with colleagues, with patients in decoding essence of the reasons of disease and ways of struggle against them.
Pediatrician (St. Petersburg). 2013;4(1):109-114
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Molecular genetics — a way to the individual personalized medicine
Gorbunova V.N.
Abstract
Review of modern technologies that are used for identification and mapping of genetic risk factors associated with different multifactorial diseases. The principles of the wide genomic association scan (GWAS) are accounted. A significance of this method is considered on the example of hereditary predisposition to autoimmune diseases. The role of MCH complex gene polymorphism and specific genetic risk factors in the autoimmunity forming and a possibility of multifactorial diseases personalized therapy with taking into account of the patient hereditary constitution are discussed.
Pediatrician (St. Petersburg). 2013;4(1):115-121
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The role of endothelium in hemostasis mechanisms
Babichev A.V.
Abstract
Formation and excretion of thrombogenous and athrombogenous factors by endothelial cells is a constant physiological process taking place in all vessels. Endothelium is a huge endocrine gland which generates a wide spectrum of biologically active substances. Biologically active substances of endothelium are involved in many hemostasis mechanisms and regulation of local blood flow. BAS composition is determined by status of endothelial cells. In physiological state BAS of endothelium provide adequate local blood flow by synthesizing powerful anticoagulants, vasodilators and other biologically active substances. Activity of endothelium in physiological conditions provides trophism of tissues and fulfils protective function. Disturbance of any function or structure of endothelium significantly changes the spectrum of biologically active substances. Endothelium starts to secrete aggregants, coagulants, vasoconstrictors and other factors many of which contribute to generalization of the pathological process.
Pediatrician (St. Petersburg). 2013;4(1):122-127
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FEATURES VACCINATION OF CHILDREN WITH HIV INFECTION
Chernova T.M., Timchenko V.N.
Abstract
HIV infection — a slowly progressive infection, occurring with impairment of the immune system. Immunocompromised patients significantly increases the risk of joining the various infections that can take prolonged and lead to death of the patient. Vaccination can prevent severe secondary complications in HIV-infected patients can prolong the patient’s life and improve its quality.
Pediatrician (St. Petersburg). 2013;4(1):128-133
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