Parvovirus B19 infection B19 in the practice of a pediatrician: features of clinical manifestations and ways to solve the problem

Jaundice can be a clinical marker of congenital hepatitis, biliary atresia, genetically determined diseases. Lesions of the hepatobiliary system in newborns and children of the first year of life are often initiated by infectious risk factors. The relevance of the problem under study is due to the high frequency of the spread of congenital infections, costly technologies aimed at finding etiologically significant risk factors, and treatment. A full-fledged examination program, carried out in an extremely short time, allows detecting markers of active replication of TORCH-associated infections at an early stage of disease progression, and helps to offer patients a personalized treatment program. The author presents and describes the materials of his own observations of children with congenital hepatitis of parvovirus etiology, and the positive experience allowed him to file a patent for the invention “Method for the treatment of parvovirus infection B19 in young children.”Желтуха может быть клиническим маркёром врождённого гепатита, билиарной атрезии, генетически детерминированных заболеваний. Поражения гепатобилиарной системы у новорождённых и детей первого года жизни часто инициируются инфекционными факторами риска. Актуальность изучаемой проблемы обусловлена высокой частотой распространения врождённых инфекций, затратными технологиями, направленными на поиск этиологически значимых факторов риска, лечение. Полноценная программа обследования, проведённая в предельно короткие сроки, позволяет обнаружить маркёры активной репликации TORCH-ассоциированных инфекций на раннем этапе прогрессирования болезни, помогает предложить пациентам персонифицированную программу лечения. Автором представлены и описаны материалы собственных наблюдений за детьми с врождённым гепатитом парвовирусной этиологии, а положительный опыт позволил оформить патент на изобретение «Способ лечения парвовирусной инфекции В19 у детей раннего возраста»

Jaundices in the neonatal period. TORCH-infections role in prolonged course of jaundice in neonates and young children

The article gives a review of a topical problem in pediatrics: the differential diagnosis of jaundice syndrome in neonates and the role of infectious factors for the prolonged course of hyperbilirubinemias in young children. The incidence of prolonged jaundice is determined: 26.4% of neonates from the risk groups were born to the mothers with sexually transmitted diseases (STD) having abnormal course of pregnancy. 88.2% of the newborns with persistent hyperbilirubinemia show markers of active replication of TORCH-infections stimulants.Статья посвящена обзору актуальной проблемы в педиатрии: диффе-ренциальной диагностике синдрома желтухи у новорожденных и роли ин-фекционных факторов в пролонгированном течении гипербилирубинемий у детей раннего возраста. Определена частота встречаемости затяжных форм желтухи - у 26,4% новорожденных из групп риска от матерей, инфицированных заболеваниями, передаваемыми половым путём, и имеющих отягощенное течение беременности. У 88,2% детей с длительной гипербилирубинемией выявляются маркеры активной репликации возбудителей оппортунистических инфекций

Characteristics of hepatitis in children of first year of life

In order to find out early clinical and laboratory markers of liver damage in children of first year of life born in group of risk for perinatal infection 147 cases of hepatitis in infants were investigated. Viral hepatitis В and С was diagnosed in 47 children, markers of TORCH-infections were found in 100 patients with hepatitis. Hepatitis С predominated in children with viral hepatitis (27%), and CMV - in children with TORCH-infection associated hepatitis (55,5%). Prolonged jaundice, hyperbilirubinemia, cytolysis syndrome, the variety of clinical syndromes of developing liver damage, development of cirrhosis in the first year of life were typical clinical and laboratory markers of TORCH-associated hepatitis.Для оценки ранних клинико-лабораторных маркёров поражения печени у детей первого года жизни, рождённых в группе риска перинатального инфицирования, был проведён ретроспективный анализ историй болезни 147 детей с гепатитом. У 47 детей диагностирован вирусный гепатит В и С, у 100 больных гепатитом были выявлены маркёры TORCH-инфекций. В группе вирусных гепатитов доминирует HCV-инфекция (27%), при TORCH-ассоциированных гепатитах ведущая роль принадлежит вирусу CMV (55,5%). Клинико-лабораторными маркёрами дебюта гепатита при TORCH-ассоциированных заболеваниях являются затяжная желтуха, гипербилирубинемия и синдром цитолиза. Также характерно разнообразие клинических синдромов на фоне развивающегося поражения печени, неблагоприятный прогноз с формированием цирроза печени на первом году жизни

