Functional constipation in children

Constipation is one of the most common nosologies that a pediatric gastroenterologist deals with during outpatient visits. In the vast majority of children with constipation the problem is functional in nature. According to studies published in the Russian Federation, the frequency of constipation in children accounts for about 25–30%. The joint clinical guidelines of the European and North American Societies of Pediatric Gastroenterologists, Hepatologists and Nutritionists for the management of children with functional constipation were published in 2014. The national guidelines for the diagnosis and treatment of functional constipation are based on these guidelines. According to the clinical guidelines, the 2006 Rome III criteria should be used to establish the diagnosis of functional constipation in children. In May 2016, the Rome IV criteria that provide separate diagnostic criteria for infants and children under 4 years of age and children over 4 years and teenagers were adopted. A group of children with symptoms of constipation, who have already had toilet skills at the time of diagnosis, was identified among infants and children under 4 years of age. The presence of anxiety symptoms or refractory constipation (constipation that does not resolve within 3 months while taking adequate therapy) is considered an indication for use of additional examination methods, including instrumental ones. The manifestation of constipation is often associated with a change in eating habits - the period of introduction of complementary feeding in infants or the beginning of going to a day-care centre, inadequate fluid intake. The onset of constipation often coincides with the period of the development of hygiene skills (potty training). The voluntary stool retention by a child who is trying to avoid painful defecation experiences is the main mechanism for the development of constipation. The aim of functional constipation treatment is to soften the stools, which facilitates painless defecation and ensure that there is an urge to defecate. Clinical examples of the treatment of patients with functional constipation and chronic colonic stasis, functional constipation and encopresis are provided. The outcome of the treatment of functional constipation is to ensure painless defecation and the development of a stable defecation reflex. The drug therapy for functional constipation is based on the use of laxatives. Dietary advice and behavioral therapy also play an important role

Оценка качества жизни реципиентов органов по итогам проведения Первых Российских трансплантационных игр

Objective: to evaluate the role of physical activity (at sports games) in improving the quality of life of organ recipients.Materials and methods. We examined 42 adult lung, heart, kidney and liver recipients, and patients undergoing renal replacement therapy (mean age 42.6 ± 12.09 years) - participants of the First Russian Transplant Games. The results were analyzed. Quality of life of the recipients was assessed using the nonspecific SF-36 questionnaire.Results. After solid organ transplantation, the interviewed recipients answered that they try to lead an active lifestyle, to engage in accessible physical activities, and to participate in sports events intended for organ recipients. Assessment of the quality of life according to the SF-36 questionnaire showed that all the participants had high scores in terms of the physical and psychological component, which is associated with regular physical training and sports. Conclusion. Physical exercise and active participation in sports activities are an important component in the socialization and rehabilitation of organ recipients. These two factors also improve the psychological and physical components of the quality of life of the recipients.Цель: оценить роль физической активности (на спортивных играх) в повышении качества жизни людей после трансплантации органов.Материалы и методы. Анализированы результаты обследования 42 совершеннолетних реципиентов легких, сердца, почки и печени, а также пациентов, находящихся на заместительной почечной терапии (средний возраст - 42,6 ± 12,09 года) - участников Первых Российских трансплантационных игр. С помощью неспецифического опросника SF-36 было оценено качество жизни реципиентов.Результаты. После трансплантации солидных органов опрашиваемые пациенты ответили, что стараются вести активный образ жизни, заниматься доступными видами физической культуры, участвовать в проводимых спортивных мероприятиях для реципиентов органов. Оценка качества жизни по шкалам опросника SF-36 показала, что у всех участников отмечаются высокие показатели в шкалах физического и психологического компонента, что связано с регулярными занятиями физической культурой и спортом.Заключение. Показано, что физические упражнения и активное участие в спортивных мероприятиях являются важной составляющей в социализации и реабилитации реципиентов органов, а также позволяют улучшить их психологический и физический компоненты качества жизни

Characterization of Pathogenic Microflora Causing Suppurative Septic Postpartum Complications: a Retrospective Cohort Study

