Клинико-эпидемиологическая характеристика гепатита А у детей в период подъема заболеваемости

Objective. Study of clinical and epidemiological characteristicsof hepatitis A in children.Materials and methods. The paper presents the epidemiological situation of this issue in the Krasnoyarsk Territory, as well as the results of clinical observations of 104 children with hepatitis A in age from 1 to 14 years.Results. It was found that at the present time is marked deterioration of the epidemiological situation of hepatitis A with involvement in the epidemiological process of young children. In this severe hepatitis A, often occurring with the phenomena of cholestasis, significantly more frequent among children aged 7–14 years. Despite the apparent beneficial for the infection at discharge on the part of school-age children has been a recovery with residual effects that require continued monitoring and corrective therapy appointment.Цель. Изучение клинико-эпидемиологической характеристики гепатита А (ГА) у детей.Материалы и методы. Представлена эпидемиологическая ситуация по данной проблеме в Красноярском крае, а также результаты клинического наблюдения за 104 детьми с ГА в возрасте от 1 до 14 лет.Результаты. Установлено, что в настоящее время отмечено ухудшение эпидемиологической ситуации по ГА с вовлечением в эпидемиологический процесс детей раннего возраста. При этом тяжелые формы ГА, зачастую протекающие с явлениями холестаза, достоверно чаще встречаются у детей 7–14 лет. Несмотря на кажущееся благоприятное течение данной инфекции, при выписке у части детей школьного возраста имело место выздоровление с остаточными явлениями, что требовало продолжения наблюдения и назначения корригирующей терапии

КЛИНИКО-ЭПИДЕМИОЛОГИЧЕСКИЕ ОСОБЕННОСТИ И ИСХОДЫ ГЕНЕРАЛИЗОВАННЫХ ФОРМ МЕНИНГОКОККОВОЙ ИНФЕКЦИИ У ДЕТЕЙ

The objective of the research was to study clinical and epidemiological features and outcomes of generalized forms of meningococcal infection in children from Krasnoyarsk and Krasnoyarsk Territory during the period from 2012 to 2016. Materials and methods. A retrospective analysis of 57 medical records of hospital patients with generalized forms of meningococcal infection was carried out in the infectious and resuscitative departments of the Krasnoyarsk Clinical Hospital No. 1 from 2012 to 2016, including 12 protocols of pathologoanatomical studies of the deceased patients and 45 medical cards of ambulatory patients – convalescents of the disease from 2012 to 2016. Results. The epidemic situation for meningococcal infection in Krasnoyarsk Territory from 2012 to 2016 is characterized by signs of inter-epidemic period. Children of the first 3 years of life are in the group of high risk for the development of GFMI, which accounts for 74% of the total number of cases of children aged 14. There are signs of meningococcal infection «aging» – in the age structure the number of children in the first year of life decreased, while the proportion of children aged 4–7 and 7–14 increased compared to previous decades. There is a tendency to a decrease in the proportion of the combined forms with an increase in the frequency of «pure» meningococcemia. In recent years there has been an «atypical» course of generalized forms of the disease, when classical hemorrhagic necrotic rashes appear only on the 3rd – 4th day of the disease. In convalescents who underwent a combined form of MI and «pure» meningitis severe residual effects leading patients to disability are possible to develop. Conclusion. The use of polyvalent conjugated vaccines in potential risk groups will allow us to reduce the morbidity and mortality from generalized forms of meningococcal infection, including younger children.Цель: изучить клинико-эпидемиологические особенности и исходы генерализованных форм менингококковой инфекции у детей г. Красноярска и Красноярского края в 2012–2016 гг. Материалы и методы: проведен ретроспективный анализ 57 медицинских карт стационарного больного пациентов с генерализованными формами менингококковой инфекции, находившимися на лечении в инфекционном и реанимационных отделениях КМДКБ №1 г. Красноярска в 2012–2016 гг., а также 12 протоколов патолого-анатомических исследований умерших больных и 45 медицинских карт амбулаторного больного – реконвалесцентов заболевания в 2012–2016 гг.Результаты: эпидемическая ситуация по менингококковой инфекции в Красноярском крае в 2012–2016 гг. характеризуется признаками межэпидемического периода. В группе повышенного риска по развитию ГФМИ находятся дети первых 3 лет жизни, на долю которых приходится 74% от общего числа заболевших детей до 14 лет. Отмечается некоторое «повзросление» менингококковой инфекции –в возрастной структуре уменьшилось количество детей первого года жизни, при этом увеличился удельный вес детей 4– лет и 7–4 лет по сравнению с предыдущими десятилетиями. Прослеживается тенденция к снижению удельного веса сочетанных форм при увеличении частоты «чистой» менингококцемии. В последние годы отмечается «атипичное» течение генерализованных форм заболевания, когда только на 3–-е сутки заболевания появляются классические геморрагически-некротические высыпания. У реконвалесцентов, перенесших комбинированную форму МИ и «чистый» менингит, возможно развитие тяжелых резидуальных последствий, приводящих пациентов к инвалидизации. Заключение: снизить заболеваемость и смертность от генерализованных форм менингнококковой инфекции, в том числе у детей раннего возраста, позволит использование поливалентных конъюгированных вакцин в потенциальных группах риска

