EOSINOPHILIC ESOPHAGITIS IN PEDIATRIC PRACTICE

Eosinophilic esophagitis (EoE) is a disease with a nonspecific clinical picture, and characteristic changes in the mucous membrane of the esophagus often become an endoscopic finding. The final diagnosis is possible only on the basis of the results of the morphological examination. The article presents the results of examination and treatment of two patients hospitalized in the dermatological and gastroenterological departments of the National Medical Research Center of Children's Health with newly diagnosed EoE. In both cases, there were no typical clinical signs of EoE in patients, however, taking into account a number of characteristic endoscopic signs, a morphological study was carried out, the diagnosis of EoE was verified and pathogenetic treatment was prescribed with the achievement of clinical and laboratory remission.

Food protein-induced enteropathy and its complications

Currently, in pediatric practice, a special place is occupied by patients with severe allergic lesions of the gastrointestinal tract, which often manifest immediately after the birth of a child. Food protein-induced enteropathy reduces the quality of life of the child and family; it is difficult to diagnose and to treat. We present a clinical case of a patient with food protein-induced enteropathy, complicated by severe B12-deficiency anemia and edema syndrome. In the tactics of patient management, attention is paid to the late diagnosis of the underlying disease and complications, the complexity of prescribing diet therapy and the lack of alertness regarding the diagnosis of malabsorption associated with food intolerance.

New opportunities of halotherapy in the prevention and medical rehabilitation of children

The article is devoted to new possibilities of using halotherapy in the prevention, treatment and medical rehabilitation of children. In recent years, active work has been carried out to develop new effective methods of reproducing the aerodispersed medium in the form of haloingalation therapy or by group method — in the conditions of a halochamber. The therapeutic effect of halotherapy is determined by the biophysical properties of a dry highly dispersed aerosol of sodium chloride. The paper presents the biophysical properties of the main active factor of halotherapy, i.e. a dry highly dispersed aerosol of sodium chloride, and reveals some aspects of the formation of the mechanism of therapeutic action. The anti-inflammatory, draining, mucolytic, immunomodulatory, sanogenetic effect of haloaerosol is shown. In pediatric practice, haloaerosol therapy is used for medical rehabilitation of children with respiratory diseases (bronchial asthma, bronchitis), ENT pathology (rhinosinusitis, tonsillitis, pharyngitis), skin diseases. Halotherapy is the method of choice in the prevention of acute respiratory diseases and improving the health of children in general education institutions. The high efficiency of the complex application of halotherapy in various diseases in children has been established. A promising direction for the development of halotherapy is the development of combined exposure technologies. The high efficiency of the use of haloingalation therapy in combination with magnetic therapy in the treatment of acute rhinosinusitis in children has been proven. Based on the conducted studies, a favorable effect of the use of halotherapy and flutter therapy on clinical and functional parameters in children with bronchial asthma was revealed. The data on the possibility of combined use of halotherapy with a pulsed low-frequency electrostatic field in the medical rehabilitation of children suffering from bronchial asthma are presented. Simplicity, safety, the possibility of personalization of exposure and good tolerability by children expands the possibilities for using halotherapy in pediatric practice.

Prevalence of breastfeeding in a baby-friendly pediatric practice in Trieste, Italy: follow up to 36 months of age

Background A breastfeeding-friendly physician’s office that applies the 13 recommendations of the Academy of Breastfeeding Medicine can help increase the exclusivity and duration of breastfeeding. Having already published the results up to five months of age of this intervention in our pediatric practice, we now report on the follow up to 36 months. Methods A cohort of 252 newborn infants was enrolled with our pediatric office in Trieste, Italy, between 1 January 2016 and 31 December 2016. The office implemented baby-friendly pediatric practices and a biological nurturing approach to the support of breastfeeding. In addition to the services offered by two pediatricians, support was provided by a peer counselor. Data on breastfeeding were collected at periodic healthy child visits up to 36 months of age. The outcome of interest for this follow up was the rate of any breastfeeding, defined as the percentage of infants and children who had received breastmilk in the previous 24 h. Results The rates of any breastfeeding at discharge and at 1, 3 and 5 months (n = 252) were 95.2, 95.8, 89.3 and 86.5%, respectively. At 8, 12, 18, 24 and 36 months of age, the rates of breastfeeding were 70.6% (163/231), 59% (135/229), 35% (78/224), 24.6% (55/224) and 7.2% (16/224), respectively. Conclusions The rates of any breastfeeding recorded in our pediatric practice up to age 36 months, are much higher than those reported elsewhere in high income countries and are likely to be associated with our baby-friendly and biological nurturing approach.

The role of azithromycin in the antibacterial therapy of acute respiratory infections in children

Acute respiratory infections are the leading cause of morbidity and mortality in childhood. Antibacterial therapy for acute respiratory infections should be prescribed carefully and under strict indications. This review analyzes the etiological structure of diseases of the upper and lower respiratory tract, identifies modern views on the rational use of antibacterial agents in diseases such as acute tonsillopharyngitis, rhinosinusitis, bronchitis and pneumonia. Among the variety of antibacterial agents, macrolide drugs, in particular azithromycin, are most often used in pediatric practice. The pharmacological properties of azithromycin, mechanisms of its antimicrobial and immunomodulatory activity, indications for use in acute respiratory infections in children are considered in the article. No conflict of interest was declared by the authors. Key words: antibiotics, acute respiratory infection, macrolides, azithromycin, children.