Saratov JOURNAL of Medical and Scientific Research

children

Cortisol level as a marker of adaptation processes in children with acute respiratory viral infections

Year: 2018, volume 14 Issue: №4 Pages: 646-650
Heading: Infectious Diseases Article type: Original article
Authors: Malyugina T.N., Malinina N.V., Averianov А.Р.
Organization: Saratov State Medical University
Summary:

Aim: to study changes in the level of cortisol in children in the acute period of respiratory viral infection, depending on the etiology, severity of the disease and the presence and nature of the developed complications to establish an adaptation option. Material and Methods. 74 patients aged 1 to 10 years on day 1-3 from the beginning ofARVI (adeno-virus, parainfluenza, respiratory syncytial infection and mixed infection) and 15 healthy children were examined. The etiology ofARVI was established by PCR. Patients in the first three days from the beginning ofARVI were determined by the level of cortisol by the method, according to the indications, chest x-ray examination was performed. The type of adaptive response in children was determined by the value of the lymphocytic index and the level of cortisol in the blood serum. Results. The study showed that in children with ARVI there is a different reaction of the adrenal glands to the disease, which is characterized by both an increase and a decrease in their function. An increase in cortisol concentration characteristic of an adequate adaptation reaction was found in 59.2% of patients. In 12.3% of children noted a decrease in cortisol compared with the control group, in the remaining patients (28.5%) cortisol content did not differ from that in healthy children. Adaptation by the reaction type of "stress" alarm stage was observed in 37.1 % of children, the reaction of "stress" in the stage of resistance at 14.3% of patients, the reaction of "stress" with the development

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The assessment system of the grade of dysplastic changes in hip joint of children of early age

Year: 2018, volume 14 Issue: №3 Pages: 505-511
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bakhteeva N.Kh., Anisimova Е.А., Zotkin V.V., Anisimov D.l.
Organization: Saratov State Medical University
Summary:

 Aim: to analyze the method of choice of treatment for children aged 1-3 yrs. with hip joint dysplasia with respect to the complex of pathological changes by the elaboration of CAD programs. Material and Methods. We defined the grade of dysplastic changes in joint components of 82 children with hip joint dysplasia (113 joints) aged 1-3 yrs by CAD program. Results. The grade of dysplastic changes in hip joint (mild — I, moderate — II, severe — III) was identified with the elaborated program and the treatment was administered. We identified 28 children (33 joints) to have mild (I) dysplasia grade, moderate (II) 31 children (42 joints) and severe (III) 23 (38 joints). Mild dysplasia grade (I) corresponded to the score from 5 to 13, and to the option of conservative treatment with dynamic follow-up and coxarthritis prevention, moderate (II) — to the score from 14 to 26 and the option of intertrochanteric detorsion varus corrective osteotomy, severe (III) — to the score from 27 to 39 and the option of pelvis osteotomy and intertrochanteric detorsion varus corrective osteotomy. Conclusion. The treatment of patients with hip dysplasia depends on the grade of dysplastic changes. The elaborated program allows effectively define dysplasia grade and choose treatment method for the patients.

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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