IBUPROFEN AS A MEDICATION FOR A CORRECTION OF SYMPTOMS OF NORMAL VACCINAL PROCESS IN CHILDREN

The pathogenetic approach to treatment of symptoms of normal vaccinal process in children after standard vaccination, based on the results of application of anti9inflammatory medications — ibuprofen (nurofen for children) and paracetamol is presented in this article. Clinical activity of ibuprofen was established on the basis of clinica catamnestic observation of 856 vaccinated children aged from 3 months to 3 years. recommendations for application of these medications as a treatment for a correction of vaccinal reactions are given.Key words: children, ibuprofen, paracetamol, vaccination

Клинико-анамнестические критерии ранней диагностики герпетической экземы у детей с атопическим дерматитом

Rationale: Herpetic eczema (HE), being one of manifestations of generalized Herpes simplex virus (HSV) infection, presents mostly as a complication of atopic dermatitis (AD). This is a potentially life-threatening infection with mortality rates of up to 9%. Early diagnosis and timely beginning of antiviral treatment may help to avoid severe complications and mortality in children with HE.Aim: To evaluate factors predisposing to the development of HE in children with AD and to identify a high risk group.Materials and methods: One hundred and fifty (150) children with AD aged from 4 months to 18 years were recruited into this one-center prospective stratified observational study. The main group included 113 children with HE with underlying AD, while the comparison group comprised 37  children with AD exacerbations without HE. HSV infection was confirmed by determination of the viral DNA in blood by polymerase chain reaction. The severity of AD at study entry and during follow up was assessed with SCORAD scale.Results: All children with HE + AD (100%) had been in contact with individuals with clinical manifestations of HSV infection (35.1% in the comparison group, p < 0.001). The main predictors of HE in AD patients were as follows: age below 1 year (relative risk increase (RRI) 2.86, 95% confidence interval (CI) -7.91 / -0.68, p < 0.001), autumn and winter season (RRI 1.68, 95% CI -5.3 / -0.15, p = 0.018), moderate and severe AD (RRI 0.91, 95% CI -2.11 / -0.17, p < 0.002).Conclusion: A combination of 3 risk factors, such as age below 1 year, autumn and winter season, moderate and severe AD, puts a patient into a high risk of HE. Children from the risk group should be isolated from patients with manifest HSV infection.Актуальность. Герпетическая экзема (ГЭ), будучи проявлением генерализованной герпетической инфекции, вызванной вирусом простого герпеса (ВПГ), главным образом, осложняет течение атопического дерматита (АтД). Это потенциально опасная для жизни инфекция, смертность от которой достигает 9%. Ранняя диагностика и своевременно начатое противовирусное лечение позволяют избежать развития тяжелых осложнений и  смертельных исходов среди детей с  ГЭ.Цель  – провести изучение предрасполагающих факторов развития ГЭ у детей с АтД и определить группу высокого риска.Материал и  методы. В  одноцентровое проспективное стратифицированное обсервационное исследование включены 150 детей с АтД в возрасте от 4 месяцев до 18 лет. Основную группу составили 113 детей с ГЭ, развившейся на фоне АтД, группу сравнения – 37 детей с АтД в периоде обострения, не сочетавшимся с ГЭ. ВПГ-инфекция подтверждена определением ДНК вируса в  крови методом полимеразной цепной реакции. Степень тяжести АтД на момент осмотра и в динамике наблюдения оценивали по шкале SCORAD.Результаты. Все дети с  ГЭ при АтД (100%) контактировали с  людьми, имеющими клинические проявления ВПГ-инфекции (35,1% в группе сравнения, p < 0,001). Основными предикторами развития ГЭ у пациентов с АтД являются: возраст до 1 года (повышение относительного риска (ПОР) 2,86, 95% доверительный интервал (ДИ) -7,91 / -0,68, p < 0,001), осенне-зимний период года (ПОР 1,68, 95% ДИ -5,3 / -0,15, p = 0,018), среднетяжелая или тяжелая форма АтД (ПОР 0,91, 95% ДИ -2,11 / -0,17, p < 0,002).Заключение. Сочетание таких факторов риска, как возраст до 1 года, осенне-зимний период года, среднетяжелая и тяжелая формы АтД, позволяет отнести пациента к группе высокого риска по заболеванию ГЭ. Детям из группы риска показано разобщение с больными манифестной ВПГ-инфекцией

