Meditsinskiy Sovet最新文献

{"title":"Features of combined mucoactive therapy for bronchopulmonary diseases in children in outpatient practice","authors":"I. M. Melnikova, Yu. L. Mizernitskiy","doi":"10.21518/ms2023-320","DOIUrl":"https://doi.org/10.21518/ms2023-320","url":null,"abstract":"In 2022, ARVI rates among the paediatric population were 72281.8 per 100,000, which is 6.2% higher than such rates in 2021 (68062.5 per 100,000; p < 0.05). Estimated influenza rates among the paediatric population were 165.8 per 100,000, which is 2.9 times higher than this rate in 2021. Impaired mucociliary clearance makes a significant contribution to the pathogenesis of acute and chronic bronchopulmonary diseases. Slowing of mucociliary clearance that results from chronic mucus hyperproduction leads to airway obstruction and infection, which acts as a cause of aggravation of the disease. There’s no question, the choice of a drug that can affect the secretory function of the mucous membrane or the bronchial mucous itself and its evacuation requires an individual approach to each patient. The article presents a detailed review of modern literature, as well as the authors’ own experience about cough therapy methods, including those used in broncho-obstructive syndrome. At the same time, the use of combination drugs that have a simultaneous effect on various pathogenetic mechanisms of respiratory diseases are justified more than ever before. Due to synergistic interactions of its components, the modern combination therapy, including a fixed-dose combination of salbutamol, bromhexine, guaifenesin (Bromhekomb), contributes to the productive treatment of acute bronchopulmonary diseases and exacerbations of chronic bronchopulmonary diseases accompanied by cough, mucostasis and events of mild bronchial obstruction, as well as ensures high compliance, including due to consideration of the syrup dosage form, which is especially important in outpatient paediatric practice","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"31 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135978393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaches to the treatment of bronchial asthma in children: leukotriene receptor antagonists","authors":"N. G. Kolosova, V. D. Denisova","doi":"10.21518/ms2023-375","DOIUrl":"https://doi.org/10.21518/ms2023-375","url":null,"abstract":"Asthma is a common heterogeneous disease, which often starts at a young age and has a reversible airway obstruction as its hallmark. Phenotypic differences in children with asthma may influence concomitant diseases and treatment choices. Despite the availability of effective drugs, asthma is poorly controlled in many children, which gives doctors the power to increasingly customize therapy from a personalized medicine perspective. The Global Initiative for Asthma (GINA) 2023 preserves and develops the agebased approach to diagnosis verification and therapy choice, which is supported in the All-Russia national program: Bronchial Asthma in Children and in the national clinical guidelines on bronchial asthma. Three age groups of patients were identified: zero to five years, six to eleven years and 12 years and older. Leukotriene receptor antagonists (in particular, montelukast) are often used in paediatric practice in children with asthma. The current guidelines show that leukotriene receptor antagonists (montelukast) are an alternative to inhaled glucocorticoids in mild, intermittent and persistent asthma. This is the first mediator-specific therapy for bronchial asthma. The best strategy in prescribing this group of drugs is to assess the severity of asthma, age and presence of concomitant diseases in children. The article uses clinical examples to discuss approaches to the asthma treatment with montelukast. The lack of asthma control tools results in high morbidity, mortality and costs of treatment, which justifies the search for new therapeutic options to improve control and reduce the risk of future exacerbations.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135978390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptomatic treatment of cough in children","authors":"N. A. Geppe, A. R. Denisova, V. D. Denisova, N. G. Kolosova, I. V. Grebeneva","doi":"10.21518/ms2023-325","DOIUrl":"https://doi.org/10.21518/ms2023-325","url":null,"abstract":"Cough is one of the most common symptoms in paediatric practice. Cough nature, duration, intensity, frequency, time and cause of occurrence should be considered in the differential diagnosis of its causes. Sputum evacuation disorders and changes in its rheological properties are indications for the prescription of mucoactive drugs. Despite the fact that the drugs included in this group have different mechanisms of action, all of them restore mucociliary clearance and lead to effective evacuation of secretions from the respiratory tract. Herbal medicinal products can be used along with classic mucoactive drugs (mucolytics, mucopegulators and mucokinetics). Ivy leaves are an example of a well-known and meticulously researched source of phytopharmaceutical products, they are included in the ESCOP monograph and entered into the positive list of the German Commission E. The efficacy and safety of ivy leaf products have been demonstrated in various controlled clinical studies. The authors presented a review of published clinical studies and non-interventional studies involving a total of 65,383 patients suffering from both acute and chronic respiratory diseases. The studies demonstrated the efficacy of ivy leaf extract preparations as achievement of a higher level of bronchodilation and surfactant production, which led to bronchospasmolytic, secretolytic, expectorant and, in turn, antitussive action. Herbal medicinal products are now actively used in the treatment of new coronavirus infection. Hedelix is one of the ivy leaf extract pharmaceutical preparations approved for use in children over the age of two years.