Preview

Pacific Medical Journal

Advanced search
No 4 (2021)
View or download the full issue PDF (Russian)

REVIEWS

5-9 511
Abstract

The article presents historical information about the development of pediatrics and pediatric education in Primorsky Region. It started from the establishment of the pediatric faculty of the Vladivostok Medical Institute in 1969 to the present day. Main directions of scientific and pedagogical activities of pediatric profile departments are highlighted. The departments were reorganized in 2016 into the Institute of Pediatrics; departments of normal and pathological physiology, pathological anatomy, and foreign languages. The article also indicates those people who were at the origins of pediatrics and pediatric education in Primorye.

10-15 581
Abstract

Modern views about the various causes of the development of anaphylactic shock in children and adolescents, the classification of anaphylactic shock based on the pathophysiological mechanisms of the development are observed in the survey. The algorithm of the diagnosis of anaphylaxis and anaphylactic shock, the emergency assistance and further management of patients with anaphylactic shock, as well as the issues of its prevention are presented.

16-20 397
Abstract

The genetic status of a person is currently assigned a major role in the pathogenesis, diagnosis and treatment of various diseases. The most important genetic factors that have been attached great importance to are the genes of the glutathione-S-transferase family (GSTs). The genes of the glutathione-S-transferase family belong to the second phase of detoxification of xenobiotics and their altered activity leads to the development of many pathological conditions. GSTM, GSTT, GSTP are considered to be the most polymorphic. The issues of the participation of polymorphic GSTs in the development of infectious, allergic and oncological diseases, disorders of the reproductive system, as well as in the development of Alzheimer's disease are discussed in the article.

21-25 418
Abstract

Review of publications on the functional features of leptin in the central nervous system in children. The participation of leptin mechanisms in the transmission of nerve impulses, the effect of leptin on cognitive functions in children. The article reveals the general mechanisms of maturation of the central nervous system in children, the participation of leptin and leptin receptors in the formation of cognitive abilities in children. Possible interrelationships of impairments in cognitive development and lipid metabolism including obesity are revealed.

26-33 463
Abstract

Cellular-molecular mechanisms and factors, regulating uterus vascularization are also a focal point ensuring reproduction processes. In the process of angiogenesis endothelium expresses a number of receptors of growth factors and ligands which control main stages of the cellular makeup during vascular walls formation process. It in turn supports proliferation and reparation of the endometrium during menstrual cycle and prepares for the implantation and placentation.

LECTURES

34-40 419
Abstract

The article presents the literature review on anesthesiological support during gastroscopy and colonoscopy including evaluation of availability, effectiveness, safety and patient’s comfort of the used methods. Data on the number of endoscopic interventions in gastrointestinal tract performed under general anesthesia and controlled sedation in Vladivostok hospitals is provided. Low availability of anesthesiological support for these procedures in public hospitals is stated. Reasonability of widespread use of moderate analgosedation during gastroscopy and colonoscopy is demonstrated.

ORIGINAL RESEARCHES

41-45 376
Abstract

Objective: To study main clinical and laboratory peculiarities of the course of urinary tract disease among children aged from newborns to 3 years old.

Methods: Research design is a prospective controlled clinical research. 102 (60.71±3.77 %) children having urinary tract infection without accompanying abnormalities of the urinary system development were included in the first group. 66 (39.29±3.77 %) children having infection of the urinary tract amid congenital kidney defect.

Results: Comparative evaluation of the results of complex examination of both groups showed that urinary tract infection is characterized by intoxication, pain and dysuric syndroms. The presence of accompanying kidneys and urinary tract abnormality development defined the latent course of the disease in every second child (59.09%) and supports the early development of renal infection (during first six months after birth).

Conclusions: It’s necessary to conduct the search of diagnostics markers and predictors of the infection of the urinary tract among children of the first years of life, especially if there is an abnormality of the organs of urinary system.

46-49 336
Abstract

Objective: Study the effect of the Ala54Thr FABP gene polymorphism on the produce of the intestinal FABP fraction in blood serum. urine and coprofiltrate in children having food allergies.

