Objective. To evaluate the therapeutic and prophylactic efficacy of recombinant interferon in children with recurrent diseases using quality of life (QOL) indicators.Materials and methods. An assessment of the possibilities of using QOL indicators to analyze the effectiveness of preventive and therapeutic measures carried out in 126 frequently and long-term ill children aged 1 to 6 years with recurrent respiratory infections living in Dushanbe. Results. The results of the examination of 126 children with recurrent respiratory infections indicate a favorable outcome of the disease with properly selected therapy using recombinant interferon-alpha- 2b with antioxidants (Viferon®) in noninvasive dosage forms. Early administration of the drug significantly reduced the duration of fever with a tendency to reduce catarrhal symptoms. The drug was used as part of complex therapy at a dosage of 150,000 IU per 1 suppository rectally 2 times a day for 5 days. The positive dynamics in the general somatic status of frequently and long-term ill children contributed to an increase in the parameters of their quality of life, especially such aspects as emotional and social well-being. Conclusion. The convenient dosage form, high therapeutic and prophylactic efficacy of Viferon®a, and the focus on the immune system make it possible to recommend this drug in the complex treatment and prevention of children with recurrent respiratory infections.
Measles is one of the most highly contagious airborne infections. Those who are not vaccinated or have not been ill after contact become ill in almost 100% of cases. Objective: to evaluate the effectiveness of emergency measles prevention in children in a specialized institution with round-the-clock stay. Materials and methods: a retrospective analysis of a measles outbreak in a specialized psychoneurological children's home was conducted. Results: the zero patient was an unvaccinated girl aged 1 year 26 days, who had previously been treated in a hospital for COVID-19, where at the same time measles patients were being treated. She fell ill after 14 days, was re-hospitalized on the 17th day. On the same day, 171 contacts were identified, 7/5.3% of employees were revaccinated with a live measles monovalent vaccine, 10/41.7% of children over 12 months of age received a combined vaccine against measles, rubella and mumps and 14/58.3% of children under 12 months of age received normal human immunoglobulin was administered intramuscularly in 1 dose (1.5 ml). During the period of epidemiological observation, 8/33.3% of children who received emergency prophylaxis fell ill (1/10.0% — trivaccine and 7/50.0% — immunoglobulin). All suffered from typical measles of moderate severity. Conclusion. The development of the disease in 50.0% of cases with consistent involvement in the epidemic process after passive prophylaxis indicates insufficient effectiveness of the administration of the minimum recommended dose of immunoglobulin.
West Nile fever (WNF) is a zoonotic natural focal arbovirus infection with a transmissible mechanism of pathogen transmission. The carriers of the disease are mosquitoes, the main reservoir is birds. In the period 2023—2024, an increase in the registration of WNF was noted in the Russian Federation, and the most intensive spread was registered in the Southern Federal District (SFD) because of significant climate warming. The aim: to demonstrate clinical cases of WNF in 3 children with a neuroinvasive form of the disease in the form of viral meningitis. Results. All patients are residents of Crimea, were hospitalized in the summer. Clinical manifestations included fever, weakness, headache and positive meningeal signs. The disease was severe in 2 patients, moderate in 1 patient. The diagnosis was based on the detection of IgM antibodies to the WNF virus in the blood serum. All patients recovered from the disease. Conclusion. WNF has no specific clinical and laboratory signs, therefore in the Republic of Crimea in the summer, when the carrier of the infection is especially active, screening for this infection should become routine procedure in children with signs of viral meningitis.
