Download the whole Issue

ORIGINAL STUDIES

Clinical physiology of the kidneys in premature: the role of follow-up. G.A. Abdullina, A.I. Safina, M.A. Daminova. P.9

Respiratory disorders in infants with vlbw and elbw. I.V. Vinogradova, A.N. Belova, E.N. Ignatieva, M.V. Krasnov, N.N. Emelyanova, D.A. Vinogradov, V.S. Emelyanova. P.14

Physical development parameters in preterm infants and modern approach to nutritional support for outpatients. E.V. Volyanyuk. P.17

Features of perinatal history and heart rate variability in premature infants born with extremely low body weight and very low body weight on the first year of life. Z.R. Dolgova. P.21

Characteristics of postnatal growth in children born with intrauterine growth restriction. A.I. Ignatkevich, Yu.V. Petrenko, D.O. Ivanov, E.А. Kurzina, K.F. Islamova. P.27

Changes in « insulin-like growth factor-1—growth hormone» axis and insulin sensitivity in children with intrautherine growth retardation. K.F. Islamova, Y.V. Petrenko, D.O. Ivanov, S.N. Filippova. P. 33

Tissue doppler in the study of circular and radial systolic strain of the left ventricle myocardium in the first year of life children with intrauterine growth retardation. N.F. Priyma, D.O. Ivanov, Yu.V. Petrenko, A.V. Kozlenok, K.F. Islamova. P.39

Influence of positive pressure ventilation on cerebral status of newborns in acute period of hypoxic-ischemic encephalopathy. D.N. Surkov, O.G. Kapustina, D.O. Ivanov. P.46

Epidemiology of neonatal sepsis: neonatal intensive care unit experience. D.N. Surkov, A.D. Surkova, D.O. Ivanov. P.56

Psychomotor development and rehabilitation methods in preterm infants after discharge. L.A. Fedorova. P. 62

CASE FROM PRACTICE

A course of polycystic kidney disease in newborn. O.L. Chugunova, S.V. Cherkasova, P.V. Shumilov, E.Yu. Grebenkina, M.A. Latysheva. P.65

REVIEWS

Interstitial lung diseases in children. E.V. Boitsova, D.Y. Ovsyannikov, M.А. Belyshova. P.71

Congenital malformations of the tracheobronchial tree in children. I.I. Zakirov, A.I. Safina. P.77

Sudden infant death syndrom in preterm infants. I.Ya. Lutfullin, A.I. Safina. P.82

Modern approaches to skin care of the newborns: tactics of pediatrician. N.L. Rybkina. P.85

Late preterm infants. L.N. Sofronova. P.89

Ultrasound diagnostics in neonatal intensive care units. O.А. Stepanova, A.I. Safina. P.92

Pathophsyology of neonatal sepsis. K.S. Khaertynov, V.A. Anokhin, S.V.Boichuk. P.98

____

ORIGINAL ARTICLES

Clinical physiology of the kidneys in premature: the role of follow-up

Gulia A. Abdulina, graduate student of the Department of pediatrics and neonatology of SBEI APE «Kazan State Medical Academy», Kazan, Russia, tel. (843) 562-52-66, e-mail: xamzina.guli@yandex.ru

Asia I. Safina, M.D., Professor, Head of the Department of pediatrics and neonatology of SBEI APE «Kazan State Medical Academy», Kazan, Russia, tel. (843)-562-52-66, e-mail: safina_asia@mail.ru

Maria A. Daminova, assistant of Professor of the Department of pediatrics and neonatology of SBEI APE «Kazan State Medical Academy», Kazan, Russia, tel. (843)-562-52-66, e-mail: daminova-maria@yandex.ru

Abstract. Aim. To identify the features of clinical renal physiology in infants born with extremely low birth weight (ELBW) and very low birth weight (VLBW). Material and methods. We carried out a dynamic monitoring of infants born with VLBW and ELBW. Were examined 80 children, 46 — with VLBW birth and 14 — with ELBW at birth. Control group consisted of 20 healthy infants born at term. Results. A reduction in glomerular filtration rate (GFR) in the group with ELBW and VLBW birth demonstrated. On the second year of life in the group with VLBW at birth, GFR values were normal. In the group of children older than 2 years with ELBW at birth, hyperfiltration was observed, which is an unfavorable factor for renal disease. Urinary syndrome was manifested of proteinuria (7% of children with ELBW), microalbuminuria (14% of children with VLBW and ELBW) and microscopic haematuria (9% of children with VLBW and ELBW). 7% of infants with VLBW and ELBW birth had an increased β2-microglobulin in the urine. Asymptomatic bacteriuria was observed in 85% of infants with ELBW at birth, 68% of infants with VLBW. Urinary tract infection at early age had a 13% of children with ELBW and 2% of children with VLBW. Conclusion. Prematurely born infants with VLBW and ELBW require dynamic monitoring for early detection of renal disease.

Key words: preterm infants, renal function, preterm birth.

 

References

1. Maslova, G.T. Biologija razvitija: organogenez i mehanizmy ontogeneza: kurs lekcij [Developmental biology: organogenesis and mechanisms of ontogenesis] / G.T. Maslova, A.V. Sidorov. — Minsk: BGU, 2012. — 104 p.
2. Assessment of long-term renal complications in extremely low birth weight children / P. Kwinta, M. Klimek, D. Drozdz [et al.] // Pediatric Nephrology. — 2011. — Vol. 26. — Р.1095—1103.
3. Black, M.J. Effects of Preterm Birth on the Kidney / M.J.Black,M.R.Sutherland,L.Gubhaju//BasicNephrology and Acute Kidney Injury. — Monash University Australia, book edited by Manisha Sahay, 2012. — Р.226.
4. Both extrauterine and intrauterine growth restriction impair renal function in children born very preterm / J. Bacchetta, J. Harambat, L. Dubourg [et al.] // Kidney International. — 2009. — № 76. — Р.445—452.
5. Does nephron number matter in the development of kidney disease? / R.N. Douglas-Denton, B.J. McNamara, W.E. Hoy, M.D. Hughson // Ethnicity and Disease. — 2006. — № 16. — Р.40—45.
6. Ekblom, P. Basement membrane proteins and growth factors in kidney differentiation / P. Ekblom // Role of Extracellular Matrix in Development / ed. R. Trelsatd. — New York: Alan R. Liss, 1984. — Р.173—206.
7. Renal function and systolic blood pressure in very-low-birth-weight infants 1—3 years of age / J.A. Frankfurt, A.F. Duncan, R.J. Heyne [et al.] // Pediatric Nephrology. — 2012. — № 27. — Р.2285—2291.
8. Glomerular filtration rate reference values in very preterm infants / R. Vieux, J.M. Hascoet, D. Merdariu [et al.] // Pediatrics. — 2010. — № 125. — Р.1186—1192.
9. Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants / M.M.Rodriguez, A.H.Gomez, C.L. Abitbol [et al.] // Pediatr. Dev. Pathol. — 2004. — № 7. — Р.17—25.
10. Increased urinary angiotensinogen is an effective marker of chronic renal impairment in very low birth weight children / N. Nishizaki, D. Hirano, Y. Nishizaki [et al.] // Clinical and Experimental Nephrology. — 2014. — № 18. — Р.642—648.
11. Influence of Birth Weight on the Renal Development and Kidney Diseases in Adulthood: Experimental and Clinical Evidence / M.C.P. Franco, V.Oliveira, B. Ponzio [et al.] // International Journal of Nephrology. — 2012. —URL: http:// dx.doi.org/10.1155/2012/608025
12. Is nephrogenesis affected by preterm birth? Studies in a non-human primate model / L. Gubhaju, M.R. Sutherland, B.A. Yoder [et al.]. // Am. J. Physiol. Renal. Physiol. — 2009. — Р.297.
13. Postnatal kidney function in children born very low birth weight / A. Gheissari, F. Naseri, H. Pourseirafi, A. Merrikhi // Iran. J. Kidney Dis. — 2012. — № 6. — Р.256—261.
14. Postnatal development of renal function in preterm and term neonates / M.A. Mannan, M. Shahidulla, F. Salam [et al.] // Mymensingh Med. J. — 2012. — № 21. — Р.103—108.
15. Renal developmental arrest in sudden infant death syndrome/S.A.Hinchliffe,C.V.Howard,M.R.Lynch[etal.] // Pediatr. Pathol. — 1993. — № 13. — Р.333—343.
16. Renal function and volume of infants born with a very low birth-weight: a preliminary cross-sectional study / M. Zaffanello, M. Brugnara, C. Bruno [et al.] // International Journal of Paediatrics. — 2010. — № 99. — Р.1192— 1198.
17. Renal function in very low birth weight infants: normal maturity reached during early childhood / M. Vanpée, M. Blennow, T. Linné [et al.] // J. Pediatr. — 1992. — № 121. — Р.784—788.
18. Renal volume and function in school-age children born preterm or small for gestational age / A. Rakow, S. Johansson, L. Legnevall, R. Sevastik [et al.] // Pediatr. Nephrol. — 2008. — № 23. — P.1309—1315.

 

Respiratory disorders in infants with vlbw and elbw

Irina V. Vinogradova, Ph.D., Head of the intensive care unit and neonatal intensive care of Presidential Perinatal Center, the Health Ministry of the Chuvash Republic, Cheboksary, Russia, tel. 8 (8352) 58-12-41, e-mail: vinir1@rambler.ru

Anastasia N. Belova, physician anesthesiologist of Presidential Perinatal Center, the Health Ministry of the Chuvash Republic, Cheboksary, Russia, tel. 8 (8352) 58-12-41

Evgenia N. Ignatieva, Head of the pathology Department of the Cheboksary interdistrict №2 Republican patolog anatomical Bureau Health Ministry of the Chuvash Republic, Cheboksary, Russia, tel. 8 (8352) 23-54-57

Mikhail V. Krasnov, M.D., Professor, Head of Department of children diseases of Chuvash State University named after I.N.Ulyanova, Cheboksary, Russia

Nina N. Emelyanova, Ph.D., associate of Professor of Department of pediatrics of Chuvash State University named after I.N.Ulyanova, Cheboksary, Russia

Dmitriy A. Vinogradov, student of faculty of pediatrics of Chuvash State University named after I.N.Ulyanova, Cheboksary, Russia

Valentina S. Emelyanova, student of medical faculty of Chuvash State University named after I.N.Ulyanova, Cheboksary, Russia

Abstract. Aim. To determine the characteristics of respiratory disorders in premature infants to improve therapy tactics. Material and methods. 89 infants with extremely low birth weight (ELBW) and very low birth weight (VLBW) infants at birth were under the supervision. Results and discussion. Breaths disorders in premature infants with VLBW and ELBW were characterized by late appearance of the first spontaneous inspiration. Normalization of respiratory rhythm occurred only after application of the blowing breath technique, noninvasive surfactant administration in the delivery room (LIST method). Frequency of LIST application in children with ELBW were 100% in children with VLBW — 33% (p <0,05). Assessment of the severity of respiratory disorder by Downes scale was low informative and did not reflect the severity of RDS. Morphology of the lungs in children with ELBW and VLBW depended on the stage of the inflammatory process, positively correlated with circulatory disturbances. It was found that in newborns under 20 days of life prophylactic administration of surfactant, and non-invasive methods of surfactant administration reduced the need for mechanical ventilation (MVL) in preterm infants with ELBW in 2,3 times and reduced the length of stay in the neonatal intensive care unit in 2,5 times. These methods reduced neurological complications in 3,6 times, bronchopulmonary dysplasia (BPD) in 1,5 times, necrotizing enterocolitis in 14 times, mortality in 1,2 times. Conclusion. Infants with ELBW had severe respiratory distress syndrome (RDS), and required more prolonged mechanical ventilation with fixed parameters. In addition, children with circulatory disturbances had more severe RDS, required prolonged mechanical ventilation with fixed parameters, which resulted in BPD and required longer hospitalization.

Key words: preterm, respiratory distress syndrome, bronchopulmonary dysplasia.

 

References

1. Northway, W.H. Pulmonary disease following respiratory therapy of hyaline membrane disease / W.H. Northway, R.C. Rosan, D.Y. Parker // The New England Journal of Medicine. — 1967. — Vol. 276. — P.357—374.
2. Ivanov, D.O. Persistiruyuschaya legochnaya gipertenziya u novorozhdennyh [Persistent pulmonary hypertension of the newborn] / D.O. Ivanov, D.N. Surkov, M.A. Ceitlin // Byulleten' Federal'nogo centra serdca, krovi i endokrinologii im. V.A. Almazova [Bulletin of the Federal Center of Heart, Blood and Endocrinology named after V.A. Almazov]. — 2011. — № 5. — S.94—112.
3. Osobennosti okazaniya medicinskoi pomoschi detyam, rodivshimsya v srokah gestacii 22—27 nedel' [Features of medical care to children born in the 22—27 weeks gestation] / D.O. Ivanov [i dr.]; pod red. D.O. Ivanova, D.N. Surkova. — SPb.: Inform-Navigator, 2013. — 132 s.
4. Serial electrocardiographic changes in healthy and stressed neonates / R. Jedeikin, A. Primhak, A.T. Shenan [et al.] // Arch. Dis. Child. — 1983. — Vol. 58. — P.605—611.
5. Jobe, A.H. Bronchopulmonary dysplasia. NICHD-NHLBIORD Workshop / A.H. Jobe, E. Bancalary // Am. J. Respir. Crit. Care Med. — 2001. — Vol. 163. — P.1723—1729.
6. Bancalary, E. Bronchopulmonary dysplasia: changes in patogenesis, epidemiology and definition / E. Bancalary, N. Claure, I. R. Sosenko // Seminars in neonatology. — 2003. — Vol. 8. — P.63—71.
7. Charafeddine L. Atypical chronic lung disease patterns in neonates / L. Charafeddine, C.T. D'Angio, D.L. Phelps // Pediatrics. — 1999. — Vol. 103. — P.759—765.