Methods: The content of the FABP intestinal fraction in urine, feces, and blood serum was determined using ELISA method. The study of FABP genes polymorphism (G163A, Ala54Thr) was carried out using PCR method.

Results: Statistically significant increase of the FABP level in blood serum, urine and feces in children with FA was detected in various biological fluids. The distribution of FABP2 alleles and genotypes obeyed the Hardy-Weinberg law (χ 2 = 0; p = 1,000) and did not significantly differ from the distribution of genotypes in children having FA andin the control sample (p = 0.638).

Conclusions: The study did not reveal an association of the pathological genotype FABP G163A, (Ala54Thr) with the hyperproduction of the FABP intestinal fraction in children having FA, confirming the diagnostic significance of this marker increase during exacerbation of the disease.

50-55 385
Abstract

Objective: Epidemiological data analysis concerning the spread of brucellosis in Russia and Primorsky Region, study of the manifestations of the epidemic process and the current state of brucellosis issue.

Methods: Descriptive epidemiological analysis of materials on infectious morbidity based on state statistical reporting forms No. 1, No. 2 “Information on infectious and parasitic morbidity”.

Results: Brucellosis affects workers in the main occupational groups of livestock breeders, workers involved in the processing of livestock, who contact sick animals and other sources of brucellosis infection. Primorsky Region is a territory with an unstable epidemiological situation on brucellosis. A different morbidity rates were registered over the years. However usually it does not exceed the national average rate. In 2009, the morbidity rate counted 27.5% less than in Russian Federation (0.21 and 0.29 per 100,000 respectively), compared to previous years, the average long-term morbidity rate in the region increased by 3.5 times. The disease rate for the period from 2009 to 2019 ranged from 0.05 to 0.21%. In 2012, it exceeded the index in the Far Eastern Federal District (0.1 per 100,000 population). Brucellosis cases were detected among livestock breeders during an extraordinary medical examination due to the bad situation on brucellosis among animals.

Conclusions: In recent decades, the epizootic and epidemiological situation on brucellosis remains tense due to the decrease in the number of serological and bacteriological studies among animals and humans, the weakening of veterinary-sanitary control and the formation of new private farms.

56-61 389
Abstract

Objective: Conducting comparative analysis of the clinical and laboratory features of the course of community-acquired bacterial pneumonia and pneumonia in the presence of laboratory-confirmed coronavirus infection (COVID-19) in children in Krasnoyarsk.

Methods: A retrospective clinical and laboratory analysis of 68 medical histories of children having a laboratory-confirmed diagnosis of a new coronavirus infection (COVID-19) complicated by pneumonia (2020), as well as 52 medical histories of children having community-acquired bacterial pneumonia (2019) is presented.

Results: More than half of the cases fall on children older than 7 years. Boys prevailed in both groups. The majority of children in group 1 had a moderate form of COVID-19 course. Cough is the most common symptom in children having bacterial pneumonia. Children having COVID-19 pneumonia had symptoms that were not present in children of group 2: headache – in 19.1% of cases, myalgia – 7.4%, various dyspeptic disorders. In more than 80% of cases of bacterial pneumonia, there were percussion sound dullness and local decreased breath sounds, and more frequent detection of adverse respiratory noises. Changes in the peripheral blood in children with COVID-19 were non-specific.

Conclusions: Clinical course of pneumonia in the presence of laboratory-confirmed coronavirus infection (COVID-19) in children has its specific clinical features. The most common symptoms are headache, myalgia, dyspeptic disorders. Children with bacterial pneumonia were more likely to suffer from cough and a strongly marked intoxication syndrome.

62-64 493
Abstract

Objective: To introduce the analysis of the clinical picture, treatment strategy and complications among children having multiple foreign magnetic bodies (FB).

Methods: Retrospective analysis of the treatment of 796 children from 2013 to September 2021 having stomach and intestine FB. Comprehensive study included plan radiography of the abdomen, fiberoptic gastroduodenoscopy, etc.