Objective: to study the psychological characteristics of children with latent tuberculosis infection (LTI) in order to develop effective options for psychological assistance in the process of preventive treatment and rehabilitation measures. Materials and methods. A prospective group-control study was conducted with the participation of 60 children aged 5—15 years. The main group (n = 30) consisted of children with LTI without confirmed contacts with TB patients with MBT+; the control group (n = 30) consisted of children infected with MBT without LTI. The clinical and anamnestic method and the projective techniques «House-tree-man» and «Non-existent animal» were used. The statistical analysis was performed using Pearson's χ2 criterion. Results. Statistically significant differences in psychological status were found in children with latent tuberculosis infection compared with the control group. In the emotional sphere, increased anxiety, emotional instability and internal tension were more often observed. In the personal sphere, low self-esteem, low level of creativity and limited imagination are noted. Difficulties in communication, a tendency to self-isolation and low openness to contacts were revealed in social adaptation. Conclusions. The identified features require the development of specialized psychological support programs in the process of preventive treatment and rehabilitation. A comprehensive approach to the treatment of children with LTI is needed, including both medical and psychological and pedagogical measures.
Objective: to analyze the clinical and anamnestic features of the course of acute intestinal infections depending on the etiology, to identify the features of the course of viral acute intestinal infections that served as a reason for prescribing empirical antibacterial therapy in children under 5 years old upon admission to the hospital.Materials and methods. The retrospective case-control study included 66 case histories of children with acute intestinal infections aged from 1 month to 4 years inclusive, hospitalized in 2023—2024 at Pediatric City Clinical Hospital No. 9 named after G.N. Speransky, Moscow. Etiological decoding of acute intestinal infections was carried out using PCR testing of feces samples, bacteriological testing of feces. Results. In children under 5 years old, viral intestinal infections predominated, with norovirus identified in 52% of cases (95% CI: 37—67%). In bacterial intestinal infections in children, complaints of diarrhea with blood and mucus, fever up to febrile values, abdominal pain were more common. The presence of vomiting lasting more than three days before admission and upon admission to the hospital were more common in acute intestinal infections of viral etiology. Antibacterial therapy was carried out in all children with bacterial acute intestinal infections, and in 57% (95% CI: 41—70%) cases of viral acute intestinal infections. Antibacterial therapy among patients with viral acute intestinal infections was significantly more often received by children with fever, other clinical and anamnestic differences could not be identified. Conclusion. The combined assessment of both clinical and anamnestic data in acute intestinal infections can serve as a basis for creating an algorithm for rapid clinical assessment of indications for empirical antibacterial therapy.
In clinical practice, inflammatory changes in the skin, mucous membranes and lymph nodes are characteristic of many infectious diseases. Erysipelas occupies a significant place in the structure of infectious pathologies in the adult population. At the same time, in children this disease is registered extremely rarely. The present study presents a rare case of erysipelas localised to the face and ear (Milian's ear sign) in a 10-year-old child with no comorbid somatic pathology.Given the rarity of erysipelas in the paediatric population and the lack of clear normative documents regarding the management of patients with this disease in paediatric practice, the clinical case presented may contribute to increased physician vigilance regarding this diagnosis.
The relevance of infectious mononucleosis at the present stage is due to its widespread prevalence, lifelong persistence of pathogens in the human body, persistent immunological changes during periods of active infectious process, lack of effective means of treatment and prevention. The purpose of the study: to analyze modern aspects of infectious mononucleosis in children. Materials and methods: the article presents literature data on the importance of the IM problem in children at the present stage and the results of their own observations of 316 children hospitalized in the Regional Infectious Diseases Clinical Hospital of Yaroslavl in the period from 2021 to 2023. Results: the age group of patients is dominated by children 4—6 and 11—17 years old. The clinical picture still shows characteristic symptoms: fever, difficulty nasal breathing, tonsillitis, lymphadenopathy, exanthema, enlarged liver and spleen. In most patients, the appearance of a rash is associated with the appointment of semi-synthetic penicillins at the prehospital stage. Atypical mononuclear cells are detected in only half of the patients, which makes it difficult to make a diagnosis based on a general blood test. In primary infection, Epstein-Barr virus (EBV) remains dominant in isolation or in combination with cytomegalovirus (CMV). Reactivation in almost all patients is caused by CMV on the background of primary EBV infection.