Background. Suppurative septic postpartum complications occupy a leading position in the structure of causes of maternal mortality. Information about the characteristics of pathogenic microflora in various forms of complications and analysis of its resistance to antibacterial drugs determine the choice of rational therapy for this pathology.Objectives — to characterize the isolated pathogenic microflora in obstetric patients with suppurative septic postpartum complications.Methods. A retrospective cohort study was conducted at the Department of Obstetrics and Gynecology No. 2 of the Omsk State Medical University and the Department of Gynecology of the Omsk Regional Clinical Hospital. The study included 123 cesarean section patients treated from January 2013 to December 2022 who were divided into three groups: Group A — uncomplicated course of postpartum endometritis, n = 55; Group B — complicated forms of postpartum endometritis, n = 48: B1 — local complications (suture failure following cesarean section; parametritis) n = 29; B2 — pelvic peritonitis, n = 19; Group C — septic complications following critical obstetric conditions, n = 20. The pathogenic microflora of uterine and abdominal cavities was examined; the extent of contamination with a pathogen and sensitivity to antibacterial drugs were determined. The isolated microorganisms were identified using a MicroTax bacteriological analyzer (Austria), Vitek2 Compact (France) and routine methods; a disk diffusion method was employed to determine the sensitivity of microorganisms to antibacterial drugs. Calculations were performed using licensed Microsoft Office Excel 2013 and Statistica 10 programs (StatSoft Inc., USA). Nonparametric nominal data were compared using Pearson’s chi-squared test with p-value determination.Results. The pathogenic microflora was dominated by S. epidermidis, E. faecalis, E. coli, and E. faecium. In 2018–2022, a statistically significant decrease was observed in the isolation rate of S. epidermidis (p = 0.016), E. faecalis (p < 0.001), and E. faecium (p = 0.05). The highest resistance was exhibited by bacteria to the following antibiotics: S. epidermidis — cephalosporins (30.16%); E. faecalis — fluoroquinolones (33.33%); E. coli — cephalosporins (65.91%) and β-lactamase-resistant penicillins (40.91%); E. faecium — aminopenicillins (64.10%) and fluoroquinolones (50.0%); А. baumannii — fluoroquinolones, cephalosporins, carbapenems (100%), and aminoglycosides (84.2%). A contamination assessment revealed a high titer of isolated microorganisms in 60.53% of cases. We found a statistically significantly higher isolation rate of S. еpidermidis (p < 0.001), E. faecium (p = 0.01), and A. baumannii (p = 0.02) in the setting of pelvic peritonitis as compared to uncomplicated endometritis. In the case of suppurative septic complications due to critical obstetric conditions, the isolation rate was higher for S. еpidermidis (p <0.001), E. coli (p = 0.04), E. faecium (p = 0.005), A. baumannii (р<0.001), and K. рneumoniae (p = 0.04).Conclusion. The antibiotic resistance of pathogenic microorganisms calls for the development of new organ system support technologies and the use of methods capable of sorbing microorganisms and their toxins in the area of inflammation

ДИАГНОСТИКА ОСТРОГО ФАРИНГИТА У ДЕТЕЙ

This literature review is dedicated to the issue of clinical and laboratory diagnosis of acute pharyngitis in children and adolescents. Relevance of the topic is justified by omnipresent (up to 70% of patients with acute pharyngitis) unreasonable prescription of antibacterial drugs. Differential diagnosis of acute pharyngitis is aimed at identifying patients with the infection induced by group A-hemolytic streptococcus requiring antimicrobial therapy. The article presents current recommendations on microbial diagnosis of streptococcal tonsillitis and a potential of using express tests for rapid diagnosis verification. Обзор литературы посвящен проблеме клинической и лабораторной диагностики острого фарингита у детей и подростков. Актуальность темы обусловлена повсеместным (до 70% пациентов с острым фарингитом) необоснованным назначением антибактериальных препаратов. Дифференциальная диагностика острого фарингита предполагает выявление больных с инфекцией, вызванной β-гемолитическим стрептококком группы А, которым требуется антимикробная терапия. В статье представлены современные рекомендации по микробиологической диагностике стрептококкового тонзиллита, раскрыты возможности применения экспресс-тестов для быстрой верификации диагноза.

Физическая реабилитация детей с трансплантированными органами

The paper analyzes the literature on physical rehabilitation in transplantology. The medical and social aspects of rehabilitation and peculiarities of physical rehabilitation in child organ recipients are reflected. A rise in the number of organ recipients, including children, is noted. The role of physical rehabilitation in increasing the body’s adaptive reserves at the pre- and postoperative stage and improving the quality of life is described.В статье представлен анализ литературы, посвященной физической реабилитации в трансплантологии. Отражены медико-социальные аспекты реабилитации и особенности физической реабилитации детей с трансплантированными органами. Отмечен рост количества реципиентов донорских органов, в том числе и детей. Изложена роль физической реабилитации в повышении адаптационных резервов организма на пред- и послеоперационном этапе, и улучшающемся качестве жизни

The genomes of two key bumblebee species with primitive eusocial organization

Background: The shift from solitary to social behavior is one of the major evolutionary transitions. Primitively eusocial bumblebees are uniquely placed to illuminate the evolution of highly eusocial insect societies. Bumblebees are also invaluable natural and agricultural pollinators, and there is widespread concern over recent population declines in some species. High-quality genomic data will inform key aspects of bumblebee biology, including susceptibility to implicated population viability threats. Results: We report the high quality draft genome sequences of Bombus terrestris and Bombus impatiens, two ecologically dominant bumblebees and widely utilized study species. Comparing these new genomes to those of the highly eusocial honeybee Apis mellifera and other Hymenoptera, we identify deeply conserved similarities, as well as novelties key to the biology of these organisms. Some honeybee genome features thought to underpin advanced eusociality are also present in bumblebees, indicating an earlier evolution in the bee lineage. Xenobiotic detoxification and immune genes are similarly depauperate in bumblebees and honeybees, and multiple categories of genes linked to social organization, including development and behavior, show high conservation. Key differences identified include a bias in bumblebee chemoreception towards gustation from olfaction, and striking differences in microRNAs, potentially responsible for gene regulation underlying social and other traits. Conclusions: These two bumblebee genomes provide a foundation for post-genomic research on these key pollinators and insect societies. Overall, gene repertoires suggest that the route to advanced eusociality in bees was mediated by many small changes in many genes and processes, and not by notable expansion or depauperation

