Experience in the Treatment of Hemangioma in Children

The article reflects modern views on epidemiology, clinical manifestations, classification, principles of diagnostics and treatment of hemangiomas. The purpose of our study was the analysis of the results of different methods of treatment inof children with hemangioma over a ten-year period (from 2007 to 2017) at Irkutsk Regional Children Hospital. We have found a significant reduction in cases of invasive treatment in patients with this pathology. In 2017, inhemangioma was excised in 179 children, and in 2017, this method was used only in 28 patients. Since 2009 cryolysis of vascular neoplasms has not been performedcryolysis. Conservative treatment of hemangiomas include hormone therapy with prednisone as well as systemic and local treatment with beta-adrenergic blocking agents. At the same time, we showed that conservative treatment of hemangiomas is effective before surgery. That is confirmed by the clinical observation of the child with an extensive perineal hemangioma, who underwent the combined treatment using surgical cryodestruction and hormone therapy. This example shows that a good aesthetic result has been obtained only when using hormone therapy, while partial excision of hemangiomas resulted in a violation of the anatomy of the external genitalia, and cryodestruction resulted in an extensive hypertrophic scar on both buttocks. It is concluded that the reasons for the change in treatment tactics in children with hemangiomas are determined by the possibility of using non-invasive methods with obtaining the optimal result of treatment in both oncological and aesthetic terms

АНТИБИОТИКО-АССОЦИИРОВАННЫЕ ДИАРЕИ И CL. DIFFICILE-ИНФЕКЦИЯ У ДЕТЕЙ: ФАКТОРЫ РИСКА

The review of literature presents data on the incidence and characteristics of the current development of antibiotic-associated diarrhea (AAD) in children. Presented research materials of Russian and foreign scientists on risk factors activation toxigenic strains Cl. difficile, showed the relationship between the depth microecologi-cal metabolomical violations and Cl. difficile-infection in children.В обзоре литературы представлены данные о частоте развития и особенностях течения антибиотико-ассоциированных диарей (ААД) у детей. Изложены материалы исследований отечественных и зарубежных ученых о факторах риска активации токсигенных штаммов Cl. difficile, показана связь между глубиной микроэкологических метаболомных нарушений и Cl. difficile-инфекцией у детей

EXPERIENCE TREATMENT OF CHILDREN WITH POST-BURN SCAR CONTRACTURE OF THE NECK

Cicatricial deformations of the neck occur in 4-30.5 % of children suffered from burn trauma, and are the most severe consequences. Early reconstructive surgery in this pathology provides free growth and development of the skull and upper body and promote psychological and social recovery of the child. The treatment of such patients presents great difficulties, and in each case requires an individual approach. The article presents the experience of treatment of two children with severe scar contracture of the neck, complicated by the lack of reserves in undamaged tissues of the neck and the surrounding areas. We used a combination of several methods of skin grafting, including axial flow and the prefabrication of flaps, divided in time into stages. In one case in a child with total neck contracture, we performed pre-surgical (3.5 weeks before the main stage surgical intervention) preparation of the two flaps - scapular and epaulet flaps. In the other case, 4-year old girl with subtotal flexion contracture, a month before the main surgery we prepared scapular flap and increased its area expander dermotension, with endoscopic implantation of endoexpander. In this paper, we describe in detail the technology of operative treatment of these two patients. In both cases, there were no postoperative complications. The use of modern medical technologies based on conventional techniques in surgical correction of severe flexion scar contractures of the neck of the presented patients decided both functional and aesthetic problems

C. difficile-инфекция у новорожденных: решенные и нерешенные вопросы

The article presents an analytical review of the works of domestic and foreign authors on the problem of studying the peculiarities of the formation of the intestinal microbiota and risk factors for the development of microdysbiosis in newborns with the activation of opportunistic bacteria, including C. difficile. Special attention is paid to the effect of antibiotics on the state of the intestinal microbiota and the activation of toxigenic strains of C. difficile. Divergent views on the role of toxigenic strains of C. difficile in the development of infectious pathology of newborns are presented.В статье представлен аналитический обзор работ отечественных и зарубежных авторов по проблеме изучения особенностей формирования микробиоты кишечника и факторов риска развития микродисбиоза у новорожденных с активацией условно патогенных бактерий (УПБ), в том числе Clostridioides difficile. Особое внимание уделено влиянию антибиотиков на состояние микробиоты кишечника и активацию токсигенных штаммов C. difficile. Приведены разнонаправленные взгляды на роль токсигенных штаммов C. difficile в развитии инфекционной патологии новорожденных

