Saratov JOURNAL of Medical and Scientific Research

children

Anatomic and functional disorders in children with flatfoot

Year: 2018, volume 14 Issue: №3 Pages: 396-401
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Sertakova.A.V., Dokhov M.M., Rubashkin S.A., Timaev M.Kh.
Organization:
Summary:

Aim: to analyze anatomic and functional changes in children with flatfoot. Material and Methods. We analyzed foot state in 40 children (34 boys and 6 girls, aged 5-14, mean age: 9.6±2.3 yrs), comparison group consisted of 30 healthy children aged 5-14 (mean age 8.5±2.5 yrs) without foot pathology. Patients were diagnosed on the basis of clinical examination: complaints, functional stress tests, QL questionnaire Oxford Ankle Foot, instrumental methods (X-ray, biomechanical investigation). Results. Right from early age (5 yrs) children start experiencing discomfort in feet in the course of various physical exercises, in our experiment 77% of patients have discomfort complaints. Mean indexes of OAFQ were 30.8±12.5. All children had signs of astragalus erection with respect to calcaneum which stipulates disturbance of longitudinal arch of foot joints and of normal function in talocalcaneal coalition. The disturbance of gait time indexes results in its decreased function. Conclusion. At present the problem of flatfoot in children did not get proper attention. The surgeons should focus on the features of pathology development in children 7-14 yrs applying all modern diagnostic methods.

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Anatomic and functional disorders in children with flatfoot

Year: 2018, volume 14 Issue: №3 Pages: 396-401
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Sertakova.A.V., Dokhov M.M., Rubashkin S.A., Timaev M.Kh.
Organization:
Summary:

Aim: to analyze anatomic and functional changes in children with flatfoot. Material and Methods. We analyzed foot state in 40 children (34 boys and 6 girls, aged 5-14, mean age: 9.6±2.3 yrs), comparison group consisted of 30 healthy children aged 5-14 (mean age 8.5±2.5 yrs) without foot pathology. Patients were diagnosed on the basis of clinical examination: complaints, functional stress tests, QL questionnaire Oxford Ankle Foot, instrumental methods (X-ray, biomechanical investigation). Results. Right from early age (5 yrs) children start experiencing discomfort in feet in the course of various physical exercises, in our experiment 77% of patients have discomfort complaints. Mean indexes of OAFQ were 30.8±12.5. All children had signs of astragalus erection with respect to calcaneum which stipulates disturbance of longitudinal arch of foot joints and of normal function in talocalcaneal coalition. The disturbance of gait time indexes results in its decreased function. Conclusion. At present the problem of flatfoot in children did not get proper attention. The surgeons should focus on the features of pathology development in children 7-14 yrs applying all modern diagnostic methods.

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Pediatric flatfoot: etiopathogenesis and diagnostics

Year: 2018, volume 14 Issue: №3 Pages: 389-395
Heading: Traumatology and Orthopedics Article type: Review
Authors: Zatravkina T.Yu., Rubashkin S.A., Dokhov M.M.
Organization:
Summary:

Longitudinal flatfoot is heterogeneous group of conditions, characterized by a decrease of longitudinal arch height. In mobile flatfoot, this decrease is dynamic, it occurs under vertical load and proceeds asymptomatically. Specialists should pay attention to the "pathological" flatfoot developing with pain syndrome or causing severe gait disturbance. The review analyzes the fundamental and current opinions of local and foreign researchers on the development of flatfoot in children. Literatural data of age dynamics of foot development, epidemiology of flatfoot in childhood, the influence of flatfoot on the foot and gait biomechanics and basic diagnostic methods are presented.

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Radiation methods for evaluating renal function in children

Year: 2018, volume 14 Issue: №3 Pages: 385-388
Heading: Radiology Article type: Review
Authors: Chekhonatskaya M.L., Averianov А.Р., Uts I.A., Velikanova M.G., Bobylev D.A., Chekhonatsky I.A.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Russian Medical Academy of Postgraduate Education, Moscow, Saratov State Medical University
Summary:

 An accurate assessment of renal function is critical for adequate dosing of medications. The most informative marker reflecting the functional state of the kidneys is glomerular filtration rate (GFR). Determination of inulin clearance is the most accurate way to assess GFR in children and adults. In this case, the method is invasive, cumbersome, younger children require the installation of a urinary catheter. Techniques for radioisotope estimation of GFR can solve this problem, but all widely used radioisotopes have the ability to bind slightly to plasma proteins, which leads to an underestimation of real values.

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On the clinical picture and diagnosis of rare neurological diseases

Year: 2018, volume 14 Issue: №1 Pages: 174-177
Heading: Neurology Article type: Case report
Authors: Ulyanova O.V., Kutashov V.A., Brezhneva N.V.
Organization: Regional Children's Clinical Hospital No. 1 (Voronezh), Voronezh State Medical Academy
Summary:

 The article presents clinical observation of patient H, 2007 year of birth., with X-linked adrenoleukodystrophy (X-ALD). This is a rare hereditary metabolic disease, not only in Russia but also worldwide. It belongs to the group of peroxisomal diseases, is associated with the accumulation of fatty acids with a very long chain and is characterized by a combined lesion of the nervous system and adrenal glands. X-ALD in neurology and Pediatrics require a targeted individual approach to each patient, genetic tests in relatives and prenatal diagnosis among patients at risk.