Results: Magnets were detected in 33 (4.15%) out of 796 cases. 9 patients swallowed multiple foreign magnetic bodies (FB) within time interval. The parts fixed in different parts of gastrointestinal tract (GIT) and required surgical removal. All patients had multiple perforations of different GIT parts. It required suturing gut wall, bowel resection applying gastrointestinal anasto mosis and celiogrhaphy, resection applying anastomosis and by leaving the programmed laparostomy. Every patient recovered. Algorithm of supervision of children having FB GIT.

Conclusions: Multiple foreign magnetic bodies of GIT among children in the current moment are the most dangerous foreign objects accompanied with big amount of complications. They are observed among children of any age and gender and require complicated and long surgical interventions. Multiple foreign magnetic bodies of GIT can be suspected in case of severe surgical pathology along with the lack of passage of radiopaque FB in GIT. Urgent surgical intervention is required in case of detecting it.

65-69 1025
Abstract

Objective: Identification of perinatal risk factors as differential predictors of violent and non-violent crimes among children and adolescents who come under the attention of juvenile departments of the internal affairs bodies of the Russian Federation.

Methods: Study of the perinatal history data of 148 juvenile offenders of comparable age (13-16 years old), selected using continuous sampling method in the course of a clinical observational cohort retrospective study.

Results: Children from the control group in half of the cases were “late premature” (48%), with protein-energy malnutrition (frequency of occurrence of FGRP 56.8% BMI 56.1 ± 13.65). The beginning of their life was accompanied by a low score according to Apgar scale (6.9 ± 1.81). From the first minutes of life, they required urgent therapy in the delivery room (35.9%) and subsequent treatment at the ICU (25.7%) due to the damage of the respiratory system (asphyxia 11.5%, RDS 19.6%, episodes of apnea 16.2 %) and increasing dysfunction of the central nervous system (IVH II-IV grade 24.3%). Subsequently, they demonstrated a disruption of early neonatal adaptation and a clinical picture of the realization of intrauterine fetal developmental disorders, which arose both as a result of improper metabolism and of a prolonged oxygen starvation (adrenal hypoplasia 27.7%, cardiomyopathy 29.7%, hypoxia 48.6%).

Conclusions: The initial protein-energy deficiency revealed in the course of the study if accompanied by the course of both acute and chronic oxygen starvation could influence the formation of destructive behavior in the group of juvenile offenders.

70-79 324
Abstract

Objective: Study specific Igg4 antibodies to milk proteins indexes in healthy babies living in different Russian megalopolises.

Methods: The complex research of the specific Igg4 antibodies to milk proteins during cohort study of 259 healthy babies of the first year of life. Children lived in five Russian cities: 60 children in Moscow, 50 newborns – in Saint Petersburg, 55 children came from Kazan, 43 children lived in Khabarovsk and 51 – in Vladivostok. Non-competitive enzyme-linked immunosorbent assay was used to quantify specific Igg4 antibodies to cow milk proteins (CMP), beta-lactoglobulin (β-LG), alpha-lactalbumin (α-LA), casein and goat's milk protein (GM) in coprofiltrates

Results: The highest frequency of the high Igg4 was discovered to CMP and goats’ milk was observed among children from Saint Petersburg during comparative assessment of the frequency of defining Igg4 to milk proteins in healthy newborns aged 2.5 months living in Moscow and Saint-Petersburg. The highest frequency of Igg4 increased rates to milk proteins among newborns from Kazan, Khabarovsk and Vladivostok was diagnosed during first three months of life on breastfeeding without any clinical symptoms of food intolerance. With age decrease of the frequency of specific Igg4 to milk proteins were observed among all babies from above-mentioned cities. By 8 month of life it made isolated cases.

Conclusions: High frequency of increased Igg4 to milk proteins among 2 months old babies on breastfeeding was observed in the cities of Central and Far Eastern districts of Russian Federation. In this regard it can be supposed that Igg4s were got from mothers in the prenatal period and after birth through breastfeed. The presence of high frequency of the increased indexes of specific Igg4 to milk proteins probably was related to mothers’ nutrition habits during pregnancy and lactation periods.

