ЭФФЕКТИВНОСТЬ ПАЛИВИЗУМАБА В СНИЖЕНИИ ЧАСТОТЫ ГОСПИТАЛИЗАЦИИ ДЕТЕЙ С РСВ ИНФЕКЦИЕЙ В ГРУППАХ ВЫСОКОГО РИСКА: ПРОСПЕКТИВНОЕ НАБЛЮДАТЕЛЬНОЕ МНОГОЦЕНТРОВОЕ ИССЛЕДОВАНИЕ

Background: Palivizumab is indicated for the prevention of serious respiratory syncytial virus (RSV) disease in high-risk infants.Aims: The purpose of the study was to assess the real-world effectiveness and safety of palivizumab in children at high risk for serious RSV disease during the 2014−2015 RSV season in the Russian Federation.Methods: A prospective, observational, multicentre, cohort study was conducted in a population of infants at high-risk for serious RSV illness: infants born ≤35 weeks of gestation and infants ≤24 months with bronchopulmonary dysplasia (BDP) or congenital heart disease (CHD), who were administered palivizumab immunoprophylaxis in routine clinical settings. The study was conducted at 16 investigational sites of European Russia and Western Siberia.Results: A total of 359 infants were enrolled (180 boys and 179 girls). Of them, 148 (41.2%) infants had BDP, 45 (12.5%) infants had hemodynamically significant CHD, and 166 (46.2%) children of prematurity were at the risk of RSV. The majority of infants (86.9%) received three or more injections during the course of study. Of the 359 participants enrolled, 11 (3.1%; 95% CI 1.5−5.4) patients were hospitalized for lower respiratory tract infection. A RSV diagnostic test was performed in 9 infants, and RSV was detected in one patient giving an overall incidence of RSV hospitalization as 0.3% (95% CI 0.0−1.5).Conclusions: This study showed that immunoprophylaxis with palivizumab was associated with a low rate of RSV hospitalization. Overall, therapy with palivizumab was well-tolerated and showed a favourable benefit-risk profile.Обоснование. Паливизумаб предназначен для профилактики тяжелых форм респираторной синцитиальной вирусной (РСВ) инфекции у детей групп высокого риска.Цель исследования ― оценка эффективности и безопасности паливизумаба в повседневной клинической практике при применении у детей с высоким риском развития тяжелой РСВ инфекции в эпидемический сезон 2014−2015 гг. в Российской Федерации.Методы. Проведено проспективное наблюдательное многоцентровое когортное исследование с участием детей грудного и раннего детского возраста групп высокого риска по развитию тяжелой РСВ инфекции: дети с гестационным возрастом при рождении ≤35 нед; дети в возрасте ≤24 мес с бронхолегочной дисплазией (БЛД) или врожденным пороком сердца (ВПС), которым в рамках рутинной клинической практики была назначена иммунопрофилактика паливизумабом. Работа выполнена на базе 16 исследовательских центров, расположенных в европейской части России и Западной Сибири.Результаты. Всего в исследование были включены 359 (180 мальчиков и 179 девочек) детей раннего детского возраста, из них 148 (41,2%) имели БЛД, 45 (12,5%) ― гемодинамически значимый ВПС, 166 (46,2%) относились к группе высокого риска тяжелого течения РСВ инфекции по причине недоношенности. Большинство детей (86,9%) получили три и более инъекции препарата. Из 359 детей, включенных в исследование, были госпитализированы по причине развития инфекции нижних дыхательных путей 11 (3,1%; 95% ДИ 1,5–5,4). Диагностический тест на РСВ был выполнен у 9 детей, РСВ инфекция подтверждена у 1 ребенка. Таким образом, частота РСВ-ассоциированной госпитализации составила 0,3% (95% ДИ 0,0–1,5).Заключение. Исследование продемонстрировало низкую частоту РСВ-ассоциированной госпитализации при проведении иммунопрофилактики паливизумабом. Терапия препаратом хорошо переносилась и показала благоприятный профиль риск/польза

COVID-19 in children: The accumulated experience? [COVID-19 в детском возрасте: о чем говорит накопленный опыт?]