UP TO DATE APPROACHES TO IMPROVING IMMUNOBIOLOGICAL THERAPY OF VIRAL DIARRHEA OF CHILDREN

The article considers issues of therapeutic tactics for virus infections of children. The authors explain the essence of changes, which take place in the immune system of body under this pathology. The article describes immuno pathogenesis of acute enteric infections and the effect of lactoprobiotics on immuno-competent cells. The findings prove the advisability of applying this group of medications for a complex therapy of children with acute diarrhea disturbance.Key words: acute enteric infections, immuno-pathogenesis, treatment, lacto probiotics, children

UP TO DATE APPROACHES TO IMPROVING IMMUNOBIOLOGICAL THERAPY OF VIRAL DIARRHEA OF CHILDREN

The article considers issues of therapeutic tactics for virus infections of children. The authors explain the essence of changes, which take place in the immune system of body under this pathology. The article describes immuno pathogenesis of acute enteric infections and the effect of lactoprobiotics on immuno-competent cells. The findings prove the advisability of applying this group of medications for a complex therapy of children with acute diarrhea disturbance.Key words: acute enteric infections, immuno-pathogenesis, treatment, lacto probiotics, children

Клинико-анамнестические критерии ранней диагностики герпетической экземы у детей с атопическим дерматитом

Rationale: Herpetic eczema (HE), being one of manifestations of generalized Herpes simplex virus (HSV) infection, presents mostly as a complication of atopic dermatitis (AD). This is a potentially life-threatening infection with mortality rates of up to 9%. Early diagnosis and timely beginning of antiviral treatment may help to avoid severe complications and mortality in children with HE.Aim: To evaluate factors predisposing to the development of HE in children with AD and to identify a high risk group.Materials and methods: One hundred and fifty (150) children with AD aged from 4 months to 18 years were recruited into this one-center prospective stratified observational study. The main group included 113 children with HE with underlying AD, while the comparison group comprised 37  children with AD exacerbations without HE. HSV infection was confirmed by determination of the viral DNA in blood by polymerase chain reaction. The severity of AD at study entry and during follow up was assessed with SCORAD scale.Results: All children with HE + AD (100%) had been in contact with individuals with clinical manifestations of HSV infection (35.1% in the comparison group, p 0.001). The main predictors of HE in AD patients were as follows: age below 1 year (relative risk increase (RRI) 2.86, 95% confidence interval (CI) -7.91 / -0.68, p 0.001), autumn and winter season (RRI 1.68, 95% CI -5.3 / -0.15, p = 0.018), moderate and severe AD (RRI 0.91, 95% CI -2.11 / -0.17, p 0.002).Conclusion: A combination of 3 risk factors, such as age below 1 year, autumn and winter season, moderate and severe AD, puts a patient into a high risk of HE. Children from the risk group should be isolated from patients with manifest HSV infection.Актуальность. Герпетическая экзема (ГЭ), будучи проявлением генерализованной герпетической инфекции, вызванной вирусом простого герпеса (ВПГ), главным образом, осложняет течение атопического дерматита (АтД). Это потенциально опасная для жизни инфекция, смертность от которой достигает 9%. Ранняя диагностика и своевременно начатое противовирусное лечение позволяют избежать развития тяжелых осложнений и  смертельных исходов среди детей с  ГЭ.Цель  – провести изучение предрасполагающих факторов развития ГЭ у детей с АтД и определить группу высокого риска.Материал и  методы. В  одноцентровое проспективное стратифицированное обсервационное исследование включены 150 детей с АтД в возрасте от 4 месяцев до 18 лет. Основную группу составили 113 детей с ГЭ, развившейся на фоне АтД, группу сравнения – 37 детей с АтД в периоде обострения, не сочетавшимся с ГЭ. ВПГ-инфекция подтверждена определением ДНК вируса в  крови методом полимеразной цепной реакции. Степень тяжести АтД на момент осмотра и в динамике наблюдения оценивали по шкале SCORAD.Результаты. Все дети с  ГЭ при АтД (100%) контактировали с  людьми, имеющими клинические проявления ВПГ-инфекции (35,1% в группе сравнения, p 0,001). Основными предикторами развития ГЭ у пациентов с АтД являются: возраст до 1 года (повышение относительного риска (ПОР) 2,86, 95% доверительный интервал (ДИ) -7,91 / -0,68, p 0,001), осенне-зимний период года (ПОР 1,68, 95% ДИ -5,3 / -0,15, p = 0,018), среднетяжелая или тяжелая форма АтД (ПОР 0,91, 95% ДИ -2,11 / -0,17, p 0,002).Заключение. Сочетание таких факторов риска, как возраст до 1 года, осенне-зимний период года, среднетяжелая и тяжелая формы АтД, позволяет отнести пациента к группе высокого риска по заболеванию ГЭ. Детям из группы риска показано разобщение с больными манифестной ВПГ-инфекцией