A Quantitative Theory of Mechanical Unfolding of a Homopolymer Globule

We propose the quantitative mean-field theory of mechanical unfolding of a globule formed by long flexible homopolymer chain collapsed in poor solvent and subjected to extensional deformation. We demonstrate that depending on the degree of polymerization and solvent quality (quantified by the Flory-Huggins $\chi$ parameter) the mechanical unfolding of the collapsed chain may either occur continuously (by passing a sequence of uniformly elongated configurations) or involves intra-molecular micro-phase coexistence of a collapsed and a stretched segment followed by an abrupt unraveling transition. The force-extension curves are obtained and quantitatively compared to our recent results of numerical self-consistent field (SCF) simulations. The phase diagrams for extended homopolymer chains in poor solvent comprising one- and two-phase regions are calculated for different chain length or/and solvent quality.Comment: 24 pages, 18 figure

ORGANIZATIONAL AND METHODICAL DIRECTIONS OF INTEGRATIVE PROGRAMS IMPLEMENTATION FOR ADOLESCENT CREATIVE DEVELOPMENT AND SOCIAL ADAPTATION

Purpose of the study: The purpose of the article is to substantiate the features of organizational and methodical directions of the programs’ complex for creative development and social adaptation of modern adolescents in difficult situations. Methodology: The study is based on the analysis of somatic and psychological changes taking place in the process of becoming a teenager, which are reflected in the biological, mental and cognitive processes. The identified components determined the grounds for the development of the structure and mechanisms of childhood social risk management. Results: It is shown that the understanding of somatic and psychological changes occurring in the process of a teenager formation, which is reflected in the biological, mental, cognitive processes, is the basis for the development of the structure and mechanisms for childhood social risks’ management in the course of an integrative program of any profile. Organizational aspects of preparation and carrying out of actions within such programs are defined. Provisions defining immanent social teaching and educational effects, including prevention of the deviant behavior, increase of educational results’ level, growth of teenagers’ cognitive interest to self-development and self-education, increase of teenagers’ motivation to active and initiative inclusion in development of the program content are allocated. The scientific-methodical and pedagogical experience of the organization of exit integrative programs, the use of pedagogical strategies of which allows achieving positive dynamics of teenagers’ creative development trajectory and social adaptation is briefly described. Applications of this study: Suggested by the author's program increases the growth of teenagers’ cognitive interest to self-development and self-education, increases the teenagers’ motivation and may be used by psychologists and teachers in educational system of all levels.   Novelty/Originality of this study: It is proved that the understanding of somatic, cognitive, social changes in the process of a teenager’s formation and compliance with certain organizational rules of activities that take into account the specifics of this age period, increase the motivation of adolescents, their involvement in the development of the program’s content, stimulate the growth of cognitive interest of adolescents to self-development and self-education

Experience in the use of docosahexaenoic acid (BrudiPlus) in patients with increased sperm DNA fragmentation index in Acad. V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology

Male factor is the reason of infertility in almost half of marriages. Infertile men have the percentage of sperm with violations of DNA integrity of over 30 %; with that, healthy fertile men have that indicator of less than 15 %. Understanding of importance of damages of sperm DNA is growing with distribution ofauxiliary reproductive technologies. As of today, these consequences have not been studies yet, and the therapeutic effect of intake of antioxidants has not direct correlation with the sperm DNA fragmentation level. Docosahexaenoic acid is one of the most valuable omega-3 polyunsaturated fatty acids for human health. Docosahexaenoic acid is the main component of the brain gray matter, retina, testes, and sperm cell membranes. In connection with that, a study was held the purpose of which was to assess the effect of the nutraceutical enzymatic docosahexaenoic acid triglyceride (BrudiPlus) in high concentrations on damaged sperm DNA of patients with idiopathic pathozoospermia. 40 patients with idiopathic pathozoospermia and the level of DNA fragmentation over the statutory value took part in this study. The following positive results were received: intake of BrudiPlus allowed decreasing sperm DNA damages and improving of antioxidant system of sperm

Experience of the implementation of the additional educational program «Palliative care in the pediatrics»

An analysis of the results of a survey of 45 pediatricians participating in a pilot project for the implementation of an additional educational program 'Palliative care in pediatrics' was conducted. As a result of the study, 80% of the practitioners indicated that the information they received about the palliative care system for children was first known to them, the additional program is timely and in demand by the pediatric community.Проведен анализ результатов анкетирования 45 врачей-педиатров, участвующих в реализации пилотного проекта по реализации дополнительной образовательной программы «Паллиативная помощь в педиатрии». В результате проведенного исследования 80% врачей практического звена указали на то, что полученная информация по системе оказания паллиативной помощи детям познается ими впервые, а проведение цикла своевременно и востребовано педиатрическим сообществом

On a snow cover composition in the vicinity of the Verkhnekamsky Salt Deposit

The snow cover chemical composition was investigated on the territory of the Verkhnekamskiy potash-magnesium salt deposit in the zone of influence of atmospheric emissions of Berezniki Potash Mining Complex (Perm Region). The object of researches was the snow in this area. Features of specific pollutants contained in the emissions of these mine groups and their relationship with the air intake and following atmospheric deposition were examined. With regard for specific character of pollutants in the emissions, studies of melt water included determination of the following chemical components – SO42-, Cl-, NO3-, NO2-, НCO3-, Ca2+, Mg2+, Na+, K+, of the pH value as well as suspended solid substances, and total mineralization. An analysis of snow composition was performed on two sites from which one was the surrounding background territory, while another area was the urban territory of city Berezniki, i.e. area of operating mine group. To assess the results the indicator of specific stock macro component was used. Increased specific stock relative to the background snowpack is clearly indicative of components directly related to the extraction and processing of salts Cl-, Na+, K+. The revealed anomalies have a local character and, as a rule, do not extend beyond boundaries of sanitary protection zones of the enterprises. Maps of distribution of values of the specific reserves for the analyzed list of components in the melt water were constructed. Our results obtained for the Verkhnekamskiy Deposit area were compared with similar published data on the territories of cities in the zone influenced by motor roads, reserves, and coastal zones of the Russian Arctic seas

