Бабик Р.К., кандидат медицинских наук, доцент
кафедры детских инфекционных болезней,
Челябинская государственная медицинская академия
(Челябинск); e-mail: babik@chelcom.ru
Babik R.K., the candidate of medical sciences,
the senior lecturer of chair of children's infectious diseases
of the Chelyabinsk state medical academy (Chelyabinsk);
e-mail: babik@chelcom.ru. Корнеева Е.В., ассистент кафедры детских
инфекционных болезней, Челябинская государственная
медицинская академия (Челябинск).
Korneyevae E.V., the assistant of chair of children's
infectious diseases of the Chelyabinsk state medical
academy (Chelyabinsk).
The heavy burden of meningococcal infection is associated not only with life-threatening complications in the acute period and high mortality in invasive forms of the disease, but also with severe consequences in survivors, who are not recorded in our country.The aim of study: to analyze clinical manifestations, complications of the acute period and outcomes of invasive forms of meningococcal disease in children in various regions of the Russian Federation.Materials and methods: an analysis of data from 1327 inpatient medical records of children with an invasive meningococcal infection from 14 regional centers of the Russian Federation for 2012-2021 was carried out (28.3% of cases of the disease in children in the represented federal districts).Results: it was found that young children predominated among the patients – the median was 27.4 (10.7-70.4) months. Complications of the acute period, often combined, were observed in 47.6% of cases. The development of septic shock was noted in 30.4%, Waterhouse-Friderichsen syndrome in 6.6%, carditis in 2.9%, cerebral edema in 15.7%, arthritis in 1.4% of cases; the formation of hydrocephalus, subdural effusion, sensorineural hearing loss in 1.8%, 0.6%, 1% of children, respectively. The presence of soft tissue necrosis requiring surgical intervention was noted in 3.5% of cases. Mortality rate was 10.1%. At the time of discharge from the hospital, 30% of children had complications associated with meningococcal infection: organ dysfunction/ failure in 13.2% of patients (severe in 1.3%), cerebral insufficiency in 19.6%; severe psycho-neurological deficits, sensorineural hearing loss, problems associated with the need for orthopedic/surgical interventions accounted for 0.7%, 0.6% and 0.8%, respectively.Conclusion. Considering the epidemiological features of meningococcal infection – the risk of a sharp increase in morbidity in short periods of time, the life-threatening nature of the disease itself, it is necessary to remain alert to these risks and take all possible measures to prevent the disease using all available means, the most effective of which is vaccine prevention.
The article covers results a study of role norovirus in etiological structure of acute enteric infections in children caused by the treated in the Chelyabinsk Children's infectious Hospital No. 8. from 2005 through 2009. Different of variants of the clinical course of noravirus infections in children of severe age are specified. The study analyzed the character of immune response and level cytokines in the noravirus infections.
Бабик Р.К., кандидат медицинских наук, доцент
кафедры детских инфекционных болезней,
Челябинская государственная медицинская академия
(Челябинск); e-mail: babik@chelcom.ru
Babik R.K., the candidate of medical sciences,
the senior lecturer of chair of children's infectious diseases
of the Chelyabinsk state medical academy (Chelyabinsk);
e-mail: babik@chelcom.ru. Богайчук Е.А., аспирант кафедры детских
инфекционных болезней, Челябинская государственная
медицинская академия (Челябинск); e-mail:
wrach@74mail.ru
Bogajchuk E.A., the post-graduate student of faculty
of children's infectious diseases the Chelyabinsk
state medical academy (Chelyabinsk); e-mail: wrach@
74mail.ru
Представлен анализ сезонных подъемов заболеваемости энтеровирусной инфекции, клинического разнообразия, зависимости проявления форм и поражения нервной системы у детей Челябинской области от распространенных эпидемических вариантов энтеровирусов. The analysis of seasonal increases in the incidence of enterovirus infection, clinical diversity, dependence of the manifestation of forms, damage to the nervous system in children of the Chelyabinsk region on common epidemic variants of enteroviruses is presented.
