Children Infections (E-Journal) / ДЕТСКИЕ ИНФЕКЦИИ
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ЭПИДЕМИЧЕСКИЙ ПАРОТИТ У ДЕТЕЙ — АКТУАЛЬНОСТЬ ПРОБЛЕМЫ
Get PDFThe aim of the study was to determine the clinical and epidemiological features of Epidemic parotitis in children in the Astrakhan Region under conditions of vaccine prophylaxis. 260 cases of laboratory-confirmed Epidemic parotitis in children under 17 years of age have been analyzed.Contact with diseased Epidemic parotitis was found in 180 (69,2%) of affected children. In the age structure of the patients, children aged 3 to 9 years (73,8%) prevailed, of which 87,5% of children in this age group had vaccination and revaccination against Epidemic parotitis. Patients aged 9 to 17 years accounted for 26,2% of cases with an immune stratum of 76,5%. Severe forms of the disease were noted when a combination of Epidemic parotitis with orchitis, pancreatitis, meningitis. The epidemiological process of Epidemic parotitis infection in children, under conditions of vaccine prevention, is characterized by an increase in the number of patients among older children and adolescents up to 26,2%. The decrease in the immune stratum, among infected children, compared with the recommended level of coverage with vaccination and revaccination against Epidemic parotitis 95% of children, may be the cause of the increase in the incidence of this pathology in the region. In the structure of clinical forms, medium-severe forms of the disease predominate (63,9%). Displacement of morbidity by Epidemic parotitis in the direction of older and adolescent years may indicate a decrease in the intensity of postvaccinal immunity after revaccination at the age of 6 years, which calls for discussion of the need for a second planned revaccination against Epidemic parotitis at the age of 15—17.
ХАРАКТЕРИСТИКА ОСТРЫХ КИШЕЧНЫХ ИНФЕКЦИЙ У ДЕТЕЙ, ГОСПИТАЛИЗИРОВАННЫХ В СТАЦИОНАР Г. МОСКВЫ
Get PDFThe article presents the results of the study of the etiological structure and clinical features of acute intestinal infections of viral, bacterial and mixed etiology in children hospitalized in a specialized department of Children's Clinical Hospital №9 named G. N. Speransky, city of Moscow in 2008—2016. It was found that during 9 years of follow-up, the number of hospitalized patients with acute intestinal infections does not have an obvious tendency to decrease. More than half of hos-pitalized patients are children 1—7 years old. Among the reasons for acute intestinal infections of established etiology, viral agents (rotaviruses and noroviruses) prevail. Among bacterial intestinal infections, the most urgent are salmonellosis, campylobacteriosis and staphylococcal infection. В статье представлены результаты изучения этиологической структуры и клинических особенностей острых кишечных инфекций (ОКИ) вирусной, бактериальной и смешанной этиологии у детей, госпитализированных в специализированное отделение ДГКБ №9 им Г.Н. Сперанского г. Москвы в 2008—2016 гг. Установлено, что на протяжении 9 лет наблюдения количество госпитализированных пациентов с ОКИ не имеет очевидной тенденции к снижению. Более половины госпитализированных пациентов составляют дети в возрасте 1—7 лет. Среди причин ОКИ установленной этиологии преобладают вирусные агенты (ротавирусы и норовирусы). Среди бактериальных кишечных инфекций наибольшую актуальность представляют сальмонеллез, кампилобактериоз и стафилококковая инфекция.
К ВОПРОСУ О РАСШИРЕНИИ ПОКАЗАНИЙ ПРИМЕНЕНИЯ ИММУНОМОДУЛИРУЮЩЕГО ПРЕПАРАТА В ЛЕЧЕНИИ И ПРОФИЛАКТИКЕ ГРИППА И ОСТРЫХ РЕСПИРАТОРНЫХ ИНФЕКЦИЙ У ДЕТЕЙ РАННЕГО ВОЗРАСТА
Get PDFThe data on the safety and effectiveness of the use of the domestic immunomodulating preparation Polyoxidonium® (azoximer bromide) in children are summarized in the following pages. Polyoxidonium has an immunomodulatory (including interferon-inducing), detoxication and anti-inflammatory effect that allows the clinical course of the disease to be quickly alleviated and the natural immune response modulated. The clinical effectiveness of the drug in acute respiratory infections (ARI) in children, including those with allergic anamnesis. Recent studies have proven the effectiveness of the 7-day course of the preparation Polyoxidonium® for the treatment and prevention of ARI and influenza in children, starting at the age of 3 years, as evidenced by a rapid positive dynamics of clinical symptoms and a 2-fold decrease in ARI frequency compared to placebo group at 6 months after the end of therapy. Обобщены данные о безопасности и эффективности применения отечественного иммуномодулирующего препарата Полиоксидоний®(азоксимера бромид (azoximer bromide) у детей. Полиоксидоний оказывает иммуномодулирующее (в том числе интерферонин-дуцирующее), детоксикационное и противовоспалительное действие, что позволяет быстро облегчать клиническое течение заболевания и модулировать естественный иммунный ответ. Доказана клиническая эффективность препарата при острых респираторных инфекциях (ОРИ) у детей, в том числе с отягощенным аллергоанамнезом. Последние исследования доказали эффективность 7-дневного курсового приема препарата Полиоксидоний® для лечения и профилактики ОРИ и гриппа у детей, начиная с 3-х летнего возраста, о чем свидетельствовала быстрая положительная динамика клинических симптомов и уменьшение частоты ОРИ в 2 раза по сравнению с группой плацебо через 6 мес. после окончания терапии.
