Russian Pediatric Journal

Journal Information
EISSN : 2687-0843
Current Publisher: Paediatrician Publishers LLC (10.15690)
Total articles ≅ 21
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L. V. Rozhkova, Tsarkova S.A. Tsarkova, E. V. Savelyeva, M. M. Arkhipova, O. U. Sevostianova, L. R. Zakirova
Russian Pediatric Journal, Volume 1, pp 25-30; doi:10.15690/10.15690/rpj.v1i2.2090

Abstract:
Morbidity parameters in children aged 0–17 years have been analyzed based on results of prophylactic medical examinations conducted in Ekaterinburg between 2013 and 2019. The prophylactic medical examination coverage of pediatric population, distribution among the health status groups and frequency of regular medical check-ups have been studied. In 2019 versus 2013, children aged 0–17 years demonstrated a 1.6-fold increase in overall morbidity, and 2.3-fold increase in primary-care morbidity. In 2013–2017, a higher level of overall morbidity was found in children aged 15–17 years compared to children 0–4 years of age, owing to the emergence of newly diagnosed diseases. It was noted than the most frequently diagnosed diseases included diseases of the musculoskeletal system and connective tissue, diseases of the eye and eye appendages, diseases of nervous system, digestive system, endocrine system, nutritional disorders and metabolic disorders. Each year, based on results of prophylactic medical examinations, the proportion of children for whom the outpatient examination has been recommended amounts to 9.5%, outpatient treatment to 35.0%, and outpatient medical rehabilitation to 9.3%. The fraction of healthy children as of 2019 was 23.1% of all examined children. In 2019 the coverage for medical check-ups at the health facilities was 605.6 per 1000 children, that is 1.8 times higher than that in 2013 (334,0 per 1000 children).
Irina V. Vakhlova, Anastasia D. Kazachina, Olga A. Beglyanina
Russian Pediatric Journal, Volume 1, pp 38-44; doi:10.15690/10.15690/rpj.v1i2.2092

Abstract:
Background. In the international clinical practice there have been occasional reports of phenylketonuria (PKU) and cystic fibrosis (CF) found simultaneously in the same patient. Both PKU and CF are the inherited disorders characterized by autosomal recessive type of inheritance. Currently the combination of two or more inherited disorders in one patient is considered to be a clinical rarity.Case description. This is a clinical case of two genetic disorders, CF and PKU, combined in a 5-year old patient who had been followed up since birth. Owing to implementation of neonatal screening for inherited and congenital diseases into clinical practice, during the first month of life the infant was diagnosed with CF (diagnostically significant elevation of immunoreactive trypsin [IRT] at the initial [163.2 ng/mL] and repeat testing on day 21 of life [138.7 ng/mL]) and PKU (phenylalanine [PA] level 15.9 mg/dL). Both disorders have been confirmed by genetic tests, i.e., homozygous DelF508 mutation was found in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, and P281L mutation in the phenylalanine hydroxylase (PAH) gene was also present in homozygous state. Child’s parents strictly adhered to dietary and treatment recommendations. By the age of 5 years the child developed symptoms of neurological disorder and disorder of the respiratory system, cognitive impairment and delay in speech development, subclinical epileptiform activity with high risk of epilepsy, and chronic inflammation of the respiratory tract.Conclusion. This case report demonstrates the important role of neonatal screening in early diagnosis and timely start of therapy, and underscores the importance of continuous medication in such genetic disorders as CF and PKU. On the whole, such approach brings about a relative preservation of functioning of the most affected organs and systems. By the age of 5 years the child does not form bronchiectases, shows no signs of chronic hypoxia, nutritional deficiency or pronounced neurologic deficit, and is at low risk for the development of autism spectrum disorder. At the same time, the larger scale and longer-term observations are required in order to make the unequivocal conclusions about the prognosis of these diseases under conditions of modern-day medical follow-up.
Tatyana A. Ryazanova, Yuliya A. Trunova, Anastasia S. Arkhipova
Russian Pediatric Journal, Volume 1, pp 45-50; doi:10.15690/rpj.v1i2.2093