 

Physical development parameters in preterm infants and modern approach to nutritional support for outpatients

Elena V. Volyanyuk, Ph.D., director of the Center catamnesis preterm infants City Children's Hospital № 1, Kazan, Russia, tel. 8-903-388-91-00, e-mail: evolanuk@mail.ru

Abstract. Aim. To evaluate physical and motor development in preterm infants at 4 months corrected age with postnatal malnutrition. Material and methods. The study included 63 children with a birth weight from 480 to 2300 g, born on 24—34 weeks of gestation. Presented observations are from own clinical practice. Results and discussion. The problem of prematurity is one of the key issues in neonatology and pediatrics as a whole. This paper discusses the features of physical development of premature infants 4 months of corrected age, depending on gestational age and physical status. In the analysis of feeding in preterm infants, we observed that most of them received adapted food (69%) in the early stages of the neonatal period. It was found that premature babies with extremely low birth weight, and particularly preterm, small for gestational age have high risk of nutritional disorders. An issue of complementary feeding timing in preterm infants remains under discussion. Nowadays, the benchmark for the introduction of the first feeding is corrected age of 3 months at the child's weight more than 5 kg. The sequence and duration of administration of each feeding, depends on the condition of the child and comorbidity. Conclusion. Only a comprehensive approach to the follow-up period for preterm infants with a history of prenatal malnutrition, allows a full rehabilitation, a sensitive marker of it are parameters of physical development.

Key words: preterm, physical development, nutritional support.

 

References

1. Alyamovskaya, G.A. Osobennosti fizicheskogo razvitiya glubokonedonoshennyh detei na pervom godu zhizni [Features of the physical development of extremely premature infants in the first year of life] / G.A. Alyamovskaya, E.S. Keshischjan, E.S. Saharova // Vestnik sovremennoi klinicheskoi mediciny [Bulletin of modern clinical medicine]. — 2013. — T. 6, vyp. 6. — S.6—13.
2. Baranov, A.A. Nauchnoe napravlenie podprogrammy «Zdorovyi rebenok» — prakticheskomu zdravoohraneniyu [Scientific direction subroutine «Healthy Child» — practical health] / A.A. Baranov // Rossiiskii pediatricheskii zhurnal [Russian Journal of Pediatrics]. — 2002. — № 2. — S.53—54.
3. Sovremennye zadachi vskarmlivaniya nedonoshennyh detei [Contemporary challenges for feeding premature infants] / A.B. Dulenkov, O.V. Potapova, O.I. Mileva, V.P. Geras'kina // Praktika pediatra [Pediatric practice]. — 2008. — № 1. — S.38—40.
4. Sravnitel'nye rezul'taty katamnesticheskogo nablyudeniya detei, perenesshih kriticheskie sostoyaniya neonatal'nogo perioda [Comparative results of follow-up of children who had neonatal critical states] / E.V. Aronskid, O.P. Kovtun, O.T. Kabdrahmanova [i dr.] // Pediatriya [Pediatrics]. — 2010. — T. 89, № 1. — S.47—50.
5. Volyanyuk, E.V. Posleduyuschee nablyudenie nedonoshennyh detei: ucheb. posobie [Follow-up of preterm infants: a tutorial] / E.V. Volyanyuk, A.I. Safina, O.A. Stepanova. — Kazan', 2013. — 120 s.
6. Postnatal weight increase and growth velocity of very low birthweight infants / E. Bertino, A. Coscia, M. Mombro [et al.] // Arch. Dis. Child Fetal Neonatal Ed. — 2006. — Vol. 91. — P.349—356.
7. Cooke, R.J. Postnatal growth and development in the preterm and small for gestational age infants. Importance of growth for health and development / R.J. Cooke, A. Lucas, M. Makrides, E.E. Ziegler // Nestle Nutr. Inst. Workshop Ser Pediatr Program. — 2010. — Vol. 65. — P.85—98.
8. Feeding preterm infants after hospital discharge. A Commentary by ESPGHAN Committie on nutrition / P.J. Aggett, C. Agostini, I. Axelsson [et al.] // J. Pediatr. — 2006. — Vol. 42. — P.596—603.
9. Infant growth before and after term: effects on neurodevelopment in preterm infants / M.B. Belfort, S.L. Rifas Shiman, T. Sullivan [et al.] // Pediatrics. — 2011. — Vol. 128. — P.899—906.
10. Nutrition of the preterm infant: scientific basic and practical guidelines / R.C. Tsang, R. Uauy, B. Koletzko [et al.]. —2 ed. — Cincinnati, OH: Digital Educational Publishing Inc., 2005. — P.201—244.

 

Features of perinatal history and heart rate variability in premature infants born with extremely low body weight and very low body weight on the first year of life

Zulfiya R. Dolgova, graduate student of the Department of pediatrics and neonatology of SBEI APE «Kazan State Medical Academy», Kazan, Russia, tel. (843)-562-52-66, e-mail: mama-z@km.ru

Abstract. Aim. To study the heart rate variability and autonomic regulation features in preterm infants with an analysis of adverse perinatal factors. Matherial and methods. Current study included preterm infants during infancy. We assessed thoroughly history, physical examination of patients, electrocardiography findings, ambulatory ECG Holter monitoring results. Results and discussion. We analyzed of the most significant perinatal risk factors for cardiovascular diseases such as burdened obstetric history, chronic fetoplacental insufficiency, preeclampsia, viral infections during the first trimester of pregnancy. There was a reduction of circadian index in the children with ELBW and VLBW, that is, the presence of the rigidity of the circadian profile of heart rate (HR). According to ECG Holter monitoring, preterm infants had such cardiac disorders as cardiac arrhythmia supraventricular and ventricular, conduction disturbances in the form of AV block, daily rhythm structure changes in the form of the rigidity of the circadian profile of HR. We found decreased temporal parameters of heart rate variability, which indicates a weakening of parasympathetic effects on the heart and relative sympathicotonia. Conclusion. The presence of autonomic imbalance with a predominance of sympathetic tone, reduced heart rate variability in conjunction with anatomical defects, overloading of the heart chambers volume or pressure and hypoxia may predispose the development of pathological myocardial remodeling in infants with extremely and very low birth weight.

Key words: preterm infants, Holter monitoring, heart rate variability.

 

References

1. Baevskii, R.M. Matematicheskii analiz izmenenii serdechnogo ritma pri stresse [Mathematical analysis of the changes in heart rate during stress] / R.M. Baevskii, O.I. Kirillov, S.Z. Kleckin. — M.: Nauka [Science], 1984. — 219 s.
2. Mihailov, V.M. Variabel'nost' ritma serdca [Heart rate variability] / V.M. Mihailov. — Ivanovo, 2000. — 200 s.
3. Ryabykina, G.V. Analiz variabel'nosti ritma serdca [Analysis of heart rate variability] / G.V. Ryabykina, A.V. Sobolev // Kardiologiya [Cardiology]. — 1996. — № 10. — S.87—97.
4. Sinus arrhythmia in acute myocardial infarction / M.W. Wolf, В.А. Varigos [et al.] // Mod. J. Austral. — 1978. — Vol. 2. — Р.52—53.
5. Esler, М. The autonomic nervous system and cardiac arrest / М. Esler // Am. J. Cardiol. — 1992. — Vol. 70. — P.441—448
6. Olimov, N.H. Prediktory narusheniya ustoichivosti ekstrakardial'noi regulyacii serdechnogo ritma i vnezapnoi smerti u bol'nyh infarktom miokarda: dis. ... d-ra med. nauk [Predictors of positive stability extracardiac regulation of heart rate and sudden death in patients with myocardial infarction] / N.H. Olimov. — M., 2009. — 229 s.
7. Shkol'nikova, M.A. Normativnye parametry cirkadnoi variabel'nosti ritma serdca u detei pervogo goda zhizni [Normative parameters of the circadian heart rate variability in infants] / M.A. Shkol'nikova, L.A. Kravcova, L.M. Makarov // Vestnik aritmologii [Herald arrhythmology]. — 2000. — № 1. — S.43—44.
8. Shkol'nikova, M.A. Zhizneugrozhayuschie aritmii u detei [Life-threatening arrhythmias in children] / M.A. Shkol'nikova. — M., 1999. — 232 s.
9. Interpretaciya v klinicheskoi fiziologii serdca [Interpretation of clinical physiology of the heart / N.I.  Yabluchanskii, I.P. Vakulenko, A.V. Martynenko, V.E. Shlyahover. — Har'kov: Izd-vo Nac. un-ta vnutrennih del, 2001. — 168 s.
10. Osnovy prakticheskogo primeneniya neinvazivnoi tehnologii issledovaniya regulyatornyh sistem cheloveka [The practical application of non-invasive technology, studies of regulatory systems of the person] / N.I. Yabluchanskii, A.V. Martynenko, A.S. Isaeva. — Har'kov: Osnova, 2000. — 88 s.
11. Task Force of the European Society of Cardiology and North American Society of Pacing and Electrophysiology. Heart Rate Variability. Standards of Measurement, Physiological Interpretation, and Clinical Use // Circulation. — 1996. — Vol. 93. — P.1043—1065.
12. Grin', V.K. Ocenka diagnosticheskoi znachimosti holterovskogo monitorirovaniya i variabel'nosti serdechnogo ritma v vyyavlenii SSSU u detei s sinusovoi bradikardiei [Assessment of the diagnostic value of Holter monitoring and heart rate variability in the identification of sick sinus syndrome in children with sinus bradycardia] / V.K. Grin', A.O. Raschupkin. — URL: http://medexpert.org.ua
13. Makarov, L.M. Holterovskoe monitorirovanie [Holter] / L.M. Makarov. — M.: Medpraktika, 2003. — 340 s.

 

Characteristics of postnatal growth in children born with intrauterine growth restriction

Anna I. Ignatkevich, neonatologist of Department of pathology, newborns and premature babies, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (952)-220-83-11, e-mail: aignatkevich@yandex.ru

Yuriy V. Petrenko, Ph. D., Head of research laboratory of physiology and pathology of the newborn of Institute of perinatology and pediatrics, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (921)-336-53-95, e-mail: alez1964@yandex.ru

Dmitriy O. Ivanov, M.D., Director of the Institute of perinatology and pediatrics, Head of the Department of children diseases, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (911)-288-90-95, e-mail: doivanov@yandex.ru

Elizaveta A. Kurzina, Ph. D., research associate laboratory of physiology and pathology of the newborn, the Institute of perinatology and pediatrics , Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (921)-386-24-03, e-mail: elizavetakurzina@yandex.ru

Кristina F. Islamova, research associate laboratory of physiology and pathology of the newborn, the Institute of perinatology and pediatrics, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (951)-677-25-11, e-mail: kislamova81@mail.ru

Abstract. Aim. To identify the relationship between the levels of insulin-like growth factor-1 (IGF-1) and growth hormone (GH) in the blood and the postnatal growth rate in children born with IUGR in the first 6 months of life. Material and methods. We prospectively examined 65 children: 33-term infants born with IUGR and 32 healthy full-term infants in the control group. Results and discussion. IGF-1 levels in cord blood in children with IUGR were reduced comparative to the control group. At 3-month age blood IGF-1 of children born with IUGR increases, which is higher than the control group, but in reference values. At 3-month age the level of growth hormone in children with symmetrical IUGR was significantly reduced compared with level at birth, in contrast to the group of children with asymmetric IUGR, in which GH persists on the same level. Children with «growth leap» mass had lower concentration of IGF-1 in the umbilical cord blood which is, on average, almost 2-times lower than children without a «growth leap». At 3-month age IGF-1 level dramatically increased in children with «growth leap» in children without it, on the contrast, IGF-1 level is significantly reduced. There were no differences of growth hormone levels between children with «growth leap» and without it. At 3-month age the level of growth hormone is reduced in comparison with the level of umbilical cord blood. Conclusion. Most children born with IUGR (over 87%) demonstrate accelerated growth rates after birth, the maximum increase in growth rates occur during the first 3 months of life. All groups examined at birth and at 3 months showed a large data spread of IGF-1 and GH.

Key words: intrauterine growth restriction, insulin-like growth factors, growth hormone, postnatal growth, «leap
growth».

