ORIGINAL ARTICLES
Based on the literature data and our personal observations in the article discusses the types of variants of the course of nervous system caused by herpesviruses. In the description of a clinical case demonstrated a classic example of limbic encephalitis infectious etiology. The study involved 36 children with various neurological and infectious diseases: 19 children with the diagnosis - convulsions, 8 children with the diagnosis — epilepsy, 5 children with acute viral encephalitis, 3 children with neuropathies. It was established that in the genesis of diseases such as epilepsy, convulsive syndrome, limbic encephalitis, neuropathy peripheral nerves leading role belongs to of herpes virus infection, in which the dominant role belongs HHV-6 infection. Pathogenetically proved the impact of the virus on the receptor apparatus of glia with the disorder of the functional state of mitochondria of these cells. According to our own observations provided data that result in persistence of HHV-6 variant-in mono or in combination with other herpesviruses growing threat of epilepsy and other neurological disorders.
Natural history of HIV infection in 91 vertically HIV infected patients and in 101 parenterally HIV infected children were investigated. High relative incidence rates regardless of the route of HIV transmission have demonstrated HIV-related symptoms — generalized lymphadenopathy, hepatomegaly, splenomegaly, underweight, anemia, prolonged unmotivated fever, and opportunistic infections — bacterial infections, candidiasis, herpes simplex, cytomegalovirus infection. Vertically HIV infected children had higher relative incidence rates of HIV-related symptoms, opportunistic infections and generalized forms of opportunistic infections.
The value of human herpes virus type 6 (HHV-6) in the structure of seizures in 114 children in three groups of patients: with neuroinfections, with epilepsy and febrile convulsions was studied. Determination of HHV-6 by polymerase chain reaction in the acute period of the disease is a reliable sign (p < 0.001), and most often diagnosed in children in the group with febrile seizures (53.8%). Recovery in children with seizures caused by HHV-6, was observed only in 28% of cases,38.8% of patients in the outcome of the disease expand the epilepsy.
The study involved 224 patients with Lyme borreliosis children with erythema (103) and without erythema (121 children) forms. The analysis of the clinical symptoms and hematological parameters in the course of the disease was prosecute. A comprehensive statistical analysis of the results allowed to highlight blood count (content stab and segmented neutrophils, erythrocyte sedimentation rate) and the number of symptoms at admission prognostic criteria of severity, chronicity of the Lyme borreliosis. This allows to make a correction in the treatment of patients with Lyme borreliosis.
The analysis of state reports «On the sanitary-epidemiological situation in Saratov region» for 2001—2013 years. In 2003 noted the maximum increase in the incidence of measles to 2.16 per 100 thousand population. Since 2007 by 2011 in the region of measles cases registered. However in 2012 in the Saratov region recorded four cases of measles adults (index — 0.15 per 100 thousand population) and in 2013 — 52 cases of measles (index — 2.07 per 100 thousand population), of these, 17 cases-importations. In 2010 pronounced decrease was registered rubella (in 6389 times) compared to 2001. In 2011 incidence of rubella is not registered. Incidence rates in 2012 and 2013 were, respectively, 0.2 and 0.04 per 100.000 populations. Since 2002, the incidence of mumps decreased 83-fold (from 6.65 in 2002 to 0,08 in 2012). In 2013 mumps incidence in the region is not registered. Analysis of the state vaccinated against measles, rubella and mumps shows that the region as a whole maintained a consistently high (not less than 95.0%) immunization coverage of children and adults from 18 to 35 years.
VACCINATION
Rotavirus is a major public health problem in all countries. The incidence of rotavirus infection is growing steadily in the Russian Federation and over the past 10 years increased by 7 times, amounting to 72 cases per 100,000 in 2010. The rotavirus vaccine was registered in the Russian Federation in 2012 and successfully applied from 2013. The vaccine used for more than 8 years and have enough experience on the efficacy and safety. Different foreign investigations have shown the herd immunity of the vaccine. The authors present data about the effectiveness and safety of vaccines, established during clinical studies of the foreign scientists.
Results of the retrospective analysis of 116 cases of complications of immunization by a tubercular vaccine at children of the Orenburg region registered during 2004—2013, the occurrence frequency, structure of clinical forms and the reasons of their development are presented.
PROBLEMS OF THERAPY
The article raises an important issue of modern clinical medicine simultaneous administration of many drugs to one person, including child, whose causes are varied, but many aspects are still poorly understood. The problem of polypharmacy, including the treatment of acute respiratory infections in children, is relevant for today., We propose the use of multi-drug course of action as a one of the way solving this problem.