The article presents the main issues of COVID-19 in children, concerning the epidemiology, clinical course and risk groups. Despite the fact that COVID-19 affects children less often and it usually has a mild or asymptomatic course, there are severe and extremely severe courses especially in children and adolescents with certain risk factors (such as immunodeficiency, oncological diseases, obesity or other chronic diseases). The authors describe a clinical case of the severe course of COVID-19 in a 14-year-old teenager. © 2020 National Academy of Pediatric Science and Innovation. All rights reserved

Comparative Analysis of Mental Working Capacity in Different Age Groups

This paper describes the age-related features of mental working capacity, which were identified with the help of Landolt’s correction test. The test persons at the age of 18–19 (N = 12) and 30–31 (N = 25) years old demonstrated differences in information processing speed, efficiency, accuracy, and reliability. Special attention was paid to the influence of stressful situation on mental working capacity in the group of persons aged 18–19 years old when they were having exams. The exam stress mobilized such features of mental working capacity as information processing speed and efficiency. The conclusion was made that the number of persons with high information processing speed became lower after the age of 30 years old. At the same time, these persons were reliably more accurate and tolerant than those aged 18–19 years old

European Registry on the management of Helicobacter pylori infection: Features of diagnosis and treatment in Kazan

© 2020 Consilium Medikum. All rights reserved. Background. As part of an observational multicenter prospective study “European Registry on the management of Helicobacter pylori infection”, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. Materials and methods. The data of 437 patients included into the register by clinical sites in Kazan in 2013-2019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. Results. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. Conclusion. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesn't reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens

Clinical outcomes of hospitalization of premature infants (Gestational age 33–35 weeks) with lower respiratory tract infections, associated and not associated with the respiratory syncytial virus, in the poni international study

Study rationale: premature infants have a higher risk of developing severe lower respiratory tract infections (LRTI), compared with full-term children. Respiratory syncytial virus (RSV) is the most common cause of LRTI in preschool children, including children aged up to 1 year. Objective of the research – to determine the incidence, severity, course and outcome of hospitalizations caused by LRTI associated and not associated with RSV in preterm infants who had no immunoprophylaxis. Study materials and methods: a surveillance epidemiological study was conducted in 23 countries (Western Europe, Eastern Europe and Russia, Middle East, Mexico, Korea) from September 2013 to July 2014. The study included premature infants born from 33 weeks +0 days to 35 weeks +6 days of gestation, within 6 months before the start of RSV season. Data were obtained from medical records during a conversation/telephone contact with the parents. Results: of 2390 children included, 64 were hospitalized due to LRTI and had at least one positive RSV test result (RSV+ group), 100 – at least one negative RSV test result (RSV–). Results for RSV+ and RSV– groups were, respectively: the incidence of coughing was in 31,3 and 8%of children; hospitalization duration (median) 7 and 5,5 days; use of additional oxygen: 73,4 and 40% of children; hospitalization in the intensive care unit: 29,7 and 24%; artificial lung ventilation: 10,9 and 8% of children; its duration (median) 4 and 3 days. Conclusion: premature infants with RSV, in contrast to preterm infants without RSV, have more severe symptoms and signs of LRTI, more frequent use of supplemental oxygen and a tendency to more severe hospitalization course. © 2017, Pediatria Ltd. All rights reserved

Clinical outcomes of hospitalization of premature infants (Gestational age 33–35 weeks) with lower respiratory tract infections, associated and not associated with the respiratory syncytial virus, in the poni international study

