15 research outputs found
Use of lactusan for the correction of microecological intestinal disturbances in children [Primenenie laktusana dlia korrektsii mikroΓ©kologicheskikh narushenii kishechnika u detei.]
The study demonstrated that lactusan (lactulose) could be used as an effective remedy in dysbacteriosis. Twenty four sick children aged 1 month to 15 years were examined. Administration of lactusan to 21 patients resulted in perceptible improvement of clinical symptoms, mainly to the cessation of diarrhea. In 14 children an increase in the population level of bifidobacteria and lactic acid bacteria and a decrease in the number of opportunistic microorganisms were observed. Lactulose should be referred to prebiotics
Use of lactusan for the correction of microecological intestinal disturbances in children [Primenenie laktusana dlia korrektsii mikroΓ©kologicheskikh narushenii kishechnika u detei.]
The study demonstrated that lactusan (lactulose) could be used as an effective remedy in dysbacteriosis. Twenty four sick children aged 1 month to 15 years were examined. Administration of lactusan to 21 patients resulted in perceptible improvement of clinical symptoms, mainly to the cessation of diarrhea. In 14 children an increase in the population level of bifidobacteria and lactic acid bacteria and a decrease in the number of opportunistic microorganisms were observed. Lactulose should be referred to prebiotics
Issues of diagnosing ROHHAD Syndrome in a 2-year-old girl : A Case Report and Review of Literature
We present a clinical case of ROHHAD syndrome. In this article we discuss the rare occurrence of this pathology and, as a result, the issues encountered in the diagnosis and treatment of such children. Thus, in highlighting the problem, the team of Authors set the goal of emphasizing the importance of timely diagnosis, as well as correctly selecting comprehensive treatment for children with ROHHAD syndrome
ΠΡΠ°ΠΊΡΠΈΠΊΡΠΌ ΠΏΠΎ ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΈΠΈ: ΡΡΠ΅Π±Π½ΠΎΠ΅ ΠΏΠΎΡΠΎΠ±ΠΈΠ΅ Π΄Π»Ρ ΡΡΡΠ΄Π΅Π½ΡΠΎΠ² 5-Π³ΠΎ ΠΊΡΡΡΠ°
Practicum in Pediatrics includes 132 clinical cases of diseases of newborns, infants and older children. In the cases, there are discharge reports from
the medical records of real patients with common diseases in pediatric practice (perinatal and neonatal diseases, deficiency conditions, anemia, as well as diseases of lungs, heart, joints, gastrointestinal tract, kidney and allergy). After discharge reports, there are questions and at the end of each section β diagnostic keys. The method of case studies refers to a non-gaming simulation methods of interactive learning and allows to apply theoretical knowledge to solve practical problems, trains making the right decisions in particular situations. Cases are designed to discuss them at classroom practice sessions, for self-study and for control of knowledge at the exam.
The manual is aimed at students, residents, graduate students, pediatricians.
Prepared by the Department of Pediatrics, Medical Faculty of Peoples' Friendship University of Russia
Issues of diagnosing of the rohhad syndrome in a 2-year-old girl
The article presents a clinical observation of ROHHAD syndrome. The importance of this description is due to the rare occurrence of this pathology and, as a result, the issues encountered in the diagnosis and treatment of such children. Thus, in highlighting the problem, the team of authors sets the goal of emphasizing the importance of timely diagnosis, as well as correctly selected comprehensive treatment for children with ROHHAD syndrome. Β© 2020, Pediatria Ltd. All rights reserved
ΠΠ΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½Π°Ρ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΡ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅Π²: ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΈ ΡΠ΅ΡΠΈΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ
Neuroendocrine hyperplasia of infancy (NEHI) is a rare disease of unknown etiology, which is observed in children of the first 2 years of life, characterized by persistent tachypnea syndrome and such nonspecific changes in lung biopsy as hyperplasia of bombesin-positive neuroendocrine cells of the peripheral respiratory tract. The article provides data on pathogenesis, clinical, morphological and image-diagnostics of this rare lung disease. It also presents data on observations of 26 patients with NEHI.ΠΠ΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½Π°Ρ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΡ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅Π² (ΠΠΠΠ) - ΡΠ΅Π΄ΠΊΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ Π½Π΅ΠΈΠ·Π²Π΅ΡΡΠ½ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, Π½Π°Π±Π»ΡΠ΄Π°ΡΡΠ΅Π΅ΡΡ Ρ Π΄Π΅ΡΠ΅ΠΉ ΠΏΠ΅ΡΠ²ΡΡ
2 Π»Π΅Ρ ΠΆΠΈΠ·Π½ΠΈ, Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠ΅Π΅ΡΡ Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΏΠ΅ΡΡΠΈΡΡΠΈΡΡΡΡΠ΅Π³ΠΎ ΡΠ°Ρ
ΠΈΠΏΠ½ΠΎΡ ΠΈ Π½Π΅ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΠΏΡΠΈ Π±ΠΈΠΎΠΏΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
Π² Π²ΠΈΠ΄Π΅ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠΈ Π±ΠΎΠΌΠ±Π΅Π·ΠΈΠ½-ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ. ΠΡΠΈΠ²Π΅Π΄Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π΅, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ, ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΈΠΌΠΈΠ΄ΠΆ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅Π΄ΠΊΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΡ
Π·Π° 26 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌΠΈ Ρ ΠΠΠΠ
Brainβlungβthyroid syndrome: Literature review and series of clinical observations
Brainβlungβthyroid syndrome (BLTS) is a rare genetic disease associated with mutations in the NKX2.1 gene encoding thyroid transcription factor 1. The most common manifestations of this syndrome are benign hereditary chorea, hypothyroidism and respiratory distress syndrome, however, mutations in the NKX2.1 gene can also cause other pathologies of nervous, respiratory systems and thyroid gland. The article describes 4 patients with mutations in the NKX2.1 gene observed by authors. Based on the analysis of the observations of 168 patients with BLTS presented in the world literature from 1998 to 2019, current information on the genetics, pathogenesis, clinical X-ray manifestations, outcomes and treatment of the syndrome are summarized. Β© 2019, Pediatria Ltd. All rights reserved
Π‘ΠΈΠ½Π΄ΡΠΎΠΌ "ΠΌΠΎΠ·Π³-Π»Π΅Π³ΠΊΠΈΠ΅-ΡΠΈΡΠΎΠ²ΠΈΠ΄Π½Π°Ρ ΠΆΠ΅Π»Π΅Π·Π°": ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΈ ΡΠ΅ΡΠΈΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ
Brain-lung-thyroid syndrome (BLTS) is a rare genetic disease associated with mutations in the NKX2.1 gene encoding thyroid transcription factor 1. The most common manifestations of this syndrome are benign hereditary chorea, hypothyroidism and respiratory distress syndrome, however, mutations in the NKX2.1 gene can also cause other pathologies of nervous, respiratory systems and thyroid gland. The article describes 4 patients with mutations in the NKX2.1 gene observed by authors. Based on the analysis of the observations of 168 patients with BLTS presented in the world literature from 1998 to 2019, current information on the genetics, pathogenesis, clinical X-ray manifestations, outcomes and treatment of the syndrome are summarized.Π‘ΠΈΠ½Π΄ΡΠΎΠΌ Β«ΠΌΠΎΠ·Π³-Π»Π΅Π³ΠΊΠΈΠ΅-ΡΠΈΡΠΎΠ²ΠΈΠ΄Π½Π°Ρ ΠΆΠ΅Π»Π΅Π·Π°Β» (Π‘ΠΠΠ©Π) - ΡΠ΅Π΄ΠΊΠΎΠ΅ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅, Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ Ρ ΠΌΡΡΠ°ΡΠΈΡΠΌΠΈ Π² Π³Π΅Π½Π΅ NKX2.1, ΠΊΠΎΠ΄ΠΈΡΡΡΡΠ΅ΠΌ ΡΠΈΡΠ΅ΠΎΠΈΠ΄Π½ΡΠΉ ΡΠ°ΠΊΡΠΎΡ ΡΡΠ°Π½ΡΠΊΡΠΈΠΏΡΠΈΠΈ-1. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌΠΈ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡΠΌΠΈ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΡΠ²Π»ΡΡΡΡΡ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½Π°Ρ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½Π°Ρ Ρ