80-84 451
Abstract

Objective: The analysis of clinical-laboratory peculiarities and the dynamics of glycemia clarifying the terms of blood glucose stabilization during the early neonatal period in children having risk factors of the development of such state.

Methods: Open, retrospective , continuous, single-center study was conducted. It was aimed at getting preliminary data that is important for planning further tactics of examining newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation).The target group of the survey included 522 newborns of both genders in the early neonatal period (from 0 to 7 days of life).

Results: There is data on the frequency of first indicated hypoglycemia in newborns having risk factors of the development of such state, clinicallaboratory peculiarities, the dynamics of glycemia during early neonatal period, and also the period of blood glucose stabilization (the age of reaching normoglycemia). Neonatal hypoglycemia was detected in 40.2% of examined children. Laboratory manifestation during the first day of life was noticed 62.9% of cases with the further normalization of glucose level in blood in 24 hours in 73.3% of newborns. Significant reduction of blood glucose was observed in 54.8% of cases requiring hypoglycemia therapy with parenteral prescription of 10% glucose solution. Hypoglycemia jugulated against oral correction of 5% glucoses solution in 40.5 % of cases. 4.8% of children got the level of glucose stabilized after introduction of supplementary feeding.

Conclusion: The results of the newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation) examinations are presented. The peculiarities of neonatal hypoglycemia are: the absence of a typical clinical symptoms among 89% of children. Asymptomatic course of hypoglycemia confirms the importance and necessity of glycemia monitoring in the early neonatal period in order to conduct timely and adequate therapy.

METHODS

85-91 673
Abstract

The article highlights one of the current issues of pediatrics - the study of the dynamics of Physical Development (PD) in children and adolescents. The numerous methods of assessment are used. The methods contain one-dimensional, two-dimensional and / or trimeric indicators. They do not fully give an idea of the level of the child's PD and do not reflect the patterns of his growth and development. In some cases, a pediatrician at the outpatient stage requires a comprehensive assessment of PD including age determination and compliance of biological age with the real age, determination of the PD harmony, somatotype determination, assessment of the direction of growth and development along with the calculation of indexes, functional state assessment, assessment of the degree of fat deposition or bioimpedance measurement, which allows determining the risk group. The assessment of PD indicators must be carried out according to regional tables.

92-94 360
Abstract

The software was designed to process and conduct comparative analysis of Big medical statistical data. This software is easy to use. It allows to conduct the analysis of medical statistical indexes in dynamics, gives a fair assessment of the time-series tendencies, helps to compare time-series of the studied indexes and presents graphic display of the information. The software can be used by health-care institutions, high education institutions, health-related scientific research organizations, physical culture organizations and institutions of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing of the Russian Federation.

PRACTICE OBSERVATIONS

95-97 493
Abstract

This clinical analysis is devoted to the case of exacerbation of ischemic heart disease in a 36-year-old man. A feature of this case is the combination of young age and obstructive coronary artery disease, as well as diagnostic search and analysis of the data obtained in the group of young patients.

98-100 409
Abstract

The article presents a clinical case of the diagnostics and treatment of the temporomandibular joint dysfunction (TMJ) in patient after orthodontic treatment. The hypertonia of masticatory muscles, limit of mouth opening and deviation of the jawbone to the right were observed during physical examination. Adhesion of the disk to the articular tubercle of the right temporal bone was detected on MRI. Hyperrotation of the articular head and the deviation of the jawbone to the right were observed on the charts during axiography. Disappearing of the feeling of heaviness in the right TMJ, free mouth opening, absence of deviation symptom, and the reduction of the rigidity of the masseter muscles were observed on the basis of diagnostic examinations after treatment. Presented clinical experience lets us make a conclusion that it is necessary to prescribe taking axiography and MRI during diagnosing and treating temporomandibular joint dysfunction.



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1609-1175 (Print)