 

References

1. Association between postnatal catch-up growth and obesity in childhood: prospective cohort studies / K. Ong, M. Ahmed, P. Emmett [et al.] // BMJ. — 2000. — № 320. — P.967—971.
2. Yajnik, C.N. Neonatal anthropometry: the thin-fat Indian baby. The pune marternal nutrition Study / C.N. Yajnik, C.H. Fall, K.J. Coyaji // Int. J. Obes. Rel. Metab. Disord. — 2003. — № 27. — P.173.
3. Low birth and catch-up-growth associated with metabolic syndrome:atenyearsystematicrewiew/V.Nobili,A.Alisi, N. Panera, C. Aqostoni // Pediatr. Endocrinol. Rev. — 2008. — № 6(2). — P.241—247.
4. Mericq, V. Low birth weight and endocrine dysfunction in postnatal life / V. Mericq // Pediatr. Endocrinol. Rev. — 2006. — № 4(1). — P.3—4.
5. D'Ercole, A.J. Evidence that somatomedin is synthesized by multiple tissues in the fetus / A.J. D'Ercole, G.T.Applewhite, L.E. Underwood // Dev. Biol. — 1980. — № 75. — T.R. Johnson, B.K. Blossey, C.W. Denko, J. Ilan // Mol. Р.315—328. Endocrinol. — 1989. — № 3. — Р.580—587.
6. Insulin-like growth factor 1 alters feto-placental protein and 12. Insulin sensitivity and secretion are related to catch-up carbohydrate metabolism in fetal sheep / J.E. Harding, growth in small-for-gestational-age infants at age 1 year: L. Liu, P.C. Evans, P.D. Gluckman // Endocrinology. — results from a prospective cohort / N. Soto, R.A. Bazaes, 1994. — № 134. — Р. 1509—1514. V. Pena [et al.] // J. Clin. Endocrinol. Metab. — 2003. —
7. Gluckman, P.D. The role of pituitary hormones, growth factors and insulin in the regulation of fetal growth / P.D. Gluckman; ed. J.R. Clarke // Oxford reviews of reproductive biology. — 1986. — Vol. 8. — P.1—60.
8. Congenital idiopathic growth hormone deficiency associated with prenatal and early postnatal growth failure. The International Board of the Kabi Pharmacia International Growth Study / P.D. Gluckman, A.J. Gunn, A. Wray [et al.] // J. Pediatr. — 1992. — Vol. 121. — P.920—923.
9. Yang, S.W. Relationship of insulin-like growth factor-I, insulin-like growth factor binding protein-3, insulin, growth hormone in cord blood and maternal factors with birth height and birthweight / S.W. Yang, J.S. Yu // Pediatr Internat. — 2000. — № 42. — Р.31—36.
10. Reduction of serum insulin-like growth factor-I by dietary protein restriction is age dependent / T. Fliesen, D. Maiter, G. Gerard [ et al.] // Pediatr Res. — 1989. — № 26. — Р.415—419.
11. Expression of insulin-like growth factor I in cultured rat hepatocytes: effects of insulin and growth hormone / T.R. Johnson, B.K. Blossey, C.W. Denko, J. Ilan // Mol. Endocrinol. — 1989. — № 3. — Р.580—587.
12. Insulin sensitivity and secretion are related to catch-up growth in small-for-gestational-age infants at age 1 year: results from a prospective cohort / N. Soto, R.A. Bazaes, V. Pena [et al.] // J. Clin. Endocrinol. Metab. — 2003. — № 88. — Р.3645—3650.
13. Insulin-like growth factors and their binding proteins in the term and preterm human fetus and neonate with normal and extremes of intrauterine growth / L.C. Giudice, F. de Zegher, S.E. Gargosky [et al.] // J. Clin. Endocrinol. Metab. — 1995. — № 80. — Р.1548.
14. Diagnostika i lechenie endokrinnyh zabolevanii u detei i podrostkov: ucheb. posobie [Diagnosis and treatment of
    endocrine disorders in children and adolescents: a Tutoria] / рod red. prof. N.P. Shabalova. — 2-e izd., ispr. i dop. — M.: MEDpress-inform, 2009. — 528 s.
15. Neonatologiya [Neonatology]: ucheb. posobie: v 2 t. / N.P. Shabalov. — 5-e izd., ispr. i dop. — M.: MEDpressinform, 2009. — T. 2. — 768 s.
16. Rost i razvitie rebenka [Growth and development of the child] / V.V. Yur'ev, A.S. Simahodskii, A.S. Voronovich, M.M. Homich. — SPb.: Piter, 2007. — 197 s.

 

Changes in « insulin-like growth factor-1—growth hormone» axis and insulin sensitivity in children with intrautherine growth retardation

Кristina F. Islamova, research associate Laboratory of physiology and pathology of the newborn, the Institute of perinatology and pediatrics, Federal Almazov Medical Research Centre of the Ministry of health of the Russia, Saint-Petersburg, tel. 8 (951)-677-25-11, e-mail: kislamova81@mail.ru

Yuriy V. Petrenko, Ph.D., Head of research Laboratory of physiology and pathology of the newborn, the Institute of perinatology and pediatrics, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (921)-336-53-95, e-mail: alez1964@yandex.ru

Dmitriy O. Ivanov, M.D., Director of the Institute of perinatology and pediatrics, Head of the Department of children diseases, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (911)-288-90-95, e-mail: doivanov@yandex.ru

Sophia N. Filipova, pediatrician Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg, tel. 8 (904)-633-55-48, e-mail: SophiaLeil@mail.ru

Abstract. Aim. To study the changes in the axis of the «growth hormone (GH) — insulin-like growth factor-1 (IGF-1)»
and the insulin sensitivity of tissues in children born with IUGR, depending on the mass-height dynamics. Material and methods. 49 children born with IUGR and 30 control children born without IUGR were prospectively examined. Levels of GH and IGF-1 levels were determined in cord blood and estimation of the insulin sensitivity of tissues was carried out using the homeostatic model (HOMA-IR) at the age of 3 months. Results and discussion. Demanstrated that IGF-1 levels in cord blood in children with IUGR in comparison with the control group was significantly lower, 52,20 (11,61—99,40) and 103,50 (46,17—181,99) ng/ml, respectively (p <0,05). There were no significant differences of growth hormone level in the umbilical cord blood between the groups. There were no significant differences of the level of IGF-1 and GH at the age of 3 months between the study and control groups. The values of basal insulin resistance of tissues (HOMAIR) were significantly higher in children of study group: 1,12 (0,36—3,99) and 0,88 (0,21—1,64) ng/ml respectively (p<0,05). 16 of 23 children born with IUGR (69,5%) had «growth leap» in the first 3 months of life assessed by weight, and/or an increase of 2 or more centile corridor (CC). Accelerating the pace of growth was associated with significantly higher levels of IGF-1 and GH levels in 3 months of life. Conclusion. Revealed features of «GH-IGF-1» axis and insulin sensitivity of tissues in children with IUGR aimed to stimulation of postnatal growth and can predispose the development of carbohydrate metabolism disorders in later life.

Key words: intrauterine growth restriction, insulin-like growth factors, growth hormone, insulin sensitivity, insulin
resistance, postnatal growth.

 

References

1. Yang, S.W. Relationship of insulin-like growth factor-I, insulin-like growth factor binding protein-3, insulin, growth hormone in cord blood and maternal factors with birth height and birthweight / S.W. Yang, J.S. Yu // Pediatr Internat. — 2000. — Vol. 42. — P.31—36.
2. Wan, G. Serum concentration of insulin-like growth factor-I in cord blood / G. Wan, G.S. Yu, J. Liu // Zhonghua Fu. Chan. Ke. Za. Zhi. — 1998. — № 33. — P.720—721.
3. Relation of cord serum levels of growth hormone, insulin-like growth factors, insulin-like growth factor binding proteins, leptin, and interleukin-6 with birth weight, birth length, and head circumference in term and preterm neonates / H.C. Lo, L.Y. Tsao, W.Y. Hsu [et al.] // Nutrition. — 2002. — Vol. 18. — P.604—608.
4. Insulin-like growth factors and their binding proteins in the term and preterm human fetus and neonate with normal and extremes of intrauterine growth / L.C. Giudice, F. de Zegher, S.E. Gargosky [et al.] // J. Clin. Endocrinol. Metab. — 1995. — Vol. 80. — P.1548—1555.
5. The somatomedin hypothesis / D. Le Roith, C. Bondy, S. Yakar [et al.] // Endocr. Rev. — 2001. — Vol. 22. — P.53—74.
6. D'Ercole, A.J. Evidence that somatomedin is synthesized by multiple tissues in the fetus / A.J.D'Ercole,G.T.Applewhite, L.E. Underwood // Dev. Biol. — 1980. — № 75. — P.315—328.
7. Harding, J.E. Insulin-like growth factor 1 alters feto-placental protein and carbohydrate metabolism in fetal sheep / J.E. Harding, L. Liu, P.C. Evans, P.D. Gluckman // Endocrinology. — 1994. — Vol. 134. — P.1509— 1514.
8. Reduction of serum insulin-like growth factor-I by dietary protein restriction is age dependent / T. Fliesen, D. Maiter, G. Gerard [et al.] // Pediatr Res. — 1989. — Vol. 26. — P.415—419.
9. Fowden, A.L. The role of insulin in prenatal growth / A.L. Fowden // J. Dev. Physiol. — 1989. — № 12. — Р.173—182.
10. Johnson, T.R. Expression of insulin-like growth factor I in cultured rat hepatocytes: effects of insulin and growth hormone / T.R. Johnson, B.K. Blossey, C.W. Denko, J. Ilan // Mol. Endocrinol. — 1989. — Vol. 3. — P.58—87.
11. Binding protein for human growth hormone: effects of age and weight / R.W. Holl, R. Snehotta, B. Siegler [et al.] // Horm. Res. — 1991. — № 35. — Р.190—197.
12. Congenital idiopathic growth hormone deficiency associated with prenatal and early postnatal growth failure. The International Board of the Kabi Pharmacia International Growth Study / P.D. Gluckman, A.J. Gunn, A. Wray [et al. ] // J. Pediatr. — 1992. — Vol. 121. — P.920—923.
13. Randhawa, R.S. The insulin-like factor system and fetal growth restriction / R.S. Randhawa // Ped. Endocrinol. Rev. — 2008. — № 6 (2). — Р.235—240.
14. Diminished beta-cell replication contributes to reduced beta-cell mass in fetal sheep with intrauterine growth restriction / S.W. Limesand, J. Jensen, J.C. Hutton, W.W. Hay // Am. J. Physiol. Regul. Integr. Comp. Physiol. — 2005. — Vol. 288. — P.1297—1305.
15. Attenuated insulinrelease and storage in fetal sheep pancreatic islets with intrauterine growthrestriction / S. Limesand, P. Rozance, G. Zerbe [et al.] // Endocrinology. — 2006. — Vol. 147. — P.1488—1497.
16. The endocrine pancreas in small-for-dates infants / F.A. Van Assche, F. De Prins, L. Aerts, M. Verjans // Br. J. Obstet. Gynaecol. — 1977. — Vol. 84. — P.751—753.
17. Longitudinal changes in insulin sensitivity and secretion from birth to age three years in small- and appropriate-for-gestational-age children / V. Mericq, K.K. Ong, R. Bazaes [et al.] // Diabetologia. — 2005. — Vol. 48. — P.2609—2614.
18. ALSPAC study team 2004 Insulin sensitivity and secretion in normal children related to size at birth, postnatal growth, and plasma insulin-like growth factor-I levels / K.K. Ong, C.J. Petry, P.M. Emmett [et al.] // Diabetologia. — 2004. — Vol. 47. — P.1064—1070.
19. Influence of Catch-up Growth on Glucose Tolerance and β-Cell Function in 7-Year-Old Children: Results From the BirthtoTwentyStudy/N.J.Crowther[etal.]//Pediatrics. — 2008. — Vol. 121. — P.1715—1722.
20. Insulin sensitivity and secretion are related to catch-up growth in small-for-gestational-age infants at age 1 year: results from a prospective cohort / N. Soto, R.A. Bazaes, V. Pena [et al.] // J. Clin. Endocrinol. Metab. — 2003. — Vol. 88. — P.3645—3650.
21. Rost i razvitie rebenka / V.V. Yur'ev, A.S. Simahodskii, A.S. Voronovich, M.M. Homich. — SPb.: Piter, 2007. — 197 s.
22. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man / D.R. Matthews, J.P. Hosker, A.S. Rudenski [et al.] // Diabetologia. — 1985. — Vol. 28, № 7. — Р.412—419.
23. Blum, W.H. Radioimmunoassays for IGFs and IGFBPs / W.H. Blum, B.H. Breier // Growth Regulation. — 1994. — Vol. 4. — P.11—19.

 

Tissue doppler in the study of circular and radial systolic strain of the left ventricle myocardium in the first year of life children with intrauterine growth retardation

Nikolay F. Priyma, Ph.D., Senior Researcher of research laboratory of physiology and pathology of the newborn, Institute of perinatology and pediatrics FI MTS of name V.A. Almazov, Saint-Petersburg, Russia, e-mail nikpriima@rambler.ru

Dmitriy O. Ivanov, M.D., Director of the Institute of perinatology and pediatrics, Head of the Department of children diseases, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg

Yuriy V. Petrenko, Ph.D., Head of research laboratory of physiology and pathology of the newborn of the Institute of perinatology and pediatrics, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg

Andrey V. Kozlenok, Ph.D., Head of Research Department of the physiology of circulation Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg,

Kristina F. Islamova, researcher of research Laboratory of physiology and pathology of the newborn of the Institute of perinatology and pediatrics, Federal Almazov Medical Research Centre of the Ministry of health of Russia, Saint-Petersburg

Abstract. Aim. To examine the circular and radial deformation of left ventricular in infants, including children born with intrauterine growth retardation (IUGR). Material and methods. The sample of 123 children were examined. 35 children with IUGR were compared with 88 children. The median age was (7,4±3,3) and (7,3±2,4) months, respectively. Using the tissue Doppler examination in Strain Rate Imaging TVI mode speed circular and radial systolic myocardial deformation of the left ventricle were studied at the level of the cross-cut the last echocardiographic short axis. Results and discussion. Were identified two main types of graphs which characterized the deformation rates of myocardial segments. First, a synchronous type, characterized by high-amplitude unidirectional monophasic curves, the second type — asynchronous, combining both positive and negative values of strain rates, which was interpreted as the presence of pronounced systolic circular shortening of individual segments of the myocardium. It was found that an asynchronous type of deformation had a longer time than synchronous. In asynchronous type strain in the group of children with IUGR and in the comparison group, indicators of strain rates of all segments were significantly lower than in the synchronous case. Conclusion. Combination of effective circular with radial systolic myocardial deformation is, in our opinion, a marker of high adaptive properties of the latter, and demands lower energy costs for the implementation of cardiac output.

