No 72 (2018)

Professor Valentina Panteleevna Sitnikova remains in our memory as a prominent scientist, pediatrician and nephrologist, who created a scientific school of pediatric nephrology at Voronezh State Medical University.

In the article kidney function parameters (blood creatinine level, glomerular filtration rate), and level of kidney injury molecules (KIM-1) in urine in cases of chronic kidney diseases of children with or without obesity were analyzed. It has been found out, that obese children with chronic kidney diseases have higher level of blood creatinine and lower glomerular filtration rate compared to non-obese children with chronic kidney diseases. In addition, obese children with chronic kidney diseases are at higher risk of exacerbation of pyelonephritis and have higher level of KIM-1 in urine.

Physical development and anamnesis of children's life with renal cysts (autosomal dominant polycystic kidney disease, multi-cystic dysplastic kidneys, single kidney cyst) were assessed at 1 stage of chronic kidney disease. It was found that the physical development of most children was not disturbed. Body mass deficiency in children with renal cysts was detected more often (body mass deficit, n=10; 16.4%) than body length deficiency (growth delay, n=3; 5.0%). The birth of children with multi-cystic dysplastic kidneys was preceded by a severe pregnancy.

The article presents a clinical case of an orphan disease of a child. Idiopathic fibrosing alveolitis is very rare in the population, it is almost not described in children. In this article, we provide our own observation of a child with a prognostically unfavorable bronchopulmonary pathology. Timely diagnosis and selection of correct treatment tactics may somewhat slow the progression of lung fibrosis and improve the quality of life.

Good pediatric asthma control can be achieved with early disease diagnostic and carrying out an adequate complex of organizational and medical measures. Monitoring of patients takes place in the regional children's pulmonology center by children pulmonologists. Individual choice of basic therapy methods and organization of educational program "Asthma school" for children and parents significantly improve disease control and patients quality of life.

In the recent decade there has been an increase of varicella zoster infection rate in Russia. In the Voronezh region the number of patients with varicella zoster infection has twiced. Among the patients in the hospital there has been a significant increase of newborns and pregnant women. Neonatal varicella zoster infection which develops between 5 days before the birth and 2 days after is the most dangerous one and can be lethal. Study of clinical pecularitie and course and complications of varicella zoster infection of 11 newborns treated in Regional Children Clinical Hospital №2 in Voronezh in 2013-2017 has been carried out. 8 patients suffered from acquired varicella zoster infection, 3- from congenital varicella zoster infection. Acquired varicella zoster infection was characterized by non-severe course with such complications as strepto- and staphilodermia. 1 child with congenital varicella zoster infection died. All children were treated with acyclovir intravenous. Injection of normal human immunoglobulin in the first 72 hours of disease prevented from the development of infection and lethal outcome.

The analysis of the taxonomic spectrum and antibiotic resistance of the causative agents of acute intestinal infections was conducted in children who were being treated for treatment at the CSTO VO "CSTO No.2" in 2014-2016. It is shown that in the structure of bacterial intestinal infections in children the first place is occupied by Esherichiosis 77%, salmonellosis is 19.5%, dysentery - 2.3%. In the etiologic structure of escherichiosis, enterotoxigenic E. coli 76% (ETCP) are leading, 4% of which have resistance to gentamicin; In 15% of cases, E. coli (E. coli) with more pronounced resistance to aminoglycosides are isolated, 4% are enteroinvasive (EIPP) and 5% enterohemorrhagic (EHEC), some of which have acquired resistance to ciprofloxacin and ceftazidine. In the etiologic structure of salmonellosis, the group D enteritidis dominates, in the last 5 years the salmonella of group B has doubled. In 2016, the resistance of group D salmonella to gentamicin has decreased from 100 to 35%, and to amikacin - up to 18%. Single cases of dysentery, mostly Sonnei, are registered, the causative agents of which remain sensitive to traditional antibacterial drugs.

A comparative analysis of the course of norovirus was conducted in 30 children that were sporadically hospitalized and 19 outbreaks of infection in a children's organized group. In all children, the diagnosis of norovirus caused by type 2 virus is confirmed by the PCR method. In sporadic disease, most children were under 5 years of age, with the outbreak of pain only children of school age. It has been detected that in children of early age the disease often begins acutely, with fever to subfebrile, less often febrile, diarrhea syndrome more pronounced and prolonged with the development of toxicosis with exsicosis, which was the reason for hospitalization. With the outbreak of infection, only moderate forms with prevalence of gastritis over enteritis were detected.

The article presents the results of the study of hemoglobin and erythrocyte indices among prematurely born children in the nursing department of newborns and prematurely born children #3 of the Perinatal Center of the VOKB#1, born at the gestational age of less than 37 weeks. The lowest indices of hemoglobin and erythrocyte were noted at the age of 40-43 days which should be taken into account during the further tactics of patients’ conduction.

The analysis of the composition of breast milk was carried out in 421 mothers of full and premature children, taking into account the gynecological and somatic status and age of women. The results obtained when analyzing the quantitative protein composition of breast milk of full-term children correspond to the proper average statistical indices. A reliable reduction in the quantitative protein content of breast milk in mothers of premature infants is associated with somatic and obstetric-gynecological pathology, leading to premature birth.

The article presents the experience of implementation of the health protecting program "Health" in the framework of experimental research project activities in the practice of Preschool Education of MBOUL " VUVK named after A. P. Kiseleva," the city of Voronezh. Timely detection of certain nosological forms with subsequent prevention of possible complications will contribute to the creation of optimal conditions for education and development of preschool children, taking into account their age individualities.

A narrative review of publications of the International CBME Collaborators has been conducted. The main characteristics of CBME, problems, current tasks and plans are defined. The information obtained can be used to improve the quality of medical education in Russia.