Children Infections (E-Journal) / ДЕТСКИЕ ИНФЕКЦИИ
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ИНФАНТИЛЬНЫЙ МИОФИБРОМАТОЗ У НОВОРОЖДЕННОГО
Get PDFThe article describes the clinical case of infantile myofibromatosis of a newborn child. Infantile myofibromatosis is a rare mesenchymal tumor of the soft tissues of the head, limbs, trunk in children with infiltrative local growth, without metastases. During the examination the patient was diagnosed multiple myofibroms, which had a tendency to increase in the combination of active herpes infection. In this case, does not exclude the impact of mixed herpetic infection on the growth of myofibroms as on the background of antiviral treatment showed positive dynamics with a decrease in the number and size of tumors.В статье приводится описание клинического случая инфантильного миофиброматоза у новорожденного ребенка. Инфантильный миофиброматоз — редко встречающаяся мезенхимальная опухоль мягких тканей головы, конечности, туловища у детей, обладающая местным инфильтративным ростом без метастазов. В ходе обследования данного пациента были диагностированы множественные миофибромы, имевшие тенденцию к росту в сочетании с активной герпесвирусной инфекцией. В данном случае не исключается влияние смешанной герпетической инфекции на рост миофибром, так как на фоне противовирусного лечения была получена положительная динамика с уменьшением количества и размеров новообразований
ЛЕКАРСТВЕННЫЙ ГЕПАТИТ У ДЕТЕЙ
Get PDFAmong toxic lesions of the liver, an important place belongs to medicinal hepatitis. Among patients with hepatitis, drug disease of the liver occurs in 0.7—1.4% of cases, and in the presence of jaundice — in 5%. A family case of sisters 9 and 4-year-old life development of acute drug hepatitis caused by ibuprofen in a daily dose of 32 mg / kg (total 3.2 g) and 25 mg / kg (total 2 g), respectively, was demonstrated in siblings. Hepatitis developed after an acute respiratory infection. Weakness, nausea, vomiting, jaundice of the skin and sclera, pruritus, multiple increase in serum transaminases and markers of cholestasis are revealed. Viral hepatitis and some hereditary liver diseases were excluded. The drug lesion of the liver was of a mixed nature: hepatocellular (cytotoxic) and cholestatic. Timely administration of therapy (detoxification, glucocorticosteroids, ursodeoxycholic acid (Ursosan) led to a regression of clinical symptoms of the disease and positive dynamics of laboratory indicators
КЛИНИКО-ЛАБОРАТОРНЫЕ АСПЕКТЫ ХРОНИЧЕСКОГО ГЕПАТИТА В НА ФОНЕ РЕФРАКТЕРНОЙ АНЕМИИ ВОСПАЛЕНИЯ У ДЕТЕЙ УЗБЕКИСТАНА
Get PDFA total of 75 children with chronic hepatitis B (ChHB) with a refractory variant of anemia of inflammation (AV) course were examined, the pathogenetic manifestation of which was the development of iron overload syndrome (IOS). It was revealed that against the background of an increase in the severity of the IOS, the incidence of progressive forms of the disease with persistent prevalence of asthenovegetative, hemorrhagic syndromes and severe hepatosplenomegaly increased. At the same time, the leading biochemical syndromes were the presence of cytolysis with prolonged hyperfermentemia, endotoxemia and mesenchymal inflammatory syndrome. A directly proportional dependence of the hepcidin-25 peptide level on the degree of expression of the IOS, the higher the presentation of the IOS, the higher the level of suppression of peptide expression in hepatocytes. Diagnostically significant tests of severe forms of IOS in ChHB in children are the presence of hemosiderin in the urine and an increase in the level of sIL-6R in the serum. Обследовано 75 детей, больных хроническим гепатитом В (ХГВ) с рефрактерным вариантом течения анемии воспаления (АВ), патогенетическим проявлением которого явилось развитие синдрома перегрузки железом (СПЖ). Выявлено, что на фоне увеличения степени выраженности СПЖ нарастали частота прогрессирующих форм заболевания со стойким преобладанием астеновегетативного, геморрагического синдромов и выраженной гепатоспленомегалии. При этом ведущими биохимическими синдромами явились: наличие цитолиза с длительной гиперферментемией, эндотоксемии и мезенхимально-воспалительный синдром. Установлена прямо пропорциональная зависимость уровня пептида гепсидин-25 от степени выраженности СПЖ, чем выше презентативность СПЖ, тем выше уровень подавления экспрессии пептида в гепатоцитах. Диагностически значимыми тестами тяжелых форм СПЖ при ХГВ у детей являются присутствие гемосидерина в моче и увеличение уровня sIL-6R в сыворотке крови.