Abstract:
Background. Renovascular hypertension (RVH) is an elevated blood pressure caused by partial or complete occlusion of one or both renal arteries or their branches. According to different studies, renal artery stenosis accounts for 5–10% of all cases of hypertension in children. The most common causes of renal artery stenosis are deemed to be atherosclerosis and fibromuscular dysplasia.Case description. The article describes clinical case of a newly diagnosed renovascular hypertension amid background of fibromuscular dysplasia of renal arteries in a 6-year old child, particulars of the clinical course, laboratory and instrumental methods of investigation and treatment including aortography and balloon angioplasty of renal arteries.Conclusion. This case report illustrates that in the absence of complaints and pronounced clinical symptoms the diagnosis of renovascular hypertension in a 6-year old child could not be established for a long time. Timely detection of elevated BP in children, including the young ones, not only during visiting specialist physicians but also during prophylactic examination by pediatrician, is required for early diagnosis of the disease and development of the examination and treatment strategy.
L. V. Rozhkova, Tsarkova S.A. Tsarkova, E. V. Savelyeva, M. M. Arkhipova, O. U. Sevostianova, L. R. Zakirova
Russian Pediatric Journal, Volume 1, pp 25-30; doi:10.15690/rpj.v1i2.2090

Abstract:
Morbidity parameters in children aged 0–17 years have been analyzed based on results of prophylactic medical examinations conducted in Ekaterinburg between 2013 and 2019. The prophylactic medical examination coverage of pediatric population, distribution among the health status groups and frequency of regular medical check-ups have been studied. In 2019 versus 2013, children aged 0–17 years demonstrated a 1.6-fold increase in overall morbidity, and 2.3-fold increase in primary-care morbidity. In 2013–2017, a higher level of overall morbidity was found in children aged 15–17 years compared to children 0–4 years of age, owing to the emergence of newly diagnosed diseases. It was noted than the most frequently diagnosed diseases included diseases of the musculoskeletal system and connective tissue, diseases of the eye and eye appendages, diseases of nervous system, digestive system, endocrine system, nutritional disorders and metabolic disorders. Each year, based on results of prophylactic medical examinations, the proportion of children for whom the outpatient examination has been recommended amounts to 9.5%, outpatient treatment to 35.0%, and outpatient medical rehabilitation to 9.3%. The fraction of healthy children as of 2019 was 23.1% of all examined children. In 2019 the coverage for medical check-ups at the health facilities was 605.6 per 1000 children, that is 1.8 times higher than that in 2013 (334,0 per 1000 children).
Tatyana A. Ryazanova, Yuliya A. Trunova, Anastasia S. Arkhipova
Russian Pediatric Journal, Volume 1, pp 45-50; doi:10.15690/rpj.v1i1.2093

Abstract:
Background. Renovascular hypertension (RVH) is an elevated blood pressure caused by partial or complete occlusion of one or both renal arteries or their branches. According to different studies, renal artery stenosis accounts for 5–10% of all cases of hypertension in children. The most common causes of renal artery stenosis are deemed to be atherosclerosis and fibromuscular dysplasia.Case description. The article describes clinical case of a newly diagnosed renovascular hypertension amid background of fibromuscular dysplasia of renal arteries in a 6-year old child, particulars of the clinical course, laboratory and instrumental methods of investigation and treatment including aortography and balloon angioplasty of renal arteries.Conclusion. This case report illustrates that in the absence of complaints and pronounced clinical symptoms the diagnosis of renovascular hypertension in a 6-year old child could not be established for a long time. Timely detection of elevated BP in children, including the young ones, not only during visiting specialist physicians but also during prophylactic examination by pediatrician, is required for early diagnosis of the disease and development of the examination and treatment strategy.
Irina V. Vakhlova, Ekaterina V. Saperova
Russian Pediatric Journal, Volume 1, pp 10-17; doi:10.15690/rpj.v1i1.2088

