Pediatrics (Suppl Consilium Medicum)
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Published By LLC Obyedinennaya Redaktsiya

2658-6630, 2658-6622

Author(s):  
Natalia A. Geppe ◽  
Elena G. Kondiurina ◽  
Vera A. Reviakina ◽  
Aleksandr B. Malakhov ◽  
Natalia G. Kolosova

Bronchial asthma (BA) is a disease that is one of the most frequent chronic diseases of childhood. Characteristic clinical symptoms of BA are wheezing, cough, difficulty in breathing, shortness of breath and, of course, recurrent episodes of bronchial obstruction. They require mandatory clarification of family and individual allergoanamnesis, assessment of symptoms, differential diagnosis with other diseases that may occur with BA. The Global Initiative for the Treatment and Prevention of Bronchial Asthma (GINA 20202021) preserves and develops the ageappropriate approach to verification of diagnosis and therapy selection, which is supported in the Russian National Program "Bronchial Asthma in Children" and in the Russian clinical guidelines "Bronchial Asthma 2021 When the diagnosis of BA is made, therapy should be started as early as possible. Administration of low-dose inhaled glucocorticosteroids (IGCS) immediately after the diagnosis allows not only to control the inflammatory process, which is the basis of BA, but also to reduce the severity of exacerbations. IGCS are the most effective drugs for children of any age, they ensure control of the disease and reduce the risk of AD exacerbations.


Author(s):  
Lada S. Starostina ◽  
Natalia A. Geppe ◽  
Vladimir S. Malyshev ◽  
Saniia I. Valieva ◽  
Irina L. Ginesina ◽  
...  

The study of external respiratory function (ERF) is important in the diagnosis of respiratory tract abnormalities in various diseases. In children, especially at an early age, there are many difficulties in conducting studies. In recent decades, due to the development of computer technology, there is great interest in the study of respiratory sounds, methods of their registration, processing and use in the assessment of the respiratory system in children and adults. Russian scientists have developed the method of respiratory airway sound investigation, which has proved its effectiveness, reliability and necessity of use in practice. Computer bronchophonography is based on the analysis of time and frequency characteristics of the spectrum of respiratory noises, arising from changes in the bronchial diameter due to increase in the stiffness of their walls or decrease in the inner diameter. Computed bronchophonography may be used for diagnostics of EFD disorders in patients of all age groups both in the in-patient and out-patient treatment.


Author(s):  
Vera P. Vavilova ◽  
Alexander M. Vavilov ◽  
Sofia A. Tsarkova ◽  
Irina A. Nechaeva ◽  
Ekaterina Iu. Burmistrova ◽  
...  