Клинико-анамнестические критерии ранней диагностики герпетической экземы у детей с атопическим дерматитом

Rationale: Herpetic eczema (HE), being one of manifestations of generalized Herpes simplex virus (HSV) infection, presents mostly as a complication of atopic dermatitis (AD). This is a potentially life-threatening infection with mortality rates of up to 9%. Early diagnosis and timely beginning of antiviral treatment may help to avoid severe complications and mortality in children with HE.Aim: To evaluate factors predisposing to the development of HE in children with AD and to identify a high risk group.Materials and methods: One hundred and fifty (150) children with AD aged from 4 months to 18 years were recruited into this one-center prospective stratified observational study. The main group included 113 children with HE with underlying AD, while the comparison group comprised 37  children with AD exacerbations without HE. HSV infection was confirmed by determination of the viral DNA in blood by polymerase chain reaction. The severity of AD at study entry and during follow up was assessed with SCORAD scale.Results: All children with HE + AD (100%) had been in contact with individuals with clinical manifestations of HSV infection (35.1% in the comparison group, p < 0.001). The main predictors of HE in AD patients were as follows: age below 1 year (relative risk increase (RRI) 2.86, 95% confidence interval (CI) -7.91 / -0.68, p < 0.001), autumn and winter season (RRI 1.68, 95% CI -5.3 / -0.15, p = 0.018), moderate and severe AD (RRI 0.91, 95% CI -2.11 / -0.17, p < 0.002).Conclusion: A combination of 3 risk factors, such as age below 1 year, autumn and winter season, moderate and severe AD, puts a patient into a high risk of HE. Children from the risk group should be isolated from patients with manifest HSV infection.Актуальность. Герпетическая экзема (ГЭ), будучи проявлением генерализованной герпетической инфекции, вызванной вирусом простого герпеса (ВПГ), главным образом, осложняет течение атопического дерматита (АтД). Это потенциально опасная для жизни инфекция, смертность от которой достигает 9%. Ранняя диагностика и своевременно начатое противовирусное лечение позволяют избежать развития тяжелых осложнений и  смертельных исходов среди детей с  ГЭ.Цель  – провести изучение предрасполагающих факторов развития ГЭ у детей с АтД и определить группу высокого риска.Материал и  методы. В  одноцентровое проспективное стратифицированное обсервационное исследование включены 150 детей с АтД в возрасте от 4 месяцев до 18 лет. Основную группу составили 113 детей с ГЭ, развившейся на фоне АтД, группу сравнения – 37 детей с АтД в периоде обострения, не сочетавшимся с ГЭ. ВПГ-инфекция подтверждена определением ДНК вируса в  крови методом полимеразной цепной реакции. Степень тяжести АтД на момент осмотра и в динамике наблюдения оценивали по шкале SCORAD.Результаты. Все дети с  ГЭ при АтД (100%) контактировали с  людьми, имеющими клинические проявления ВПГ-инфекции (35,1% в группе сравнения, p < 0,001). Основными предикторами развития ГЭ у пациентов с АтД являются: возраст до 1 года (повышение относительного риска (ПОР) 2,86, 95% доверительный интервал (ДИ) -7,91 / -0,68, p < 0,001), осенне-зимний период года (ПОР 1,68, 95% ДИ -5,3 / -0,15, p = 0,018), среднетяжелая или тяжелая форма АтД (ПОР 0,91, 95% ДИ -2,11 / -0,17, p < 0,002).Заключение. Сочетание таких факторов риска, как возраст до 1 года, осенне-зимний период года, среднетяжелая и тяжелая формы АтД, позволяет отнести пациента к группе высокого риска по заболеванию ГЭ. Детям из группы риска показано разобщение с больными манифестной ВПГ-инфекцией

