Characteristics of adverse side effects of corticosteroid therapy in children with nephrotic syndrome and methods of pharmacological correction

The article discusses the issues of the long-term glucocorticosteroid therapy in children with nephrotic syndrome that results in severe adverse side effect

Analysis of dynamics of antibiotic resistance of pathogens in patients with diabetic foot syndrome undergoing in-patient treatment

In this paper we discuss the approaches to the choice of antibiotic therapy, subject to the sensitivity of these microorganisms to antibiotic therapy in the surgical department of St. Joseph Belgorod Regional Clinical Hospital. The obtained data state that III-IV generation pseudomonas cephalosporins and fluoroquinolones can be used for empirical therap

New methods to detect early manifestations of adverse side effects of glucocorticosteroids in children

The article focuses on the early manifestations of adverse side effects in children with nephrotic syndrome receiving glucocorticosteroids. The search for criteria of early side effect manifestations is a real challenge nowadays. The authors developed new diagnostic criteria for early detection of pharmacotherapeutical side effects in children with nephrotic syndrom

Complex therapy of chronic pancreatitis complicated by anxio-depressive disorders in railroad workers

The authors have found out negative impact of anxio-depressive disorders on the course of chronic pancreatitis with the development of stable pain syndrome, gastro-intestinal disorders, resistance to the performed pharmacotherapy, and decrease of reaction rate to presented stimul

Pathogenetic features of acute naphazoline poisoning in children

Acute poisoning by nasal decongestants is an important issue in pediatrics due to physiological and anatomical characteristics of the child’s body and pharmacokinetics of drugs in early childhoo

БЕЗОПАСНОСТЬ ДЛИТЕЛЬНОЙ ГЛЮКОКОРТИКОСТЕРОИДНОЙ ТЕРАПИИ У ДЕТЕЙ С НЕФРОТИЧЕСКИМ СИНДРОМОМ

Background: Long-term corticosteroid therapy in children leads to plenty of adverse effects with negative influence on health. Objective: analysis of adverse effects of corticosteroids in children with steroid-sensitive  nephrotic syndrome and development of recommendations of their early detection.Methods: A retrospective study is conducted on children with this syndrome aged 3–18 who applied to Voronezh Regional Children’s Clinical Hospital № 1 in 2011–2014.  Complications  of corticosteroid  therapy revealed during clinical examination of children were taken into account. Data on 118 healthy children examined in 2012–2014 were used to calculate integral index.Results: The study analyses treatment results of 18 children who received glucocorticosteroids  during 6 months before hospitalization and 13 children who were withdrawn from glucocorticosteroids  for 6 months or more before hospitalization. Among adverse reactions in group 1 there prevailed overweight/obesity  (78%), reactive pancreatitis (72%), leukemoid reactions (67%), liver damage (61%), Cushingoid syndrome (44%), chronic gastroduodenitis  (33%). Hyperglycemia (11%), hypertension (6%) and infection (6%) were less common. In group 2 only 2 (15%) patients had chronic gastroduodenitis,  other complications were not documented. Indices that change in children with nephrotic syndrome during corticosteroid treatment (body mass index, blood serum glucose and amylase) were measured by a single scale using modifications coefficients. Average value of the coefficients is suggested to be a new diagnostic criterion (metabolic reaction index) which allows to reveal corticosteroid adverse effects before any clinical manifestations.Conclusion: Most adverse reactions of glucocorticosteroids are short-term and continue after 6 months in a small number of patients.Длительная  глюкокортикостероидная терапия у детей с нефротическим синдромом является причиной развития многочисленных побочных реакций, негативно влияющих на здоровье ребенка.Цель исследования — изучить нежелательные побочные реакции  глюкокортикостероидной терапии  у детей  со стероидчувствительным  нефротическим  синдромом и разработать  рекомендации по их раннему выявлению.Методы.  В ретроспективном  исследовании  изучали результаты лечения детей в возрасте 3–18 лет со стероидчувствительным  нефротическим синдромом, госпитализированных  в стационар в 2011–2014  гг. Учитывали  осложнения  терапии, выявленные при клинико-лабораторном и инструментальном обследовании.  Для расчета интегрального  индекса метаболических реакций использовали данные 118 здоровых детей,        165 обследованных  в 2012–2014 гг.Результаты. Проанализированы  данные 18 детей, получавших глюкокортикостероиды в течение 6 мес до госпитализации,  и 13 детей, завершивших лечение  глюкокортикостероидами за 6 мес и более  до госпитализации.  У больных первой группы в числе побочных реакций чаще всего определяли избыточную массу тела или ожирение  (78%), реактивный панкреатит (72%), лейкемоидные  реакции (67%), поражение  печени (50%), кушингоидный синдром (44%) и хронический гастродуоденит (33%). Относительно редко встречались гипергликемия (11%), артериальная гипертензия (6%), инфекционное  заболевание  (6%). У больных второй группы только  у 2 (15%) сохранялись проявления хронического гастродуоденита. На основании значений индекса массы тела, уровня глюкозы и амилазы сыворотки крови рассчитывали  индекс метаболических  реакций — интегральный  показатель  риска возникновения  побочных эффектов глюкокортикостероидой терапии.Заключение. Большинство побочных реакций глюкокортикостероидной терапии являются краткосрочными и сохраняются по прошествии 6 мес у небольшого числа больных

