ORIGINAL ARTICLES
The article provides an overview of the literature data about new pneumotropic viruses - metapneumovirus and bokavirus: taxonomy, structural features, pathogenesis, laboratory diagnosis, clinical symptoms of the diseases they cause and complications. The high incidence and bokavirus metapnevmovirus structure of SARS infections in preschool children, the authors have shown the example carried out at the Department of Infectious Diseases in Children Medical University (now RNIMU named after N.I. Pirogov) and on the basis of clinical Institute of Virology, multicenter, randomized, blind, placebo-controlled study on the therapeutic efficacy and safety of interferon inducer Kagocel in 120 children aged 2 to 6 years. The findings to point out on significant reduction in the rate of relief of basic clinical manifestations of SARS, regardless of etiology, in children taking Kagocel in compare with a group of children who took a placebo.
From January 2008 to December 2013, a study was conducted of children patients (between the ages of 3 months to 14 years) with purulent meningitis (n = 210) and pneumonia (n = 265) admitted to specialized hospitals of Tashkent city. The material for the study were the blood, cerebrospinal fluid, pleural fluid. Of the 210 patients with purulent meningitis 98 (46.6%) cultures of S. pneumoniae were isolated, of 265 patients with pneumonia 37 (13.9%) cultures of S. pneumoniae were isolated (33 strains from the blood, 4 strains from pleural fluids). It has been found that there is a high sensitivity of the isolates of S. pneumoniae (94.8%) to penicillin. It is recommended to rationally use macrolides in the treatment of invasive pneumococcal diseases in children, given the spread of strains of S.pneumoniae, resistant to the drugs of these group. Identified pneumococcal serotypes are included in the pneumococcal vaccines, which quite justifies the need to introduce preventive vaccination in the schedule of vaccination of children against pneumococcal diseases in the Republic of Uzbekistan.
Еxamined 43 children with inflammatory bowel disease (IBD). IBD activity, except clinical and endoscopic manifestations of the disease was evaluated in terms of total protein, g-globulin, immunoglobulin (Ig) G, A, M, fibrinogen, soluble fibrin monomer complexes (SFMC), C-reactive protein (CRP), serum. All children per formed a serological examination of blood by ELISA for antibodies to herpes simplex virus types 1—2 (HSV1—2), Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes zoster virus (VZV). All patients underwent determination of specific DNA HSV1—2, herpes virus type 6 (HHV6), CMV and EBV in blood cells and/or intestinal biopsies using PCR. 25 children held definition of indicators of interferon (IFN). Set imbalance of IFN, characterized by increased levels of serum IFN-induced synthesis and decreased blood cells IFNa and IFNg. Active herpes virus infection in children with IBD occurred in 88.4% of cases. In 30.2% of cases were determined monogerpesvirusnye infection in 58.1% of cases — mikstgerpesvirusnye active infection. Laboratory indicators of activity in IBD were significantly higher in children with active herpes virus infection, indicating that the negative effects of chronic active herpesvirus infections on the course of IBD in children.
The article presents the result of observation of children born to mothers with HBV infection and peculiarities of primary chronic hepatitis B in the dynamics.
We carried out clinical morphological examination for 80 Evenks (Evenkia is in the North of Siberia) and 90 Tyvins (Tyva Republic is in the South of Siberia) in the ages of 7 to 17 years aimed at studying H. pylori infection and its associations with gastroduodenal diseases in children. We found increased level of contamination and its connection with dyspepsia syndrome in the Evenks. Both ethnic populations show the association of the infection with gastric activity. At the same time we didn’t mark the higher rate of contamination in children with erosive ulcer lesion of gastroduodenal mucosa. We found the increased level of mucosa bacterial dissemination with H. pylori in the Evenks who had destructive changes.
REVIEW OF THE LITERATURE
The review of literature presents data on the incidence and characteristics of the current development of antibiotic-associated diarrhea (AAD) in children. Presented research materials of Russian and foreign scientists on risk factors activation toxigenic strains Cl. difficile, showed the relationship between the depth microecologi-cal metabolomical violations and Cl. difficile-infection in children.
