ЧАСТО БОЛЕЮЩИЕ ДЕТИ. ВЗГЛЯД ФИЗИОТЕРАПЕВТА

The prevention of frequent respiratory infections in children is one of the urgent issues of modern pediatrics. At present the range of non-drug technologies of prevention of acute respiratory infections (ARI) in children has considerably increased due to the appearance of new effective methods of physical rehabilitation. The article gives a literary review of the main methods of drug prevention of frequent ARI in childhood applied in practical healthcare on the modern stage.Профилактика частых респираторных инфекций у детей является одной из актуальных проблем современной педиатрии. В настоящее время спектр немедикаментозных технологий для профилактики острых респираторных инфекций (ОРИ) у детей значительно расширился за счет возникновения новых эффективных методов физической реабилитации. В статье представлен литературный обзор основных методов немедикаментозной профилактики частых ОРИ в детском возрасте, используемых в практическом здравоохранении на современном этапе

Аромафитобальнеотерапия в лечении и профилактике частых респираторных инфекций у детей с хроническими и инвалидизирующими болезнями

In children with chronic pathologies, co-occurring frequent respiratory infections of a prolonged course obstructs and reduce the effectiveness of rehabilitation measures, and adversely affect the adaptation reserves. Hydrotherapeutic factors are widely used for the prevention of colds in children from the first days of life. Addition to the water of medicinal and phytoaromatic preparations increases their efficiency. For patients with chronic pathology, when prescribing balneotherapeutic factors for treatment and prophylaxis of respiratory infections, it is important to take into account the potential risk of adverse effects on the symptoms of the underlying disease. Researches in patients with orthopedic, chronic gastroenterological diseases, spastic forms of cerebral palsy, with co-occurring frequent respiratory infections of a prolonged course in history revealed that addition of medicinal baths based on phytoaromatic preparation, containing eucalyptus oil, to the rehabilitation complex is an effective method of preventing and stopping initial symptoms of respiratory infections. It also contributes to the adaptation reserves of the organism, without adversely affecting the course of the underlying disease.У детей с хронической патологией сопутствующие частые респираторные инфекции с затяжным течением затрудняют проведение и снижают эффективность реабилитационных мероприятий, крайне неблагоприятно влияют на адаптационные резервы. Водолечебные факторы широко используются для профилактики простудных заболеваний у детей с первых дней жизни. Повышает их эффективность добавление в воду лекарственных и фитоароматических препаратов. Для пациентов с хронической патологией при назначении бальнеотерапевтических процедур с целью лечения и профилактики респираторных инфекций важно учитывать возможный риск неблагоприятного влияния на симптомы основного заболевания. Исследования, проведенные у пациентов с ортопедической, хронической патологией желудочно-кишечного тракта, спастическими формами детского церебрального паралича, с сопутствующими частыми затяжными острыми респираторными болезнями в анамнезе, выявили, что включение в реабилитационный комплекс лекарственных ванн на основе фитоароматического препарата, содержащего эвкалиптовое масло, является эффективным методом профилактики и купирования начальных симптомов респираторных инфекций, способствует повышению адаптационных резервов организма, не оказывая отрицательного влияния на течение основного заболевания

ВОЗМОЖНОСТИ ВОССТАНОВИТЕЛЬНОГО ЛЕЧЕНИЯ ПАЦИЕНТОВ ОРТОПЕДИЧЕСКОГО ПРОФИЛЯ В УСЛОВИЯХ СОВРЕМЕННОГО РЕАБИЛИТАЦИОННОГО ЦЕНТРА

The rehabilitation of patients after surgery is an integral part of treatment in modern medicine. Restorative treatment is a complex of measures which includes participation of different medical specialists. The goal of child post-surgery rehabilitation is the restoration of physical and social adaptation of the patient. This article covers the main principles of restorative treatment in a multi-profile children’s medical institution. Examples of child rehailitation after reconstructive surgery of most frequent orthopedic pathologies are included.Реабилитация пациентов после оперативного лечения в современной медицине является неотъемлемой частью лечебного процесса. Восстановительное лечение — это комплекс мероприятий, включающий в себя участие врачей разных специальностей. Целью реабилитации детей в послеоперационном периоде является восстановление физической и социальной адаптации пациента. В статье изложены основные принципы восстановительного лечения в условиях многопрофильного детского медицинского учреждения. Приведены клинические примеры реабилитации детей после реконструктивных операций при наиболее распространенной ортопедической патологии.

