Микробиота кишечника у детей: от профилактики нарушений становления к предупреждению неинфекционных заболеваний

The article presents an overview of modern Russian and foreign scientific literature, which summarizes data on the value of normal intestinal microflora formation, and on the formation of normal microbiocenosis in ontogeny features. The causes of microbiota formation lesions and their impact on child health are described. Relevant data on the effectiveness of pre- and probiotics in the prophylaxis of noninfectious diseases is given.Представлен обзор современной отечественной и зарубежной научной литературы, обобщающий данные о значении нормального состава микробиоты кишечника, особенностях формирования нормального микробиоценоза в онтогенезе. Описаны причины нарушения нормального состава микробиоты и их влияние на состояние здоровья детей. Приводятся актуальные данные об эффективности пре- и пробиотиков в профилактике неинфекционных болезней

Functional dyspepsia in adolescents: particulars of its etiology, premorbid background, and a comprehensive treatment approach

The adolescence is characterized by high rates of gastroenterological morbidity due to physiological characteristics of the body and social and psychological status of the teenager. Dyspepsia takes the leading position in the structure of functional pathology. Studies have shown the role of family, unhealthy habits and addictions in the development of this disorder. One should also bear in mind that the adolescence is characterized by an increase in organic pathology. There is a  close association of the functional dyspepsia and the premorbid background, such as autonomous dysfunction and vertebral abnormalities. The use of cholinolytics, prokinetics, opioid receptor antagonists, antacids and anti-secretory agents seems rational for treatment of dyspepsia. If the above mentioned groups of agents lack efficacy, the second line therapy is proposed, which includes tricyclic antidepressants

Constipation in babies: Nutritional and behavioral aspects

Constipation in children remains one of the topical problems of pediatrics and pediatric gastroenterology. Functional constipation accounts for about 95% of its cases. The article deals with the main causes of constipation in babies. An algorithm for the management of an infant with functional constipation involves correction of infant feeding in addition to medical treatment. Dietary fiber deficiency in infants may cause constipation. That is why functional foods should be used for infant feeding

The conditions of upper gastrointestinal tract in the presence of various types of basic treatment of children’s bronchial asthma

The purpose of the study is to investigate the state of the upper gastrointestinal tract (UGIT) in various types of basic treatment of children’s bronchial asthma. There was conducted a clinical-instrumentalsurvey of children with bronchial asthma. They have been receiving a basic anti-inflammatory therapy inhaled glucocorticosteroids (IGCS) (1st group, n=33) or anti-inflammatory cromone drugs (2nd group, n=33) for 3 years and more. Most of the children with the bronchial asthma complained about the gastrointestinal problems, mostly abdominal pain; the heartburn was recorded reasonably oftener in the children of 1st group. While conducting endoscope survey, 97% of children of 1st group were revealed having the UGIT pathology. As the result of microscopy of gastric mucosa bioptic sample, most of the patients of 1st group appeared having fungal infection; the significant lymphoplasmacytic or eosinophilic infiltration in own layer of the gastric mucosa was determined. Moreover, H. pylori was revealed more frequently for the children of 1st group, and the level of invasion was higher. The data given indicate the need for measures limiting the entry of steroids into GIT, as well as the use of medicines that reduce damaging effect of IGCS on the mucous layers

PREBIOTICS IN NUTRITION OF CHILDREN OF EARLY AGE

Abstract. Proper nutrition is the key factor of growth and development of the child. Early artificial feeding and irrational introduction of complementary food is one of the problems of infants leading to development of functional disorders of the gastrointestinal tract, impaired immunological protection and manifestation of atopic diseases. We described the effects of the main pre-biotic components of functional nutrition in children of early age. Also we demonstrated the importance of prebiotics for the formation of intestinal microflora, including the development of local mucosal homeostasis due to immunomodulatory action

Intestinal Microflora in Children: from Formation Disturbances Prophylaxis to Preventing Non-Infectious Diseases

The article presents an overview of modern Russian and foreign scientific literature, which summarizes data on the value of normal intestinal microflora formation, and on the formation of normal microbiocenosis in ontogeny features. The causes of microbiota formation lesions and their impact on child health are described. Relevant data on the effectiveness of pre- and probiotics in the prophylaxis of noninfectious diseases is given