PROBLEMS OF THERAPY
Clinical, immunological and virologic examination of 67 HIV infected children receiving highly activity antiretroviral therapy (HAART) within 12—60 months is conducted. HAART promoted suppression of HIV replication, increase of T-helpers count, reduction of clinical symptoms frequency and its expressiveness. At long HAART application the considerable part of patients needs therapy correction because of loss of efficiency of the starting scheme or development of side effects. For increase of therapy efficiency it is necessary lopinavir/ritonavir to include in HAART schemes, and also to carry out selection of preparations taking into account HIV drug resistance.
The article presents the data of the literature about the history of the development and introduction into clinical practice the method of oral rehydration, the clinical efficacy of standard hyperosmolar glucose-saline solutions, recommended by WHO and new solutions hyperosmolar ESPGHAN for relief exsicosis (dehydration syndrome) in intestinal infections of various etiologies and types of diarrhea in children.
The article presents the history of the study of intestinal lesions of viral origin. The literature data was generalized, which regarding changes in the gastrointestinal tract viral infections transmitted not only by the fecal-oral route, but also airborne. The description of the clinical picture of viral infection of the intestine, morphological data, new approaches to treatment was presented.
TO HELP OF PRACTICAL PEDIATRICS
A clinical observation and treatment of 36 children between the ages of 5 months up to 3 years old with measles. In 34 persons. (94.4%) diagnosed with typical moderate forms, from 2 people (5.6%) — atypical (mitigirovannaya) a mild form of the disease. All children are vaccinated against measles. Typical measles char-acterized by moderate forms of cyclical flow with the change of the classical period and the presence of characteristic clinical syndromes. Pathognomonic symptom found: spots Belsky — Filatov — Koplik (67.7%), stages a rash (100%), stages of pigmentation (100%). Causal therapy was VIFERON®. Revealed the rapid disappearance of intoxication and normalization of body temperature, the early decline in the severity and duration of catarrhal syndrome, reducing the severity and frequency of complications, no stratification of SARS.
The developed technique of “loading” test in vitro was used for choice of biological agent for correction of the intestinal dysbacteriosis (ID) in 75 children with chronic hepatitis B (CHB) associated with lambliasis. There was established direct proportional decrease in ability of lymphocytes to E-rosette forming in dependence on severity degree of intestinal dysbacteriosis. Bifilax-immuno (62.7%) appeared to be most sensitive biological agent in the test in vitro which was differed by qualitative and quantitative contents in comparison with Lacto-G (48.0%) and Narimax-plus (38.7%), , p<0,05. The evaluation of the efficacy of the directed therapy allowed increase in efficacy of the treatment by 40.1%. Development of clinical, biochemical and microbiological remission was achieved in 76.5%, 64.4% and 62.0% respectively. In this connection the children with chronic hepatitis B associated with lambliasis were recommended to examine intestinal microflora and to use test in vitro before choice of biological agents for effective correction of the intestinal dysbacteriosis taking onto account body individual sensitivity.
CASE FROM PRACTICAL
A clinical case of Hib-infection is the clinic purulent meningitis and pannikulita young child. Shows the complexity of the differential diagnosis of meningitis in combination with panniculitis with meningococcal disease (meningitis, meningokokktsemiya).
In sectional clause the clinical case of a tubercular meningocephalitis at the child 6 years from the center drug resistant bacterial excretion is described. The analysis of the parents and risk factors of occurrence sectional astroprocessor of the shape of tuberculosis is given.
DISCUSSION
On the basis of current scientific evidence substantiated opinion about the primacy of the prokaryotes (bacteria and viruses) in the existence of human life. Infectious disease is presented as a «rebellion prokaryotes» due to the conflict of the human microbiota and exogenous microorganisms.
ISSN 2618-8139 (Online)