КЛИНИКО-ЛАБОРАТОРНЫЙ АНАЛИЗ ЛЕТАЛЬНЫХ СЛУЧАЕВ ТЯЖЕЛОЙ ФОРМЫ ГРИППА А(H1N1) PDM 2009 ЗА ПЕРИОД ЭПИДЕМИИ 2015/2016 ГГ. В САНКТ-ПЕТЕРБУРГЕ
Get PDFThe purpose of our study was to investigate the characteristics of severe form of influenza A (H1N1) pdm 2009 with a fatal outcome, given the comorbidities. Materials and methods. Medical histories of 105 people who died in hospitals of St. Petersburg for the period of the epidemic of 2015/16 served as material for analysis.The lethality caused by the pandemic virus type A/ H1N1 / 2009 pdm was higher in males. Most of the patients had concomitant chronic diseases in the anamnesis. Obesity was observed in 44.8% (47/105) of patients, diabetes mellitus — 28.5% (30/105), isolated heart disease — 19.0% (20/ 105), combined pathology — 48.6% (51/105). In the first biochemical analysis of blood, creatine phosphokinase, lactate dehydrogenase were increased, total protein and prothrombin consumption index were reduced. The patient's death occurred after 5 days of illness in 88.6% cases, in 11.4% — up to 5 days of illness (inclusive). The analysis of fatal cases up to 5 days of a disease and death from complications (2—4 week) didn't find significant differences in the character and frequency of comorbidity. Specific antiviral therapy has been assigned to all patients, but 48 hours later.Bilateral subtotal viral and bacterial pneumonia was identified on the section, in the majority of cases, in 70.5% with hemorrhagic component. 30% patients had cerebral oedema, 41% patients had severe toxic parenchymatouse degeneration of miocardium, liver and kidneys. The pathology of the cardiovascular system, diabetes and obesity worsen the prognosis of the disease. Increased creatine phosphokinase, lactate dehydrogenase, and reduced total protein and prothrombin consumption index can be considered as markers of severe influenza. The ineffectiveness of antiviral therapy due to its late appointment, thus timely initiation of etiotropic treatment is very impotent.
СОВРЕМЕННЫЕ АСПЕКТЫ ДИАГНОСТИКИ, ЛЕЧЕНИЯ И ПРОФИЛАКТИКИ ВРОЖДЕННОГО ТОКСОПЛАЗМОЗА
Get PDFDiagnostics of intrauterine infection associated with T. gondii, today is a task with an ambiguous solution for different specialists — gynecologists, obstetricians, neonatologists, infectious disease specialists, resuscitators. This problem is interdisciplinary, and its coordinated decision, diagnosis and treatment of this disease at an early stage will reduce the risk of stillbirths, deaths and severe consequences. The article reflects the current literature data on the clinical features of toxoplasmosis in relation to the genotype of Toxoplasmа, circulating in the world. Particular importance is given to the selection of methods for prenatal and postnatal diagnosis of toxoplasmosis. The data of the latest review (2017) of theAmericanAcademy of Pediatrics on the diagnosis, treatment and prevention of congenital toxoplasmosis are presented. The main clinical manifestations of toxoplasmosis were revealed. Basic preparations for treatment of toxoplasmosis is Trimethoprim + sulfamethoxazole (Biseptol) and spiramycin (Rovamycin)
СЛУЧАЙ ГЕРПЕТИЧЕСКОЙ ЭКЗЕМЫ У РЕБЕНКА С ВРОЖДЕННЫМ ИХТИОЗОМ И АТОПИЧЕСКИМ ДЕРМАТИТОМ
Get PDFThe case of the development of herpetic eczema (Kaposi's eczema) is presented against the background of congenital ichthyosis and atopic dermatitis. It has been shown that the presence of atopic diseases such as allergic rhinitis and pollinosis, sensitization to many common allergens, and a positive family history of atopic dermatitis are factors of a more severe course of Kaposi's eczema. The presented clinical observation of the child with Kaposi's eczema showed that early diagnosis and timely initiated complex therapy are the determining factors of a favorable prognosis of the disease.Представлен случай развития герпетической экземы (экземы Капоши) на фоне врожденного ихтиоза и атопического дерматита. Показано, что наличие атопических заболеваний, таких как аллергический ринит и поллиноз, сенсибилизация ко многим распространенным аллергенам, а также положительная семейная история атопического дерматита являются факторами более тяжелого течения экземы Капоши. Представленное клиническое наблюдение ребенка с экземой Капоши показало, что ранняя диагностика и своевременно начатая комплексная терапия являются определяющими факторами благоприятного прогноза заболевания
ВРОЖДЕННЫЕ И ПРИОБРЕТЕННЫЕ ИНТЕРФЕРОНОПАТИИ: ДИФФЕРЕНЦИРОВАННЫЕ ПОДХОДЫ К ИНТЕРФЕРОНКОРРЕКТИРУЮЩЕЙ ТЕРАПИИ