ΠΎΡΠ΅Ρ, Π³ΠΈΠΏΠΎΡΠΈΡΠ΅ΠΎΠ· ΠΈ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠΉ Π΄ΠΈΡΡΡΠ΅ΡΡ-ΡΠΈΠ½Π΄ΡΠΎΠΌ, ΠΎΠ΄Π½Π°ΠΊΠΎ ΠΌΡΡΠ°ΡΠΈΠΈ Π² Π³Π΅Π½Π΅ NKX2.1 ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΈ Π΄ΡΡΠ³ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠΎ ΡΡΠΎΡΠΎΠ½Ρ Π½Π΅ΡΠ²Π½ΠΎΠΉ, Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌ ΠΈ ΡΠΈΡΠΎΠ²ΠΈΠ΄Π½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΠΎΠΏΠΈΡΠ°Π½ΠΈΠ΅ 4 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΌΡΡΠ°ΡΠΈΡΠΌΠΈ Π² Π³Π΅Π½Π΅ NKX2.1, Π½Π°Π±Π»ΡΠ΄Π°Π²ΡΠΈΡ
ΡΡ Π°Π²ΡΠΎΡΠ°ΠΌΠΈ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π°Π½Π°Π»ΠΈΠ·Π° Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ 168 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π‘ΠΠΠ©Π, ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΡΡ
Π² ΠΌΠΈΡΠΎΠ²ΠΎΠΉ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ Ρ 1998 ΠΏΠΎ 2019 Π³Π³., ΠΎΠ±ΠΎΠ±ΡΠ΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΡΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΎ Π³Π΅Π½Π΅ΡΠΈΠΊΠ΅, ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π΅, ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡΡ
, ΠΈΡΡ
ΠΎΠ΄Π°Ρ
ΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ°
ΠΠ΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½Π°Ρ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΡ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅Π²: ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΈ ΡΠ΅ΡΠΈΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ
Neuroendocrine hyperplasia of infancy (NEHI) is a rare disease of unknown etiology, which is observed in children of the first 2 years of life, characterized by persistent tachypnea syndrome and such nonspecific changes in lung biopsy as hyperplasia of bombesin-positive neuroendocrine cells of the peripheral respiratory tract. The article provides data on pathogenesis, clinical, morphological and image-diagnostics of this rare lung disease. It also presents data on observations of 26 patients with NEHI.ΠΠ΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½Π°Ρ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΡ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅Π² (ΠΠΠΠ) - ΡΠ΅Π΄ΠΊΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ Π½Π΅ΠΈΠ·Π²Π΅ΡΡΠ½ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, Π½Π°Π±Π»ΡΠ΄Π°ΡΡΠ΅Π΅ΡΡ Ρ Π΄Π΅ΡΠ΅ΠΉ ΠΏΠ΅ΡΠ²ΡΡ
2 Π»Π΅Ρ ΠΆΠΈΠ·Π½ΠΈ, Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠ΅Π΅ΡΡ Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΏΠ΅ΡΡΠΈΡΡΠΈΡΡΡΡΠ΅Π³ΠΎ ΡΠ°Ρ
ΠΈΠΏΠ½ΠΎΡ ΠΈ Π½Π΅ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΠΏΡΠΈ Π±ΠΈΠΎΠΏΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
Π² Π²ΠΈΠ΄Π΅ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠΈ Π±ΠΎΠΌΠ±Π΅Π·ΠΈΠ½-ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ. ΠΡΠΈΠ²Π΅Π΄Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π΅, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ, ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΈΠΌΠΈΠ΄ΠΆ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅Π΄ΠΊΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΡ
Π·Π° 26 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌΠΈ Ρ ΠΠΠΠ
Π§Π°ΡΡΠΎΡΠ°, ΡΠ°ΠΊΡΠΎΡΡ ΡΠΈΡΠΊΠ°, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ Π±ΡΠΎΠ½Ρ ΠΎΠ»Π΅Π³ΠΎΡΠ½ΠΎΠΉ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠ΅ΠΉ ΠΈ Π²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²