Key words: tissue Doppler study, radial and circular deformation of the myocardium of the left ventricle, delayed fetal development.

 

References

1. Paradoxical increase in ventricular torsion and systolic torsion rate in type 1 diabetic patients under tight glycemic control / J. Chung, P. Abraszewski, X. Yu [et al.] // J. Am. Coll. Cardiol. — 2006. — Vol. 47. — P. 384—390.
2. MRI assessment of LV relaxation by untwisting rate: a new isovolumic phase measure of tau / S. Dong, P. Hees, P. Hees [et al.] // Am. J. Physiol. Heart Circ. Physiol. — 2001. — Vol. 281. — P.2002—2009.
3. Measure of left ventricular torsion with cardiac pacing and right bundle branch block patients by two-dimension ultrasound speckle tracking imaging / A. G. Luo, L.X. Yin, C.M.LI[etal.]//Chin.J.Ultrasonogr(Chinese). —2006.— Vol. 15. — P.641—645.
4. Meunier, J. Ultrasonic texture motion analysis: theory and simulation / J. Meunier, M. Bertrand // IEEE Trans. Med. Imaging. — 1995. — Vol. 14. — P.293—230.
5. Maturational and adaptive modulation of left ventricular torsional biomechanics: Dopple tissue imaging observation from infancy to adulthood / Y. Notomi, G. Srinath, T. Shiota [et al.] // Circulation. — 2006. — Vol. 113. — P.2524— 2533.
6. Notomi, Y. Presto untwisting and legato filling / Y. Notomi, J.Thomas//JACCCardiovasc.Imaging.— 2009.—Vol.2 (6). — P.717—719.
7. Age-related changes in myocardial relaxation using three-dimensional tagged magnetic resonance imaging // H.C. Oxenham, A.A. Young, B.R. Cowan [et al.] // J. Cardiovasc. Magn. Reson. — 2003. — Vol. 5. — P.421—430.
8. Ventricular mechanics in disastole: material parameter sensitivity / C. Stevens, E. Remme, I. LeGrice [et al.] // J. Biomech. — 2003. — Vol. 36. — P.737—748.
9. Application of' novel echocardiographic two-dimensional tracking system to define regional' heterogeneity of radial and longitudinal myocardial-strain and strain-rate (abstr) / R. Sukmawan, N. Watanabel, E. Toyota [et al.] // Circulation. — 2005. — Vol. 112. — P.2561.
10. Taber, L.A. Mechanics of ventricular torsion / L.A. Taber, M. Yang, W.W. Podszus // J. Biomechanics. — 1996. — Vol. 29. — P.745—752.
11. Age-related changes in left ventricular twist assessed by two-dimensional speckle-tracking imaging / M. Takeuchi, H.Nakai,M.Kokumai[etal.]//J.Am.Soc.Echocardiogr. — 2006. — Vol. 19. — P.1077—1084.
12. The structure and function of the helical heart and its buttress wrapping.The normal macroscopic structure of the heart / F. Torrent-Guasp, G.D. Buckberg, C. Clemente [et al.] // Semin. Thorac. Cardiovasc. Surg. — 2001. — Vol. 1. — P.301—319.

 

Influence of positive pressure ventilation on cerebral status of newborns in acute period of hypoxic-ischemic encephalopathy

Denis N. Surkov, Ph.D., Head of the Department of anesthesiology and intensive care unit for newborns with subintensivnogo treatment for premature and sick newborns Public enterprise «Regional children’s hospital» of Dnepropetrovsk, Chief freelance pediatric anesthesiologist General directorate of health Dnipropetrovsk regional state administration of Ukraine; Ukraina, e-mail: densurkov@hotmail.com

Oksana G. Kapustina, pediatric anesthesiologist doctor of anesthesiology and intensive care for newborns Regional children’s hospital, Dnepropertrovsk, Ukraina

Dmitriy O. Ivanov, M.D., Director of the Institute of perinatology and pediatrics, Head of the Department of children diseases, Federal Almazov Medical Research Centre of the Ministry of health of the RussianFederation, Saint-Petersburg, tel. 8 (911)-288-90-95, e-mail: doivanov@yandex.ru

Abstract. Aim — to improve the quality of treatment of full term infants with hypoxic-ischemic encephalopathy (HIE)
by choosing the best option of mechanical ventilation. To study the impact of mechanical ventilation on the cerebral
blood flow, assessment of cerebral perfusion and systemic hemodynamics. Material and methods. Prospective,
observational, multicenter, longitudinal cohort study included 115 children with severe HIE. Children had II and
III classes of HIE based on Sarnat scale (modified by Hill A., Volpe J.J., 1994) were treated in the neonatal intensive
care in 2007—2011. Results and discussion. Analysis and assessment of the impact of positive pressure ventilation
on cerebral perfusion were examined and there was no evidence of negative correlation. Therefore, we can draw a
conclusion of the safety of mechanical ventilation in preterm infants with severe hypoxic-ischemic encephalopathy.
Conclusion. In current paper we summarized and solved actual scientific problems: improving the quality of treatment of full term infants with hypoxic-ischemic encephalopathy by choosing the best option of mechanical ventilation based on this study of its impact on the performance of cerebral circulation, assessment of cerebral perfusion and systemic hemodynamics.

Key words: newborns, hypoxic-ischemic encephalopathy, ventilation support, cerebral perfusion.

 

References

1. Zanelli, S.A. Hypoxic-ischemic encephalopathy / S.A. Zanelli, D.P. Stanley, D. Kaufman. — 2012. — URL: http://emedicine.medscape.com/article/973501
2. Raju Tonse, N.K. Hypoxic-ischemic brain injury in the newborn / N.K. Raju Tonse, T. Rosenkrantz, R. Konop. — 2003. — URL: http://www.emedicine.com/ped/byname/ hypoxic-ischemic-encephalopathy.htm
3. De Menezes, M.S. Hypoxic-ischemic brain injury in the newborn / M.S. de Menezes. — 2013. — URL: http:// emedicine.medscape.com/article/1183351
4. Posledstviya perinatal’nyh porazhenii central’noi nervnoi sistemy: diskusionnye voprosy [The consequences of perinatallesionsofthecentralnervoussystem:discoursive questions]/A.P.Volosovec,S.P.Krivopustov,I.A.Loginova [i dr.] // Neonatologiya [Neonatology]. — 2008. — T. 4, № 13. — C.12—17.
5. Long-term cognitive and behavioral consequences of neonatal encephalopathy following perinatal asphyxia: a review / M. van Handel, H. Swaab, L.S. de Vries, M.J. Jongmans // Eur. J. Pediatr. — 2007. — Vol. 166, № 7. — P.645—654.
6. Pin, T.W. A review of developmental outcomes of term infants with post-asphyxia neonatal encephalopathy / T.W. Pin, B. Eldridge, M.P. Galea // Eur. J. Paediatr. Neurol. — 2009. — Vol. 13, № 3. — P.224—234.
7. Effect of neonatal resuscitation courses on long-term neurodevelopmental outcomes of newborn infants with perinatal asphyxia / R. Duran, I. Gorker, B. Acunas [et al.] // Pediatr. Int. — 2012. — Vol. 54, № 1. — P.56—59.
8. Ivanov, D.O. Narusheniya obmena glyukozy u novorozhdennyh: monografiya [Glucose metabolism disorders in the newborn: a monograph] / D.O. Ivanov. — SPb.: Izd-vo N-L., 2011. — 100 s.
9. Donn, S.M. Manual of neonatal respiratory care. — 2th ed / S.M. Donn, S.K. Sinha. — Philadelphia: Elsevier, 2006. — 580 p.
10. Sarnat, H.B. Neonatal encephalopathy following fetal distress: A clinical and electroencephalographic study / H.B. Sarnat, M.S. Sarnat // Arch. of Neurol. — 1976. — Vol. 33. — P.696—705.
11. Hill, A. Neurologic disorders / А. Hill, J.J. Volpe, G.B. Avery [et al.] // Neonatology: Pathophysiology and management of the newborn. — Philadelphia, New York: Lippincott. Raven, 1994. — P.1117—1138.
12. Iova, A.S. Puti povysheniya chuvstvitel’nosti shkaly komy Glazgo u detei (pediatricheskaya shkala komy Glazgo, Sankt-Peterburg) [Ways to improve the sensitivity of Glasgow coma scale in children (Pediatric Glasgow Coma Scale St. Petersburg)] / A.S. Iova, L.M. Schugareva, Yu.A. Garmashov // Pervaya Vseros. konf. po detskoi neirohirurgii [First All-Russia. conf. for Pediatric Neurosurgery]. — M., 2003. — S.134—135.
13. Ааslid, R. Transcranial Doppler sonography / R. Ааslid. — Vienna; New York: Springer-Verlag, 1986. — 39 р.
14. American Academy of Pediatrics, American Heart Association. Textbook of Neonatal Resuscitation. 6th ed. / American Heart Association. — 2010. — P.329.

 

Epidemiology of neonatal sepsis: neonatal intensive care unit experience

Denis N. Surkov, Ph.D., Head of the Department of anesthesiology and intensive care unit for newborns with subintensivnogo treatment for premature and sick newborns Public enterprise «Regional children’s hospital» of Dnepropetrovsk, Chief freelance pediatric anesthesiologist General directorate of health Dnipropetrovsk regional state administration of Ukraine, Ukraina, e-mail: densurkov@hotmail.com

Alexandra D. Surkova, Dnipropetrovsk State Medical Academy, Dnepropetrovsk, Ukraina Dmitriy O. Ivanov , M.D., Director of the Institute of perinatology and pediatrics, Head of the Department of children diseases, Federal Almazov Medical Research Centre of the Ministry of health of the Russian Federation, Saint-Petersburg, tel. 8 (911)-288-90-95, e-mail: doivanov@yandex.ru

Abstract. Aim.To study the epidemiological indicators and risk factors for neonatal sepsis of the neonatal intensive
care unit (NICU) of tertiary hospital.Material and methods: A retrospective, single-center, observational cohort study of 48 case reports of newborns with early and late neonatal sepsis treated in NICU in 2012—2013. Results and discussion. It was revealed that nowadays the differences between early and late sepsis in relation to gestational age and weight of infants as well as risk factors and even representatives of Gr+ and Gr- strains disappeared. Particular concern is the allocation of a significant number of multi-drug resistant Gr + and Gr isolates in neonates admitted from maternity hospitals. Conclusion. Neonatal sepsis might be determined not as separate disease but as a syndrome. Its division into early and late does not affect the choice of therapy and should be considered in the planning activities of hospital infection control.

Key words: newborns, neonatal sepsis, bacterial culture, risk factor.

 

References

1. Anderson-Berry, A.L. Neonatalsepsis / A.L. Anderson-Berry, T. Rosenkrantz. — 2014. — URL: http://emedicine. medscape.com/article/978352-overview#a0101
2. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis / G.J. Chan [et al.] // PLoS Med. — 2013. — Vol. 10(8). — P.e1001502.
3. Trends in the epidemiology of pediatric severe sepsis / M.E. Hartman, W.T. Linde-Zwirble, D.C. Angus, R.S. Watson // Pediatr. Crit. Care Med. — 2013. — Vol. 14(7). — P.686—693.
4. Malloy, M.H. Chorioamnionitis: epidemiology of newborn management and outcome United States 2008 / M.H. Malloy // Journal of Perinatology. — 2014. — doi:10.1038/jp.2014.81.
5. Verbal autopsy: an analysis of the common causes of childhood death in the Barekese sub-district of Ghana / S. Manortey [et al.] // Journal of Publ. Health in Africa. — 2011. — Vol. 2(2). — doi:10.4081/jphia.2011.e18.
6. Mathur, N.B. Neonatal sepsis / N.B. Mathur // Elsevier. — 2010. — 104 p.
7. Newborn numbers // Healthy Newborn Network. — 2014. — URL: http://www.healthynewbornnetwork.org/ page/newborn-numbers.
8. Thomas, W. Chorioamnionitis: important risk factor or innocent bystander for neonatal outcome? / W. Thomas, C.P. Speer // Neonatology. — 2011. — Vol. 99. — P.177—187.
9. Antimicrobial resistance: global report on surveillance // World Health Organization. — 2014. — URL: http://www. who.int/drugresistance/en

 

Psychomotor development and rehabilitation methods in preterm infants after discharge

Larisa A. Fedorova, associate professor of Department of pediatrics, endocrinology and abilitologii Saint-Petersburg State Pediatric Medical University, St. Petersburg, Russia

Abstract. Introduction. The development of nursing techniques of extremely premature infants has increased the survival rate of children with very low and extremely low birth weight infants. Aim. To identify features of psychomotor development of preterm infants in the first year of life and develop a plan of clinical examination and rehabilitation in order to improve neurological and functional outcomes. Material and method. In the present study included 93 preterm infants with birth weight 1500 g or less and gestational age at birth less than 32 weeks, admitted to the Intensive Care Children’s Hospital № 17 St. Petersburg. Results and discussion. All infants were observed up to 2 years of age, undergone neonatologist and neurologist examination monthly. Adverse neurological outcome correlated with abnormal clinical and laboratory conditions of the acute period: multi-organ failure, hyponatremia, oliguria, necrotizing enterocolitis, bronchopulmonary dysplasia and sepsis. Conclusion. Revealed the importance of nutritional therapy: an early start of enteral nutrition with adequate quantity and quality composition of all necessary ingredients improved neurological outcome. A comprehensive method of rehabilitation by means of adaptive physical culture was developed. Proposed plan of clinical examination and rehabilitation of such children in order to improve the neurological and functional outcomes.