Abstract:
Background. Congenital heart defects (CHD) are the most common type of developmental anomalies in children. At present the early diagnosis of congestive heart failure (CHF) and CHF-associated pathologic conditions is becoming increasingly important for optimization of protocols for following up pediatric patients in the primary health care settings.Objective. The study aimed at determining the prognostic role of brain natriuretic peptide (BNP) as a diagnostic marker of CHF progression and development of CHF-associated pathological conditions in babies with CHD during the first year of life.Methods. A prospective cohort study was carried out in a total of 114 children of the first year of life. The main study group was comprised of 61 children with confirmed diagnosis of CHD, and the control group of 53 health status group I–IIA children without CHD.Results. Diagnostic role of BNP elevation > 30 pg/mL was determined. At this BNP level the risk for developing stage 2A CHF increased 7-fold (OR 7.5 [1.8–31.5]), for developing functional class (FC) 2 CHF — nearly 5-fold (OR 4.6 [1.3–16.0]), and for FC 3 CHF such risk increased 9-fold (OR 9.2 [2.3–36.1]). Our results demonstrated that the BNP level measurements can be used in clinical practice to determine the likelihood of persistence of symptoms of perinatal CNS injuries during the first year of life (OR 7.6 [1.7–34.5]) and protein and energy deficit (PED) (OR 9.5 [2.5–35.5]) in children with CHD.
Elena V. Anufrieva, Lidia Yu. Neupokoeva, Olga P. Kovtun
Russian Pediatric Journal, Volume 1, pp 5-9; doi:10.15690/rpj.v1i1.2087

Abstract:
Background. Prevalence of excess body weight and obesity among children and adolescents has been gradually and significantly increasing over the last decades. The obesity detection rate is markedly affected by both low awareness of primary care physicians and the attitude of parents who pay no attention to the child’s excess weight for a long time considering it the manifestation of excellent health and normal development.Objective. The study aimed at comparative evaluation of the prevalence of obesity among children in the Sverdlovsk region.Methods. A comparative analysis of the prevalence of obesity was carried out, based on official statistical information and results of prophylactic medical examinations over the 2005–2019 period. The gender- and age-related particulars of pathologic obesity among children have been analyzed across the following age groups: 0–4, 5–9, 10–14 and 15–17 years.Results. Based on the incidence of office visits, a two-fold increase of morbid obesity was found in children 0–14 years of age (from 8.3‰ in 2005 to 16.3‰ in 2019 ), and a three-fold increase in adolescents 15–17 years of age (from 11.8‰ to 35.5‰, respectively; р < 0.001). The obesity rate registered during prophylactic medical examinations is two-fold higher than that during the office visits. Over 50% of obesity cases fall on the 10–14 age group, whereas the maximum rates of increase were found in children 5–9 years of age. In the age group of 15–17 years obesity is registered more often in boys than in girls.Conclusion. Significant differences in obesity prevalence rates, according to the office visits and prophylactic medical examinations’ data, attest to delayed diagnosis of excess body weight and insufficient effectiveness of pediatricians dealing with obese children at the stage of pediatric primary care. Cons idering the age-related particulars of obesity prevalence, health professionals working in educational institutions should play a leading role in the diagnosis of excess body weight and provision the follow-up care for children who are at risk for obesity.
Irina V. Vakhlova, Anastasia D. Kazachina, Olga A. Beglyanina
Russian Pediatric Journal, Volume 1, pp 38-44; doi:10.15690/rpj.v1i2.2092

Abstract:
Background. In the international clinical practice there have been occasional reports of phenylketonuria (PKU) and cystic fibrosis (CF) found simultaneously in the same patient. Both PKU and CF are the inherited disorders characterized by autosomal recessive type of inheritance. Currently the combination of two or more inherited disorders in one patient is considered to be a clinical rarity.Case description. This is a clinical case of two genetic disorders, CF and PKU, combined in a 5-year old patient who had been followed up since birth. Owing to implementation of neonatal screening for inherited and congenital diseases into clinical practice, during the first month of life the infant was diagnosed with CF (diagnostically significant elevation of immunoreactive trypsin [IRT] at the initial [163.2 ng/mL] and repeat testing on day 21 of life [138.7 ng/mL]) and PKU (phenylalanine [PA] level 15.9 mg/dL). Both disorders have been confirmed by genetic tests, i.e., homozygous DelF508 mutation was found in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, and P281L mutation in the phenylalanine hydroxylase (PAH) gene was also present in homozygous state. Child’s parents strictly adhered to dietary and treatment recommendations. By the age of 5 years the child developed symptoms of neurological disorder and disorder of the respiratory system, cognitive impairment and delay in speech development, subclinical epileptiform activity with high risk of epilepsy, and chronic inflammation of the respiratory tract.Conclusion. This case report demonstrates the important role of neonatal screening in early diagnosis and timely start of therapy, and underscores the importance of continuous medication in such genetic disorders as CF and PKU. On the whole, such approach brings about a relative preservation of functioning of the most affected organs and systems. By the age of 5 years the child does not form bronchiectases, shows no signs of chronic hypoxia, nutritional deficiency or pronounced neurologic deficit, and is at low risk for the development of autism spectrum disorder. At the same time, the larger scale and longer-term observations are required in order to make the unequivocal conclusions about the prognosis of these diseases under conditions of modern-day medical follow-up.
Elena V. Anufrieva, Lidia Yu. Neupokoeva, Olga P. Kovtun
Russian Pediatric Journal, Volume 1, pp 5-9; doi:10.15690/rpj.v1i2.2087