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135978391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issues of interdisciplinary interaction during detection and diagnosis of tuberculosis in children and adolescents: a literature review and comments","authors":"E. S. Ovsyankina, L. V. Panova, I. N. Zakharova","doi":"10.21518/ms2023-262","DOIUrl":"https://doi.org/10.21518/ms2023-262","url":null,"abstract":"Interdisciplinary interaction between phthisiatricians and pediatricians on the issues of detection and diagnosis of tuberculosis provides basis for the reduction of duration of the diagnostic process and the early identification of disease progression. The purpose of this review and comments is to systematize the knowledge of pediatricians about the detection and diagnosis of tuberculosis in children and adolescents in primary health care (PHC) facilities to improve the diagnostic process. We have performed an analysis and systematization of the current directive and methodological documents, articles on the detection and diagnosis of tuberculosis in PHC facitlities. The significance of skin immunological tests (Mantoux test using 5 tuberculin units (TU) of purified protein derivative (PPD)-L and a test with recombinant tuberculosis allergen (RTA)) during mass and selective screening to form groups at high risk for Tuberculosis and detect the disease is emphasized. The doctor’s actions based on the current guiding documents and laws are presented for cases when parents/legal representatives or the patient himself refuses from immunological skin tests. Positions that determine the need for interdisciplinary interaction for pediatricians on the issues of detection, diagnosis and differential diagnosis of tuberculosis are clearly articulated. The pathway to diagnosis begins with the formation of groups at high risk for tuberculosis in PHC facilities and with seeking medical help from a pediatrician in the presence of clinical signs similar to those of tuberculosis. Particular attention is paid to the detection of the disease when patients with clinical symptoms similar to those of tuberculosis seek medical help, and the missed opportunities for its early diagnosis are presented. Predictors allowing pediatricians to suspect tuberculosis and promptly refer a patient to a phthisiatrician to confirm / exclude the disease are provided.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135978387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of acute respiratory viral infections in children with chronic exudative otitis media in the postoperative period","authors":"N. Е. Kuznetsova, I. M. Veshkurtseva, T. B. Kuznetsova","doi":"10.21518/ms2023-334","DOIUrl":"https://doi.org/10.21518/ms2023-334","url":null,"abstract":"Introduction. Chronic otitis media vis effusion (COME) is a disease characterized by the presence of exudate in the cavities of the middle ear and hearing loss. Predisposing factors to the development of COME can be recurrent upper respiratory tract infections. Aim. To study the effectiveness of the drug Sinupret® in children who have undergone surgical treatment for COME Materials and methods. A clinical study was conducted at the Department of Otorhinolaryngology of TMU and GBUZ TO OKB No. 2 in 2020–2021. This study involved 30 children (15 boys and 15 girls) with HESO. The mean age of all patients was 6.33 ± 0.31 years. In the 1st group of children, consisting of 15 people (10 boys and 5 girls), Sinupret® was prescribed in the postoperative period, in the 2nd group of children, consisting of 15 people (5 boys and 10 girls), Sinupret® was not prescribed. Diagnosis of chronic POE was carried out on the basis of clinical and instrumental examination and integral indices of peripheral blood. Conservative treatment consisted of topical decongestant therapy and rifamycin 2.6% ear drops for a week. The observation period included 12 months. Results. ARVI episodes during the year in group I were observed in 20%, in group II in 60% of children, the average duration of the disease in group I was 5 ± 0.71 days, in group II 7.8 ± 0.42 days (p = 0.01), stable hearing recovery in children of the 1st group was recorded in 100%. POE recurrence in children of group II was registered in 27% (4 people), which required repeated shunting to restore hearing. Conclusions. Prophylactic use of the drug Sinupret® in children who have undergone surgical treatment for chronic OME allows you to achieve a stable restoration of hearing and contributes to complete recovery.