Background. At present, due to high prevalence of allergic diseases which start in early childhood, the search for new prevention and treatment methods is in great demand. Aim. To study the effectiveness of the Russian-produced enterosorbent colloidal silicon dioxide in the treatment of patients with food allergies combined with atopic dermatitis and gastrointestinal manifestations. Materials and methods. An open, randomized, comparative clinical study of the enterosorbent (colloidal silicon dioxide) effectiveness has been conducted in parallel groups of infants and preschool children with food allergy skin and gastrointestinal manifestations. The main groups (1 67 children with food allergies and atopic dermatitis skin manifestations, 3 60 children with food allergies and gastrointestinal manifestations) received, along with basic medication, colloidal silicon dioxide enterosorbent day at an age-specific dosage twice a for 1014 days. Control groups (2 60 children with food allergies and atopic dermatitis skin manifestations, 4 60 children with food allergies and gastrointestinal manifestations) did not receive enterosorbent. All children underwent a clinical, functional and laboratory status assessment, including medical records analysis, a pediatrician clinical examination, narrow specialists (allergist-immunologist) examination, laboratory and instrumental research. The treatment effectiveness was being evaluated on the 14th day after the initiation of therapy and after 30 days. The therapy effectiveness was assessed based on regression of skin syndrome clinical and gastrointestinal manifestations, intoxication syndrome and laboratory parameters (IgE, hemogram eosinophilia duration). The study was conducted from 2017 to 2019. On the basis of LLC Modern Medical Technologies Clinics (Kemerovo). Results. Therapy with colloidal silicon dioxide increases the significance of food allergy skin manifestations positive dynamics, which makes it possible to reduce the volume of medication and the duration of topical glucocorticosteroids use to 5.340.35 days, in the compared group 10.520.85 days (p=0.002). All patients with food allergy combined with atopic dermatitis in the main and control groups noted positive clinical dynamics, appearing as decrease in the skin inflammatory reaction area and intensity. However, the of colloidal silicon dioxide use accelerates skin syndrome condition normalization significantly (group 1 skin syndrome persisted in 2.92.0% after 14 days, in group 2 18.34.9%; p=0.003). Colloidal silicon dioxide use accelerates humoral immunity state normalization (IgE) and peripheral blood parameters (hemogram eosinophilia). Colloidal silicon dioxide therapy accelerates food allergy gastrointestinal manifestations positive dynamics in children. Two weeks after the sorbent therapy started, gastrointestinal tract lesions symptoms frequency is less than in patients in the compared group. Diarrhea frequency before treatment started was 48.36.5%, 45.06.4% in the compared groups. After two weeks it decreased to 6.73.2% with the Polisorb therapy and to 16.64.8% in the compared group (p=0.003). Abdominal pain was noted by patients of both groups equally often before the study began. After 2 weeks, abdominal pain was noted by ten percent 10.03.9% of patients taking colloidal silicon dioxide and 25.05.6% of the compared group (p=0.009). Conclusion. Taking into account the composition of the colloidal silicon dioxide, it makes sense to include this medication in childrens food allergies complex treatment starting from infancy, which contributes to a more rapid relief of gastrointestinal system damage symptoms, life quality improvement for children and their parents, and decrease in medication load. When using colloidal silicon dioxide in children with food allergies, a faster dynamics of disease symptoms relief (p=0.003) was noted, which allows us to conclude that it is highly effective in the treatment of allergic diseases associated with food sensitization.


Author(s):  
Margarita K. Ermakova ◽  
Larisa P. Matveeva ◽  
Natalya R. Kapustina

Aim. To study the prevalence of bronchial asthma (BA) symptoms among elementary schoolchildren in the Udmurt Republic in the dynamics over 20 years. Materials and methods. A comparative study of the prevalence of BA was carried out. A questionnaire was administered to 2899 parents of first-graders, using the international standardized ISAAC program. Results. The prevalence of BA symptoms on the ISAAC program among elementary schoolchildren in the Udmurt Republic in 2020 was 7.70.2%, being significantly lower than in the previous studies of 2002 and 2009 (p0.001). Conclusion. There was a further downward trend in the prevalence of AD symptoms in younger schoolchildren. The difference between the current symptoms of the disease and the established diagnosis remained rather significant. Reliable (p10.001) increase in the number of children with dry cough, not related to cold, and children with bronchospasm connected with physical load was revealed.


Author(s):  
Oleg S. Glazachev ◽  
Natalia A. Geppe ◽  
Iurii S. Timofeev ◽  
Marina D. Shakhnazarova ◽  
Natalia G. Kolosova ◽  
...  

Aim. To study the characteristics of resistance/sensitivity to normobaric hypoxia in 50 children with bronchial asthma (BA) from 9 to 12 years old, 24 of them after a previous coronavirus infection СOVID-19. Materials and methods. A normobaric hypoxic test (HT) was carried out by creating hypoxemia (threshold level SpO2 80%) during mask inhalation of a gas mixture with 1011% O2 by a child using a ReOxy Cardio apparatus (Ai Mediq S.A., Luxembourg). The data obtained were compared with the results in a group of healthy children the same age. Results. It was found that the integral level of hypoxic resistance of children with BA was generally lower in comparison with the group of healthy children, which was manifested in lower values of the hypoxic index (3.11.4, in the group of healthy children 4.92.8, p=0.005), a significantly increased level of tachycardia and a hypotonic response to dosed hypoxia. Conclusion. When typing reactions to HT, it was found that in children with BA, the type of low resistance to hypoxia is more common (to a greater extent in children with BA after a coronavirus infection), which confirms the need to involve such children in comprehensive rehabilitation programs.