Key words: preterm infants, psychomotor development.

 

References

1. Aleksandrova, V.A. Perinatal’nye porazheniya central’noi nervnoi sistemy i ih posledstviya u detei v praktike pediatra [Perinatal lesions of the central nervous system and their implications for children in pediatric practice] / V.A. Aleksandrova, E.A. Bratova. — SPb., 2010. — 70 s.
2. Baibarina, E.N. Klinicheskie rekomendacii po uhodu za novorozhdennymi s ekstremal’no nizkoi massoi tela pri rozhdenii [Clinical practice guidelines for the care of newborns with extremely low birth weight] / E.N.Baibarina, A.G. Antonov, A.A. Lenyushkina // Voprosy prakticheskoi pediatrii [Questions Practical Pediatrics]. — 2006. — T. 1, № 4. — S.96—100.
3. Vinogradova, I.V. Katamnesticheskoe nablyudenie za det’mi s ekstremal’no nizkoi massoi tela pri rozhdenii [Follow-up of children with extremely low birthweight] / I.V. Vinogradova, M.V. Krasnov, L.G. Nogteva // Prakticheskaya medicina [Practice of medicine]. — 2008. — № 31. — S.67—69.
4. Nevrologiya nedonoshennyh detei [Neurology preterm infants] / A.B. Pal’chik, L.A. Fedorova, A.E. Ponyatishin. — 2-e izd., dop. — M.: MEDpress-inform, 2011. — 352 s.
5. Fiziologicheskie aspekty i standarty vyhazhivaniya nedonoshennyh detei [Physiological aspects and standards of care for premature children] / рod red. N.P. Shabalova. — SPb., 2005. — 96 s.
6. Matur, A.M. Understanding brain injury and neurodeve-lopmental disabilities in preterm infant: the involving role of advanced magnetic resonance imaging / A.M. Matur, J.J. Neil, T.E. Inder // Semin. Perinatol. — 2010. — Vol. 34, № 1. — Р.57—66.
7. Sizun, J. Erly developmental care for preterm babies: a call for more research / J. Sizun, B. Westrap // Arch. Dis. Child. Fetal. and neonatal. edition. — 2004. — № 89. — Р.384—388.

 

CASE REPORT

A course of polycystic kidney disease in newborn

Olga L. Chugunova, M.D., Professor of the Department of hospital pediatrics of SBEI HPE «National Research Medical University after name Nicolai I. Pirogov» Russian Ministry of Health, Moscow, Russia, e-mail: ol_chugunova@mail.ru

Svetlana V. Cherkasova, Ph.D., Assistant Professor of the Department of hospital pediatrics of SBEI HPE «National Research Medical University after name Nicolai I. Pirogov» Russian Ministry of Health, Moscow, Russia, tel. +7(965)343-93-10, e-mail: cherkasovasv@mail.ru

Petr V. Shumilov, M.D., Head of the Department of hospital pediatrics of SBEI HPE «National Research Medical University after name Nicolai I. Pirogov» Russian Ministry of Health, Moscow, Russia

Elizaveta Yu. Grebenkina, medical student, pediatric faculty of SBEI HPE «National Research Medical University after Name Nicolai I. Pirogov» Russian Ministry of Health, Moscow, Russia, tel. +7(903)-552-67-63

Maria A. Latysheva, medical resident of Department pediatric of medical faculty FBSEI HPE «People’s Friendship University of Russia» Russian Ministry of Education, Moscow, Russia, tel. +7(926)114-34-47

Abstract. Aim. The purpose of this research is to the study the peculiarities of autosomal recessive polycystic kidney disease in the newborn child based on clinical case. Materials and methods. A clinical case of autosomal recessive polycystic kidney disease in the newborn child presented as an example of a newborn child with a congenital kidney development. Results and discussion. In this case, ultrasound diagnostics revealed the fetal malformation of urinary tract at 24 gestation weeks. A large kidneys with undifferentiated parenchyma represented areas of hypo- and hyperechogenicity. The prenatal diagnosis was established: bilateral polycystic kidney disease. The child was born at 36 weeks of pregnancy in mild asphyxia classified 7—5 points of Apgar score. In the neonatal period the diagnosis was defined as: polycystic kidney disease, the infantile type; chronic renal failure; renal hypertension. Symptomatic therapy, monitoring of blood pressure, urine output, blood biochemistry, nephrectomy on first month of life followed by peritoneal dialysis after nephrectomy were recommended. However, parents of the child refused from the proposed treatment. Only symptomatic therapy was carried out. On the therapy the illness aggravated. At the age of 1 month 26 days there was an acute deterioration. During resuscitation cardiac and respiratory arrest occurred. Biological death was pronounced. Conclusion. This case demonstrates the complex ethical issues that arise when a child is born with this genetic problem and the difficulty of correction of symptomatic manifestations of autosomal recessive polycystic kidney disease variant.

Key words: newborn, polycystic kidney disease, polycystic kidney and hepatic disease.

 

References

1. Andreeva, E.F. Autosomno-dominantnyi i autosomnorecessivnyi polikistoz pochek [Autosomal dominant and autosomal recessive polycystic kidney disease] / E.F. Andreeva, V.I. Larinova, N.D. Savenkova // Nefrologiya [Nephrology]. — 2004. — T. 8, № 2. — S.7—13.
2. Arutyunyan, S.S. Autosomno-dominantnyi polikistoz pochek u vzroslyh i detei [Autosomal dominant polycystic kidney disease in adults and children] / S.S. Arutyunyan, N.D. Savenkova, V.I. Larinova // Nefrologiya  [Nephrology]. — 2010. — T. 14, № 3. — S.58—67.
3. Ermolenko, V.M. Autosomno-dominantnaya bolezn’ pochek: novye patogeneticheskie i terapevticheskie aspekty [Autosomal dominant kidney disease: new pathogenetic and therapeutic aspects] / V.M. Ermolenko, S. Baterdene // Nefrologiya i dializ [Nephrology and Dialysis]. — 2008. — № 2 — S.111—122.
4. Ignatova, M.S. Problemy nefrologii detskogo vozrasta na sovremennom etape razvitiya [Problems Nephrology childhood at the present stage of development] / M.S.Ignatova // Nefrologiya i dializ [Nephrology and Dialysis]. — 2011. — T. 13, № 2. — S.66—75.
5. Fomin, V.V. Primenenie dlitel’no deistvuyuschih digidropiridinovyh antagonistov kal’ciya dlya lecheniya i profilaktiki hronicheskoi bolezni pochek: vozmozhnosti i perspektivy [The use of long-acting dihydropyridine calcium antagonists in the treatment and prevention of chronic kidney disease: opportunities and prospects] / V.V. Fomin, S.S. Girina // Klinicheskaya nefrologiya [Clinical Nephrology]. — 2010. — T. 2, № 3. — S.72—75.
6. Chugunova, O.L. Porazhenie organov mochevoi sistemy v perinatal’nom i neonatal’nom periode (novye tehnologii v diagnostike, ocenke effektivnosti v lechenii i prognoze) [The defeat of the urinary system in the perinatal and neonatal period (new technologies in the diagnosis, evaluation of the effectiveness of treatment and prognosis)]: avtoref. dis. ... d-ra med. nauk / O.L. Chugunova. — M., 2001. — 57 s.
7. Cyst number but not the rate of cystic growth is associated with the mutated gene in autosomal polycystic kidney disease / P.C. Harris, K.T. Bae, S. Rossetti [et al.] // J. Am. Soc. Nephrol. — 2006. — № 17. — P.3013—3019.

 

REVIEWS

Interstitial lung diseases in children

Evgenija V. Boitsova, M.D., Head of the Laboratory of pediatric pneumology research Institute of pulmonology, St. Peterburg State Medical University named after I.P. Pavlov, St. Petersburg, tel. 8 (812)542-53-62, e-mail: evboitsova@mail.ru

Dmitriy Y. Ovsyanikov, M.D., Head of the Department of pediatrics of People’s Friendship University of Russia, Moscow, tel. 8 (499)23152, e-mail: mdovsyannikov@yahoo.com

Maria А. Belyashova, medical resident of Department pediatric, medical faculty of People’s Friendship University of Russia, Moscow, Russia

Abstract. Introduction. Interstitial lung diseases (ILD, synonym, diffuse lung diseases) are a heterogeneous group of
diseases in which a pathological process primarily involved alveoli and perialveolar interstitium, resulting in impaired
gas exchange, restrictive changes of lung ventilation function and diffuse interstitial changes detectable by X-ray. Aim. To summarize the current knowledge of interstitial lung diseases in children. Matherial and method. The paper presents current information on the classification, epidemiology, clinical presentation, diagnosis, treatment and prognosis of these rare diseases. Results and discussion. The latest classification of interstitial lung diseases in children was proposed by the experts of the American Thoracic Society (ATS) in 2013. CT-scans semiotics in this classification was described in details. Particular attention was paid to interstitial lung diseases, occurring mainly in newborns and children during the first two years of life, such as hereditary deficiencies of protein surfactant, neuroendocrine hyperplasia of infancy, pulmonary interstitial glycogenosis. Conclusion. Interstitial lung diseases in children is an actual problem in pediatric pulmonology.

Key words: interstitial lung disease, children, diagnosis, therapy.

 

References

1. Redkoe intersticial’noe zabolevanie legkih — neiroendokrinnaya giperplaziya mladencev [A rare interstitial lung disease — infants neuroendocrine hyperplasia] / D.Yu. Ovsyannikov, M.A. Belyashova, N.O. Zaiceva [i dr.] // Pediatriya [Pediatrics]. — 2013. — T. 92, № 3. — S.32—37.
2. Intersticial’nye zabolevaniya legkih u mladencev [Interstitial lung disease in infants] / D.Yu. Ovsyannikov, E.V. Boicova, M.A. Belyashova, I.K. Asherova. — M.: Izd-vo RUDN, 2014. — 180 s.
3. Fan, E.L. Pediatric Interstitial Lung Disease. Children Are Not Small Adults / E.L. Fan, L. Langston // Am. J. Respir. Crit. Care Med. — 2002. — Vol. 165. — P.1466—1467.
4. An Official American Thoracic Society Clinical Practice Guideline: Classification, Evaluation, and Management of Сhildhood Interstitial Lung Disease in Infancy / G. Kurland, R.R. Deterding, J.S. Hagood [et al.] // Am. J. Respir. Crit. Care Med. — 2013. — Vol. 188, iss. 3. — P.376—394.
5. Dinwiddie, R. Idiopathic interstitial pneumonitis in children: a national survey in the United Kingdom and Ireland / R. Dinwiddie, N. Sharief, O. Crawford // Pediatr. Pulmonol. — 2002. — Vol. 34(1). — P.23—29.
6. Clement, A. Interstitial lung diseases in infants and children / A. Clement, E. Eber // Eur. Respir. J. — 2008. — Vol. 31(3). — P.658—666.
7. Diffuse lung disease in young children: application of a novel classification scheme / G.H. Detsch, L.R. Young, R.R. Deterding [et al.] // Am. J. Respir. Crit. Care Med. — 2007. — Vol. 176(11). — P.1120—1128.
8. Ovsyannikov, D.Yu. Vrozhdennyi deficit belkov surfaktanta [Congenital deficiency of surfactant proteins] / D.Yu.Ovsyannikov,M.A.Belyashova,A.A.Krushel’nickii// Neonatologiya:novosti,mneniya,obuchenie[Neonatology: news, views, learning]. — 2014. — № 1(3). — S.80—90.
9. Round table discussion: children’s interstitial lung diseas // R.R. Deterding, A.S. Brody, J.S. Hagood, L.R. Young // Pediatric Allergy, Immunology and Pulmonology. — 2010. — Vol. 23(1). — P.91—95.
10. Interstitial lung disease in children / A. Clement, N. Nathan, R. Epaud [et al.] // Orphanet Journal of rare disease. — 2010. — Vol. 5(22). — P.1—24.
11. Evaluation of a diagnostic approach to pediatric interstitial lung disease // L.L. Fan, C.A. Kozinetz, R.R. Deterding, S.M. Brugman // Pediatrics. — 1998. — Vol. 101. — P.82—85.
12. Diagnostic accuracy of thin-section CT and chest radiography of pediatric interstitial lung disease / Copley, M. Coren, A.G. Nicholson [et al.] // Am. Roentgenol. — 2000. — Vol. 174(2). — P.549—554.
13. Guillerman, R.P. Imaging of Childhood Interstitial Lung Disease / R.P. Guillerman // Pediatric Allergy, Immunology and Pulmonology. — 2010. — Vol. 23(1). — P.43—69.
14. Interstitial lung disease in children: a multicentre survey on diagnostic approach / A. Barbato, C. Panizzolo, A. Cracco [et al.] // Eur. Respir. J. — 2000. — Vol. 16(3). — P.509—513.
15. Balfour-Lynn, I.M. BTS guidelines for home oxygen in children / I.M. Balfour-Lynn, D.J. Field, P. Gringras // Thorax. — 2009. — Vol. 64, suppl 2. — P.1—26.
16. Fan, L.L. The diagnostic value of bronchalveolar lavage in immunocomplement children wich chronic diffuse pulmonary infiltrates / L.L. Fan, M.C. Lung, J.S. Wagener // Pediatr. Pulmonol. — 1997. — Vol. 23(1). — P.8