Rotavirus infection (RVI) occupies a leading position in the structure of viral diarrhea, is characterized by a high level of morbidity, predominantly affecting the child population, a variety of clinical manifestations, and the possible development of adverse outcomes. The purpose of the study. To study the clinical and epidemiological features of RVI against the background of an increase in morbidity in the Krasnoyarsk Territory in 2024. Materials and methods. A retrospective analysis of 438 medical records of children aged 28 days to 17 years hospitalized in the infectious diseases hospital of the Krasnoyarsk Interdistrict Children's Clinical Hospital No. 1 in 2024 with a diagnosis of rotavirus infection was conducted. Results. In 2024, an increase in the incidence of RVI was noted in almost all age groups, the risk group is children aged 1—3 years (52%), the number of children aged 1 year decreased by half compared to the previous year, while the number of children over 11 years old increased by 4.2 times. An increase in the proportion of severe forms of the disease was noted, including in older children. Extraintestinal manifestations were detected in 73.1% of children with RVI, which affected the nature of the course and outcome of the disease. 48.8% of convalescents were discharged from the hospital with residual effects, which subsequently required observation at the place of residence. Conclusion. Clinical and epidemiological features of RVI at the present stage indicate a continuing epidemiological problem. In this regard, the inclusion of vaccination against RVI in the national calendar of preventive vaccinations of the Russian Federation is justified and should be a priority.
Objective: to assess the level of commitment to vaccination among medical students of the Siberian State Medical University. Materials and methods. The material for the study was the methodology of D.V. Kaunina et al., 2023, consisting of four groups (scales) and including 27 questions that are indicators for assessing the level of commitment to vaccination. In the period from November 2023 to January 2024, an anonymous survey was conducted using an online platform based on the Siberian State Medical University, in which 289 respondents from 4th to 6th years of the General Medicine and Pediatrics Faculties took part. Results. The level of commitment was calculated depending on the points scored. In the total sample, the level of commitment to vaccination was average in 231 respondents (80%), high in 52 (18%) and low in 6 (2%).
Russia ranks among the first countries both in Europe and around the world in terms of the number of children infected with the hepatitis C virus, which determines the medical and social importance of this problem for domestic healthcare. The aim of the study was to evaluate the clinical and laboratory features of the course and effectiveness of direct antiviral therapy of HCV in children and adolescents living in the Moscow region. Materials and methods. 28 children (13 boys and 15 girls) aged 3—16 years with HCV were under observation. The genotype of the pathogen was determined for all children before the start of antiviral therapy, and before and after completing an 8-week course of treatment with the direct antiviral drug glecaprevir+pibrentasvir, the viral load was determined by PCR, IgM and IgG antibodies to HCV by ELISA, clinical and biochemical blood tests, coagulogram, ultrasound of the abdominal organs and fibroelastography were performed. the liver. Results. Chronic hepatitis C (HCV) is detected mainly in school-age children (in 67.9%), in 60.7% of patients it is combined with other various pathologies. Infection occurs in 89.3% of cases during perinatal contact with a mother with HCV. The clinical picture is characterized by low symptoms, asthenia prevails (weakness — 35.8%, decreased appetite — 32.1%, headache — 7.2%, dizziness — 3.6%, drowsiness — 3.6%) and impaired motor function of the gastrointestinal tract (17.9%). Cytolysis syndrome is slightly pronounced, it is noted in 39.3—42.9% of children. Genotypes 1b (32.1%), 3a (25%) and 1a (17.9%) predominate. According to ultrasound data, hepatomegaly is observed in 28.6% of children, fibrosis grade F1 on the METAVIR scale is formed in 39.3% of patients. Antiviral therapy provides a stable virological response in 100% of cases and contributes to the normalization of biochemical parameters, as well as regression of fibrosis in all children treated with glecaprevir+pibrentasvir for 8 weeks. Conclusion. Currently, the most effective method for the further spread of hepatitis C is the early detection and treatment of children and adolescents suffering from this infection using direct antiviral agents.
