ТОНЗИЛЛИТЫ У ДЕТЕЙ: ВОПРОСЫ ПАТОГЕНЕЗА И ВОЗМОЖНОСТИ ФИТОТЕРАПИИ

Inflammation of palatine tonsils (acute and chronic tonsillitis) is a pressing issue of pediatrics. Several pathogenetic links of chronictonsillitis development have not been identified yet despite high prevalence of the disease. The article presents current data onformation of biofilms at chronic tonsillites and immunological peculiarities of the Pirogoff-Waldeyer’s tonsillar ring’s lymphoid tissue in children. Authors emphasize the fact that prescription of antibacterial therapy at inflammation of palatine tonsils must be clearly justified due to the risk of development of microflora resistance, as well as of disturbed natural balance of mouth cavity microbiota. Differential diagnosis of tonsillitis and rare Marshall syndrome is important for determining appropriate management tactics. The authors demonstrated effectiveness of using a complex phytopreparation for acute and chronic tonsillites in children. Воспаление небных миндалин (острый и хронический тонзиллит) ― актуальная проблема педиатрии. До настоящего времени не установлены некоторые звенья патогенеза формирования хронического тонзиллита, несмотря на высокую распространенность болезни. В статье представлены современные данные о формировании биопленок при хронических тонзиллитах, а также об иммунологических особенностях лимфоидной ткани кольца Пирогова−Вальдейера у детей. Авторы подчеркивают, что назначение антибактериальной терапии при воспалении небных миндалин должно быть четко обосновано в связи с возможным развитием резистентности микрофлоры, а также нарушением естественного баланса микробиоты полости рта. Для определения правильной тактики ведения немаловажным является дифференциальная диагностика тонзиллита и достаточно редко встречающегося синдрома Маршалла. Продемонстрирована эффективность использования комплексного фитопрепарата при острых и хронических тонзиллитах у детей.

ДЕТСКАЯ АСТМА: КЛЮЧЕВЫЕ ПРИНЦИПЫ ДОСТИЖЕНИЯ КОНТРОЛЯ НА СОВРЕМЕННОМ ЭТАПЕ

The article is dedicated to the issue of bronchial asthma in children. Immaturity of respiratory and immune systems, peculiarities of the disease course, difficulty in establishing diagnosis and selecting delivery devices for drugs and a limited amount of evidence-based recommendations determine the current situation: only few guides touch upon the subject of infant asthma management. Although asthma is the most widespread disease of lower respiratory tract in children, a significant number of patients do not receive adequate treatment, which is why they cannot control asthma. The authors of this article analyzed the most up-to-date documents (ICON, GINA, PRACTALL, NAEPP, SIGN) that touch upon this subject and briefly stated the key principles of attaining control over this nosology in order to increase availability, spread and introduction of standard therapy of infant asthma. Статья посвящена проблеме бронхиальной астмы у детей. Незрелость дыхательной и иммунной систем, особенности течения болезни, трудности при постановке диагноза и выборе средств доставки лекарственных средств, а также небольшое количество доказательных рекомендаций по лечению астмы у детей обусловливают тот факт, что немногие руководства касаются вопроса ведения детской астмы. Несмотря на то, что астма является наиболее распространенным хроническим заболеванием у детей, значительное количество пациентов не получают адекватного лечения, в связи с чем по-прежнему не могут контролировать свою болезнь. Авторами статьи в целях увеличения доступности, распространения и внедрения стандартной терапии детской астмы были проанализированы наиболее современные документы (ICON, GINA, PRACTALL, NAEPP, SIGN), касающиеся данного вопроса, и кратко изложены основные ключевые принципы достижения контроля над астмой

MEANS OF DRUG DELIVERY IN THE EVENT OF INHALATION THERAPY IN CHILDREN: SELECTION CRITERIA

Inhalation therapy as means of drug delivery is a key aspect of therapy of respiratory diseases in children, which plays an important role in achieving control over bronchial asthma. Optimal clinical effect requires comprehensive selection of inhalation devices given the drug’s peculiarities, the child’s age, severity of his/her condition, the patient’s cognitive potential and capabilities of his/her parents, as well as clinical recommendations on the corresponding diseases. It is rather important to observe individual approach and the patient’s preferences in order to ensure adherence to the recommendations. One of the crucial conditions of effective inhalation therapy is a clear explanation of the inhalation technique and device maintenance by the doctor, as well as regular medical control over observation of the given instructions by the patient and his/her parents. The article presents an algorithm of selecting means of inhalation drug delivery for use in children and the review of currently marketed inhalers, their advantages and drawbacks

COUGH PHYTOTHERAPY IN CHILDREN

Cough is one of the most widespread causes of outpatient pediatrician’s visits. There has been a notable increase in the use of phytogenic drugs recently, including treatment of respiratory infections in children. The article examines physiological and pathological effects of cough. Issues of phytotherapy efficiency and safety are covered. Data on the use of phytogenic drugs in the treatment of respiratory diseases are presented

Principles of Diagnosis and Therapy of Bronchial Asthma in Children at the Present Stage: GINA 2014–2015 Review Updates

Bronchial asthma is one of the most prevalent breathing illnesses. Today there is a sufficiently wide spectre of effective medicines with a good safety profile and an acceptable price. Despite this, a large number of patients receive inadequate treatment, which leads to a decrease in life quality, permanent bronchial obstruction and even death. In 2014 the Global Initiative for Asthma (GINA) significantly renewed its regularly issued Global Strategy for Asthma Management and Prevention. It includes relevant asthma information together with practical clinical recommendations. This article highlights the renovations published in the document in 2014 and 2015. The authors present modern approaches to child bronchial asthma diagnosis, including differential, together with the actualized treatment goals and principles. The criteria for evaluating the disease control and child asthma severity are also covered. The possible problems of achieving adequate control of the disease are also analyzed

Phytotherapy: Present State of the Issue

Phytotherapy is one of the oldest treatment methods. Studies and conclusions of the World Health Organization (WHO) Expert evidence of the trend towards greater demand for alternative treatments, including herbal medicine. The article presents such actual data on the issue under review as herbal preparations use at the present stage, frequency of and reasons for the use of medicinal plants in the world pediatric practice. There is a review of the WHO documents on quality assessment, harvesting, preparation and use of vegetable raw materials in the article. It also highlights the key provisions of the WHO strategy for ethnoscience in 2014–2023. There also is data on the properties of one of the plant-based drugs components and results of clinical trials of its effectiveness in children