Clinical and morphological features of lesions hepatobiliary system in infants

The purpose of the study. To study the features of jaundice in newborns with markers TORCH-infection, to assess the degree of morphological damage to the liver in infants with manifestations of neonatal hepatitis and cholestasis. Material and methods. The analysis of data from 110 children aged 1 to 12 months with persistent jaundice (control group) and 98 with physiological jaundice (control group). Exclusion criteria were hereditary genetic disease, sepsis, hemolytic disease, biliary atresia, congenital syphilis, perinatal contact, HIV infection, drug abstinence, infection of the urinary system, pyloric stenosis, intestinal obstruction, drug-induced hepatitis, parenteral nutrition. Markers TORCH-complex was determined by ELISA analysis, the test systems from Vector-Best, and polymerase chain reaction sets AmpliSens. Gepatobioptat studied 21 children aged from 1 to 5 months, held a survey in 2004-2006. In histological findings using semiquantitative assessment of activity by Knodell and fibrosis by Desmet. Results. Hyperbilirubinemia in infants with prolonged jaundice lasts from 31.6 to 101.7 days in the control group 5,3-12,7 days. Breastfeeding and vaccination of children against hepatitis В does not lead to a prolonged duration of jaundice. In 60,9% of children in comparison group developed hepatitis, p <0,0005. In 69,1 % of children identified markers TORCH-infection: CMV 48 (43,6%), herpes virus 8 (7,3%), Epstein-Barr virus 2 (1,8%), hepatitis С virus 6 (5,4 % ) and 3 (2,7%), toxoplasmosis 3 (2,7%), ureaplasmosis 6 (5,4%), chlamydia, 4 (3,6%), mycoplasmosis 5 (4,5%). Morphological violations described in the form of giant-cell (52,4%) and chronic hepatitis (33,3%). Intrahepatic biliary atresia-hypoplasia observed in 52.4% of children. When giant cell hepatitis inflammatory activity is higher than in chronic hepatitis, p <0,05. The histological features of intrahepatic cholestasis observed in 76,2% of patients with giant cell hepatitis cholestasis occurs significantly more frequently.Цель исследования. Изучить особенности течения желтухи у новорождённых с маркёрами TORCH-инфекции, оценить степень морфологических повреждений печени у детей первого года жизни, имеющих проявления неонатального гепатита и холестаза. Материал и методы. Проведён анализ данных у 110 детей от 1 до 12 месяцев с затяжной желтухой (группа сравнения) и 98 с физиологической желтухой (группа контроля). Критериями исключения стали наследственно-генетические заболевания, сепсис, гемолитическая болезнь, билиарная атрезия, врождённый сифилис, перинатальный контакт по ВИЧ-инфекции, наркотическая абстиненция, инфекция мочевой системы, стеноз привратника, кишечная непроходимость, лекарственно-индуцированный гепатит, парентеральное питание. Маркёры TORCH-комплекса определяли методом твёрдофазного иммуноферментного анализа, тест системы фирмы Вектор-Вест и полимеразной цепной реакции наборами АмплиСенс. Исследованы гепатобиоптаты 21 ребенка в возрасте от 1 до 5 месяцев, проходивших обследование в 2004-2006 гг. В гистологическом заключении использовали полуколичественную оценку степени активности по Knodell и фиброза по Desmet. Результаты. Гипербилирубинемия у детей с затяжной желтухой длится от 31,6 до 101,7 дней, в группе контроля 5,3-12,7 дня. Естественное вскармливание и вакцинация детей от гепатита В не приводят к затяжному течению желтухи. У 60,9% детей группы сравнения развивается гепатит, р<0,0005. У 69,1% детей выявляются маркёры TORCH-инфекции: цитомегаловирус 48 (43,6%), герпесвирус 8 (7,3%), вирус Эпштейн-Барр 2 (1,8%), вирусы гепатита С 6 (5,4%) и В 3 (2,7%), токсоплазмоз 3 (2,7%), уреаплазмоз 6 (5,4%), хламидиоз 4 (3,6%), микоплазмоз 5 (4,5%). Морфологические нарушения описаны в виде гигантоклеточного (52,4%) и хронического гепатита (33,3%). Внутрипечёночная билиарная атрезия-гипоплазия наблюдается у 52,4% детей. При гигантоклеточном гепатите воспалительная активность выше, чем при хроническом гепатите, р<0,05. Гистологические признаки внутрипечёночного холестаза отмечаются у 76,2% больных, при гигантоклеточном гепатите холестаз встречается достоверно чаще

A contemporary view of the problem of newly diagnosed chronic hepatitis in children

The article presents the results of a retrospective study of case histories of children with a first established diagnosis of chronic hepatitis. Based on the results of the study, we determined the etiological structure, clinical picture, and features of the epidemiology of chronic hepatitis.В статье представлены результаты ретроспективного исследования историй болезни детей с впервые установленным диагнозом хронического гепатита. По результатам обследования определена этиологическая структура и клиническая картина гепатитов, особенности эпидемиологи