Study rationale: premature infants have a higher risk of developing severe lower respiratory tract infections (LRTI), compared with full-term children. Respiratory syncytial virus (RSV) is the most common cause of LRTI in preschool children, including children aged up to 1 year. Objective of the research – to determine the incidence, severity, course and outcome of hospitalizations caused by LRTI associated and not associated with RSV in preterm infants who had no immunoprophylaxis. Study materials and methods: a surveillance epidemiological study was conducted in 23 countries (Western Europe, Eastern Europe and Russia, Middle East, Mexico, Korea) from September 2013 to July 2014. The study included premature infants born from 33 weeks +0 days to 35 weeks +6 days of gestation, within 6 months before the start of RSV season. Data were obtained from medical records during a conversation/telephone contact with the parents. Results: of 2390 children included, 64 were hospitalized due to LRTI and had at least one positive RSV test result (RSV+ group), 100 – at least one negative RSV test result (RSV–). Results for RSV+ and RSV– groups were, respectively: the incidence of coughing was in 31,3 and 8%of children; hospitalization duration (median) 7 and 5,5 days; use of additional oxygen: 73,4 and 40% of children; hospitalization in the intensive care unit: 29,7 and 24%; artificial lung ventilation: 10,9 and 8% of children; its duration (median) 4 and 3 days. Conclusion: premature infants with RSV, in contrast to preterm infants without RSV, have more severe symptoms and signs of LRTI, more frequent use of supplemental oxygen and a tendency to more severe hospitalization course. © 2017, Pediatria Ltd. All rights reserved

Palivizumab: Four seasons in Russia

In 2010, the Russian Federation (RF) registered palivizumab - innovative drug, based on monoclonal antibodies for passive immunization of seasonal respiratory syncytial virus (RSV) infection in children of disease severe progress risk group, which include primarily premature infants, children with bronchopulmonary dysplasia and hemodynamically significant congenital heart disease. Currently, palivizumab is included in the list of recommended medicines and medical care standards of different countries, including Russia. In the review the results of Russian research on the progress of RSV infection, its epidemiology and immunization experience gained over the 2010-2014 period are summarized in relation to the foreign data. During the four epidemic seasons palivizumab immunization covered more than 3,200 children of severe RSV infection risk group with a progressive annual increase in the number of patients who received the drug. Geography of palivizumab immunization is also greatly expanded in our country during this time. If during the first two seasons measures of immunization were taken mainly in Moscow and St. Petersburg, at the present time, thirty one territorial entities of the Russian Federation have the experience in the drug application. Analysis of the results of RSV infection immunization (made in several regions) confirms the high clinical efficacy and palivizumab safety already demonstrated in international studies. In addition, the analysis presents the potential to improve the efficiency of the integrated RSV infection immunization programs, realizing in the establishment of high-risk child group register, adequate counseling for parents, as well as the development of the routing of patients and coordination of interaction between different health institutions during the immunization. © 2014, Izdatel'stvo Meditsina. All rights reserved

Palivizumab: Four seasons in Russia

In 2010, the Russian Federation (RF) registered palivizumab - innovative drug, based on monoclonal antibodies for passive immunization of seasonal respiratory syncytial virus (RSV) infection in children of disease severe progress risk group, which include primarily premature infants, children with bronchopulmonary dysplasia and hemodynamically significant congenital heart disease. Currently, palivizumab is included in the list of recommended medicines and medical care standards of different countries, including Russia. In the review the results of Russian research on the progress of RSV infection, its epidemiology and immunization experience gained over the 2010-2014 period are summarized in relation to the foreign data. During the four epidemic seasons palivizumab immunization covered more than 3,200 children of severe RSV infection risk group with a progressive annual increase in the number of patients who received the drug. Geography of palivizumab immunization is also greatly expanded in our country during this time. If during the first two seasons measures of immunization were taken mainly in Moscow and St. Petersburg, at the present time, thirty one territorial entities of the Russian Federation have the experience in the drug application. Analysis of the results of RSV infection immunization (made in several regions) confirms the high clinical efficacy and palivizumab safety already demonstrated in international studies. In addition, the analysis presents the potential to improve the efficiency of the integrated RSV infection immunization programs, realizing in the establishment of high-risk child group register, adequate counseling for parents, as well as the development of the routing of patients and coordination of interaction between different health institutions during the immunization. © 2014, Izdatel'stvo Meditsina. All rights reserved