Ретикулоцитарные индексы в диагностике и контроле эффективности лечения железодефицитных состояний у детей

High prevalence of iron-deficiency conditions (IDC) in children dictates the need in searching for sensitive, accurate and simple methods of identifying such diseases on early stages of development. New methods of laboratory screening diagnosis are especially needed. The article presents an analysis of new methods of IDC laboratory diagnosis — hematological and biochemical. It presents a discussion of role of a new parameter — mean reticulocyte hemoglobin content (CHr) — for IDC diagnosis and treatment effectiveness control. The article presents data on CHr sensitivity and specificity as compared with the other hematological parameters frequently used for IDC diagnosis. Распространенность железодефицитных состояний (ЖДС) среди детей высока, что диктует необходимость поиска чувствительных, точных и простых методов их определения на ранних стадиях развития заболеваний. Особенно необходимы новые методы лабораторной диагностики для проведения скрининга. В статье анализируются новые методы лабораторной диагностики ЖДС — гематологические и биохимические. Обсуждается значение в диагностике ЖДС и контроле эффективности их лечения нового параметра — среднего содержания гемоглобина в ретикулоците (Reticulocyte Hemoglobin Content, CHr). Приводятся сведения о чувствительности и специфичности CHr в сравнении с другими гематологическими показателями, наиболее часто применяемыми для диагностики ЖДС.

Факторы риска развития железодефицитных состояний у подростков города Москвы

The article presents data on prevalence structure and causes of iron-deficiency conditions (IDC) in adolescents. The authors describe both literature data and the findings of their own study in the adolescents (n = 337) studying at Moscow comprehensive schools. Iron- deficiency anemia was revealed in 5.3% of the examined adolescents, latent iron deficiency — in 17%; vast majority of the last were females. The authors also determined the most common causes of IDC development in adolescents: growth spurt (according to the anamnesis), a source of chronic blood loss (prolonged and abundant menstruations [in girls], frequent nasal bleeding), vegetarianism, intense physical activity, diet compliance, excess weight, and obesity. Статья посвящена распространенности, структуре и причинам развития железодефицитных состояний (ЖДС) у подростков. Авторы наряду с литературными данными представили результаты собственного исследования подростков — учащихся общеобразовательных школ Москвы (n = 337). Железодефицитная анемия выявлена у 5,3% обследованных, латентный дефицит железа — у 17%, в преобладающем большинстве у лиц женского пола. Определены также наиболее частые причины развития ЖДС у подростков: наличие в анамнезе «скачка роста», источника хронической кровопотери (длительные и обильные менструации у девушек, частые носовые кровотечения), вегетарианство, а также интенсивные физические нагрузки, приверженность диетам, наличие избыточной массы тела и ожирения.

Профилактика и лечение железодефицитной анемии у детей первого года жизни

The article presents features of physiological processes and pathological conditions in under one-year children that predispose the development of iron-deficiency anemia. Basic methods of iron deficiency prophylaxis and principles of iron drug selection and dose selection for iron-deficiency anemia treatment for children in the stated age category are described in the article. Particular attention is paid to the prevention and treatment of iron deficiency anemia in preterm infants; foreign and domestic recommendations on this issue are presented. A practicing pediatrician needs to know the features of the disease’s development and treatment caused by differences in physical conditions accompanied by a high activity of metabolic processes and the immaturity of the young patients’ anatomic structures in order to identifiy and select the right iron-deficiency anemia treatment strategy.В статье представлены особенности физиологических процессов и патологических состояний у детей первого года жизни, предрасполагающих к развитию железодефицитной анемии (ЖДА). Описаны основные способы профилактики железодефицитных состояний, а также принципы выбора препарата железа и его дозы для лечения ЖДА у детей указанной возрастной категории. Особое внимание уделено профилактике и лечению ЖДА у недоношенных детей, представлены зарубежные и отечественные рекомендации по данному вопросу. Практикующему педиатру для своевременного выявления и выбора правильной тактики лечения ЖДА у детей первых 12 мес жизни необходимы знания об особенностях развития и лечения патологии, обусловленных отличиями физиологического состояния на фоне высокой интенсивности обменных процессов и незрелости анатомических структур у маленьких пациентов