Bronchopulmonary dysplasia (BPD) and bronchial asthma (BA) are the most common chronic lung diseases in children, but the relationship between these diseases has not been fully defined. The incidence of atopic diseases (atopic dermatitis, allergic rhinitis, and BA) in children with BPD are significantly different according to national and international studies. There is not enough data on risk factors for the development, clinical and laboratory features of the course and treatment of BA in children with BPD. Material and methods. The case histories of 1104 patients (2004-2017) with BPD criteria were analyzed at the Department of Pediatrics at the RUDN University. On the basis of clinical and anamnestic data, allergological examination, and study of respiratory function, the frequency of asthma was determined. The comparative study was conducted in patients with isolated diseases - BPD (without BA) and BA (without BPD) - to determine the risk factors and characteristics of BA in children with BPD. Results and discussion. The frequency of BA was 7%, atopic dermatitis - 3.8% and allergic rhinitis - 3.6%. The risk factors for the development of BA in children with BPD were determined for low birth weight (LBW) (p=0.0037), late prematurity (p=0.0007), family history of allergy through asthma (p=0.0334), concomitant atopic dermatitis (p=0.0018) and allergic rhinitis (p=0.0022). Severe BPD (p=0.0002), episodes of bronchial obstruction in the first 3 years of life (p=0.0272). It was found that BA in children with BPD, compared with children without BPD is statistically significant. It characterized by an earlier onset (p=0.0168), a mild intermittent course (p=0.0003), a rarer need for inhaled bronchodilators (p=0.0034) and more frequent administration of inhaled corticosteroids as basic therapy (p=0.0399). Conclusion. We suggested that BA in children could be a respiratory consequence of BPD and a comorbid disease with a separate phenotype. The management of children suffering from BA and BPD should include the registration and evaluation of epidemiology, risk factors, clinical and laboratory features. It would be necessary to implement the clinical and allergological examination and the development of an individualized management program for patients.ΠΡΠΎΠ½Ρ
ΠΎΠ»Π΅Π³ΠΎΡΠ½Π°Ρ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΡ (ΠΠΠ) ΠΈ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½Π°Ρ Π°ΡΡΠΌΠ° (ΠΠ) ΡΠ²Π»ΡΡΡΡΡ ΡΠ°ΠΌΡΠΌΠΈ ΡΠ°ΡΡΡΠΌΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ Π»Π΅Π³ΠΊΠΈΡ
Ρ Π΄Π΅ΡΠ΅ΠΉ, ΠΎΠ΄Π½Π°ΠΊΠΎ ΡΠ²ΡΠ·Ρ ΠΌΠ΅ΠΆΠ΄Ρ Π΄Π°Π½Π½ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ Π΄ΠΎ ΠΊΠΎΠ½ΡΠ° Π½Π΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π°. Π§Π°ΡΡΠΎΡΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ (Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π΄Π΅ΡΠΌΠ°ΡΠΈΡΠ°, Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠ½ΠΈΡΠ° ΠΈ ΠΠ) Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΠΠ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΠΎΡΠ»ΠΈΡΠ°Π΅ΡΡΡ; ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΈ Π·Π°ΡΡΠ±Π΅ΠΆΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, Π½Π΅ΠΌΠ½ΠΎΠ³ΠΎΡΠΈΡΠ»Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΡΠ°ΠΊΡΠΎΡΠ°Ρ
ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ, ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΡ
ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΠΠ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠ»ΠΈ ΠΈΠ·ΡΡΠ΅Π½Ρ ΠΈΡΡΠΎΡΠΈΠΈ Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ ΠΈ ΠΠΠ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅, Π½Π°Π±Π»ΡΠ΄Π°Π²ΡΠΈΡ
ΡΡ Π½Π° ΠΊΠ°ΡΠ΅Π΄ΡΠ΅ ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΈΠΈ Π€ΠΠΠΠ£ ΠΠ Β«Π ΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ ΡΠ½ΠΈΠ²Π΅ΡΡΠΈΡΠ΅Ρ Π΄ΡΡΠΆΠ±Ρ Π½Π°ΡΠΎΠ΄ΠΎΠ²Β» (ΠΠΎΡΠΊΠ²Π°) Π½Π° Π±Π°Π·Π΅ ΠΊΠΎΠ½ΡΡΠ»ΡΡΠ°ΡΠΈΠ²Π½ΠΎ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡ Ρ Π΄Π½Π΅Π²Π½ΡΠΌ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠΎΠΌ ΠΠΠ£Π Β«ΠΠ΅ΡΡΠΊΠ°Ρ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½Π°Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»ΡΠ½ΠΈΡΠ° β 6Β» ΠΠ΅ΠΏΠ°ΡΡΠ°ΠΌΠ΅Π½ΡΠ° Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ Π³. ΠΠΎΡΠΊΠ²Ρ Ρ 2004 ΠΏΠΎ 2017 Π³. Π‘ΡΠ΅Π΄ΠΈ ΡΡΠΈΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π°Π½Π°ΠΌΠ½Π΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄Π°Π½Π½ΡΡ
