[Nutritional management of kidney diseases in children].

The prevalence of various kidney diseases in children remains high in recent decades. Adequate nutrition management can enhance the effectiveness of drug treatment, slow the frequency of relapses andprevent the progression of the disease. The article is devoted to modern approaches to diet therapy in various kidney diseases in children with the defeat of tubular and glomerular appa ratus. For the first time the therapeutic diets for children with various kidney diseases are presented. Particular attention is paid to diet therapy in nephrotic syndrome (steroid-responsive and steroid-refractory). Dietary approaches with modern formulas for enteral nutrition in cases of steroid therapy complications in children with renal insufficiency (in predialysis stage and on dialysis) are described. Differentiated nutritional approaches for patients with different types of crystalluria are separately presented.

[Dengue fever in Russian tourists who have come from Thailand].

The review analyzes the major epidemiological and clinical aspects of Dengue fever, by providing the clinical examples of using its imported cases. It gives algorithms for examining patients who have come from tropical countries with the fever of unknown origin. Based on the extensive data available in the literature and international guidelines, the authors present treatment algorithms for out- and inpatients with Dengue fever. Promising studies of vaccination against Dengue fever are analyzed.

[Retrospective analysis of endovascular thrombectomy in anterior cerebral circulation out of 6-hours «therapeutic window¼ in regional vascular centers of Saint-Petersburg]. / Retrospektivnyi analiz rezul'tatov vnutrisosudistoi tromboembolektomii v karotidnom basseine za predelami 6-chasovogo «terapevticheskogo okna¼ v regional'nykh sosudistykh tsentrakh Sankt-Peterburga.

OBJECTIVE: Based on a retrospective analysis, to evaluate technical results and functional outcomes at discharge after endovascular thrombectomy (EVT) in anterior circulation out of 6-hours «therapeutic window¼ in patients with stroke. MATERIAL AND METHODS: The retrospective analysis of EVT in 594 acute stroke patients (303 male, 291 female, median age 69 years) with the anterior circulation large vessel occlusion was performed. EVT was carried out before 6 hrs in 550, later in 44 patients. Time to artery puncture was defined as a cut point. Patients were included in the study if they met the criterion for 0-6 hours «therapeutic window¼. RESULTS: No significant differences in functional outcomes at discharge assessed with the Rankin scale (mRs 0-2 29.8% and 20.5% p<0.19; mRs 3-5 38.7% and 38.6% p<0.99; mRs 6 31.5% and 40.9% p<0.2) and the rates of intracranial haemorrhage, haemorrhagic transformation and symptomatic haemorrhagic transformation (4% and 0% p<0.17; 20.9% and 29.5% p<0.49; 10.1% and 11.4% p<0.78) were observed in patients exposed to EVT before 6 hrs and later. CONCLUSION: EVT in anterior circulation stroke over 6 hrs «therapeutic window¼ based on the criterion for 0-6 hrs provides comparable functional outcomes at discharge without the increase in the frequency of intracranial haemorrhages, haemorrhagic and symptomatic haemorrhagic transformations.

[Endothelial dysfunction in children's chronic glomerulonephritis].

Production of NO, sVCAM-1, Et-1, FV, PAI- 1 was measured in blood sera of children with different forms of chronic glomerulonephritis. Endothelial dysfunction (ED) occurred in the active phase of the disease and persisted during remission regardless of the clinical form of glomerulonephritis. Severity of ED and involvement of its markers depended on morphological type of the disease. Production of endothelin-1 was highest in patients with sclerotic glomerulonephritis and accompanying arterial hypertension. ED caused activation of hemostasis with the prevalence of prothrombotic condition. ED contributed to the progress of glomerulonephritis acting via sclerotization and cell proliferation. Selected markers ED are shown to be of prognostic value in children with chronic glomerulonephritis.

[Polymorphism of catalase and glutathione peroxidase genes in macrovascular complications in patients with non-insulin-dependent diabetes mellitus and hypertension]. / Polimorfizm genov katalazy i glutationperoksidazy i makrososudistye oslozhneniia u bol'nykh insulinnezavisimym sakharnym diabetom i gipertoniei.