 

Congenital malformations of the tracheobronchial tree in children

Ilnur I. Zakirov, Ph.D., associate professor of Department of pediatrics and neonatology of SBEI APE «Kazan State Medical Academy», Head of Department of pulmonology DRKB MoH, Kazan, tel. (843)562-52-66, e-mail: zakirov.ilnur@inbox.ru

Asia I. Safina, M.D., Professor, Head of Department of pediatrics and neonatology of SBEI APE «Kazan State Medical Academy», Kazan, tel. (843)562-52-66, e-mail: safina_asia@mail.ru

Abstract. Aim. To consider the peculiarities of malformations of the trachea and bronchi in children. Material and methods. At the present stage, in the structure of infant morbidity, disability and infant mortality rates, congenital malformations are becoming increasingly important. Results and discussion. A general classification of malformations of the respiratory tract is presented. We produced clinical-medical history characteristics of malformations of the respiratory tract. We considered the most frequent nosological forms of bronchial malformations in children and therapeutic approaches. Conclusion. Congenital malformations occurs in 4—6% of newborns, and its contribution to the structure of the infant mortality rate is more than 20%. Among all malformations 4,6% of cases are congenital bronchopulmonary. According to the International Classification of Diseases (ICD-10), congenital bronchopulmonary system malformations are included in XVII class «Congenital anomalies (birth defects), deformations and chromosomal abnormalities» (Q30—Q34).

Key words: children, a malformation of the trachea and bronchi.

 

References

1. Antonov, O.V. Nauchnye, metodicheskie i organizacionnye podhody k profilaktike vrozhdennyh porokov razvitiya u detei: dis. ... d-ra med. nauk / O.V. Antonov. — Omsk, 2007. — 408 s.
2. Bolezni organov dyhaniya u detei / pod red. prof. V.K. Tatochenko. — M.: Pediatr, 2012. — 480 s.
3. Prikaz Ministerstva zdravoohraneniya i social’nogo razvitiya RF ot 09.03.2006 № 139 «Ob utverzhdenii standarta medicinskoi pomoschi bol’nym vrozhdennymi anomaliya (porokami razvitiya) trahei i bronhov i vrozhdennymi anomaliyami (porokami razvitiya) legkogo». — URL: http:// www.minzdravsoc.ru/docs/
4. Rozinova, N.N. Sindrom Vil’yamsa-Kempbella i lobarnaya emfizema — redkie poroki razvitiya legkih s edinoi patogeneticheskoi osnovoi / N.N. Rozinova, E.V. Sorokina, M.V. Kostyuchenko // Trudnyi pacient. — 2009. — № 8. — S.24—29.
5. Prokop, M. Spiral’naya i mnogosloinaya komp’yuternaya tomografiya / M. Prokop, M. Galanski. — M.: MEDpressinform, 2007. — 153 s.
6. Kosarev, V.V. Spravochnik pul’monologa / V.V. Kosarev, S.A. Babanov. — Rostov n/D.: Feniks, 2011. — 445 s.
7. Hronicheskie zabolezniya legkih u detei / pod red. N.N. Rozinovoi, Yu.L. Mizernickogo. — M.: Praktika, 2011. — 224 s.
8. Pneumonectomy in a child with congenital bronchiectasis: A case report and review of literature / G. Shankar, P. Kothari, D. Sarda [et al.] // Annals of Thoracic Medicine. — 2006. — Vol. 1, № 2. — Р.81—83.
9. URL: www.mkb-10.com

 

Sudden infant death syndrom in preterm infants

Ildus Yа. Lutfulin, Ph.D., assistant professor of Department of pediatrics and neonatology of Kazan State Medical Academy, Kazan, Russia, tel. (843)562-52-66, e-mail: lutfullin@list.ru

Asia I. Safina, M.D., Professor, Head of Department of pediatrics and neonatology of Kazan State Medical Academy, Kazan, Russia, tel. (843)562-52-66, e-mail: safina_asia@mail.ru

Abstract. Aim. Current paper reviews the modern aspects of sudden infant death syndrome, including preterm infants. Material and methods. Epidemiological data shows that preterm infants are at high risk for this disease. Results and discussion. Immaturity of regulatory mechanisms characteristic for premature infants, can lead to the realization of the catastrophic scenario of sudden death in case of exogenous stress factors exposure in the critical period of development. The features of the epidemiology of this syndrome, known major risk factors for developing this disease are presented. The article describes today’s generally accepted three-component thanatogenesis concept of sudden infant death syndrome, and also reflects the features of the pathogenesis of sudden infant death syndrome in premature infants. We listed recommendations for parents and health professionals on the prevention of sudden infant death syndrome, developed by the American Academy of Pediatrics in 2011. Conclusion. Simple and effective preventive measures allow reduce the risk of sudden infant death syndrome with a high probability.

Key words: sudden infant death syndrome, preterm infant.

 

References

1. Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome / P.S. Blair, P.J. Fleming, I.J. Smith [et al.] // CESDI SUDI Research Group. BMJ. — 1999. — № 319(7223). — Р.1457—1462.
2. Filiano, J.J. A perspective on neuropathologic findings in victims of the sudden infant death syndrome: the triplerisk model / J.J. Filiano, H.C. Kinney // Biol. Neonate. — 1994. — № 65. — Р.194—197.
3. French Reference Centers for SIDS. Sudden unexpected death in infants under 3 months of age and vaccination status: a case-control study / A.P. Jonville-Béra, E. Autret-Leca, F. Barbeillon, J. Paris-Llado // Br. J. Clin. Pharmacol. — 2001. — № 51(3). — Р.271—276.
4. Fu, L.Y. Bed sharing among black infants and sudden infant death syndrome: interactions with other known risk factors / L.Y. Fu, F.R. Hauck, R. Moon // Acad Pediatr. — 2010. — № 10(6). — Р.376—382.
5. Horne, R.S. Effects of prematurity on heart rate control: implications for sudden infant death syndrome / R.S. Horne // Expert Rev. Cardiovasc. Ther. — 2006. — № 4. — Р.335—343.
6. Immunization Safety Review: Vaccinations and Sudden Unexpected Death in Infancy / K. Stratton, D.A. Almario, T.M. Wizemann [et al.]. — Washington: National Academies Press, 2003. — 104 p.
7. Infant sleeping position and the risk of sudden infant death syndrome in California, 1997—2000 / D.K. Li, D.B. Petitti, M. Willinger [et al.] // Am. J. Epidemiol. — 2003. — № 157(5). — Р.446—455.
8. Kinney, H.C. The Sudden Infant Death Syndrome / H.C. Kinney, B.T. Thach // N. Engl. J. Med. — 2009. — № 361(8). — Р.795—805.
9. Major epidemiological changes in sudden infant death syndrome: a 20-year population-based study in the UK / P.S. Blair, P. Sidebotham, P.J. Berry [et al.] // Lancet. — 2006. — № 367. — P.314—319.
10. Molteno, C.D. Early childhood mortality in Cape Town / C.D. Molteno, E. Ress, M.A. Kibel // S. Afr. Med. J. — 1989. — № 75. — Р.570—574.
11. Moon, R.Y. Sudden infant death syndrome / R.Y. Moon, R.S. Horne, F.R. Hauck // Lancet. — 2007. — № 370. — Р.1578—1587.
12. Moon, R.Y. Task Force on Sudden Infant Death Syndrome / R.Y. Moon // Pediatrics. — 2011. — № 128(5). — Р.1030—1039.
13. Respiratory instability of term and near-term healthy newborn infants in car safety seats / J. R. Merchant, C. Worwa, S. Porter [et al.] // Pediatrics. — 2001. — № 108(3). — Р.647—652.
14. Risk factors for sudden infant death syndrome among / S. Iyasu, L.L. Randall, T.K. Welty [et al.] // Northern Plains Indians. JAMA. — 2002. — № 288. — Р.2717—2723.
15. Sleep environment and the risk of sudden infant death syndrome in an urban population: the Chicago Infant Mortality Study / F.R. Hauck, S.M. Herman, M. Donovan [et al.] // Pediatrics. — 2003. — № 111. — Р.1207—1214.
16. Sleeping position, oxygenation, and lung function in prematurely born infants studied post term. Archives of Disease in Childhood / T. Saiki, H. Rao, F. Landolfo [et al.] // Fetal & Neonatal Edition. — 2009. — № 94(2). — Р.133—137.
17. Sudden infant death syndrome and smoking in the United States and Sweden / M.F. MacDorman, S. Cnattingius, H.J. Hoffman [et al.] // Am. J. Epidemiol. — 1997. — № 146(3). — Р.249—257.
18. Sudden infant deaths in sitting devices / A. Côté, A.Bairam, M. Deschesne, G. Hatzakis // Arch. Dis. Child. — 2008. — № 93(5). — Р.384—389.
19. The UK accelerated immunization programme and sudden unexpected death in infancy: case-control study / P.J. Fleming, P.S. Blair, M.W. Platt [et al.] // BMJ. — 2001. — № 322(7290). — Р.822.

 

Modern approaches to skin care of the newborns: tactics of pediatrician

Nadezhda L. Rybkina, M.D., neonatologist, assistant professor of Department of pediatrics and neonatology of Kazan State Medical Academy, tel. (843)262-52-66, e-mail: kafped@ya.ru

Abstract. Aim. To specify the major features of a newborn baby skin structure. To introduce the principles of skin care of the newborn, as well as care of the cord. Material and method. The main reasons that might violate the integrity of the skin care in violation of tactics are listed. The basic skin care of the newborn, practical recommendations for the use of these funds are reviewed. Results and discussion. Features of the structure of the skin of a newborn child explain the requirements for skin care facilities. Skin care of the newborn has the following components: prevention of irritation or epidermis damage; maintaining the desired composition of the skin. Modern approaches to skin care of the newborn based of the anatomical and physiological features of the structure ensure smooth, velvety, delicate skin. Conclusion. No damage to the skin provides a basis for well-being of the child and his parents. It must be remembered that the damage to the skin is easier to prevent than to cure. Different cosmetics proper selected, proper care and monitoring the skin lesions condition provide preventive maintenance and health preservation of the child.

Key words: newborn care, skin care, care of the cord, skin care products.

 

References

1. Abaev, Yu.K. Vospalitel’nye zabolevaniya novorozhdennyh [Inflammatory disease of the newborn] / Yu.K. Abaev. — Rostov n/D.: Feniks, 2007. — 256 s.
2. Bazovaya pomosch’ novorozhdennomu — mezhdunarodnyi opyt [Basic newborn care — International Experience] / рod red. N.N. Volodina, G.T. Suhih. — M.: GEOTAR-Media, 2008. — 208 s.
3. Bor’eson, B. Rannie otnosheniya i razvitie rebenka [Early relationships and the development of the child] / B. Bor’eson, S. Britten, S.V. Dovbnya. — SPb.: Piter, 2009. — 160 s.
4. Neonatologiya: nacional’noe rukovodstvo [Neonatology: national leadership] / pod red. N.N. Volodina. — M.: GEOTAR-Media, 2007. — 848 s.
5. Detskie bolezni [Childhood diseases]: uchebnik v 2 t. + CD/ pod red. I.Yu. Mel’nikovoi. — M., 2009. — 540 s.
6. Detskie bolezni [Childhood diseases]: uchebnik + CD/ pod red. A.A. Baranova. — 2-e izd., ispr. i dop. — M., 2007. — 1008 s.
7. Ivanova, N.A. Opyt primeneniya bepantena i bepantena plyus v lechenii atopicheskogo dermatita u detei [Experience of using Bepanten and Bepanten plus in the treatment of atopic dermatitis in children] / N.A. Ivanova, L.N Kostrakina // Consilium Medicum (pril. Pediatriya). — 2005. — № 7(1). — S.31—33.
8. Keshishyan, E.S. Ispol’zovanie mazi i krema «D-pantenol» dlya profilaktiki i lecheniya povrezhdeniya kozhi u detei rannego vozrasta [The use of ointments and creams «D-panthenol» for the prevention and treatment of skin lesions in infants] / E.S. Keshishyan, E.S. Saharova // Consilium medicum (Pediatriya). — 2007. — № 1. — S.8—10.
9. Keshishyan, E.S. Uhod za kozhei detei pervyh let zhizni [Skin care babies and toddlers] / E.S. Keshishyan, E.S. Saharova // Lechaschii vrach. — 2004. — № 10. — S.62—65.
10. Keshishyan, E.S. Profilaktika narushenii celostnosti kozhi razlichnogo geneza u detei rannego vozrasta pri ispol’zovanii zaschitnoi plenki [Prevention of violations of the integrity of the skin of various origins in infants with protective film] / E.S. Keshishyan // Glavnaya medicinskaya sestra. — 2013. — № 10. — S.119—122.
11. Pediatriya [Pediatrics]: uchebnik + CD / pod red. N.A. Geppe. — M.: GEOTAR-Media, 2009. — 352 s.
12. Poliklinicheskaya pediatriya [Outpatient pediatrics] / pod red. A.S. Kalmykovoi. — M.: GEOTAR-Media, 2007. — 624 s.
13. Prakticheskoe rukovodstvo po neonatologii [A Practical Guide to neonatology] / pod red. G.V. Yacyk. — M.:  MIA, 2008. — 344 s.
14. Propedevtika detskih boleznei [Propedevtika childhood diseases]: uchebnik + CD / pod red. N.A. Geppe. — M.: GEOTAR-Media, 2008. — 464 s.
15. Osnovy uhoda za novorozhdennymi i grudnoe vskarmlivanie [Basics of newborn care and breastfeeding] / Evropeiskoe regional’noe byuro VOZ. — М., 2002. — 173 s.
16. Rukovodstvo po ambulatorno-poliklinicheskoi pediatrii [Guidelines for outpatient pediatrics] / pod red. A.A. Baranova. — M.: GEOTAR-Media, 2006. — S.41—65.