Thrombophilia is a heterogeneous group of inherited and acquired diseases and syndromes characterized by increased blood clotting and a high risk of thromboembolic complications. Thrombophilia is not a disease in the generally accepted sense, since it has no clinical manifestations until the first thrombosis, which complicates its diagnosis. At the same time, thromboses make a significant contribution to the overall morbidity and mortality in children of all age groups. Currently, many genetic polymorphisms have been identified that increase the predisposition to thrombosis, including mutations of factor V (Leiden mutation) and prothrombin, as well as polymorphisms of the genes of the blood coagulation system and folate cycle. Risk factors for the development of thrombotic complications also include deficiency of proteins C and S and lack of antithrombin III. Newborns from mothers with hereditary thrombophilia have a significantly increased risk of fetal hypoxia and various pathological conditions and diseases. The presence and combination of various genetic markers of thrombophilia leads to the development of a hypercoagulable state, which increases the risk of thrombohemorrhagic complications. Diagnosis of thrombophilia includes, first of all, the determination of thrombogenic risk factors: permanent (genetic and/or clinical) and temporary (clinical and/or laboratory). The article presents the main genetic markers of thrombophilia, the mechanisms of its development and diagnostic methods.
It is important to individualize therapy goals, including control of the cough reflex and inflammation suppression when treating cough in children with acute respiratory viral infections (ARVI). Aim. To evaluate the efficacy and safety of the drug Rengalin in children over 3 years old with ARVI in clinical practice, focusing on cough management capabilities, an observational non-interventional program was conducted. Methods. The study included 90 children with ARVI and cough, divided into three groups: monotherapy with Rengalin (Group 1, n = 31), combined treatment Rengalin and a Mucolytic (Group 2, n = 29), and monotherapy with a Mucolytic (Group 3, n = 30). Patients were monitored in a day hospital with follow-up visits on days 1.4 (±1), and 8 (±1). ARVI symptoms, cough severity was assessed using the specialized scales, therapy effectiveness was evaluated based on physicians' and parents' opinions, and adverse events were recorded. Results. At visit 2 by day 3 of therapy, a significant reduction in cough severity was observed in Groups 1 and 2 (p < 0.0001), whereas Group 3 showed no statistically significant difference (p = 0.53). By day 7, at visit 3, the total cough score was significantly lower in patients receiving Rengalin: Group 1 — 0.6 ± 0.9, Group 2 — 1.2 ± 1.0, Group 3 — 2.8 ± 1.5; p1—3, 2—3 < 0.0001, and the proportion with a cough severity scale score of ≤1 point was significantly higher (93.5%, 75.9% and 23.3% in groups 1, 2 and 3, respectively (p1—3, 2—3 < 0.0001). No adverse events were reported. Conclusions. Rengalin therapy, whether as monotherapy or combined with a mucolytic agent, provides better control of cough compared to mucolytic monotherapy and is well tolerated in children.
Objective: to study the anamnestic and clinical-laboratory features of the course of tick-borne infections in hospitalized patients aged 2 to 14 years with an assessment of their prognostic ability. Materials and methods. The study involved 66 children aged 2 to 14 years, hospitalized for tick-borne encephalitis (TBE) or ixodid tick-borne borreliosis. We studied the anamnesis, carried out a set of serological and molecular biological methods to assess the specific immune response of patients and tick infestation. Results. In the group of children with tick-borne encephalitis, the meningeal form of the disease was established in 74.3% (26/35) of children, febrile in 17.1% (6/35), inapparent in 5.7% (2/35) and subclinical in 2.9% (1/35) of children. In children with tick-borne borreliosis, the erythema form of the disease was noted in 58% (18/31) of patients, while the remaining 42% (13.31) had a non-erythema form. It was found that the time period from the tick bite to the onset of clinical manifestations did not have reliable differences in the groups: in patients with tick-borne encephalitis it was 14 days (IQR 4.5; 17), and in patients with tick-borne borreliosis — 12 days (IQR 6.5; 16), p = 0.670. A history of tick bite in the anamnesis was noted in 59/66 cases (89.3%), but a tick study using PCR was performed only in 25/66 (37.8%) people: in 14/25 (56%) cases, RNA of the tick-borne encephalitis virus was detected, in the remaining cases — exclusively Borrelia DNA or a combination of pathogens. Mathematical modeling has determined prognostic criteria that determine with high probability the course of tick-borne encephalitis in a patient: leucocyte, neutrophils, lymphocytes blood count, the values of the enzymes ALT and AST. Conclusions. A formula has been obtained that is a convenient tool for rapid assessment of the risk of tick-borne encephalitis, based exclusively on laboratory data. This is especially relevant in endemic regions where rapid differentiation of TBE from other tick-borne infections, such as ixodid tick-borne borreliosis.