КЛИНИКО-ИММУНОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА ШИГЕЛЛЕЗА, АССОЦИИРОВАННОГО С ГЕРПЕСВИРУСНЫМИ ИНФЕКЦИЯМИ, У ДЕТЕЙ: КЛИНИКА, ДИАГНОСТИКА И ЛЕЧЕНИЕ
Get PDFThe purpose is to characterize the features of the clinical picture, interferon and immune system status in shigellosis associated with herpesvirus infections in children, and to justify the inclusion of recombinant interferon-a2b (VIFERON®) in the complex treatment program of the disease. Clinical and immunological examination of 136 patients with shigellosis at the age from 1 to 3 years was carried out. In 65 children the active form of herpesvirus infection was diagnosed, in 20 patients it was absent. Active form of herpesvirus infection developed in children with a burdened premorbid background. These patients showed a violation of the immune response regulation by cellular type (reduction of interferon-g spontaneous and stimulated production, expression of CD119 receptors), the effector stage of the adaptive immune response. Clinically associated shigellosis was characterized by a severe course, a frequent development of complications. Inclusion of recombinant interferon-a2b (VIFERON®) in the complex program of treatment promoted the modulation of the regulatory and effector stages of the immune response. There was a reduction in the duration of the main symptoms of the disease and the stay of patients in the hospital.High efficiency of recombinant interferon-a2b (VIFERON®) application make it possible to recommend the inclusion of this drug in the treatment of shigellosis associated with herpesvirus infection in children.
ЭТИОТРОПНАЯ ТЕРАПИЯ ВИРУСНЫХ ГЕПАТИТОВ
Get PDFTreatment of chronic viral hepatitis is not a fully resolved problem, especially in children. There are no convincing criteria for recovery. The paper presents various schemes used for etiotropic therapy of viral hepatitis at the present stage — interferons and antiviral drugs. For the treatment of hepatitis B, synthetic nucleoside and nucleotide analogues are used as an antiviral therapy, in the case of hepatitis C — ribavirin and protease and polymerase inhibitors. In children, interferon therapy remains important with the use of domestic drugs, including rectal forms of interferon administration (VIFERON®). At the same time, active research is underway to study non-interferon regimens for the treatment of chronic viral hepatitis in pediatric practice, but so far the choice of drugs for non-interferon therapy is limited to individual drugs. With hepatitis B, it is a lamivudine, prescribed from 3 years (the reception of which is accompanied by frequent development of resistance) and — tenofovir (appointed from 12 years). With hepatitis C, ribavirin can be administered from 3 years.
ОЦЕНКА ЭФФЕКТИВНОСТИ ЖЕЛАТИНА ТАННАТА ПРИ ОСТРЫХ ИНФЕКЦИОННЫХ ДИАРЕЯХ У ДЕТЕЙ
Get PDFSpecific features of the course of acute intestinal infections of viral and bacterial etiology in children are described, features of the syndrome of endogenous intoxication in children carrying infectious diarrhea are characterized. As a result of the study, the efficacy and safety of gelatin tannate (LLC «YADRAN», Croatia) with intestinal infections of bacterial and viral etiology in children has been confirmed. Установлены особенности течения острых кишечных инфекций вирусной и бактериальной этиологии у детей, охарактеризованы особенности синдрома эндогенной интоксикции у детей, переносящих инфекционные диареи. В результате проведенного исследования подтвержена эффективность и безопасность желатина танната (ООО «ЯДРАН», Хорватия) при кишечных инфекциях бактериальной и вирусной этиологии у детей.