 

Late preterm infants

Lyudmila N. Sofronova, Ph.D., assistant of Рrofessor of Department of pediatrics, endocrinology and abilitologii Postgraduate Medical Faculty Medical of SBEI HPE «Saint Petersburg State Pediatric Medical University», St. Petersburg, tel. 8 (921)446-29-95, e-mail: mila_sofronova@hotmail.ru.

Abstract. Aim. If we consider the historical emergence of the term «late preterm», then the previously used concept of «near term», in a special way these kids did not characterized, they do not stand out as a separate group, their problems are equated to the pathology of term infants. However, recent, more detailed studies have shown that morbidity and mortality even term infants depends on the exact time of gestational age. Since children born to 37—38 weeks sick more often than those born at 39 weeks; it contributed to the emergence of a new term — «early full-term» to describe children born at 37—38 weeks. Material and methods. Babies born at 34—36 (6/7) weeks’ gestation, marked as «late preterm». Results and discussion. Because the number of children increases, the knowledge of their problems such as transient tachypnea, hypothermia, hypoglycemia, hyperbilirubinemia, the development of late sepsis more frequently than in full-term, and others. Although this disease is not unique, but these children there are notable differences in the manifestation and currents. Equally important is the selection of the group of preterm in connection with the remote poor outcome — a violation or zaderzhennym neurodevelopmental manifests itself in early school age. This proves the need to separate them in a special risk group. More detailed understanding of issues of respiratory pathology and nutrition «late preterm». Conclusion. Finally, we discuss future directions of research on the outstanding issues in the field of neonatology.

Key words: late preterm infants, prevention respiratory morbidity, nutrition, treatment.

 

References

1. Clinical outcomes of near-term infants / M.L. Wang, D.J. Dorer, M.P. Fleming, E.A. Catlin // Pediatrics. — 2004. — Vol. 114. — P.372—376.
2. «Late preterm» infants: a population at risk / W.A. Engle, K.M. Tomashek, C. Wallman [et al.] // Pediatrics. — 2007. — Vol. 120, № 6. — P.1390—1401.
3. McIntir, D.D. Neonatal mortality and morbidity rates in late preterm births compared with births at term / D.D. McIntir, K.J. Leveno // Obstetrics and Gynecology. — 2008. — Vol. 111, № 1. — P.35—41.
4. Jain, L. Respiratory morbidity in late-preterm infants: prevention is better than cure! / L. Jain // American Journal of Perinatology. — 2008. — Vol. 25, № 2. — P.75—78.
5. Jain, L. Alveolar fluid clearance in developing lungs and its role in neonatal transition / L. Jain // Clin. Perinatol. — 1999. — Vol. 26, № 3. — P.585—599.
6. Adamkin, D.H. Nutritional strategies for the very low birthweight infant / D.H. Adamkin. — Cambridge: Cambridge University Press, 2009. — 209 p. — URL: www.cambridge.org/9780521732468

 

Ultrasound diagnostics in neonatal intensive care units

Olga А. Stepanova, Ph.D., assistant of Рrofessor of Department of pediatrics and neonatology of Kazan State Medical Academy, Kazan, Russia, tel. (843)562-52-66, e-mail: kafped@yandex.ru

Asia I. Safina, M.D., Professor, Head of the Department of pediatrics and neonatology of Kazan State Medical Academy, Kazan, Russia, tel. (843)562-52-66, e-mail: safina_asia@mail.ru

Abstract. Aim. In this article we discuss the possibility of the ultrasonic method for the diagnosis of various diseases in patients in intensive care units (ICUs) and neonatal intensive care units. Material and method. We described echographic semiotics of major emergency conditions in newborns. Results. The introduction of new devices and technologies allows obtaining images with greater resolution. Preferably, use more powerful stationary devices for optimal visualization of internal organs. The ultrasonic method is used for the detection of neonatal disease of brain, heart, lung and pleura, kidneys, hepatobiliary system, acute surgical pathology of the intestine and the scrotum, and is also used for imaging of large vessels in time of catheterization. The use of Doppler flow study technology expands the diagnostic possibilities of this method. Conclusion. Ultrasound diagnostics because of its  informativeness, safety and availability remains a major instrumental method of neonates examination in intensive care units to timely identify various pathological cases and to provide the necessary medical care to the children.

Key words: newborn babies, emergency cases, ultrasound diagnostics.

 

References

1. Bykov, M.V. Ul’trazvukovoi kontrol’ pri kateterizacii central’nyh ven u detei [Ultrasonic testing at central venous catheterization in children] / M.V. Bykov, A.A. Neretin, D.F. Bykov [i dr.] // Sono Ace-Ultrasound (Ul’trasonografiya). — 2008. — № 17. — S.42—47.
2. Vasil’eva, N.P. Sluchai ul’trazvukovoi diagnostiki mnozhestvennyh bronhogennyh kist legkogo u novorozhdennogo [A Case of Ultrasound Diagnostics of Multiple Bronchogenic Lung Cysts in a Newborn] / N.P. Vasil’eva, A.A. Gumerov, R.SH. Hasanov [i dr.] // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2001. — № 2. — S.140—141.
3. Vatolin, K.V. Ul’trazvukovaya diagnostika zabolevanii golovnogo mozga u detei [Ultrasound diagnosis of brain diseases in children] /K.V. Vatolin. — 2-e izd., dop. — M.: Vidar-M, 2000. — 136 s.
4. Veselova, A.N. Monitoring sostoyaniya mozgovogo krovotoka u nedonoshennyh detei s postgemorragicheskoi gidrocefaliei [Cerebral Blood Flow State Monitoring in the Premature Children with Posthemorrhagic  Hydrocephalus] / A.N. Veselova, G.M. Dement’eva, K.V. Vatolin [i dr.] // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2006. — № 1. — S.83—88.
5. Volodin, N.N. Standartizaciya protokola ul’trazvukovogo issledovaniya golovnogo mozga u novorozhdennyh i detei rannego vozrasta [Brain Echography Protocol Standardization in Newborns and Early Age Children] / N.N. Volodin, V.V. Mit’kov, E.A. Zubareva [i dr.] // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2001. — № 4. — S.74—76.
6. Gnusaev, S.F. Znachenie dopplerehokardiograficheskogo metoda v diagnostike gipoksicheskoi ishemii miokarda u novorozhdennyh [Significance of Doppler Echocardiography in Neonatal Myocardium Hypoxic Ischemia  Diagnosis] / S.F. Gnusaev, A.N. Shibaev, O.B. Federyakina [i dr.] // Ul’trazvukovaya i funkcional’naya  diagnostika [Ultrasound and functional diagnostics]. — 2006. — № 1. — S.89—96.
7. Dvoryakovskii, I.V. Ul’trazvukovaya diagnostika pri sindrome srygivaniya i rvoty u novorozhdennyh i detei grudnogo vozrasta [Ultrasound in the Diagnosis of Regurgitation and Vomiting Syndrome in Newborns and Infants] / I.V. Dvoryakovskii, A.B. Sugak // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and  functional diagnostics]. — 2007. — № 1. — S.84—92.
8. Dvoryakovskii, I.V. Ehografiya legkih u novorozhdennyh detei [Lungs Echography of Newborn Infants] / I.V. Dvoryakovskii, N.D. Odinaeva, T.V. Potehina // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2010. — № 6. — S.41—49.
9. Dvoryakovskii, I.V. Gaz v sisteme vorotnoi veny — vazhnyi prognosticheskii priznak? [Gas in the portal venous system — an important prognostic sign?] / I.V. Dvoryakovskii, I.V. Sil’nova, S.A. Ivleva // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]: tez. 3-go s’ezda specialistov po ul’trazvukovoi diagnostiki PFO. — 2014. — № 3. — S.109.
10.  Zubareva, E.A. Ul’trazvukovaya diagnostika perinatal’nyh gipoksicheski-ishemicheskih porazhenii golovnogo  mozga [Ultrasound Diagnostics of PerinatalHypoxy-Ischemic Brain Lesions] / E.A. Zubareva, E.A. Ulezko //  Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2005. — № 2. — S.92—101.
11. Kryukova, I.A. Sravnitel’naya ocenka vozmozhnostei metodik ul’trazvukovogo issledovaniya mozga novorozhdennogo[A comparative evaluation of ultrasound investigation of infant’s brain] / I.A. Kryukova, Yu.A. Garmashov, A.P. Skoromec [i dr.] // Nevrologicheskii vestnik [Neurogical Journal]. — 2008. — T. XL, vyp. 2. — S.24—27.
12. Mironova, A.K. Vozmozhnosti ul’trazvukovoi diagnostiki kistoznyh adenomatoidnyh mal’formacii legkih u novorozhdennyh detei [Possibilities of ultrasound diagnosis of cystic adenomatoidnyh malformation in newborns] / A.K. Mironova, E.I. Dorofeeva, E.A. Filippova // Anesteziya i reanimaciya v akusherstve i  neonatologii: materialy V Vseros. obrazovatel’nogo kongressa. — M., 2012. — S.85—86.
13. Mironova, A.K. Vozmozhnosti ul’trazvukovogo issledovaniya v differencial’noi diagnostike sekvestracii i  adenomatoidnoi mal’formacii legkih u novorozhdennyh [Possibility of ultrasound in differential diagnosis of sequestration and adenomatoidnoy malformation neonatal lung] / A.K. Mironova, E.I. Dorofeeva, E.A. Filippova // Anesteziya i reanimaciya v akusherstve i neonatologii: materialy V Vseros. obrazovatel’nogo kongressa. — M., 2012. — S.86—87.
14. Mironyuk, O.A. Ul’trazvukovye simptomy nekroticheskogo enterokolita [Ultrasonic symptoms of necrotizing enterocolitis] / O.A. Mironyuk, M.I. Pykov // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2013. — № 4. — S.49—54.
15. Ol’hova, E.B. Ul’trazvukovaya diagnostika portal’nogo tromboza u novorozhdennyh. Klinicheskie nablyudeniya i obzor literatury [Ultrasound Diagnostics of Portal Vein Thrombosis of a Newborn (Clinical Reports and Literature Overview)] / E.B. Ol’hova, G.T. Tumanyan, E.V. Kuznecova // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2002. — № 1. — S.65—74.
16. Ol’hova, E.B. Ul’trazvukovaya diagnostika ostryh zabolevanii moshonki u novorozhdennyh [Ultrasound Diagnosticsof the Acute Scrotum Diseases in Newborn] / E.B. Ol’hova // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2003. — № 1. — S.76—83.
17. Ol’hova, E.B. Ostraya pochechnaya nedostatochnost’ u novorozhdennyh [Acute Renal Failure in Neonatal] /  E.B. Ol’hova // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2004. — № 4. — S.92—99.
18. Ol’hova, E.B. «Gaz portal’noi sistemy» kak ehograficheskii fenomen u novorozhdennyh [«Gas in Portal  System» as an Echographic Phenomenon in Neonatals] / E.B. Ol’hova // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2005. — № 5. — S.44—49.
19. Ol’hova, E.B. Vozmozhnosti ehograficheskoi vizualizacii krovoizliyanii v zadnyuyu cherepnuyu yamku u novorozhdennyh [Possibility of echographic imaging hemorrhages in the posterior cranial fossa in newborns] / E.B. Ol’hova // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]: tez. VI S’ezda Rossiiskoi associacii specialistov ul’trazvukovoi diagnostiki v medicine. — 2011. — № 5. — S.91—92.
20. Prikaz MZ RF ot 15 noyabrya 2012 g. № 921n «Ob utverzhdenii poryadka okazaniya medicinskoi pomoschi po profilyu “neonatologiya”».
21. Pykov, M.I. Ul’trazvukovaya diagnostika patologii legkih i plevry [Ultrasound Diagnosis of Lungs and Pleura Pathology in Newborn] / M.I. Pykov, D.S. Dubovik, M.S. Efimov // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2008. — № 3. — S.69—73.
22. Pykov, M.I. Vliyanie gemodinamicheski znachimogo otkrytogo arterial’nogo protoka na pokazateli central’noi gemodinamiki i organnogo krovotoka u nedonoshennyh novorozhdennyh [Influence of Hemodynamically  Significant Patent Ductus Arteriosus on Central Hemodynamic and Organ Blood Flow Parameters in Premature Newborns] / M.I. Pykov, M.S. Efimov, T.I. Vokueva // Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. — 2008. — № 3. — S.26—33.
23. Pykov, M.I. Vozmozhnosti ul’trazvukovogo issledovaniya v diagnostike sekvestrov legochnoi tkani u novorozhdennyh [Possibility of ultrasound in the diagnosis of lung tissue seizures in newborns] / M.I. Pykov, E.I. Dorofeeva, A.K. Mironova [i dr.] // Ul’trazvukovaya i funkcional’naya diagnostic [Ultrasound and functional  diagnostics]a. — 2012. — № 6 — S.79.
24. Ul’trazvukovaya diagnostika v neonatologii [Ultrasound diagnosis in neonatology] / pod red. I.V. Dvoryakovskogo, G.V. Yacyk. — M.: Izdat. dom «Atmosfera», 2009. — 168 s.

