Aim. To study efficacy of sodium deoxyribonucleate use for the treatment of community-acquired pneumonia in children of school age. Methods. 102 children aged 7 to 17 years were observed: 25 relatively healthy children (control group), 39 children with community-acquired pneumonia, who received only conventional treatment (comparison group) and 38 patients with community-acquired pneumonia receiving complex treatment with additional sodium deoxyribonucleate (study group). All patients underwent clinical and instrumental and laboratory examination. Cytomorphologic features of neutrophils and epithelial cells, cytokine concentration (interleukin-8, -10 and -17, tumor necrosis factor α) were examined in nasal secret of patients with community-acquired pneumonia dynamically on different therapy regimens. Evaluation of dynamics of clinical signs was performed in the studied groups. Results. In the study clinical efficacy of the medication was discovered and caused decreased disease duration, acceleration of inflammatory changes reparation in the lungs in rhinocytogram, decreased level of neutrophils and their destructive forms, decreased levels of pro-inflammatory cytokines - interleukin-8 and tumor necrosis factor α. Conclusion. Sodium deoxyribonucleate enhances adaptive resources of mucosal immunity, leads to restoration of epithelium lining the upper respiratory airways and therefore potentiates local immunity.

ВАХИТОВ ХАКИМ МУРАТОВИЧ, докт. мед. наук, доцент, исполняющий обязанности зав. кафедрой госпитальной педиатрии с курсом поликлинической педиатрии ФГБОУ ВО «Казанский государственный медицинский университет»Минздрава России, Россия, 420012, Казань, ул. Бутлерова, 49, e-mail: vhakim@mail России, Россия, 420012, Казань, ул. Бутлерова, 49, тел. (843) 236-71-72, e-mail: pdb-fp@yandex Россия, 420012, Казань, ул. Бутлерова, 49, тел. (843) 236-71-72, e-mail: azakirova@gmail Россия, 420012, Казань, ул. Бутлерова, 49, тел. (843) 236-71-72, e-mail: ajn78@mail.ru Реферат. Цель -провести анализ публикаций и подготовить литературный обзор, посвященный современ-ному пониманию метаболических сдвигов в организме ребенка при патологии органов дыхания. Материал и методы. Изучены публикации отечественных и зарубежных авторов. Результаты и их обсуждение. Про-анализированы особенности кооперации метаболизма белков, жиров и углеводов при бронхолегочной патологии у детей. Раскрыты важные патогенетические звенья инициации и развития воспалительного поражения легких, обосновывающих необходимость дифференцированного подхода к назначению метаболических корректоров. Отражена роль нарушения липидного обмена в стимуляции процессов фагоцитоза, активации «респираторного взрыва» и перекисного окисления липидов. Сделан акцент на метаболизм углеводов, выражающийся в пре-обладании гликолиза, накоплению лактата и пирувата, что ведет к формированию метаболического ацидоза. Обобщена приоритетная роль биоэлементов в каскаде патогенетических механизмов патологии легочной системы, являющихся не только компонентами местной защиты легких, но и участвующих в контроле функцио-нальной активности клеток при развитии воспалительного процесса и иммунного ответа. С клинических позиций данный факт может служить индикатором донозологической диагоностики развития легочной патологии, что позволяет на ранних сроках прогнозировать инициацию заболевания. Выводы. Таким образом, необходимы поиск новых подходов к изучению патогенеза пневмонии, коррекция гомеостатических нарушений на клеточном и субклеточном уровнях, а также разработка методов доклинической диагностики, позволяющих корригировать минимальные метаболические нарушения и купировать их развитие. University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: vhakim@mail Russia, 420012, Kazan, Butlerov str., 49, tel. (843) 236-71-72, 8-987-296-38-48, e-mail: suleimanova_zulfia@mail Russia, 420012, Kazan, Butlerov str., 49, e-mail: ajn78@mail.ru Abstract. Aim. The goal was to analyze the publications and to prepare a review of the works devoted to the modern understanding of metabolic shifts in the child organism in respiratory organ disorders. Material and methods. The publications of native and foreign authors have been studied. Results and discussions. The features of the metabolism CASCADE OF METABOLIC DISORDERS IN RESPIRATORY ORGAN DISORDERS IN CHILDREN VAKHITOV KHAKIM M., D. Med. Sci., associate professor, the acting head of the Department of pediatrics with the course of outpatient pediatrics o...