Менингококковая инфекция у детей в Красноярском крае: анализ летальных исходов

Meningococcal infection (MI) for many years has occupied one of the most important places in the structure of acute neuroinfections in children. Some decline in MI morbidity in recent years has reduced the alertness of doctors to early detection of the disease that in some cases becomes the cause of late hospitalization, developmentof decompensated shock and ineffective resuscitation. The purpose of the given research is to identify the causes of deaths from generalized forms of MI and the prospects of mortality reduction. The paper gives the expert analysis of 22 medical histories of children who died of generalized forms of MI during the period from 2005 to 2014 in Krasnoyarsk. The work describes the features of the clinical picture of MI generalized forms in children at the present stage, reveals the causes of deaths during the period of sporadic morbidity in the Krasnoyarsk Territory and determines the adverse prognostic features that indicate the particular severity and the development of fulminant course of the disease.Менингококковая инфекция (МИ) в течение многих лет продолжает занимать одно из главных мест в структуре острых нейроинфекций у детей. Некоторый спад заболеваемости МИ в течение последних лет привел к снижению настороженности врачей в отношении ранней диагностики заболевания, что в ряде случаев является причиной поздней госпитализации, развития декомпенсированного шока и неэффективности реанимационных мероприятий. Цель исследования — выявить причины летальных исходов от генерализованных форм МИ и резервы снижения летальности. Проведена экспертная оценка 22 историй болезни детей, умерших от генерализованных форм МИ за период 2005—2014 гг. в г. Красноярске. Представлены особенности клинической картины генерализованных форм МИ у детей на современном этапе, выявлены причины летальных исходов в период спорадической заболеваемости в Красноярском крае, определены неблагоприятно-прогностические признаки, указывающие на особую тяжесть и развитие молниеносного течения заболевани

Effect of combination of pectin substances on viscosity of their aqueous solutions

Viscosity is one of the characteristic properties of pectin substances, as well as other lyophilic colloids. Pectin molecules are easily associated with each other or with large molecules of related substances. This article contains the results of the study of dynamic viscosity, internal friction, thixotropic index of aqueous solutions (1 % and 4%) of various types of pectin substances and their combinations. The article presents the results of the study of the influence of different types of pectin substances and their combinations on the dynamic viscosity of pectin solutions and their internal friction. The analysis of values of dynamic viscosity and friction force depending on the type of pectin substances and their combinations is given. It is established that in cases where information on dissipative processes in pectin structures at low speeds and shear loads is required, it is necessary to rely on data on internal friction, in others - on the given information on their viscosity. The thixotropic index is calculated. It is established that the internal friction in pectin solutions and their dynamic viscosity depend on the type of pectin substances and their combinations. In pectin solutions, the internal friction is maximum for Apple pectin, and the dynamic viscosity – for a combination of citrus pectins with beet. When combining pectins, both indicators are most important for the combination of citrus with beet. The obtained data on the viscosity, internal friction and thixotropic index of solutions of different types and combinations of pectins make it possible to regulate the rheological properties of food systems with the addition of pectin substances

CANDIDATE SELECTION FOR HEART TRANSPLANTATION IN KRASNODAR REGION

The article presents the basic provisions of the selection of patients for transplantation of the heart, and the volume of the order of examination of potential recipients, the organization of the selection and monitoring of recipients in our center. Also analyzed the experience of the disease and outcomes of patients at the waiting list for a heart transplant for the 6 years of follow up in our center

Influence of pectin hydration on internal friction and viscosity of their aqueous solutions

In the work the effect of hydration on the viscosity and internal friction of pectin solutions has been studied. The dynamic viscosity has been measured on a rotational viscometer, and internal friction on a torsion pendulum with a small vibration amplitude. Hydration has been studied using thermogravimetric method and differential scanning calorimetry. It has been revealed that internal friction in pectin solutions and their dynamic viscosity depend on the type of pectin substances and their combinations. The data obtained are explained on the basis of ideas about the movement of the pectin molecule, which is carried out in the form of sequential movement along the totality of potential wells formed by neighboring hydrated molecules. In addition, it has been shown that internal friction in suspensions of citrus dietary fiber in the concentration range of 1.2-2 % is determined mainly by dissipative processes in a dispersion medium, which is a solution of pectin. The presented data on the viscosity and internal friction of solutions of various types and combinations of pectins and their relationship with hydration make it possible to control rheological properties of food systems with the addition of pectin substances

Clinical and epidemiological characteristics of hepatitis A in children during rise of morbidity

Objective. Study of clinical and epidemiological characteristicsof hepatitis A in children.Materials and methods. The paper presents the epidemiological situation of this issue in the Krasnoyarsk Territory, as well as the results of clinical observations of 104 children with hepatitis A in age from 1 to 14 years.Results. It was found that at the present time is marked deterioration of the epidemiological situation of hepatitis A with involvement in the epidemiological process of young children. In this severe hepatitis A, often occurring with the phenomena of cholestasis, significantly more frequent among children aged 7–14 years. Despite the apparent beneficial for the infection at discharge on the part of school-age children has been a recovery with residual effects that require continued monitoring and corrective therapy appointment

Meningococcal Infection in Children in the Krasnoyarsk Territory: Analysis of Fatal Outcomes

Meningococcal infection (MI) for many years has occupied one of the most important places in the structure of acute neuroinfections in children. Some decline in MI morbidity in recent years has reduced the alertness of doctors to early detection of the disease that in some cases becomes the cause of late hospitalization, developmentof decompensated shock and ineffective resuscitation. The purpose of the given research is to identify the causes of deaths from generalized forms of MI and the prospects of mortality reduction. The paper gives the expert analysis of 22 medical histories of children who died of generalized forms of MI during the period from 2005 to 2014 in Krasnoyarsk. The work describes the features of the clinical picture of MI generalized forms in children at the present stage, reveals the causes of deaths during the period of sporadic morbidity in the Krasnoyarsk Territory and determines the adverse prognostic features that indicate the particular severity and the development of fulminant course of the disease