STATE OF THE MATRIX METALLOPROTEINASES AND THEIR ROLE IN FORMATION OF THE CHRONIC HEART FAILURE IN CHILDREN WITH DILATED CARDIOMYOPATHY

The article is devoted to an important section of the pediatric cardiology — dilated cardiomyopathy (DCMP). This is largely due to the spread of the given disease, its possible progress and tendency to the formation of the chronic heart failure (CHF). The progress in the research of the DCMP'accompanied CHF formation and development processes is the studies of the extracellular matrix status (EM), which is defined by the activity of the matrix metalloproteinases (MMP) and their tissue inhibitors (TIMMP). This article describes the complex clinical and biochemical studies of the serum MMP'1, MMP'2, MMP'9 and TIMMP'1 levels in children with DCMP at different stages of the illness course. MMP and their inhibitor concentration were defined by means of the enzyme'linked immunosorbent assay (ELISA). Based on the results from the morphofunctional studies and data of the biochemical analyses, the authors determined the importance of changes in the isomeric EM composition pertaining to the disturbances of the systolic and diastolic functions, as well as in heart remodeling for such children.Key words: chronic heart failure, dilated cardiomyopathy, extracellular matrix, matrix metalloproteinases, tissue inhibitors of the matrix metalloproteinases

DISTANT SHOCKWAVE LITHOTRIPSY IN CHILDREN

Shockwave lithotripsy implemented in the clinical practices in the 1980-s drastically altered the treatment approach for the urolithiasis and took a leading place in the therapy of this disease. The key task of the distant shockwave lithotripsy is to provide for the fast, reliable, safe and noninvasive kidney and renal duct litholysis. The article highlights the outcome of the shockwave lithotripsy application on Econolith 3000 for the treatment of 27 children. The results of the performed treatment indicated the high efficiency and low invasiveness of this method to eliminate the concrements, as well as the perspective of its use, including in the infants. Shockwave lithotripsy allows the specialists to abandon the traumatic surgeries.Key words: distant shockwave lithotripsy, urolithiasis, children

DISTANT SHOCKWAVE LITHOTRIPSY IN CHILDREN

Shockwave lithotripsy implemented in the clinical practices in the 1980-s drastically altered the treatment approach for the urolithiasis and took a leading place in the therapy of this disease. The key task of the distant shockwave lithotripsy is to provide for the fast, reliable, safe and noninvasive kidney and renal duct litholysis. The article highlights the outcome of the shockwave lithotripsy application on Econolith 3000 for the treatment of 27 children. The results of the performed treatment indicated the high efficiency and low invasiveness of this method to eliminate the concrements, as well as the perspective of its use, including in the infants. Shockwave lithotripsy allows the specialists to abandon the traumatic surgeries.Key words: distant shockwave lithotripsy, urolithiasis, children

TUBULAR DISORDERS WITH RICKETS-LIKE SYNDROME

Often under the guise of «ordinary» Rickets are more severe kidney diseases, developing as a result of inherited or acquired, primary or secondary defects in the renal tubules. Incorrect diagnosis leads to an inadequate therapy, rapid progression of disease and renal failure. The article describes the main approaches to the diagnosis and treatment of disorders of tubular rachitis similar syndrome, presents a number of clinical cases in author's practice.Key words: tubulopathy, acidosis, electrolyte disorders, rickets, rickets-like syndrome, diagnostics, treatment, children

TUBULAR DISORDERS WITH RICKETS-LIKE SYNDROME

Often under the guise of «ordinary» Rickets are more severe kidney diseases, developing as a result of inherited or acquired, primary or secondary defects in the renal tubules. Incorrect diagnosis leads to an inadequate therapy, rapid progression of disease and renal failure. The article describes the main approaches to the diagnosis and treatment of disorders of tubular rachitis similar syndrome, presents a number of clinical cases in author's practice.Key words: tubulopathy, acidosis, electrolyte disorders, rickets, rickets-like syndrome, diagnostics, treatment, children

EFFICACY AND SAFETY OF ALENDRONIC ACID IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS AND OSTEOPOROSIS

Search for and practical application of new medications to treat of osteoporosis is one of the critical issues in pediatric rheumatology. The article reviews the efficacy and safety of alendronic acid in 64 subjects with juvenile rheumatoid arthritis and systemic osteoporosis. It is demonstrated that alendronate-based therapy in weekly 1 mg/kg doses over 12 months facilitated reliably increased bonedensity, decreased intensity of pain syndrome, and lowered C-terminal telopeptide serum concentration, which indicates improved bone metabolism processes.Key words: juvenile rheumatoid arthritis, osteoporosis, children, treatment, bisphosphonates, alendronic acid. (Pediatric Pharmacology. – 2010; 7(1):48-54