Breastfeeding: answers to some difficult questions lactating women

The modern society places before the specialists in various fields of knowledge all the new challenges. A pediatrician is not an exception, who in his/her daily practice has to solve problems of children’s health, guided by modern knowledge of medical science and using a personalized approach to patient care. This article is intended to help practicing pediatricians to find the answers to some of the complex issues related to breastfeeding and questions that lactating women currently have

Pediatrician’s approaches to the treatment of acute tonsillopharyngitis in children

Sore throat is one of the most common complaints with which patients seek the aid of pediatricians. Acute tonsillopharyngitis is a frequent cause of sore throat in children. In a majority of cases, the disease has viral etiology, and less frequently bacterial. Acute tonsillopharyngitis in children is often associated with irrational prescribing of antibacterial agents. Antibiotics are only indicated for tonsillopharyngitis caused by group A beta-hemolytic streptococcal infection. In order to choose rational therapy for acute tonsillopharyngitis, pediatrician should perform differential diagnosis, guess the etiology of the disease based on the clinical pattern using the McIsaac score, and, if possible, quick tests for identification of group A beta-hemolytic streptococcus. In the treatment of acute tonsillopharyngitis in children, regardless of the etiology, the doctor should be guided by a comprehensive approach including the use of drugs with a local antimicrobial effect

BREASTFEEDING HISTORY OF THE PEOPLES OF THE WORLD

For many thousands of years, breastfeeding was reflected in all spheres of human life, from life traditions to sacred religious and philosophical thoughts. Various factors influenced breastfeeding traditions at different times and among different peoples: climatic conditions, national political  and social  systems,  religious  views, relationships with other nations, cultural and household patterns of the nation. Again, the specifics of the breastfeeding process was interwoven into and had a visible impact on many spheres of life of all classes of society. The article is an overview of literature devoted to traditions and peculiarities of breastfeeding of various peoples of the Earth since the ancient world till the 20th century

Diagnosis and treatment of urinary tract infections in children: what’s new?

Urinary tract infection (UTI) is one of the most frequent problems in children, especially early age. A practicing pediatrician, pediatric urologist, nephrologist is frequently faced with the problem of diagnosis and treatment of UTI. Clinical manifestations of UTI in children are diverse and depend on the age and sex of child, severity of the inflammatory process, presence and nature of comorbidity. The experts dealing with the problem of UTI in children in different countries initiated the establishment of clinical guidelines that can assist clinicians in the diagnosis and treatment of UTI in children. The paper presents national European recommendations for the treatment and diagnosis of UTI in pediatrics

BREAST MILK IS A LIVING TISSUE! HOW TO PRESERVE BREASTFEEDING?

From the history of the mankind it’s known that during all times breastfeeding was given specific attention and until now this subject is very urgent. All the community is aware that breast feeding is important and it must be preserved for the maximum time. The article provides data on the unique components of the breast milk that make it indispensible in all respects for the baby

SKIN CARE IN YOUNG CHILDREN: INNOVATIVE APPROACHES

The article presents modern data on the ontogenesis of the skin, the formation of all its elements and structures during prenatal development and postnatal period. The modern ideas about the features of the structure of the skin in the newborn and infant are highlighted in detail. Particular attention is paid to the protective mechanisms of the skin, providing a mechanical barrier, and factors of innate immunity, lipids, as well as skin microbiome. Much attention is paid to the importance of the dampening for the skin of the fetus and newborn, as well as the processes of adaptation of the skin of the newborn to the extrauterine environment. The modern recommendations for skin care, based on data of the features of the development, structure and functioning of the skin of the newborn and infant are presented

PHYSIOLOGY OF TASTE PERCEPTION: THE ROLE OF GENETIC AND ENVIRONMENTAL FACTORS IN THE FORMATION OF TASTE PREFERENCES

Taste perception has a significant impact on the formation of human food preferences. The basics of taste perception of the child are formed under the influence of genetic polymorphism and congenital taste preferences, developing under the influence of a number of environmental factors. A significant impact on the formation of taste hasthe mother’s nutrition during pregnancy, the nature of the child’sfeeding, the baby’s health during the first year of life, as well as national and family traditions of nutrition. The article describes the mechanisms of formation of different taste sensations, summarizes the results of modern research on the genetics of taste receptors, the role of individual environmental factors in the development of food preferences. Special attention is paid to the peculiarities of the child’s nutrition during the first year of life