Abstract:
Background. Prevalence of excess body weight and obesity among children and adolescents has been gradually and significantly increasing over the last decades. The obesity detection rate is markedly affected by both low awareness of primary care physicians and the attitude of parents who pay no attention to the child’s excess weight for a long time considering it the manifestation of excellent health and normal development.Objective. The study aimed at comparative evaluation of the prevalence of obesity among children in the Sverdlovsk region.Methods. A comparative analysis of the prevalence of obesity was carried out, based on official statistical information and results of prophylactic medical examinations over the 2005–2019 period. The gender- and age-related particulars of pathologic obesity among children have been analyzed across the following age groups: 0–4, 5–9, 10–14 and 15–17 years.Results. Based on the incidence of office visits, a two-fold increase of morbid obesity was found in children 0–14 years of age (from 8.3‰ in 2005 to 16.3‰ in 2019 ), and a three-fold increase in adolescents 15–17 years of age (from 11.8‰ to 35.5‰, respectively; р < 0.001). The obesity rate registered during prophylactic medical examinations is two-fold higher than that during the office visits. Over 50% of obesity cases fall on the 10–14 age group, whereas the maximum rates of increase were found in children 5–9 years of age. In the age group of 15–17 years obesity is registered more often in boys than in girls.Conclusion. Significant differences in obesity prevalence rates, according to the office visits and prophylactic medical examinations’ data, attest to delayed diagnosis of excess body weight and insufficient effectiveness of pediatricians dealing with obese children at the stage of pediatric primary care. Cons idering the age-related particulars of obesity prevalence, health professionals working in educational institutions should play a leading role in the diagnosis of excess body weight and provision the follow-up care for children who are at risk for obesity.
Anna N. Plaksina, Olga P. Kovtun, Elena A. Stepanova, Elena A. Dugina, Valeriya A. Makutina, Svetlana L. Sinotova, Oksana V. Limanovskaya
Russian Pediatric Journal, Volume 1, pp 18-24; doi:10.15690/10.15690/rpj.v1i2.2089

Abstract:
Background. Assisted reproductive technology (ART) poses an increased risk for preterm birth. Women with high body mass index, who opted for ART, have the elevated levels of the insulin-like growth factor 1 (IGF-1) which is involved in the development of pathologic vasoproliferation in retinopathy of prematurity (ROP). Children with ROP are at increased risk for co-morbid pathology.Objective. The study aims at evaluating physical development and state of health in ART-conceived children with ROP.Methods. This is a population, one-time study to evaluate physical development and state of health in children with ROP. Statistical analysis was carried out using the SPSS v. 14.0 software package, and included determination of normality (Shapiro-Wilk test), descriptive statistics (М — mean value, σ — standard deviation of the mean), and non-parametric methods (Mann-Whitney U-test, Z-test of a proportion).Results. The anthropometric characteristics of infants with ROP did not differ from those in spontaneously conceived babies. Children with ROP born to mothers with high BMI had lower anthropometric parameters (p < 0.001) and required longer dynamic follow-up while being diagnosed as “risk group for ROP”. A significantly higher number (a total of 65) of nosologies has been revealed in the ART-conceived infants. Statistically significant predominant diagnoses (p = 0.0047) included dwarfism and obesity despite the absence of anthropometric differences at birth (p = 0.123).Conclusion. The ART-conceived infants with ROP at birth do not differ in their physical development from infants in the general population, however, on prospective follow-up the former developed dwarfism and obesity significantly more often. Children born to mothers with high BMI have significantly lower parameters of weight and height, and require longer follow-up period while being diagnosed with ROP. The ART-conceived infants with ROP have co-morbid pathology significantly more often than children with ROP in the control group.
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