Get PDFVarious disturbances in the interferon system (IFN) — interferonopathy are considered. The classification of developed by the author is given. The clinical features of Type I interferonopathy associated with the overexpression of type I interferons in the rare Mendelian genetic diseases, some autoimmune diseases, the immune dysregulation syndrome, are characterized. The developed methods of targeted therapy of type I interferonopathies aimed at blocking overexpression of type I interferons as hyperproduction IFNa are described. Interferonopathies most often occur as IFN deficiency: congenital or acquired IFNa/b and IFNg deficiencies in children and adults who are associated with atypical viral or mycobacterial infections. Patients with congenital IFNa deficiency are shown to have replacement interferon therapy. With the acquired deficiency of IFNa, differentiated interferon-corrective therapy is performed. For replacement and interferon-corrective therapy, it is used with good clinical efficacy, safe, no side effects, recombinant human IFNa2b in combination with antioxidants — VIFERONR
ОЦЕНКА ДОЛГОСРОЧНОЙ ЭФФЕКТИВНОСТИ ИММУНИЗАЦИИ ПРОТИВ ГЕПАТИТА В В РАМКАХ НАЦИОНАЛЬНОГО КАЛЕНДАРЯ ПРИВИВОК
Get PDFThe analysis of serological efficiency and duration of maintaining specific immunity at the children imparted by various vaccines against hepatitis B within the national calendar of inoculations in the territory of St. Petersburg is submitted. It is revealed that high credits of antibodies (more 100 mME/ml) were more often observed at children in the first 3 years after vaccination (68.2%). Eventually levels of antibodies decreased, and in 5 years protective credits have remained at 84.5% examined, the number of patients with a caption of antibodies less than 10 Mmeml has grown from 8.5 to 15.5%.Представлен анализ серологической эффективности и длительности сохранения специфического иммунитета у детей, привитых различными вакцинами против гепатита В в рамках национального календаря прививок на территории Санкт-Петербурга. Выявлено, что высокие титры антител (более 100мМЕ/мл) чаще наблюдались у детей в первые 3 года после вакцинации (68,2%). С течением времени уровни антител снижались, и через 5 лет защитные титры сохранились у 84,5% обследуемых, число пациентов с титром антител менее 10 Мме/мл выросло с 8,5 до 15,5%
МЕДИКО-СОЦИАЛЬНЫЕ АСПЕКТЫ ИНФЕКЦИЙ, ПЕРЕДАВАЕМЫХ ПОЛОВЫМ ПУТЕМ, У ПОДРОСТКОВ В РЕСПУБЛИКЕ САХА (ЯКУТИЯ)
Get PDFIn order to develop health-improving interventions for the prevention of sexually transmitted infections (STIs), a comprehensive socio-hygienic study of various groups of adolescents and young people was conducted. The questionnaires were analyzed on the following main parameters: social and personal characteristics, level of awareness about sexual relations and about STIs. In the study, two groups were identified: 1 group (main) - adolescents with STIs, 2 group (comparisons) - healthy adolescents. The first information on the existence of sexual relations, 48.7% of adolescents from the main group received from older friends and peers. Among the adolescents in the comparison group, 14% had sexual contact. Those who love their family and want their future family to be similar to their parents were significantly more (9 times) in the comparison group than in the main group (20.0% vs. 2.2%, p <0.0001). Information on STIs, transmission routes, complications, prevention is available in 39.7% of STIs patients, and only 18.7% in the comparison group. The objective reasons for the formation of a low moral and cultural level are identified: education in incomplete and unfavorable families, lack of study and work, low level of awareness of STIs and questionable sources of knowledge on this issue
СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ ИКСОДОВОГО КЛЕЩЕВОГО БОРРЕЛИОЗА (БОЛЕЗНИ ЛАЙМА) У ДЕТЕЙ
Get PDFLiterature review describes the problem of Tick-borne Borreliosis (Lyme Disease). The review analyzes modern date on etiology, epidemiology, clinical course, treatment and prognosis of disease in children. The modern capabilities of diagnosis are discussed.Обзор литературы посвящен проблеме иксодового клещевого боррелиоза (болезни Лайма). Анализируются современные сведения об этиологии, эпидемиологии, клиническом течении, терапии и прогнозе заболевания у детей. Рассмотрены современные возможности диагностики иксодового клещевого боррелиоза