СОВЕРШЕНСТВОВАНИЕ ТАКТИКИ БИОЦЕНОЗСБЕРЕГАЮЩЕЙ ТЕРАПИИ ПРИ ПРИМЕНЕНИИ АНТИБИОТИКОВ У ДЕТЕЙ С ОСТРЫМИ КИШЕЧНЫМИ ИНФЕКЦИЯМИ

50 children aged from 3 to 67 months with acute intestinal infections receiving antibiotic therapy, were clinically and microbiologically examined using gas-liquid chromatographic test with the measurement of short-chain fatty acids (SCFAs) in coprofiltrates. The influence on the biocenosis is assessed upon treatment with an-tidiarrhoeal medication Gelatin tannat (Adiarin), which acts by forming a protective film on the surface of intestinal mucosa preventing loss of body fluids and microbial toxins. 20 children in the control group received antibiotics, sorbents, probiotics. The study has proved the clinical effect of Gelatin tannat, resulting in reduction of time to normalization of diarrhea and intoxication for 2 days, and data on the probiotic effect of the drug, similar to that of probiotics in the control group which expands the indications for the use of Gelatin tannat for prevention of antibiotic-associated diarrhea.  Проведено клиническое и микробиологическое обследование с применением метода газожидкостной хроматографии (ГЖХ) с определением короткоцепочечных жирных кислот (КЖК) у 50 детей в возрасте от 3-х до 67 месяцев с ОКИ, получавших антибактериальную (АБ) терапию. Биоценозсохраняющая функция исследовалась на фоне применения противодиарейного средства Желатина танната (Адиарин), механизм действия которого основан на образовании на поверхности слизистой кишечника защитной пленки, препятствующей потери жидкости организмом и абсорбции микробных токсинов. В группе сравнения дети (20 пациентов) получали АБ, сорбенты, пробиотики. В результате исследования доказан клинический эффект Желатина танната, заключающийся в сокращении сроков нормализации стула и интоксикации на 2 дня, а также получены данные о пробиотическом эффекте препарата, аналогичном применению пробиотиков в группе сравнения, что расширяет показания к применению Желатина танната для профилактики антибиотикоассоциированных диарей. 

ANTIBIOTIC-ASSOCIATED DIARRHEA AND CL. DIFFICILE-INFECTION IN CHILDREN: RISK FACTORS

The review of literature presents data on the incidence and characteristics of the current development of antibiotic-associated diarrhea (AAD) in children. Presented research materials of Russian and foreign scientists on risk factors activation toxigenic strains Cl. difficile, showed the relationship between the depth microecologi-cal metabolomical violations and Cl. difficile-infection in children

АНТИБИОТИКО-АССОЦИИРОВАННЫЕ ДИАРЕИ И CL. DIFFICILE-ИНФЕКЦИЯ У ДЕТЕЙ: ФАКТОРЫ РИСКА

The review of literature presents data on the incidence and characteristics of the current development of antibiotic-associated diarrhea (AAD) in children. Presented research materials of Russian and foreign scientists on risk factors activation toxigenic strains Cl. difficile, showed the relationship between the depth microecologi-cal metabolomical violations and Cl. difficile-infection in children.В обзоре литературы представлены данные о частоте развития и особенностях течения антибиотико-ассоциированных диарей (ААД) у детей. Изложены материалы исследований отечественных и зарубежных ученых о факторах риска активации токсигенных штаммов Cl. difficile, показана связь между глубиной микроэкологических метаболомных нарушений и Cl. difficile-инфекцией у детей