Current options for aromaphytotherapy in the treatment of acute respiratory infections in children

Acute infectious respiratory diseases are among the most common childhood pathologies in the structure of medical aid appealability. A child typically suffers from 2 to 5-6 episodes of ARI during the year, which are often complicated by bronchitis, pneumonia or ENT diseases. Medication treatment recommended by the doctor does not always result in full recovery, and leads to certain side effects. Aromaphytotherapy is one of the major symptomatic treatments for respiratory diseases in children, which in many cases allows to significantly reduce the pharmacotherapeutic burden on the child's organism. The crucial task for today is to develop innovative standardized medicines for aromaphytotherapy with proven efficacy and safety in children, and easy to administrate formulations

THE EXPERIENCE OF PHYSIOTHERAPY TREATMENT OF VESICO-DEPENDENT FORMS MEGAURETER IN CHILDREN

The article reflects one of the important challenges in pediatric urology — treatment of megaureter in children, the condition which can lead to sclerotic changes in renal parenchyma and development of chronic renal failure. The authors used the physiotherapeutic method of treatment, including electrophoresis with the anti-sclerotic agent at the area of bladder and lower third of ureters. The received results, demonstrating successful effect of this treatment, are represented in the article

Aromaphytobalneotherapy in Treatment and Prophylaxis of Frequent Respiratory Infections in Children with Chronic and Disabling Diseases

In children with chronic pathologies, co-occurring frequent respiratory infections of a prolonged course obstructs and reduce the effectiveness of rehabilitation measures, and adversely affect the adaptation reserves. Hydrotherapeutic factors are widely used for the prevention of colds in children from the first days of life. Addition to the water of medicinal and phytoaromatic preparations increases their efficiency. For patients with chronic pathology, when prescribing balneotherapeutic factors for treatment and prophylaxis of respiratory infections, it is important to take into account the potential risk of adverse effects on the symptoms of the underlying disease. Researches in patients with orthopedic, chronic gastroenterological diseases, spastic forms of cerebral palsy, with co-occurring frequent respiratory infections of a prolonged course in history revealed that addition of medicinal baths based on phytoaromatic preparation, containing eucalyptus oil, to the rehabilitation complex is an effective method of preventing and stopping initial symptoms of respiratory infections. It also contributes to the adaptation reserves of the organism, without adversely affecting the course of the underlying disease

Adherence to Clinical Quidelines on Preoperative Assessment and Correction of Cardiovascular Risk in Non-cardiac Surgery

Surgical care is associated with a high risk of complications. In 2014 the updated joint ESC/ESA guidelines on preoperative assessment and perioperative management of patients were published to improve patient safety in non-cardiac surgery. The increase in the adherence to clinical guidelines promotes the improving of the healthcare quality and safety improvement.Aim. To study physicians' level of adherence to ESC/ESA clinical guidelines for preoperative assessment and perioperative management of patients.Material and methods. A retrospective observational study included 102 patients admitted to Moscow general hospital from 01.03.2019 to 30.06.2018 for elective surgery. All of them underwent preoperative examination in outpatient department of the hospital and had at least one concomitant disease requiring drug therapy. The medical records data on the preoperative examination and perioperative treatment with beta-blockers, HMG CoA reductase inhibitors and angiotensin-converting-enzyme (ACE) inhibitors/ angiotensin receptor blockers (ARBs) were analyzed for compliance with the ESC/ESA guidelines.Results. A standardized cardiac risks assessment was not documented in the results of preoperative examination. Electrocardiography (ECG), echocardiography and non-invasive stress tests were performed according to clinical guidelines in 100%, 77.8% and 25% of cases, respectively. Unnecessary ECG and echocardiography were prescribed in 50.5% and 72% of cases, respectively. Appropriate correction of ACE inhibitors/ARBs therapy was performed in 66.7% patients with congestive heart failure and only in 2.7% with arterial hypertension. In 19 patients with ischemic cardiac disease, 13 (84.2%) patients received HMG CoA reductase inhibitors and 16 (68.4%) ones received beta-blockers during hospitalization. Inappropriate omission of statins, beta-blockers and ACE inhibitors (ARBs) during hospitalization was registered in 22.2%, 11% and 4.9% patients, respectively.Conclusion. The number of inappropriate ECGs and echocardiographies, as well as incorrect treatment with beta-blockers, HMG CoA reductase inhibitors and ACE inhibitors (ARBs) in perioperative period evidence that the adherence of physicians to the clinical guidelines on preoperative assessment and perioperative management of patients remains low.It is reasonably to develop risk-based interdisciplinary protocols for preoperative examination, algorithms for interdisciplinary communication and interaction between specialists and the healthcare levels, as well as physicians' education for better adherence to clinical guidelines