The Aim: To analyze the state of lipid metabolism, body composition, and liver parenchyma structure in children with chronic hepatitis C (СHC). Methods . The study group consisted of 63 children with СHC aged 3—17 years without concomitant endocrine pathology, who were examined in 2022—2024 at the NCCIB. The control group consisted of 37 healthy children aged 9—17 years. All underwent anthropometry, laboratory examination (HCV RNA PCR, lipidogram), liver elastography with assessment of steatosis. Results . Children with СHC are significantly more likely to have hypolipidemia in the form of a decrease in total cholesterol and low-density lipoprotein (LDL) levels (p < 0.05), while in healthy children there is a decrease in high-density lipoproteins (HDL) and an increase in the coefficient of atherogenicity (p < 0.05). In the study group, abnormalities in lipid metabolism were found in 39.6% of children, while the majority (64%) had a «healthy weight». An increase in the level of non-HDL cholesterol was more often recorded in children with a «healthy weight» and was associated with genotypes 1 and 2 (non-3) of the virus (p < 0.05). Almost half (43.2%) of children with СHC had liver steatosis associated with the non-3 genotype of the virus (p < 0.05). Children with СHC without obesity are significantly more likely to develop steatosis compared with the control group (p < 0.05). Conclusions . Virus-induced changes in lipid metabolism parameters, regardless of the presence or absence of overweight, associated with the non-3 genotype of the virus, were found in children with СHC. Hypolipidemia is significantly associated with HCV. Liver steatosis is significantly more common in children with СHC without excess weight compared to healthy children, which further confirms the effect of the virus on the lipid profile.
Objective . To study the clinical characteristics and principles of therapy of acute stenosing laryngotracheitis in young children with acute respiratory infection (ARI). Materials and methods. A clinical study was conducted on 30 children aged 1 to 7 years with ARI and acute stenosing laryngotracheitis hospitalized in the Dushanbe City Clinical Hospital of Pediatric Infectious Diseases in October–December 2020. The diagnosis was confirmed by PCR; 53.3% of patients had influenza, 26.7% had parainfluenza, 13.3% had respiratory syncytial virus infection, and 6.7% had adenovirus infection. Results . All patients presented with catarrhal symptoms for 1–3 days, accompanied by subfebrile fever in 23.3% patients and febrile fever in 66.7% children. The onset of the disease in all children was sudden, with the appearance of signs of stenosing laryngotracheitis mainly in the evening and at night and rapid progression in the duration of the attack, from several minutes to 1-2 days. The majority of young children with ARI (22/73.3%) were noted to have the second degree of stenosing laryngotracheitis with characteristic stenotic breathing, sleep disturbance, periodic agitation and an increase in all clinical symptoms at rest, 5 (16.7%) children were observed to have the first degree with mild hoarseness and periodic «barking» cough, and 3 (10%) children with the third degree of stenosing laryngotracheitis were admitted to the intensive care unit in a serious condition with constant dyspnea, severe anxiety, alternating with lethargy, drowsiness, as well as a sharp hoarse voice, up to aphonia. All children were prescribed recombinant interferon-alpha-2b with antioxidants (VIFERON®) as part of combination therapy at an age-appropriate dosage of 150,000 IU, one suppository twice daily, for a 5-day course. Conclusion . Stenosing laryngotracheitis in young children with acute respiratory infection most often occurred in the second and third stages (83.3%), with pronounced signs of acute respiratory failure (66.7%).