The experience in the development and validation of method for testosterone measurement in blood serum of premenopausal women using HPLC-MS/MS

Testosterone assessment is essential for detecting biochemical hyperandrogenism, one of the important diagnostic criteria of polycystic ovary syndrome (PCOS) both in clinical practice and in epidemiological studies. Currently, tandem liquid chromatography-mass spectrometry (LC-MS/MS) is the most preferred technique to measure testosterone level in women. Its validation is important to reproducibility of androgen tests results for clinical practice and for epidemiological studies of the prevalence PCOS.The aim of the study. To develop and validate a method for determining total testosterone in blood serum using highly efficient LC-MS/MS to assess androgenemia in the epidemiological study of the prevalence of PCOS and its phenotypes in Eastern Siberia (ESPEP STUDY).Materials and methods. We determined a total testosterone level in serum blood using triple quadrupole mass spectrometer LCMS-8060 (Shimadzu, Japan). The protocol of technique was developed using self-prepared purified human testosteronefree serum with a known concentration of analyzed compound. We used the serum samples of women of reproductive age to test the developed method.Results. Optimum chromatographic conditions were obtained with a Kromasil 100-2.5-C18 column (2.1 mm × 100 mm; AkzoNobel, Netherlands), and an isocratic elution mode using a mobile phase consisting of acetonitrile and 0.1 % aqueous solution of formic acid. The total flow rate was 0.35 ml/min. The lower limit of quantification was 5 ng/dl with an average accuracy of 100.2 %. During the approbation of the method in a test population sample of 1138 premenopausal women (mean age – 34.3 ± 6.3 years), the median testosterone concentration was 26.9 ng/dl.Conclusion. It was found that the proposed method for determining testosterone in blood serum has acceptable linearity and reproducibility and meets the requirements for bioanalytical methods under the regulatory documentation. This method can be used for clinical practice and epidemiological study of the prevalence of PCOS

Measurements of π±\pi ^\pm , K±K^\pm , p and pˉ\bar{p} spectra in 7^7Be+9^9Be collisions at beam momenta from 19A to 150A GeV ⁣/ ⁣c{\mathrm{Ge} \mathrm{V}}\!/\!c with the NA61/SHINE spectrometer at the CERN SPS

The NA61/SHINE experiment at the CERN Super Proton Synchrotron (SPS) studies the onset of deconfinement in hadron matter by a scan of particle production in collisions of nuclei with various sizes at a set of energies covering the SPS energy range. This paper presents results on inclusive double-differential spectra, transverse momentum and rapidity distributions and mean multiplicities of π ± π± , K ± K± , p and p ¯ p¯ produced in the 20% most central 7 7 Be+ 9 9 Be collisions at beam momenta of 19A, 30A, 40A, 75A and 150A GeV/c GeV/c . The energy dependence of the K ± K± /π ± π± ratios as well as of inverse slope parameters of the K ± K± transverse mass distributions are close to those found in inelastic p+p reactions. The new results are compared to the world data on p+p and Pb+Pb collisions as well as to predictions of the Epos, Urqmd, Ampt, Phsd and Smash models

Measurements of π−\pi ^- production in 7^7Be + 9^9Be collisions at beam momenta from 19A to 150A GeV ⁣/ ⁣cA\,\text{ GeV }\!/\!c in the NA61/SHINE experiment at the CERN SPS

The NA61/SHINE experiment at the CERN Super Proton Synchrotron (SPS) studies the onset of deconfinement in hadron matter by a scan of particle production in collisions of nuclei with various sizes at a set of energies covering the SPS energy range. This paper presents results on inclusive double-differential spectra, transverse momentum and rapidity distributions and mean multiplicities of $\pi ^\pm$, $K^\pm$, p and $\bar{p}$ produced in the 20% most central$^7$Be+$^9$Be collisions at beam momenta of 19A, 30A, 40A, 75A and 150A ${\mathrm{Ge} \mathrm{V}}\!/\!c$. The energy dependence of the $K^\pm$/$\pi ^\pm$ ratios as well as of inverse slope parameters of the $K^\pm$ transverse mass distributions are close to those found in inelastic p+p reactions. The new results are compared to the world data on p+p and Pb+Pb collisions as well as to predictions of the Epos, Urqmd, Ampt, Phsd and Smash models