Characteristics of CD34+ cells mobilization were studied in children suffering with various diseases, like as their dependence on type and extent of inflammatory response. It was revealed that the children with signs of systemic inflammatory response syndrome exhibit a significant increase of absolute content and percentage of circulating CD34+ cells, whereas children with frequent infections, and with clinical signs of allergy during recurrence of their chronic allergic disease showed a significant decrease in CD34+ cell percentage. Meanwhile, children with allergoses, and those with common recurrent infectious states did not reveal any deviations in CD34+ cells from normal values.
The article covers results a study of role virus in etiological structure of acute enteric infections in 1378 children caused by the treated in the Chelyabinsk Children's infectious Hospital No. 8. from 2005 through 2009. A comparativ evaluation of the infor-mativity of methods of diagnosing acute enteric infections showed that the hiqher sensitivity was PCR. Specific clinical of the mono and mixt rota, noro, adeno, astrovirus enteric infections in children's are studied. The different interferon figures in severe and mixt forms virus infections have been found. On the background of different acute enteric virus infections in children of severe age of imbalance of proand anti-inflammatory cytokines were noted.
С разработкой противовирусных препаратов прямого действия терапия хронического гепатита С (ХГС) у детей вышла на новый уровень этиотропной направленности – на элиминацию вируса. Хронический гепатит С – заболевание, вызываемое РНК-содержащим вирусом, с гемоконтактным механизмом передачи. При развитии инфекционного процесса вирус гепатита С (НСV) проникает в гепатоциты, где происходят его репликация и иммунопатологический процесс. Геном НСVкодирует структурные и неструктурные белки, к каждому из них вырабатываются антитела, которые не обладают вирус-нейтрализующим свойством. Особенность HСV заключается в способности к быстрой замене нуклеотидов, что приводит к образованию большого числа генотипов, субтипов и мутантных штаммов. Выделяют 7 генотипов вируса и более 90 субтипов НСV. Изменчивость генома вируса, строения антигенных детерминант определяют выработку специфических антител, не способных элиминировать возбудителя из организма и препятствующих созданию эффективной вакцины против гепатита С. В апреле 2019 года EMA было одобрено применение пангенотипного противовирусного препарата глекапревир/пибрентасвир в фиксированной дозе для подростков 12-17 лет, инфицированных HCV, на основе высокой частоты устойчивого вирусного ответа (100%; 47 из 47 пациентов) в исследовании Dora [1, 4, 25]. Целью назначения прововирусных препаратов прямого действия детям, по рекомендации ESPGHAN, является лечение инфекции для предотвращения потенциального прогрессирования заболевания печени, связанного с НСV, и его осложнений. Эффективностью терапии ХГС у детей является не обнаруживаемая с помощью чувствительного метода исследования (нижний порог чувствительности <15 МЕ/мл) РНК НСVв крови через 12 недель (устойчивый вирусный ответ – УВО12) после окончания лечения препаратами прямого противовирусного действия. With the development of direct-acting antiviral drugs, the therapy of chronic hepatitis C in children has reached a new level - an etiotropic focus on the elimination of the virus. Chronic viral hepatitis C is a disease caused by the RNA-containing hepatitis C virus (HCV), with a hemocontact transmission mechanism. With the development of the infectious process, HCV penetrates into hepatocytes, where its replication and immunopathological process occur. The HCV genome encodes structural and non-structural proteins, and antibodies are produced to each of them that do not have a virus-neutralizing property. The peculiarity of HCV is the ability to quickly replace nucleotides, which leads to the formation of a large number of genotypes, subtypes and mutant strains. There are 7 genotypes of the virus and more than 90 subtypes. The variability of the virus genome, the structure of antigenic determinants determine the production of specific antibodies that are unable to eliminate the virus from the body and prevent the creation of an effective vaccine against hepatitis C. In April 2019 EMA approved the use of the fixed-dose pan-genotypic antiviral drug glecaprevir-pibrentasvir for adolescents 12-17 years old infected with HCV, based on the high frequency of sustained viral response (100%; 47 out of 47 patients) in the Dora study [1,4,25]. The goal of therapy in children, according to the recommendation of ESPGHAN, is the treatment of HCV infection to prevent the potential progression of HCV-related liver disease and its complications. The effectiveness of therapy in children is not detectable by a sensitive method of investigation (lower threshold of sensitivity < 15 IU / ml) NSO RNA in the blood after 12 weeks (sustained viral response) after the end of treatment with direct antiviral drugs.