Post-infectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease that develops in children following lower respiratory tract infections (LRTI). The pathogenesis is based on impaired reparative processes in the bronchiolar epithelium, productive-sclerotic inflammation, and the formation of peribronchiolar fibrosis, accompanied by chronic neutrophilic-lymphocytic inflammation and cytokine imbalance. The clinical presentation of PIBO is characterized by chronic cough, expiratory dyspnea, hypoxemia, and prolonged bronchial obstruction. The diagnosis is established based on a history of severe LRTI, persistent clinical signs of airway obstruction, and characteristic findings on chest computed tomography, including mosaic attenuation and air-trapping phenomena. Despite the use of various pharmacological strategies, including systemic and inhaled corticosteroids, macrolides, and leukotriene receptor antagonists, a standardized therapy protocol for PIBO has not yet been established. The disease course is variable: most patients demonstrate a reduction in respiratory symptoms and improvement in functional parameters with age, whereas others may experience slow disease progression. Computed tomography features of small airway involvement may persist or vary over time.
The aim of the study was to analyze the relationship between comorbid diseases and the severity of COVID-19 in children to develop a stratified approach to the management of pediatric patients. The study methods included a comprehensive analysis of data from 370 children with confirmed COVID-19, divided into a main group of 273 children with comorbid conditions and a control group of 97 children without comorbidities. Clinical methods for assessing the severity of the course, laboratory diagnostics of inflammatory markers, the pSOFA scale for assessing multiple organ failure, statistical analysis using logistic regression and machine learning algorithms were used. The results showed that the comorbidity structure was characterized by the predominance of anemia in 49.5% of patients and immunodeficiency states in 11.4% of children with significant age differences. Severe and extremely severe forms of COVID-19 accounted for 49.8% of cases in the comorbidity group versus a significantly lower proportion in the control group. A direct correlation was established between the levels of C-reactive protein and ferritin with the severity of the disease. Anemia reached a maximum frequency of 65.7% in the age group of 0—3 years, while immunodeficiency states prevailed in adolescents aged 14—18 years with a frequency of 47.8%. The developed mathematical models based on the pSOFA scale and logistic regression demonstrated high prognostic significance for assessing the risk of an unfavorable course of COVID-19 in children with comorbid conditions, which justifies the need for a personalized approach to the diagnosis and treatment of this category of patients.
Over the past 20 years, human herpes virus infections have continued to occupy leading positions in statistics. Frequent infection of newborns with several herpes viruses at once causes an atypical course of the infectious process. The development of neonatal chickenpox is associated with maternal infection with Varicella Zoster Virus in late pregnancy, which poses a serious threat to the life and health of the newborn. The carriage of the chromosomally integrated form of herpes type 6 by parents causes the transmission of the genetic material of the virus in several generations. The high probability of transmission of infectious agents from mother to newborn necessitates the development of algorithms for pregravid preparation that increase the probability of the birth of a healthy full-term child. The aim of the work was to present a clinical case of vertical transmission of herpes viruses types 3 and 6 from mother to newborn, with the implementation of a combined herpesvirus infection already in the early neonatal period. Materials and methods : an analysis of the medical records of a child who was hospitalized in a children's multidisciplinary hospital with a diagnosis of neonatal varicella was conducted; a review of modern literature, an analysis of statistical and regulatory documents using the PubMed, NIH, Scopus, scientific library eLibrary.RU, ResearchGate databases were conducted.
Recurrent respiratory infections are one of the most common reasons for visiting a pediatrician in preschool age. In domestic practice, the term «frequently ill children» is traditionally used, but to date there is no unified clinical interpretation of this condition. International reviews use the concept of recurrent respiratory infections (RRIs), the approach to which is based on the exclusion of severe chronic diseases, atopy and immunodeficiencies. The review presents data from modern international consensuses and practical algorithms. The criteria for the frequency of recurrent respiratory infections by age groups, features of infectious and allergic anamnesis, key laboratory markers and approaches to the interpretation of molecular biological and microbiological studies are covered. Particular attention is paid to the diagnosis of primary and secondary immunodeficiencies in children, including on the basis of clinical and anamnestic signs. The necessity of a personalized rather than a template approach to the management of frequently ill children is substantiated, taking into account the individual clinical context and infectious profile.