We present the results of the etiologic diagnosis and therapy of 243 frequent and prolonged ill children aged from 1 to 17 years. Microbiological, serological and molecular biological methods for the determination of bacterial agents, respiratory chlamydia and mycoplasma, Epstein-Barr virus, human herpes virus type 6 and cytomegalovirus were used. The dominant role of the active persistence of herpesviruses was shown (87%); bacterial pathogens were identified rarely, mainly in association with herpesvirus. 96 patients received a medication of recombinant interferon D-2 (VIFERON) and then endogenic interferon inductor, 57 patients - recombinant interferon D-2 (VIFERON) in conjunction with antibiotic therapy and then bacterial lysates. Treatment of children depending on the diagnosed infections allowed to achieve stable normalization of state in 78% of cases.
TO HELP OF PRACTICAL PEDIATRICS
The article presents the results of clinical and laboratory studies of patients with influenza complicated by pneumonia. Peculiarities of clinical manifestations of pneumonia caused by influenza virus have been disclosed.
Recently the actual direction is development of programs of rehabilitation of the second stage of recovering of infectious diseases children. The purpose of this work is justification of need of the organization of offices of rehabilitation in a children's infectious hospital according to Order of the organization of medical rehabilitation. The retrospective analysis of clinical records of the patients who have arrived on treatment in clinical divisions of Federal State Budgetary Institution of Research of Children's Infections of Russia in 2011—2012 is carried out. It is established, that among surveyed 14 363 for 2 years of patients (in a year on the average more than 7000 children) — about 40% (2800 patients a year) children for whom rehabilitation actions of the second stage in the conditions of a hospital, including carrying out a diet therapy, physiotherapy exercises, physical therapy and pharmacotherapy are necessary. On a profile of infectious patients for rendering the rehabilitation help it is expedient to organize 2 offices on 30 beds: for treatment of children with consequences of neuroinfections and children with somatic pathology. The organization of two offices for carrying out medical rehabilitation of the second stage to recovering infectious diseases children taking into account recommended standards on equipment, according to the Order of the organization of medical rehabilitation, will allow to give high-tech help to patients and to prevent development of complications.
Currently in Russia number of cases of dengue fever in adults grows up, whereas in endemic areas, due to the wide spread of the disease is more common in children, which symptoms has its own characteristics. In the article is reviewed a clinical case of girl living in Moscow who has been returned from the Thailand vacation — the first registered case of dengue fever in childhood. In the article were discussed the problems of diagnostics of the disease, an algorithm for diagnosis of dengue fever.
The results of clinical and laboratory (blood count) and serological monitoring of 156 children with various forms of early congenital syphilis in the initial period and the dynamics on the background of specific therapy. Violations in haemogram characterized hypochromic anemia, thrombocytopenia, leukocytosis, neytrofillezom stab shift with a sharP increase in ESR, which prevailed among the most children with the disease over polisimptomnym and significantly exceeded the level of the norm even after specific therapy. For serological examination in 84.62 % cases registered positive results in microprecipitation reaction (RMR) to 56.52% — IgM, and 97.83% — IgG reaction Enzymeimmuno assay (EIA) and 100 % — Treponema pallidum hemagglutination assay (ТРHА). On the background of specific therapy indicated positive results in the growth of bladder cancer (85.19 %), in the formulation of IgM EIA (72.22 %) and IgG (100%), thus, recorded a decline titer positivity serological RMR 2 times , IgM EIA reaction 12 times with simultaneous increase IgG positivity 4 times and 2 times in the ТРHА in the formulation of these reactions in the dynamics.
CASE FROM PRACTICAL
Tuberculosis of intrathoracic lymph nodes in part of patients is complicated by the break of molten caseous node in the lumen of the bronchus lumen and obstruct it with thick caseous masses and granulation tissue. The severity of state in children is determined by the caliber of the affected ones.
This article describes a clinical case, representing the diagnostic difficulties. The baby of 4 months with bright neurological symptoms that appeared after vaccination, and coming with a diagnosis of "post-vaccination complications" in the survey diagnosed active cytomegalovirus infection and spinal muscular atrophy type 1. The role of the infective matter within the underlying disease was analyzed.
The authors presented the results of clinical example of seldom meeting pathology with demyelinazed diseases of central nervous system – Miller-Fisher's syndrome in the three-year child was on treatment in children's infectious branch of №2 Vladivostok clinical hospital №2.
ANNIVERSARY
ISSN 2618-8139 (Online)