Кафедре педиатрии Российской медицинской академии непрерывного профессионального образования — 85 лет: от прошлого к будущему

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Analysis of vitamin D availability of premature infants in the south of Russia

Introduction. Inadequate vitamin D supply worldwide is a public health problem. Low vitamin D levels during pregnancy can lead to abnormal placentation, placental insufficiency and abnormal fetal development, which contributes to poor health after birth.Objective of the study is to analyze the vitamin D status of premature infants born in the south of Russia.Materials and methods. A total of 141 premature infants were examined. Extremely low birth weight was found in 19 (13.4%) newborns, very low birth weight in 35 (24.8%), and low birth weight in 75 (53.2%).Results and discussion. Premature infants had vitamin D deficiency in the majority of cases (51%), with a median of 16.9 [11.7; 22.9] ng/mL. Correlation analysis demonstrated a positive association between 25(OH)D levels and body weight in very low birth weight infants (r = 0.34, p = 0.043). Serum vitamin D concentrations were 1.6 times lower in infants whose mothers did not receive multivitamins than in those whose mothers received multivitamins, 13.8 [9.7; 20.9] and 21.6 [16.9; 28.6] ng/mL, respectively (p = 0.001). Infants with an Apgar score of 7-10 had higher vitamin D levels, 17.8 [11.9; 22.7] ng/mL, than infants with severe asphyxia, 13.8 [9.9; 16.8] ng/mL (p = 0.036). Premature infants with congenital infection had lower 25(OH)D levels than infants without an infectious process, 15.6 [10.8; 22.9] and 18.4 [14.2; 22.7] ng/mL, respectively. Children with an infectious process that subsequently ended in death had lower 25(OH)D levels than children without an infectious process (p = 0.001). Children with cerebral ischemia had lower 25(OH)D concentrations than children without cerebral ischemia (p = 0.001).Conclusions. Premature infants born in the south of Russia have vitamin D deficiency in more than half of the cases. Administration of preparations containing cholecalciferol reduces the proportion of newborns with severe vitamin D deficiency, but does not ensure optimal serum levels. Initially low levels of 25(OH)D can be considered as an unfavorable prognostic sign against the background of the development of congenital infection

Профилактика и лечение железодефицитной анемии у детей первого года жизни

The article presents features of physiological processes and pathological conditions in under one-year children that predispose the development of iron-deficiency anemia. Basic methods of iron deficiency prophylaxis and principles of iron drug selection and dose selection for iron-deficiency anemia treatment for children in the stated age category are described in the article. Particular attention is paid to the prevention and treatment of iron deficiency anemia in preterm infants; foreign and domestic recommendations on this issue are presented. A practicing pediatrician needs to know the features of the disease’s development and treatment caused by differences in physical conditions accompanied by a high activity of metabolic processes and the immaturity of the young patients’ anatomic structures in order to identifiy and select the right iron-deficiency anemia treatment strategy.В статье представлены особенности физиологических процессов и патологических состояний у детей первого года жизни, предрасполагающих к развитию железодефицитной анемии (ЖДА). Описаны основные способы профилактики железодефицитных состояний, а также принципы выбора препарата железа и его дозы для лечения ЖДА у детей указанной возрастной категории. Особое внимание уделено профилактике и лечению ЖДА у недоношенных детей, представлены зарубежные и отечественные рекомендации по данному вопросу. Практикующему педиатру для своевременного выявления и выбора правильной тактики лечения ЖДА у детей первых 12 мес жизни необходимы знания об особенностях развития и лечения патологии, обусловленных отличиями физиологического состояния на фоне высокой интенсивности обменных процессов и незрелости анатомических структур у маленьких пациентов

The Idea of a Visual Sacred Scripture in the Works of Patriarch Germanos I of Constantinople

This article explores the early stage of theological disputes regarding the presence of icons in the church, in which Patriarch Germanos I of Constantinople took a direct and active part. The author discusses several particularities of these disputes and by referring to the patriarch’s use of the idea of a visual Sacred Scripture demonstrates that already at the very beginning of the seventh century, the hierarch already opposed the iconoclasts with a complete and well prepared theology of icon

New COVID-19 coronavirus infection in the practice of a neonatologist and pediatrician [Новая коронавирусная инфекция COVID-19 в практике неонатолога и педиатра]

The article analyses the data published from January 2020 to April 25, 2020 in the print media or available on the official websites of peer-reviewed medical sources (pre print), international and national medical professional communities, and state regulatory authorities dedicated to the epidemiological and clinical laboratory features of the new coronavirus infection in newborns, infants and older children. The authors have concluded that currently there are no convincing data on vertical transmission of infection. At the same time, they have found that there is a risk of horizontal infection of a newborn child; therefore, there is the need for strict adherence to the recommended algorithms for monitoring children in the neonatal period born by the women with positive or presumably positive COVID-19 (Coronavirus disease 2019) status. The authors note that due to the limited quantity of observation cases, all existing recommendations are temporary and may be revised. The newborns from mothers with COVID-19 demonstrate the variability of clinical picture from asymptomatic course to severe respiratory failure. In the post-neonatal period children have asymptomatic or mild course of a new coronavirus infection. The authors note that some children with an asymptomatic course of the disease have pneumonia detectable during X-ray examination. Children with the manifest forms of COVID-19 do not have specific clinical symptoms; both children and adults have fever, cough and other catarrhal symptoms; tachypia, tachycardia and gastrointestinal symptoms are much less common. It has been found that children with COVID-19, unlike adults, are unlikely to develop severe pneumonia, as well as conditions requiring intensive care and mechanical ventilation. Changes in laboratory parameters in children also do not have a consistent pattern and they are less pronounced than in adults. The epidemiological data indicate that children are one of the main sources of the ongoing spread of infection in the human population. The authors present the first-ever data on the cases of 45 infants born from the mothers with positive COVID-19 status in Moscow. © 2020 National Academy of Pediatric Science and Innovation. All rights reserved