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Research on the level of thyroid-stimulating hormone and thyroid hormones in children with neuroinfections to evaluate the process of adaptation

Year: 2018, volume 14 Issue: №1 Pages: 65-69
Heading: Infectious Diseases Article type: Original article
Authors: Zakharova I.S., Malyugina T.N.
Organization: Saratov State Medical University
Summary:

The aim is to study the features of the adaptation process in children of different ages with acute neuroinfections depending on the etiology, severity of the disease and the period of the disease using indicators of the pituitary-thyroid system. Material and Methods. A comprehensive clinical and laboratorial checkup of 237 children with different noso-logical forms of neuroinfections was carried out: meningitis: viral, enteroviral, purulent and cerebromeningitis. Control board group was composed of 15 healthy children of the identical age. All the patients underwent the thyroid-stimulating hormone and thyroid hormones blood serum level, IFA technique being used, during acuity and reconvalesence. Re-sults. The neuroinfections status of the pituitary-thyroid system depends on the period and severity of the disease and does not depend on the etiology, age and sex of the child. Conclusion. According to the indices of the pituitary-thyroid system revealed that different adaptive responses develop in neuroinfections depending on the reactivity of child's organism and severity of the disease.

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The cytokine status and the levels of thyroid hormones in children with acute respiratory viral infections

Year: 2018, volume 14 Issue: №1 Pages: 61-65
Heading: Infectious Diseases Article type: Original article
Authors: Malinina N.V., Malyugina T.N.
Organization: Saratov State Medical University
Summary:

The research goal is to study the performance of INF-а, INF-y and IL-1(3 in children with acute respiratory viral infection (ARVI) depending on etiology, the presence of mixed infection, disease severity, presence of complications, the concentration of thyroid hormones. Material and Methods. Examined 147 patients aged from 1 to 10 years at the outbreak of the ARVI and 15 healthy children. Patients in the midst of acute respiratory infections was conducted to determine levels of IL-1(3, INF-а, INF-y, triiodothyronine (T3) and free thyroxine free (T4) by ELISA using standard test kits JSC "Vector-best" (Koltsovo, Novosibirsk region). Results. It was showed elevated level of INF-y in patients with PC-infection in comparison with the same indicator in healthy children. Set the increased level of INF-а in severe ARVI and the level of INF-y at medium severe form. It was showed increased levels of INF-y in patients with mixed infection. In children with complications, the level of IL-1 (3 was lower almost in 2.4 times, than in children without complications. Among patients with complications, the highest numbers of INF-а were detected in children with pneumonia and INF-y increased in patients with bronchitis. When conducting correlation analysis, the highest rates of INF-а were observed in children with the syndrome of "low T3", and INF-y in children as low T3 and low T4. Conclusion. An increase in the level of INF-y in patients with RS infection was found. Revealed that in children in acute period of SARS levels IL-1 IS, INF-а do not depend on the etiological factor of SARS. These indicators are influenced by the severity of the disease, which in our study was due to the development of mixed infection, the presence and nature of complications. High rates of INF-а and INF-y have significant inverse correlation with the level of T3, which reflects the degree of intoxication in the acute period of infectious diseases.

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Talipes equinovarus in children

Year: 2017, volume 13 Issue: №3 Pages: 514-520
Heading: Traumatology and Orthopedics Article type: Review
Authors: Timaev M.Kh., Sertakova A.V., Kurkin S.A., Rubashkin S.A., Anisimova E.A., Anisimov D.l.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

The research goal of the review is to present data on etiology, prevalence, classification of different types TEN/ in children. Mechanisms of pathological foot type, indications for conservative and surgical methods of treatment have been analyzed.

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Characteristics of cases with poor outcomes of rendering medical care to children in six regions of the Russian Federation

Year: 2017, volume 13 Issue: №1 Pages: 010-013
Heading: Forensic medicine Article type: Original article
Authors: Erofeev S.V., Kupryushin A.S., Efimov А.А., vishnyakova Zh.S., Semina M.N.
Organization: Bureau of Forensic Medical Examination of the Ivanovo Region, Ivanovo State Medical Academy, Penza State University, Saratov State Medical University
Summary:

Objective: to determine the characteristics of the outcome of the improper care for children, established during the commission of forensic examinations. Material and Methods. The material of this study was commission a forensic medical examination of the archives department of complex expertise of the Bureaus of Forensic Medicine of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia, conducted from 1996 to 2006. The method of this study was a statistical database processing using Excel software application package. Results. The article presents the results of the analysis of 279 forensic medical examinations conducted by committees in the Bureaus of Forensic Medical Examination of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia from 1996 to 2006. The examinations were conducted in connection with poor outcomes of rendering medical care to children. Conclusion. The number of conducted examinations correlates with the population of the region. The parents of the children affected by poor treatment mostly demand the medical staff to be prosecuted and more often make legal claims to the quality of emergency medical care; dissatisfaction with the quality of medical care is more often expressed by the parents of children under 3 years old. Legal claims are more often made against obstetricians-gynecologists, pediatricians, surgeons, infectious disease specialists and anesthesiologists-resuscitators. If the conclusion of the forensic medical examination committee on the nature of the pathological process coincides with the final clinical diagnosis, the provided medical care often turns out to be adequate; in cases of inadequate medical care the risks of moderate and grievous bodily harm as well as the patient's death are high.

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Clinical case of a Goldenhar syndrome diagnostics in a newborn boy

Year: 2016, volume 12 Issue: №3 Pages: 511-513
Heading: Dermatovenerology Article type: Case report
Authors: Slesarenko N.A., Eremina M.G., Belonogova Y.V., Roshepkin V.V., Eremin A.V.
Organization: Saratov State Medical University
Summary:

Relative importance of the current issue is based on rare occurrence of this dermatosis, its genetic predisposition and occurrence in early childhood. The Goldenhar syndrome diagnosing is a difficult task and causes difficulty in selecting treatment, due to large number of clinical syndromes presenting with facial deformities and the inability to quickly identify concomitant signs of damage to other organs and systems.

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