РОЛЬ ПИТАНИЯ И КИШЕЧНОЙ МИКРОБИОТЫ БЕРЕМЕННОЙ ЖЕНЩИНЫ В ПРОГРАММИРОВАНИИ ЗДОРОВЬЯ РЕБЕНКА
Get PDFObjective: to study the diet and the composition of the intestinal and vaginal microbiota of pregnant women and their influence on the process of establishing the intestinal microbiota of their children. Materials and methods: we examined 45 pairs of pregnant women and their newborns. Of these, 36 women with a pathological course of pregnancy (study group) and 9 clinical healthy (control group). Determined the daily diet of pregnant women with calculation of consumption of proteins, fats, carbohydrates, vitamins, minerals and energy values per day. Research results: most women with patologicheskie pregnancy irregularities were detected in the diet: excessive consumption of protein 1.96 times, fats and carbohydrates — in 1,2 times and the lack of consumption of vitamin C and calcium. At 73.2% of them were detected dysbiotic changes of the vagina, in 67.5% of intestinal, from 57.5 per cent in the two habitats at the same time. Conclusion: the majority of women during pregnancy, the food was unbalanced and unsustainable. The identified correlation of deviations of supply pregnant women with those of their intestinal microbiota and the negative impact of these factors on the process of establishing the intestinal microbiota of their children, programming a congenital reduction of colonization resistance and the metabolic activity of the intestinal microbiota and the high risk of allergic, metabolic and infectious diseases
ИССЛЕДОВАНИЕ ЗНАЧИМОСТИ ОБНАРУЖЕНИЯ НУКЛЕОКАПСИДНОГО АНТИГЕНА ВИРУСА ГЕПАТИТА С У ДЕТЕЙ С ХРОНИЧЕСКИМ ГЕПАТИТОМ С
Get PDFThe aim of this study was to investigate the clinical and diagnostic significance of the detection of core-antigen of hepatitis C virus (HCV) in children with chronic hepatitis C (CHC). Sera of 101 patients and 24 non-infected participants were analyzed. Core-antigen was determined by chemiluminescent method using «ARCHITECT HCV Ag» (Abbott, USA). HCV RNA was detected by highly sensitive OT-PCA. The presence of liver fibrosis was established by non-invasive methods. Antibody to core-antigen was detected by ELISA using commercial test-systems. A correlation was found between concentration of core-antigen and HCV RNA, viral subtypes, ALT level, and presence of liver fibrosis. High sensitivity and specificity of the chemiluminescent method for the detection of core antigen in children with CHC was shown. For the first time three ranges of core-antigen concentrations were proposed. Цель исследования — изучить клинико-диагностическое значение обнаружения нуклеокапсидного (core) антигена вируса гепатита С у детей с хроническим гепатитом С. Анализировали сыворотки крови 101 больных и 24 неинфицированных участников. Сore-антиген определяли хемилюминисцентным методом (Architect HCV Ag, «Abbott», США), РНК ВГС — методом ОТ-ПЦР, фиброз печени — неинвазивными методами, специфические антитела — методом ИФА. Установлена зависимость между содержанием core-антигена и РНК ВГС, субтипами вируса, уровнем АЛТ и фиброзом печени. Показаны высокая чувствительность и специфичность хемилюминисцентного метода определения core-антигена у детей с ХГС. Впервые предложены три диапазона концентраций core-антигена
ХРОНИЧЕСКИЙ ВИРУСНЫЙ ГЕПАТИТ В И С У ДЕТЕЙ, РОЖДЕННЫХ ОТ ИНФИЦИРОВАННЫХ HBV И HCV МАТЕРЕЙ
Get PDFThere were 164 children with chronic hepatitis B (CHB) and chronic hepatitis C (CHC) at the age of 1—18 years of age, 78 of which (48%) had a perinatal route of infection (CHB — 46; CHC — 32). Observed for 5 years. Chronic hepatitis B and C was characterized by subclinical signs, with minimal fibrosis, in the immu- noactive phase of HBV (69%) and high viremia HCV (56%). Etiopathogenetic therapy (alpha-2b interferon (VIFERON, PegIntron), lamivudine (Zeffix), ribavirin (Rebetol) promoted the development of clinico-virologic remission in 83% of children with CHB and 63% in CHC.Наблюдалось164 ребенка с хроническим гепатитом В (ХГВ) и хроническим гепатитом С (ХГС) в возрасте 1—18 лет жизни, из которых у 78 (48%) был установлен перинатальный путь инфицирования (ХГВ — 46; ХГС — 32). Проводилось наблюдение в течении 5 лет. Хронический гепатит В и С характеризовался субклиническими признаками, с минимальным фиброзом, в имму- ноактивной фазе HBV (69%) и высокой виремией HCV (56%). Этиопатогенетическая терапия (альфа-2b интерферон (ВИФЕРОН, ПегИнтрон), ламивудин (Зеффикс), рибавирин (Rebetol) способствовала возникновению клинико-вирусологиче- ской ремиссии у 83% детей с ХГВ и у 63% — с ХГС
РЕСПИРАТОРНО-СИНЦИТИАЛЬНАЯ ВИРУСНАЯ ИНФЕКЦИЯ: КЛИНИКО-ЛАБОРАТОРНЫЕ ОСОБЕННОСТИ
Get PDFInfants are dominated among patients with respiratory syncytial viral infection (RSVI). In patients with RSVI characteristic are lesions of the lower respiratory tract and development of bronchial obstruction. Laboratory indicators of intoxication (the level of CRP, Leukocyte index of intoxication (LII), hematologic indicator of intoxication (GPI), metabolic disorders and decreased oxygen saturation below 93% are indicators of the severity of the disease, which can predict the development of a more severe course of RSVI and its complications. Среди больных респираторно-синцитиальной вирусной инфекцией (РСВИ) чаще оказываются дети раннего возраста. Для РСВИ характерно поражение нижних дыхательных путей и развитие бронхообструктивного синдрома. Лабораторные показатели интоксикации (уровень CРБ, лейкоцитарный индекс интоксикации (ЛИИ), гематологический показатель интоксикации (ГПИ), метаболические нарушения и снижение сатурации кислорода ниже 93% позволяют прогнозировать развитие тяжелой формы и осложнений