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"58 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal nursing care is essential! Breastfeeding: focus on maternal health","authors":"I. N. Zakharova, A. E. Kuchina, I. N. Kholodova, V. V. Pupykina","doi":"10.21518/ms2023-317","DOIUrl":"https://doi.org/10.21518/ms2023-317","url":null,"abstract":"This article deals with the importance and necessity of breastfeeding for both mother and baby. The timeliness of this topic has been brought about by technological advances, which imposes its own rules and offers alternatives in which it seems much easier to neglect the main maternal responsibility – the role of the breastfeeding mother. One gets the feeling that scientific research into breast milk is limited to finding evidence of the benefits of breastfeeding to convince novice mothers to breastfeed. The article mentions the evolutionary significance of breastfeeding, explains the reasons for the mammary glands “suffering” if the only “evolutionarily assigned” function for this female organ is not implemented, which makes us look at the need for natural breastfeeding from a different angle. Evidence of the need for breastfeeding to prevent the development of breast cancer that has high mortality rates in the female population is presented. At the same time, the issue of malignant tumours is not limited only to the mammary glands. The role of the breast milk microbiota disorders in the formation of the above processes is discussed. The preventive role of breastfeeding in the development of metabolic disorders, cardiovascular and endocrine diseases in women has been shown. The article presents data on this issue from numerous clinical studies, reviews and meta-analyses. The emphasis was placed on the prenatal discussions with pregnant women about the importance and necessity of breastfeeding, which should be carried out at the stage of preparing women for childbirth. The question has been raised about the role of the local paediatrician in the prenatal nursing care for women. It explains why “early” acquaintance with the mother is far from being an additional needless burden for the local paediatrician, as it might seem at first glance, but rather, on the contrary, additional opportunities.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"58 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mono- or multistrain probiotics? Comparative clinical study of different therapeutic strategies for infantile colic","authors":"V. P. Novikova, D. M. Magamedova, A. E. Blinov, O. N. Varlamova, A. E. Kondratieva","doi":"10.21518/ms2023-313","DOIUrl":"https://doi.org/10.21518/ms2023-313","url":null,"abstract":"Introduction. The highest level of evidence for the treatment of colic in breastfed infants is with L. reuteri monoprobiotic therapy. Recently multistrain probiotics have been used to treat colic. А im. Is to evaluate the effectiveness of various strategies for the treatment of infantile colic, including monoand multistrain probiotics. Materials and methods. A total of 110 infants aged 1–5 months with colic and 20 healthy infants were examined. The effectiveness of treatment was assessed in three groups of infants with colic: Group 1 consisting of 30 children who received BioGaia Probiotic drops for baby ( L. reuteri ); Group 2 consisting of 40 children who received Bac-Set Baby multistrain probiotic, and Group 3 consisting of 40 children who received symptomatic therapy. The estimated parameters included duration of crying, fecal levels of zonulin measured by ELISA assays, and gut microbiota composition. Results. Children with colic had longer crying duration compared to healthy children, higher levels of zonulin in the stool and differences in the microbiota. In group 2, colic relief occurred on average within 5 days, which is significantly faster than in groups 1 and 3 (10 and 12 days, respectively). In group 2, colic relief occurred in the majority of children (87.5%), the differences with groups 1 and 3 were statistically significant (53.3% and 10% of children, respectively). Also in group 2 there was a decrease in the level of zonulin by 41.4% from the initial level, in group 1 – by 40.1%, in group 3 – by 10.8%. Group 2 has also showed positive changes in the microbiota. Discussion. The results confirm the effectiveness of multistrain probiotics in the treatment of colic. Conclusions. Bac-Set Baby multistrain probiotic proved to be more effective than BioGaia Probiotic drops for baby monostrain probiotic and symptomatic therapy in the relief of infantile colic. The effect of Bac-Set Baby is associated with its ability to normalize the intestinal microbiota and reduce the permeability of the intestinal wall.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"58 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted reproductive technologies and the children’s heart","authors":"E. N. Pavlyukova, M. V. Kolosova, E. О. Alekseeva, R. S. Karpov","doi":"10.21518/ms2023-279","DOIUrl":"https://doi.org/10.21518/ms2023-279","url":null,"abstract":"The active use of assisted reproductive technologies has allowed us to achieve very impressive results, which allows us to consider this method as one of the effective approaches to infertility treatment. More than eight million children have been born worldwide with the help of assisted reproduction to date. At the same time, assisted reproductive technologies are an important risk factor, since long-term consequences for the morphology and function of the child’s heart can predispose to premature cardiovascular morbidity and mortality. These facts require a revision of traditional ideas about the long-term safety of their use, the formation of special registers. The creation of registers of the use of