 

Pathophsyology of neonatal sepsis

Khalit S. Khaertynov, Ph.D., associate of Рrofessor of Department of children infectious diseases of SBEI HPE «Kazan State Medical University», Kazan, Russia, tel. 9-903-342-96-27, e-mail: khalit65@rambler.ru

Vladimir A. Anokhin, M.D., Professor, Head of Department of children infectious diseases of of SBEI HPE «Kazan State Medical University», Kazan, Russia, tel. 8-903-306-33-70, e-mail: anokhin56@mail.ru

Sergey V.Boichuk, M.D., professor, Head of department of pathophysiology of SBEI HPE «Kazan State Medical University», Kazan, Russia, tel. 8-917-894-03-22, e-mail: boichuksergei@mail.ru

Abstract. Relevance. Among infectious diseases neonatal sepsis has the greatest relevance caused by a significant
prevalence and mortality in this age group. Predisposing factors. As a particular microorganism and the immune system of the body both plays an important role in developing sepsis. One of the main predisposing factors contributing to the development of sepsis in newborn infants is the immune system immaturity, especially in preterm manifested by adaptive and innate immunity factors deficiency. An important predisposing factor for the development of neonatal sepsis is reduced expression of receptors of innate immunity and polymorphism of genes, in particular Toll-like receptors. Immune response in sepsis is biphasic and characterized by a succession of systemic inflammatory response syndrome and anti-inflammatory response syndrome. Fatal neonatal sepsis can occur at any stage of the disease, however, the modern methods of treatment have led to a shift of this indicator in the second phase, characterized by the formation of immunosuppression. One of the main mechanisms of formation of immunosuppression in sepsis is apoptosis. The result of sepsis-induced apoptosis in neonates is reduced number of innate and adaptive immunity cells. Along with immune system, apoptosis registers in cells of parenchymatous organs, vascular endothelium and epithelium of digestive tract. The result of sepsis-induced apoptosis is a marked decrease of the immune response efficiency and internal environment clearance deterioration. Conclusion. Modern concepts of the pathophysiology of neonatal sepsis necessitate using a wide range of studies aimed at identifying markers as inflammation, so immunosuppression.

Key words: neonatal sepsis, innate immunity, inflammatory markers, immunosuppression.

 

References

1. Mayanskii, A.N. Reaktivnost’ neitrofila / A.N. Mayanskii, A.N. Galiullin. — Kazan’, 1984. — 157 s.
2. Samsygina, G.A. O predraspolagayuschih faktorah i faktorah riska razvitiya neonatal’nogo sepsisa i o sovremennyh podhodah ego lecheniya / G.A. Samsygina // Pediatriya. — 2012. — T. 91, № 3. — S.32—37.
3. Simbircev, A.S. Funkcional’nyi polimorfizm genov regulyatornyh mehanizmov vospaleniya / A.S. Simbircev, A.Yu. Gromova // Citokiny i vospalenie. — 2005. — № 1.
4. Tolstopyatova, M.A. Rol’ receptorov vrozhdennogo immunitetavrazvitiiinfekcionnoipatologiiunovorozhdennyh detei / M.A. Tolstopyatova, G.A. Buslaeva, I.G. Kozlov // Pediatriya. — 2009. — T. 87, № 1. — S.115—120.
5. Shabalov, N.P. Neonatologiya / N.P. SHabalov. — MEDpress-inform, 2009. — T. 2.
6. Shirokova, A.V. Apoptoz. Signal’nye puti i izmenenie vodnogo i ionnogo balansa kletki / A.V. Shirokova // Citologiya. — 2007. — T. 49, № 5. — S.385—394.
7. Ahrens, P. Mutation of genes involved in the innate immune system as predictors of sepsis in very low birth weight infants / P. Ahrens, E. Kattner, B. Kohler [et al.] // J. Pediatr. Res. — 2004. — Vol. 55. — P.652—656.
8. Bektas, S. Decreased Adherence, Chemotaxis and PhagocyticActivitiesofNeutrophilsfromPretermNeonates / S. Bektas, B. Goetze, C.P. Speer // Acta Pediatr. Scand. — 1990. — Vol. 79. — P.1031—1038.
9. Bone, R.C. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis: the ACCP/SCCM consensus conference committee / R.C. Bone, R.A. Balk, F.B. Cerra // Chest. — 1992. — Vol. 101. — P.1644—1655.
10. Bochud, P.Y. Pathogenesis of sepsis: new concepts and implication for future treatment / P.Y. Bochud, Th. Calandra // BMJ. — 2003. — Vol. 326, № 738. — Р.262—265.
11. Chang, Zl. Important aspects of Toll-like receptors, ligands andtheirsignalingpathways/Zl.Chang//Inflamm.Res. — 2010. — Vol. 59, № 10. — P.791—808.
12. Coopersmith, C.M. Inhibition of intestinal epithelial apoptosis and survival in a murine model of pneumonia-induced sepsis / C.M. Coopersmith, P.E. Stromberg, W.M. Dunne [et al.] // JAMA. — 2002. — Vol. 287. — P.1716.
13. Cuenca, A.G. / Role of Innate Immunity in Neonatal Infection / A.G. Cuenca, J.L. Wynn, L.L. Moldawer [et al.] // Am. J. Perinatol. — 2013. — Vol. 30, № 2. — P.105—112.
14. Elmore, S. // Toxicologic Pathology. — 2007. — Vol. 35, issue 4. — P.495—516.
15. Dzwonek, A.B. The role of mannose-binding lectin in susceptibility to infection in preterm neonates / A.B. Dzwonek, O.W. Neth, R. Thiebaut [et al.] // Pediatr. Res. — 2008. — Vol. 63, № 6. — P.680—685.
16. Felmet, K.A. Prolonged lymphopenia, lymphoid depletion, and hypoprolactinemia in children with nosocomial sepsis and multiple organ failure / K.A. Felmet, M.W. Hall, R.S. Clark [et al.] // J. Immunol. — 2005. — Vol. 174. — P.3765—3772.
17. Forster-Waldi, E.K. Monocyte TLR4 expression and LPS-induced cytokine production increase during gestational aging / E.K. Forster-Waldi, D. Sadeghi, B. Tamandl [et al.] // J. Pediatr. Res. — 2005. — Vol. 58. — P.121—124.
18. Genel, F. Monocyte HLA-DR expression as predictor of poor outcome in neonates with late onset neonatal sepsis / F.Genel,F.Atlihan,E.Ozsu[etal.]//Journalofinfection. — 2010. — Vol. 60, № 3. — P.224—228.
19. Goldstein, B. International pediatric sepsis consensus conference: Definition for sepsis and organ dysfunction in pediatrics / B. Goldstein, B. Giror, A. Randolph [et al.] // Pediatr. Crit. Care Med. — 2005. — Vol. 6, № 1. — P.2—8.
20. Kasten, K.R. / T cells are potent early mediators of the host response to sepsis / K.R. Kasten, J. Tschöp, S.G. Adediran [et al.] // Shock. — 2010. — Vol. 34, № 4. — P.327—336.
21. Hacker, G. Themorphologyofapoptosis/G.Hacker//Cell Tissue Res. — 2000. — Vol. 301. — P.5—17.
22. Landelle, C. Low monocyte human leukocyte antigen-DR is independently associated with nosocomial infections after septic shock / C. Landelle [et al.] // Intensive Care Med. — 2010. — Vol. 36. — P.1859—1866.
23. Lawn, J.E. Lancet Neonatal Survival Steering. 4 million neonatal deaths: when? Where? Why? / J.E. Lawn, S. Cousens, J.T. Zupan // Lancet. — 2005. — Vol. 365. — P.891—900.
24. Levy, M.M. SCCM/ESICM/ACP/ATS/SIS International Sepsis Definitions Conference / M.M. Levy, M.P. Fink, J.P.Marshall[etal.]//Int.CareMed.— 2003.—Vol.29.— P.530—538.
25. Marodi, L. Innate cellular immune responses in newborns / L. Marodi // Linical. Immunology. — 2006. — Vol. 18, № 2/3. — P.137—144
26. Marshall, J.P. Complexity, chaos and incomprehensibility: Parsing the biology of critical illness / J.P. Marshall // Crit. Care Med. — 2000. — Vol. 28. — P.2648.
27. Medzitov, R. Toll-like receptors and innate immunity / R. Medzitov // Nature Rev. Immunol. — 2001. — Vol. 1. — P.136—144.
28. Hotchkiss,R.S. Apoptotic cell death in patients with sepsis, shock, and multiple organ dysfunction / R.S. Hotchkiss [et al.] // Crit. Care Med. — 1999. — Vol. 27. — P.1230— 1251.
29. Hotchkiss, R.S. Sepsis-induced apoptosis causes progressive profound depletion of B and CD4+ T-lymphocytes in humans / R.S. Hotchkiss, K.W. Tinsley, P.E.Swanson[etal.]//J.Immunol.—2001.—Vol.166.— P.6952—6963.
30. Hotchkiss, R.S. The pathophysiology and treatment of sepsis / R.S. Hotchkiss, I.E. Karl // The New England journal of medicine. — 2003. — Vol. 348, № 2. — P.138—150.
31. Hotchkiss,R.S. Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy / R.S. Hotchkiss, G. Monneret, D. Payen // Immunology. — 2013. — Vol. 13. — P.862—874.
32. Hotchkiss, R.S. Immunosuppression in sepsis: novel understanding of the disorder and a new therapeutic approach / R.S. Hotchkiss, G. Monneret, D. Payen // Lancet Infect. Dis. — 2013. — Vol. 13. — P.260—268.
33. Pastille, E. Modulation of dendritic cell differentiation in the  bone marrow mediates sustained immunosuppression after polymicrobial sepsis / E. Pastille [et al.] // J. Immunol. — 2001. — Vol. 186. — P.977—986.
34. Picard, C. Clinical features and outcome of patients with IRAK-4 and MyD88 deficiency / C. Picard, H. von Bernuth, P.Ghandil[etal.]//Medicine(Baltimore). —2010. –Vol.89, № 6. — P.403—425.
35. Reinhart, K. New approaches to sepsis: molecular diagnostics and biomarkers / K. Reinhart, M. Bauer, N.C. Riedemann [et al.] // Clin. Microbiology Rev. — 2012. — Vol. 25, № 4. — P.609—634.
36. Sadeghi, K. Immaturity of infection control in preterm and term newborns is associated with impaired toll-likereceptor signaling / K. Sadeghi, A. Berger, M. Langgartner [et al.] // J. Infect. Dis. — 2007. — Vol. 195, № 2. — P.296—302.
37. Shah, B.A. Neonatal sepsis. An old problem with new insights / B.A. Shah, J.F. Padbury // Virulence. — 2014. — Vol. 5, № 1. — P.163—171.
38. Stoll, J. Late-onset sepsis invery lowbirth weight neonates: the experience of the NICHD Neonatal Research Network / J. Stoll, N.I. Hansen, A.A. Fanaroff [et al.] // Pediatrics. — 2002. — Vol. 110. — P.285—291.
39. Stoll, J. Early onset neonatal sepsis: the burden of group B Streptococcal and E.coli disease continues / J. Stoll, I. Hansen, P.J. Sanchez [et al.] // Pediatrics. — 2011. — Vol. 127, № 5. — P.817—826.
40. Tissieres, P. Innate Immune Deficiency of Extremely Premature Neonates Can Be Reversed by Interferon-γ / P. Tissieres, A. Ochoda, I. Dunn-Siegrist [et al.] // PLos ONE. — 2012. — Vol. 7, issue 3.
41. Toti, P. Spleen depletion in neonatal sepsis and chorioamnionitis / P. Toti [et al.] // Am. J. Clin. Pathol. — 2004. — Vol. 122. — P.765—771.
42. Viemann, D. Expression of toll-like receptors in neonatal sepsis / D. Viemann, G. Dubbel, S. Schleifenbaum [et al.] // Pediatric Research. — 2005. — Vol. 58, № 4. — P.654—659.
43. Wittebole, X. Toll-like Receptor 4 Modulation as a Strategy to Treat Sepsis / X. Wittebole, D. Castanares-Zapatero, P.F. Laterre // Mediators of Inflammation. — 2010.
44. Yan, S.R. Role of MyD88 in diminished tumor necrosis factor alpha production by newborn mononuclear cells in response to lipopolysaccharide / S.R. Yan, G. Qing, D.M. Byers [et al.] // Infect. Immun. — 2004. — Vol. 72, № 3. — P.1223—1229.
45. Zhang, J.P. Changes and clinical significance of Toll-like receptor 2 and 4 expression in neonatal infections / J.P. Zhang, C.C. Yang, Y. Changes // Zhonghua Er Ke Za Zhi. — 2007. — Vol. 45, № 2. — P.130—133.