, Π°Π»Π»Π΅ΡΠ³ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ½ΠΊΡΠΈΠΈ Π²Π½Π΅ΡΠ½Π΅Π³ΠΎ Π΄ΡΡ
Π°Π½ΠΈΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΡΠ°ΡΡΠΎΡΠ° ΠΠ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌΠΈ Ρ ΠΈΠ·ΠΎΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ: ΠΠΠ (Π±Π΅Π· ΠΠ) ΠΈ ΠΠ (Π±Π΅Π· ΠΠΠ) Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΠΈ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΠ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΠΠ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½ΠΎ 1104 ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΊΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΡΡΡΠΈΡ
ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΠΠΠ, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΡΠ°ΡΡΠΎΡΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Ρ Π½ΠΈΡ
Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ. Π§Π°ΡΡΠΎΡΠ° ΠΠ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 7%, Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π΄Π΅ΡΠΌΠ°ΡΠΈΡΠ° - 3,8%, Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠ½ΠΈΡΠ° - 3,6%. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ ΡΠ°ΠΊΡΠΎΡΡ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΠΠ: Π½ΠΈΠ·ΠΊΠ°Ρ ΠΌΠ°ΡΡΠ° ΡΠ΅Π»Π° ΠΏΡΠΈ ΡΠΎΠΆΠ΄Π΅Π½ΠΈΠΈ (Ρ=0,0037), ΠΏΠΎΠ·Π΄Π½ΡΡ Π½Π΅Π΄ΠΎΠ½ΠΎΡΠ΅Π½Π½ΠΎΡΡΡ (Ρ=0,0007), ΠΎΡΡΠ³ΠΎΡΠ΅Π½Π½ΡΠΉ ΡΠ΅ΠΌΠ΅ΠΉΠ½ΡΠΉ Π°Π»Π»Π΅ΡΠ³ΠΎΠ°Π½Π°ΠΌΠ½Π΅Π· ΠΏΠΎ ΠΠ (Ρ=0,0334), ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠΈΠ΅ Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΠΉ Π΄Π΅ΡΠΌΠ°ΡΠΈΡ (Ρ=0,0018) ΠΈ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΈΠ½ΠΈΡ (Ρ=0,0022), ΡΡΠΆΠ΅Π»Π°Ρ ΠΠΠ (Ρ=0,0002), ΡΠΏΠΈΠ·ΠΎΠ΄Ρ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠΈ Π² ΠΏΠ΅ΡΠ²ΡΠ΅ 3 Π³ΠΎΠ΄Π° ΠΆΠΈΠ·Π½ΠΈ (Ρ=0,0272). Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ ΠΠ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΠΠ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π΄Π΅ΡΡΠΌΠΈ Π±Π΅Π· Π΄Π°Π½Π½ΠΎΠ³ΠΎ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
Π½ΠΎΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ°ΡΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ Π±ΠΎΠ»Π΅Π΅ ΡΠ°Π½Π½ΠΈΠΌ Π½Π°ΡΠ°Π»ΠΎΠΌ (Ρ=0,0168), Π»Π΅Π³ΠΊΠΈΠΌ ΠΈΠ½ΡΠ΅ΡΠΌΠΈΡΡΠΈΡΡΡΡΠΈΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ (Ρ=0,0003), Π±ΠΎΠ»Π΅Π΅ ΡΠ΅Π΄ΠΊΠΎΠΉ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΡΡ Π² ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΡΡ
Π±ΡΠΎΠ½Ρ
ΠΎΠ»ΠΈΡΠΈΠΊΠ°Ρ
(Ρ=0,0034) ΠΈ Π±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΡΡ
Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ΠΎΠ² Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π±Π°Π·ΠΈΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Ρ=0,0399). ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ Ρ Π΄Π΅ΡΠ΅ΠΉ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠΌ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ΠΌ ΠΠΠ, ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ Ρ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΠΌ ΡΠ΅Π½ΠΎΡΠΈΠΏΠΎΠΌ. ΠΠΊΠ°Π·Π°Π½ΠΈΠ΅ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π΄Π΅ΡΡΠΌ, ΡΡΡΠ°Π΄Π°ΡΡΠΈΠΌ ΠΠ ΠΈ ΠΠΠ, Π΄ΠΎΠ»ΠΆΠ½ΠΎ ΠΏΡΠ΅Π΄ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡ ΡΡΠ΅Ρ ΠΈ ΠΎΡΠ΅Π½ΠΊΡ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ, ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ Ρ ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠ΅ΠΉ ΡΡΠ°ΠΏΠ½ΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ Π°Π»Π»Π΅ΡΠ³ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈ Π²ΡΡΠ°Π±ΠΎΡΠΊΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²