Association between placental insufficiency and manifestations of preeclampsia

Aim. Provide evidence for the connection between placental insufficiency and preeclampsia and rationalize a unified approach to the prevention of placenta associated disorders. Materials and methods. The study was carried out in two stages. At the first (clinical statistical) stage, the incidence rates of preeclampsia (PE) and placental insufficiency (PI) were compared based on the data from Rosstat and from a regional perinatal center for the past 25 years; the most informative predictors of PI and PE were compared using the known clinical epidemiological tests. At the second stage, a prospective study of 140 high-risk pregnant patients with severe PI was carried out to confirm and generalize the hypothesis on the common predictors of PI and PE. Two groups of patients were compared: I – 68 women with isolated PI and II – 72 women with PI combined with earlyor late-onset PE. The control group included 30 women with uncomplicated pregnancy. Immunoenzyme assays, immunofluorescence, biochemical analyses, and morphological studies of placenta were used. Results. The incidence rates of PI and PE, both in the communities and in the tertiary care hospital, pointed to their intercorrelation. This similarity of informative values of PI and PE predictors related to the most important operational characteristics of clinical epidemiology indicates the lack of pathognomonic significance of the early predictors and, on the other hand, supports the concept of the common mechanisms of placenta-associated pregnancy complications. In pregnant women with a high risk of PI decompensation, PE developed in 51% of cases (early-onset – 72%, late-onset – 28%); of those, 18% were diagnosed with severe PE, and 33% – with moderate PE. The obtained data confirm that the manifestation of early-onset PE is pathogenetically related to structural and functional disorders of the early fetoplacental complex (FPC), while late-onset PE is associated with FPC changes in the subsequent stages of pregnancy, and with a synergistic effect of extragenital and obstetrical pathology. The proposed predictive model of PE connects the manifestation of PE with the status of the placenta. Conclusion. The knowledge of pathogenetically significant risk factors allows for stratifying pregnant women in order to conduct a common preventive monotherapy of placenta associated disorders. The present approach to the management of high-risk pregnancy is in line with the principles of 4Р-medicine

Why do acute respiratory infections in children remain a pressing problem? Current, prevention and treatment options

Literary data on peculiarities of immune system, anti-infectious immunity, including local protection of respiratory tract (lymphaticepithelial pharyngeal system), in children of early and preschool age, causing their higher incidence of acute respiratory infections (ARI) are given in the article. This age period is characterized by «physiological» humoral immune deficiency, reduced activation of the complement system, insufficient synthesis of cytokines, including interferons, T-cell immunosuppression, impaired intercellular cooperation, poor functional activity of natural killers and phagocytes. Despite the large range of means and methods of prophylaxis of infectious and inflammatory diseases of viral and bacterial etiology, it is necessary to search for new approaches taking into account the peculiarities of immune status in young children. The article presents the possibilities of controlling the system of congenital and adaptive immunity with medications, in particular, by using the bacterial lysate Broncho-munal®. The immunoregulatory role of bacterial lysates is presented in detail. The pathogenetic substantiation of the use of bacterial lysate Broncho-munal® for the prevention of acute respiratory infections in children, including children with recurrent respiratory infections is given

Effect of a synbiotic containing Lactobacillus rhamnosus GG and fructooligosaccharides on the dynamics of the level of fecal calprotectin in children of first year of life

Rationale: As clinical efficacy of probiotics and prebiotics is determined by their joint effects both on the mechanism of immune tolerance, gut inflammation and intestinal wall permeability, one of the objective methods to assess efficacy of probiotic strain-containing agents could be based on measurement of fecal calprotectin levels.Aim: To evaluate changes in fecal calprotectin as an efficacy parameter of treatment with the Lactobacillus rhamnosus GG  – fructooligosacсharide complex for prevention of atopic dermatitis in infants.Materials and methods: Sixty healthy newborns from the risk group for allergic disorders were randomized (envelope randomization) into two groups: the infants from the control group (n = 31) were given widely used recommendations to prevent atopic dermatitis, whereas the infants from the study group (n = 29) were additionally administered a synbiotic containing Lactobacillus rhamnosus GG with fructooligosaccharides. The efficacy of the synbiotic therapy was assessed by measurement of fecal calprotectin levels at 3 and 6  months of the follow-up.Results: The first measurement of fecal calprotectin levels at 3 months showed its significant increase in all infants (mean 276.9 ± 128.8  mcg/G), compared to the normal range (below 50  mcg/G). The second measurement at 6  months demonstrated a  decrease in fecal calprotectin in infants from both groups (mean 75.8 ± 55.3 mcg/G). However, mean levels of fecal calprotectin in the infants from the study group who had been administered the synbiotic, was significantly lower than that in the control group (48.6 ± 38.5 and 99.7 ± 57.4  mcg/G, respectively; р < 0.05).Conclusion: The observed changes in fecal calprotectin levels support the positive role of synbiotics and lyophilized complex of Lactobacillus rhamnosus GG with fructooligosaccharides in the growth of gut microbiota in infants and in the reduction of inflammation, all of this being an important prerequisite for development of the oral tolerance mechanisms