Lyme disease is an infectious disease caused by bacteria of the Borrelia burgdorferi sensu lato (Bbsl) complex and is characterized by predominant lesions of the skin, cardiovascular system, nervous system and musculoskeletal system. We have described a clinical case of first-degree atrioventricular block in a 14-year-old boy caused by Lyme borreliosis. The disease started with the manifestations of cardiovascular system involvement. The patient and his parents did not recall observing a tick bite or manifestation of erythema migrans (EM). The boy was prescribed doxycycline. Three weeks after antibiotic therapy a second ECG examination was performed and showed no abnormalities.
<abstract> <p>Diseases of respiratory tract in young children are often accompanied by the development of bronchial obstruction syndrome. Recurrent episodes of bronchial obstruction are a common problem in young children with respiratory disorders in neonatal period. The aim of our work was to test secondary prophylactic measures concerning development and progression of recurrent bronchial obstructive syndrome in young children, who had suffered respiratory disorders in neonatal period. Prophylactic complex included basic therapy (inhalation of glucocorticosteroids—fluticasone propionate or budesonide), administration of immunomodulating drug Ribomunyl and conducting of prophylactic vaccination in specialized inpatient department after prior preparation whith antihistamines.</p> <sec> <title>Objectives</title> <p>The feature of disease course was assessed based on the need of using drugs with symptomatic action, frequency of exacerbations, their mean duration and severity in 60 children, who had breathing disorders in neonatal period. Children were randomly divided into two groups. The study of efficacy of secondary prophylactic measures was conducted in 30 children (basic group) and in other 30 patients secondary prophylactic complex was not used (control group).</p> </sec><sec> <title>Methods</title> <p>Algorithm of secondary prophylactic complex included basic therapy involving inhalation glucocorticosteroids, administration of immunomodulatory drug Ribomunyl as recommended and conduction of planned prophylactic inoculations with the use of antihistamines.</p> </sec><sec> <title>Conclusions</title> <p>In children, who were administered secondary prophylactic complex was a positive dynamics in clinical picture and laboratory data.</p> </sec><sec> <title>Results</title> <p>Administration of secondary prophylactic complex enabled, to a certain extent, to prevent progression of bronchial obstructive syndrome and achieve a reliable increase in γ-INF, IgA, IgM, IgG levels and decrease in IL-4 (р < 0.01).</p> </sec></abstract>
Background. Cow's milk protein allergy is a topical issue in pediatrics. This disease affects 2-3% of young children. Methods. The study included 30 children with a confirmed cow’s milk protein allergy and a prescribed milk elimination diet. The children were observed for 36 months. The molecular profile was evaluated by detecting the major components of milk (Bos d 8, Bos d 5, Bos d 4), minor (Bos d 6), and cross-reactive with serum albumin (Fel d 2, Can f 3). Results. The study group included 46.7% of boys. The mean age of the subjects was 14.5±3.18 months. Nine of the 25 analyzed factors were identified in the course of our work by the method of logistic regression with progressive selection, which in combined action affect the formation of tolerance to cow's milk proteins in allergic children. There are three clinical examples of calculating the prediction of the complete tolerance development in the elimination diet in children with cow's milk protein allergy. Conclusions. Independent predictors that reduce the likelihood of the tolerance development in the elimination diet, have identified: skin test to milk, Bos d 8, Bos d 5, Bos d 4, Bos d 6. Independent predictors of the tolerance development in the elimination diet are: milk-specific IgE, total IgE, Fel d 2, Can f 3. Low probability of tolerance development by elimination therapy is a recommendation for prescribing treatment to a patient by specific oral tolerance induction.
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