Author(s):  
Vera A. Reviakina ◽  
Natalia A. Geppe ◽  
Aleksandr B. Malakhov ◽  
Oleg V. Kaliuzhin ◽  
Natalia G. Astaf'eva ◽  
...  

Significant progress has been made over the past decade in the treatment of allergic diseases such as atopic dermatitis and bronchial asthma. Dupilumab, which targets interleukin IL-4 and IL-13, has become an innovative targeted therapy. Immunobiologic therapy with the interleukin inhibitor is indicated for patients with moderate to severe uncontrolled atopic dermatitis, moderate to severe eosinophilic phenotype of uncontrolled Bronchial asthma and patients with poorly controlled severe chronic polyposis rhinosinusitis. A clinical case and recent data on the use of dupilumab for the treatment of type 2 inflammatory disease and prospects for its use are discussed.


Author(s):  
Angelina V. Meleshkina ◽  
Natalia A. Geppe ◽  
Svetlana N. Chebysheva ◽  
Marina D. Velikoretskaia ◽  
Darima V. Dagbaeva

Mother's milk is a unique product for children in the first and second year of life. In addition to the components that provide the energy needs of the baby, breast milk contains many biologically active compounds, microorganisms, stem cells that influence the maturation of organs and systems, including the immune system. Even in the most advanced artificial formula, it is impossible to replicate the composition and effects of breast milk completely. Nevertheless, it is possible to introduce some components into the formula that have a positive effect on the developing immune system. These include fat components, in particular long-chain polyunsaturated fatty acids and -palmitate, nucleotides, the most valuable of which are adenosine, guanine, uridine, cytidine and inosine monophosphates, oligosaccharides, probiotics, macro- and microelements. Goat's milk is an attractive natural product for the production of quality infant formula. Enriching milk formulas based on goat's milk with components with immunomodulatory functions homologous to those of breast milk makes it possible to significantly reduce the adverse effects of artificial feeding of infants, as well as to achieve a positive immunomodulatory effect. Kabrita adapted goat milk formula contains all the beneficial natural components of goat milk, adapted by the manufacturer according to the protein, fat, carbohydrate, micro- and macronutrient composition, with the addition of probiotic complex BB-12 and lipid complex DigestX.


Author(s):  
Vera A. Reviakina ◽  
Natalia G. Astaf'eva ◽  
Natalia A. Geppe ◽  
Oleg V. Kaliuzhin

The PRIMA Consensus document developed by leading Russian experts reviews the principles of outpatient immunotherapy in children with frequent acute respiratory viral infections.


Author(s):  
Olga A. Egorova

The data about the prevalence of ENT organ diseases in children and the necessity of prescription of nasal forms of vasoconstrictors (decongestants) are presented. A review of the data about the mechanism of action of decongestants, safety and evidence base of their effectiveness in treatment of otorhinolaryngological diseases is presented. It is concluded that decongestants with a higher safety level are chosen a modern combined preparation containing antihistamine (dimethinden) and vasoconstrictor (phenylephrine) components.


Author(s):  
Valery M. Svistushkin

Interview with Valery M. Svistushkin, MD, Professor, Director of the Clinic ofDiseasesof theEar,ThroatandNose and Head of the Department of Ear, Nose and Throat Diseases of the I.M. Sechenov First Moscow State Medical University, Chief Outpatient Otorhinolaryngologist of the Central Federal District of Russia


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