EFFICACY AND SAFETY OF ALENDRONIC ACID IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS AND OSTEOPOROSIS

Search for and practical application of new medications to treat of osteoporosis is one of the critical issues in pediatric rheumatology. The article reviews the efficacy and safety of alendronic acid in 64 subjects with juvenile rheumatoid arthritis and systemic osteoporosis. It is demonstrated that alendronate-based therapy in weekly 1 mg/kg doses over 12 months facilitated reliably increased bonedensity, decreased intensity of pain syndrome, and lowered C-terminal telopeptide serum concentration, which indicates improved bone metabolism processes.Key words: juvenile rheumatoid arthritis, osteoporosis, children, treatment, bisphosphonates, alendronic acid. (Pediatric Pharmacology. – 2010; 7(1):48-54

STUDIES OF SAFETY AND FUNCTIONAL AND METABOLIC EFFECTS OF NON-IONIC CONTRAST MEDIA IN CHILDREN WITH NEPHROPATHIES

A study was conducted to assess the safety of non-ionic contrast media in paediatric nephrourology and their impact onto renal function and homeostasis, reflecting the risk of development of contrast-induced nephropathy. After contrast media use we observed elevation of cystatin C and endothelin, decrease of sodium fractional excretion and hypocoagulation were identified. The results obtained indicate that renal hypoperfusion with a consequent decrease of sodium fractional excretion and elevation of endothelin production may play a role in contrast-induced nephropathy. Increased serum cystatin C reflects adverse impact of contrast agents on renal function. Hypocoagulation effect requires that coagulation disorders must be excluded before use of contast media.Key words: children, contrast-induced nephropathy, renal function, cystatin C, endothelin, hemostasis. (Pediatric Pharmacology. – 2010; 7(2):78-82

STUDIES OF SAFETY AND FUNCTIONAL AND METABOLIC EFFECTS OF NON-IONIC CONTRAST MEDIA IN CHILDREN WITH NEPHROPATHIES

A study was conducted to assess the safety of non-ionic contrast media in paediatric nephrourology and their impact onto renal function and homeostasis, reflecting the risk of development of contrast-induced nephropathy. After contrast media use we observed elevation of cystatin C and endothelin, decrease of sodium fractional excretion and hypocoagulation were identified. The results obtained indicate that renal hypoperfusion with a consequent decrease of sodium fractional excretion and elevation of endothelin production may play a role in contrast-induced nephropathy. Increased serum cystatin C reflects adverse impact of contrast agents on renal function. Hypocoagulation effect requires that coagulation disorders must be excluded before use of contast media.Key words: children, contrast-induced nephropathy, renal function, cystatin C, endothelin, hemostasis. (Pediatric Pharmacology. – 2010; 7(2):78-82

ДИСТАНЦИОННАЯ УДАРНО-ВОЛНОВАЯ ЛИТОТРИПСИЯ У ДЕТЕЙ

Shockwave lithotripsy implemented in the clinical practices in the 1980-s drastically altered the treatment approach for the urolithiasis and took a leading place in the therapy of this disease. The key task of the distant shockwave lithotripsy is to provide for the fast, reliable, safe and noninvasive kidney and renal duct litholysis. The article highlights the outcome of the shockwave lithotripsy application on Econolith 3000 for the treatment of 27 children. The results of the performed treatment indicated the high efficiency and low invasiveness of this method to eliminate the concrements, as well as the perspective of its use, including in the infants. Shockwave lithotripsy allows the specialists to abandon the traumatic surgeries.Key words: distant shockwave lithotripsy, urolithiasis, children.Внедренный в клиническую практику в 80–е годы метод ударно–волновой литотрипсии коренным образом изменил лечебную тактику при мочекаменной болезни и занял ведущее место в лечении этого заболевания. Основная задача дистанционной ударно-волновой литотрипсии заключается в обеспечении быстрого, надежного, безопасного и атравматичного разрушения камней в почках и мочеточниках. В работе представлены результаты применения метода ударно-волновой литотрипсии на аппарате «Econolith 3000» при лечении 27 детей. Результаты проведенного лечения указывают на высокую эффективность и малую инвазивность данного способа устранения конкрементов, а также перспективность его использования, в том числе у детей раннего возраста, что позволяет полностью отказаться от выполнения открытых травмирующих операций. Ключевые слова: дистанционная ударно-волновая литотрипсия, уролитиаз, дети. (Педиатрическая фармакология. – 2009;6(2):99-102