HOSPITALIZATION AND AMBULATORY TREATMENT OF CHILDREN: ADVANTAGES AND RISKS

The need in hospitalization of pediatric patients was significantly decreased in last 20 years due to including of innovative methods of treatment into the practice. This fact leaded to arising of questions, related to ambulatory treatment. The article presents analysis of advantages and shortcomings of present being practice of children’s with acute diseases management at ambulatory and hospital stages. It was shown that the number of beds (calculated to 10 000 children under the age 0–14 years old) is differ from 4–5 in USA to 90 in Russian Federation, with tendency to beds’ concentration in large hospitals. The main reason of hospitalization is nosocomial respiratory (up to 40% of cases) and rotaviral (up to 25% of cases in epidemic season) infections. It was marker, that shortening of stay in hospital and implementation of hospital-replacing technologies (day hospital) for the treatment of children with chronic pathology can decrease the rate of morbidity with nosocomial infections. Lessening the need in hospital stay can be realized by optimization of ambulatory care, particularly, shortening of patient’s visits at home, and using diagnostic abilities of out-patient clinics for the needs of patients with acute diseases.Key words: children, hospitalization, ambulatory treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4):26-31

ANTIPYRETICS

(Pediatric Pharmacology. — 2011; 8 (5): 83–86.

ANTIPYRETICS

(Pediatric Pharmacology. — 2011; 8 (5): 83–86.

DIAGNOSTICS AND THERAPY IN CHILDREN'S ACUTE GASTROENTERITIS

The work aimed at studying a series of diagnostic aspects and determination of the possible treatment of children with acute gastroenetrites according to the protocol based on international recommendations and standards. The study involved 130 children, of whom in 71 patients the presence of rotavirus antigen in coprofilters was checked via latex particle agglutination method. In 85% rotavirus infection was confirmed. It was shown that the majority of cases fall on November to may. Infant and early children are the most susceptible to rotavirus gastroenteritis. The analysis of therapy results showed that antibioticsfree treatment of watery diarrhea patients worked well, and prescription of antibacterial therapy for the concomitant bacterial infection does not influence the time of gastroenteritis reduction. The results of dehydration therapy show that oral rehydration is not always effective for the 2nd stage dehydration, especially with late treatment. However, the time of recovery (diarrhea reduction) does not depend on the type of rehydration or symptomatic therapy. A diagnostic algorithm that helps use the minimum diagnostic methods in stationary conditions and at the same time provides the optimum scope of therapeutic intervention was worked out.Key words: rotavirus infection, children, rehydration, antibacterial therapy

RATIONAL THERAPY OF CHILDREN'S CROUP

Basing upon proprietary research including data on 130 patients with acute steno sing laryngotracheobronchitis, the authors conclude that the usage of systematic and topical glucocorticosteroids promotes reduction of upper air passages obstruction within 24chour period among 83% of patients. Inhalation with moistened air is inefficient and cannot be considered as an independent method for croup therapy. In this research, 14% of patients took antibiotics: in most cases with evident or probable bacterial infection; with no evident signs — just about 3% of patients took the medication. For children with bacterial infections accompanying croup, the introduction of antibiotics had no effect on the croup symptoms dynamics.Key words: acute stenosing laryngotracheobronchitis, children, curing, glucocorticosteroids, antibiotics

RATIONAL THERAPY OF CHILDREN'S CROUP

Basing upon proprietary research including data on 130 patients with acute steno sing laryngotracheobronchitis, the authors conclude that the usage of systematic and topical glucocorticosteroids promotes reduction of upper air passages obstruction within 24chour period among 83% of patients. Inhalation with moistened air is inefficient and cannot be considered as an independent method for croup therapy. In this research, 14% of patients took antibiotics: in most cases with evident or probable bacterial infection; with no evident signs — just about 3% of patients took the medication. For children with bacterial infections accompanying croup, the introduction of antibiotics had no effect on the croup symptoms dynamics.Key words: acute stenosing laryngotracheobronchitis, children, curing, glucocorticosteroids, antibiotics.</strong

Acute Infectious Diarrhea in Children

<em>The article highlights the key principles for detection and differentiation of the acute infectious diarrhea in children. The modern guidelines for treatment of the acute gastroenteritis and gastroenterocolitis are based on the rational application of the antibacterial medications and minimization drugs administration. There are therapeutic approaches recommended by WHO and ESPGHAN.</em><br /><em><strong>Key words: acute gastroenteritis, gastroenterocolitis, diarrhea, acute enteric infections, detection, treatment, oral rehydration, nifuroxazide, children</strong>.</em

ACUTE INFECTIOUS DIARRHEA IN CHILDREN

The article highlights the key principles for detection and differentiation of the acute infectious diarrhea in children. The modern guidelines for treatment of the acute gastroenteritis and gastroenterocolitis are based on the rational application of the antibacterial medications and minimization drugs administration. There are therapeutic approaches recommended by WHO and ESPGHAN.Key words: acute gastroenteritis, gastroenterocolitis, diarrhea, acute enteric infections, detection, treatment, oral rehydration, nifuroxazide, children