Tissue-resident natural killer cells: Features of functioning in the uterus and decidual membrane [Тканерезидентные натуральные киллеры: особенности функционирования в матке и децидуальной оболочке]

Natural killers are a heterogeneous population of innate immune lymphocytes, among which in recent years 2 categories of cells have been distinguished - circulating (cNK) and tissue-resident (trNK). The circulating pool of these cells is now fairly well characterized: these are cells of bone marrow origin with predominantly cytolytic activity, predominanly CD56dimCD16+ phenotype and a high level of perforin and granzymes expression. The tissue-resident pool has not yet been sufficiently studied, but a number of its features have been established: the ability to differentiate in tissues, the predominance of the CD56brightCD16- phenotype, the ability to produce high levels of certain regulatory cytokines (IFN-γ, TNFα, GM-CSF), the nature of the expression of receptors specific to class I histocompatibility molecules, etc. One of the most important features of trNKs is that their properties correspond to the specific organ where they are localized. This review is devoted to the characteristics of the natural killer cells of the uterus (uNK) and the decidual membrane (dNK) during pregnancy, the features of their origin, phenotype, cytokine production and the set of implemented functions. © 2021 Meditsina Publishers. All rights reserved

OPPORTUNITIES TO USE THE LACTOCONTAINING PROBIOTICS IN CHILDREN PRACTICES

The article characterizes the modern approach to the lacto containing probiotics application in the clinical practices. The authors clarify the mechanisms of the functional activity of the lacto bacteria, l. reuteri inclusive. It is recommended to use the lacto containing probiotics in the complex therapy for acute enteric infections, gastroenterological and allergic diseases, functional disorders of the gastrointestinal tract, secondary immunodeficiency states.Key words: probiotics, lacto bacteria, children, infectious and noninfectious diseases of the gastrointestinal tract, nutrition, immunity

Herpetic eczema in children with atopic dermatitis: Prognosis, clinical and immunological diagnostics and management tactics

Herpetic eczema (HE), being a manifestation of disseminated herpetic infection, mainly complicates the course of atopic dermatitis (AtD). This is a potentially life-threatening infection for children, the mortality of which, according to the literature, reaches 9%. Early diagnosis of HE helps to reduce the incidence of adverse outcomes and improve treatment quality for these patients. The goal is to improve the management tactics of children with herpetic eczema based on the patient-oriented algorithm for monitoring children with AtD risk groups, taking into account the predictors complex of disease development and severity. Material and methods: the single-center prospective observational study included 150 children aged from 4 months to 18 years with AtD. The main group consisted of 113 children with HE caused by AtD, the comparison group – 37 children with AtD in the exacerbation period not combined with HE. HSV infection is confirmed by determining the virus DNA in blood by the method of polymerase chain reaction. The diagnosis of AtD in children was verified according to the criteria proposed by J. Hanifin and G. Rajka. The severity of AtD at the time of inspection was assessed according to the SCORAD scale. Results: the main predictors of HE development in patients with AtD are: age up to 1 year (increase in relative risk (IRR) 2,86, 95% confidence interval (CI) 7,91/0,68, p<0,001), autumn-winter period (IRR 1,68, 95% CI 5,3/0,15, p=0,018), close relatives with combination of pollinosis and asthma (IRR 2,56, 95% CI – 9,95/–0,16, p<0,001), moderate or severe form of AtD (IRR 0,91, 95% CI – 2,11/–0,17, p<0,001). Laboratory immunological signs of HE developing risk in children with AtD include eosinophilia more than 3•109/l (p<0,001); an increased level of IL8 more than 2 times the norm value (p<0,001); prediction of a severe course of the disease — an increase in total IgE level to 850 kE/l (p<0,017) and an increase TNFα serum concentration above 2 pg/ml (p<0,001). Conclusion: the combination of at least 3 risk factors allows to classify a patient with AtD as a high risk group for HE development with recommendations for nonspecific prophylaxis, namely: separation from patients with manifest HSV infection. If a child has a high risk of HE adverse course, differentiated therapy is necessary, сonsidering the possible accession of a secondary infection and the exacerbation of AtD after HE regression. © 2019, Pediatria Ltd.. All rights reserved