In this article described were the main milestones of life of the founder of the pediatric school in Kazan - Professor P.M. Argutinskiy-Dolgoruky. He made great efforts to organize the teaching of pediatrics in Kazan University at the European level, was one of the founders of a new pediatric hospital on the Arskiy field in 1900. Professor P.M. Argutinskiy-Dolgorukov devoted his scientific career mainly to the study of infectious diseases. In Russia P.M. Argutinskiy-Dolgorukov was the founder of the studies of malaria in children. Progressive methods of diagnosis and treatment were introduced into the clinical practice under the guidance of the Professor, including such as the method of treatment of scarlet fever with the Moser serum, the study of measles, X-ray examinations at the patient’s bedside.

Nowadays the problems of medical ethics are gaining the special significance as a result of changes in social and economic relations, healthcare modernization due to appearance of new effective methods for instrumental and laboratory examinations, treatment approaches, development of market relations in medicine. The aim of the presented paper is to cover the actual aspects of medical ethics in pediatrics. The paper reviews the ethical aspects of the work of a in detail. Differentiated approach in choosing pediatrician interns, which is based not only on academic progress, but also on professional and moral qualities of the medical university alumni and continuity in their upbringing starting form the first years of the medical school until the end of post-graduate education, seems rationale. It is during the student years when the cognitive and moral values of a forthcoming specialist are formed, which may be a criterion of a suitability of working with children. The roles of the competition, including the modular approach to knowledge evaluation, professional competencies and rating system are stressed. Considering the modern requirements to a young professional, the accent is made on the role of the leading tutor in a forthcoming specialist formation. The requirements to a higher education teacher and the importance of the moral atmosphere in hospitals and faculties for forming the ethical features of a forthcoming pediatrician and improving his/her professional level according to the medical progress are outlined. Thus, teaching pediatrics has a lot of particularities, including teaching the basics of medical ethics, having an extremely important role in professional education of pediatricians for proper forming of the young professional according to contemporary life requirements.

Study Objective: To study the clinical efficacy of adding the novel mechanical bacterial lysate to the therapy and its effect for the local immunity in children with acute and recurrent respiratory infections in children. Study Design: comparative study. Materials and Methods. The study included 97 children hospitalised with uneventful moderate bronchitis. The subjects were divided into two groups comparable on all selection parameters. Study group: 54 patients, 3 to 10 years old, who had a microbial immunomodulatory (bacterial lysate) added to the standard therapy, 1 sublingual tablet once daily: 25 children with acute bronchitis — for 10 days; 29 children with recurrent bronchitis — 3 x 10 days with 20-day intervals. Control group included 43 children of the same age (22 subjects with acute disease and 21 — with recurrent disease) who were prescribed general therapy only. Clinical examination results and local immunity were assessed using rhinocytogram and cytokine status. Study Results. The clinical effect of the bacterial lysate was 2.4-fold reduction in acute respiratory infection rate. Acute respiratory infection duration reduced by 1.3 times. Arrest of the respiratory syndrome with the help of bacterial lysate was recorded in 10.3 ± 0.2 days, while in control group it was 13.5 ± 0.4 days (р = 0.041). The study group demonstrated statistically significant reduction in the neutrophil and epithelial cell court (rhinocytogram), interleukin-8 and tumour necrosis factor α, markers of a system respiratory inflammation. Conclusion. Prescription of the product for prevention and therapy ensures reduction in morbidity rates; it is well-tolerated, easy-to-use and has no adverse drug reactions, facilitating compliance in children and their parents. Keywords: children, acute and recurrent infections, bacterial lysate.