assisted reproductive technologies optimizes the process of long-term monitoring of children born with their use. The analysis of experimental and clinical studies presented in the review creates a theoretical basis for understanding the subtle mechanisms of the formation of postnatal health in children born prematurely and in the process of using inflammatory reproductive technologies. This review of the literature will allow doctors of various specialties (embryologists, reproductologists – obstetricians-gynecologists, neonatologists, pediatricians, therapists, cardiologists) and producers of culture media to significantly expand traditional ideas about the impact of assisted reproductive technologies on the health of the cardiovascular system in childhood, since even small changes in the conditions of cultivation and the composition of the culture medium for the embryo, the peculiarities of the course of pregnancy can have significant delayed effects on the health of children, born with the use of assisted reproductive technologies. Therefore, it is obvious the importance of monitoring children of this clinical group in order to further clarify possible long-term health consequences, a deeper understanding of the fundamental patterns of postnatal development and early diagnosis of subclinical disorders of the cardiovascular system.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"58 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to selecting mucoactive medications to treat cough in children","authors":"N. G. Kolosova, V. D. Denisova, D. A. Sazаnova","doi":"10.21518/ms2023-285","DOIUrl":"https://doi.org/10.21518/ms2023-285","url":null,"abstract":"Cough is the most common symptom of acute respiratory infections in children. Rational approaches to the therapy of cough should be based on the diagnosis and analysis of cough features. In accordance with sputum quality and quantity, a dry (unproductive, minimally productive) and wet (productive) cough is distinguished. The cough can be acute (up to 4 weeks), subacute, chronic, recurrent in duration. Cough assessment should involve considering the following characteristics: rhythm, timbre, nature, intensity, time of onset, duration, frequency, body position while coughing, impact of cough on the patient’s condition and sleep; presence of airway obstruction, etc. All presentations of cough can change during the development of the disease, which must be considered in the diagnosis and therapy. These characteristics of cough help the therapist select a rational therapy. Particular attention is paid to the therapy of wet cough, which is based on the stimulation of mucociliary clearance, restoration of the drainage function of the lungs; improvement of sputum elimination, thinning and removal of viscous bronchial secretion from the respiratory tract; prevention of mucostasis. The article discusses the pharmacokinetics and mechanism of action for Ambroxol in terms of its indications for OTC drug delivery, clinical data on the use of ambroxol in children. The primary mechanism of action for Ambroxol involves stimulation of surfactant synthesis, a complex mechanism that is not yet fully understood, but which provides Ambroxol with effective mucokinetic and secretion-stimulating properties, thus contributing to mucus clearance, which facilitates expectoration and productive cough.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular complications in the context of COVID-19: arrhythmias","authors":"A. S. Zmitrukevich, A. E. Mamedova, E. V. Reznik","doi":"10.21518/ms2023-309","DOIUrl":"https://doi.org/10.21518/ms2023-309","url":null,"abstract":"The COVID-19 pandemic has become a global crisis of unprecedented level for all mankind. The whole process of studying the disease (etiopathogenesis, diagnosis, treatment, prevention, prognosis) was not easy, because COVID-19 is a relatively new nosology that the world has never encountered. Cardiovascular complications in COVID-19 play an important role in the prognosis of morbidity and mortality. As the COVID-19 pandemic spreads, more and more patients with cardiac arrhythmias, arterial hypertension and other cardiovascular complications appear. This may be due to the impact of the SARS-CoV-2 virus on the respiratory, cardiovascular and other systems, as well as the development of inflammation. During the COVID-19 pandemic, there were more patients with arrhythmias. According to some data, the risk of arrhythmias in COVID-19 in hospitalized patients varies from 7.57% to 17.97%. The main causes of arrhythmia in the context of COVID-19 are hypoxia (acute respiratory distress syndrome, pulmonary embolism, the effect of SARS-CoV-2 on chemoreceptors), myocarditis (direct and indirect effects of SARS-CoV-2 on the myocardium), electrolyte imbalance, autonomic dysfunction, cardiotoxic drugs used in COVID-19. There can often be several reasons, and it is quite difficult to figure out which one has become the main one for each patient. This review focuses on the potential mechanisms for the development of cardiac arrhythmias in patients with COVID-19. Cardiologists, therapists and family medicine physicians should be aware of cardiovascular complications in the management of patients with COVID-19, and the prophylactic medical examination of the population.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135462097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}