Study of novel 1,4-dihydropyridine derivatives as prospective anti-inflammatory remedies: a randomised controlled trial

Background. Over the past decades, scientific community is motivated on finding new anti-inflammatory agents with a safe and high-effective profile to manage pathology.Objectives. A study of the anti-inflammatory action of novel compounds, 1,4-dihydropyridine derivatives, in a classical formalin-induced paw oedema test in white rats.Methods. Originally synthesised 1,4-dihydropyridine derivatives were preliminarily subjected to virtual screening using the SwissTargetPrediction toolkit. White laboratory rats (130 animals) were divided into a control (formalin oedema) and intact group, 4 comparison (meloxicam, sodium metamizole, sodium diclofenac and indomethacin) and 7 experiment groups by the number of 1,4-dihydropyridine derivatives studied. The samples anti-inflammatory efficacy was evaluated in acute formalin-induced paw oedema model simulated by right hind limb subplantar injection of 0.1 mL 2% formalin. The studied substances were administered intragastrically at 5 mg/kg 1.5 h prior to oedema induction. Oncometry was assessed quantitatively by limb circumference. Animals were managed in compliance with GOST 33044–2014 “Principles of Good Laboratory Practice” at all experiment steps. Experimental data were analysed statistically to describe quantitative variability with variance σ2, mean limb girth a and standard deviation σ. Data homogeneity and reliability were estimated by variation coefficient V and the Wilcoxon T(W) criterion.Results. As the most anti-inflammatory effective, partially hydrogenated mar-040 pyridines (ethyl 4-({[5-cyano-6-{[2-(diphenylamino)-2-oxoethyl]thio}-4-(2-furyl)-2-methyl-1,4-dihydropyridin-3-yl]carbonyl}amino) benzoate) were shown 33-fold superior to indomethacin, 26-fold — to sodium diclofenac, 25-fold — to meloxicam and 30-fold — to sodium metamizole; mar-037 pyridines (ethyl 4-[({[3-cyano-5-({[4-(ethoxycarbonyl)phenyl]amino}carbonyl)-4-(2-furyl)-6-methyl-1,4-dihydropyridin-2-yl]thio}acetyl)amino] benzoate) — 17–23-fold superior vs. reference drugs. We also show that mаr-014 (ethyl 4-({[5-cyano-6-({2-[(3,5-dichlorophenyl) amino]-2-oxoethyl}thio)-4-(2-furyl)-2-methyl-1,4-dihydropyridin-3-yl]carbonyl}amino)benzoate) and mar033 (ethyl 2-[({[3-cyano-5-({[4-(ethoxycarbonyl)phenyl]amino}carbonyl)-4-(2-furyl)-6-methyl-1,4-dihydropyridin-2-yl]thio}acetyl)amino]-4,5,6,7-tetrahydro-1-benzothiophene-3-carboxylate) compounds are 2.7-fold more effective vs. reference drugs.Conclusion. The synthesised 1,4-dihydropyridine compounds reveal high efficacy in experimental assays. Selected novel 1,4-dihydropyridine derivatives exhibit a marked anti-inflammatory activity and offer value in future preclinical trials

ADVERSE EFFECTS OF LONG-TERM CORTICOSTEROID THERAPY OF NEPHROTIC SYNDROME IN CHILDREN

Background: Long-term corticosteroid therapy in children leads to plenty of adverse effects with negative influence on health. Objective: analysis of adverse effects of corticosteroids in children with steroid-sensitive  nephrotic syndrome and development of recommendations of their early detection.Methods: A retrospective study is conducted on children with this syndrome aged 3–18 who applied to Voronezh Regional Children’s Clinical Hospital № 1 in 2011–2014.  Complications  of corticosteroid  therapy revealed during clinical examination of children were taken into account. Data on 118 healthy children examined in 2012–2014 were used to calculate integral index.Results: The study analyses treatment results of 18 children who received glucocorticosteroids  during 6 months before hospitalization and 13 children who were withdrawn from glucocorticosteroids  for 6 months or more before hospitalization. Among adverse reactions in group 1 there prevailed overweight/obesity  (78%), reactive pancreatitis (72%), leukemoid reactions (67%), liver damage (61%), Cushingoid syndrome (44%), chronic gastroduodenitis  (33%). Hyperglycemia (11%), hypertension (6%) and infection (6%) were less common. In group 2 only 2 (15%) patients had chronic gastroduodenitis,  other complications were not documented. Indices that change in children with nephrotic syndrome during corticosteroid treatment (body mass index, blood serum glucose and amylase) were measured by a single scale using modifications coefficients. Average value of the coefficients is suggested to be a new diagnostic criterion (metabolic reaction index) which allows to reveal corticosteroid adverse effects before any clinical manifestations.Conclusion: Most adverse reactions of glucocorticosteroids are short-term and continue after 6 months in a small number of patients

Analysis of dynamics of antibiotic resistance of pathogens in patients with diabetic foot syndrome undergoing in-patient treatment

In this paper we discuss the approaches to the choice of antibiotic therapy, subject to the sensitivity of these microorganisms to antibiotic therapy in the surgical department of St. Joseph Belgorod Regional Clinical Hospital. The obtained data state that III-IV generation pseudomonas cephalosporins and fluoroquinolones can be used for empirical therap