Allelic and genotypic distributions of the polymorphic markers C1167T and Pro197Leu of the genes of catalase (CAT) and glutathione peroxidase (GPX1), respectively, were studied in patients with non-insulin-dependent diabetes mellitus (NIDDM) and hypertension without complications (the control group, n = 52) and with complications: myocardial infarction (MI, n = 53) or stroke (n = 50). No significant differences were found between complicated and uncomplicated patients with respect to the allelic or phenotypic distribution. Thus, there were no association between these polymorphic regions and either MI or stroke in hypertensive NIDDM patients.

[Fibronectin levels in blood, urine and kidney in children with kidney diseases]. / Soderzhanie fibronektina v krovi, moche i pochechnoi tkani pri bolezniakh pochek u detei.

The level of plasma fibronectin (FN) is increasing in prognostically unfavourable morphological forms of childrens glomerulonephritis being in direct relationship with the activity index and sclerosis index. Urine FN excretion depends upon generalization of the tubulointerstitial changes, presence in the kidney of synechia and segmentary sclerosis of the glomeruli capillaries. A direct correlation is established between FN in the renal tissue and the degree of the mesangial cell proliferation and the spread of sclerotic changes.

[The evaluation of the efficacy of a first course of immunization against diphtheria and tetanus in children with kidney diseases]. / Otsenka éffektivnosti pervichnogo kursa immunizatsii protiv difterii i stolbniaka u detei s zabolevaniiami pochek.

The results of the determination of the level of antitoxic antibodies (Ab) to diphtheria and tetanus toxoids in children with glomerulonephritis and pyelonephritis are presented. The influence of the form of the disease and the kind of medicinal therapy on level of specific Ab has been studied. As shown in this study, the injection of adsorbed DT toxoid with reduced antigen content leads to the formation of the protective titers of antidiphtheria and antitetanus Ab, but a lower level than after the injection of adsorbed DPT vaccine.

[Nephrotic syndrome in minimal change disease (kidney), focal segmental glomerulosclerosis, and focal mesangioproliferative glomerulonephritis]. / Nefroticheskii sindrom pri bolezni minimal'nykh izmenenii (pochki), fokal'nom segmentarnom glomeruloskleroze i fokal'nom mezangioproliferativnom glomerulonefrite.

AIM: To specify clinical and laboratory characteristics of minimal change disease (MCD), focal mesangioproliferative glomerulonephritis (MPGN), focal-segmental glomerulosclerosis (FSGS). MATERIAL AND METHODS: A retrospective analysis of 45 case histories of children (renal biopsy for nephrotic syndrome) has shown that morphologically 13 of them had MCD, 15--FSGS and 17--focal MPGN. Clinical, laboratory, immunofluorescent and electron microscopy findings typical for each of the morphological types were studied. RESULTS: The data obtained suggest that MCD, FSGS and focal MPGN may represent independent forms of glomerulonephritis. CONCLUSION: If a differential diagnosis by renal biopsy is difficult, information from the disease history and clinico-laboratory evidence should be used.

[Activity of endogenous proteinases in glomerulonephritis in children]. / Aktivnost' éndogennykh proteinaz pri glomerulonefrite u detei.

Protease activities in serum and urine of 116 children with glomerulonephritis and 16 healthy children were tested using chromogenic peptide substrates Z-Dala_Leu-Arg-pNA and Glp-Ala-ALa-Leu-pNa. We found the dependence between activity of serine proteinases and clinical, morphological forms of primary glomerulonephritis and hypertension.

[Effects of vitamin D on protein turnover in children with renal osteopathy]. / Vliianie vitamina D na pokazateli belkovogo obmena u detei s renal'nymi osteopatiiami.

Amino acid analysis and investigation of nitrogen balance were done in 2 groups of the patients with renal failure and osteodystrophy on the diet and vitamin D treatment. The results of the investigations confirm vitamin D influence on free amino acid turnover. We observed significant elevations of plasma amino acids in patients treated with the diet and vitamin D in comparison with the patients without vitamin D supplementation. Vitamin D didn't influence on the retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure

[Efficacy of ceruloplasmin in the resuscitation oncology clinic]. / Effektivnost' tseruloplazmina v reanimatsionnoi onkologicheskoi klinike.

The use of ceruloplasmin in the intensive therapy of oncological patients has been shown to optimize the course of the rehabilitative period promoting dissipating of polyorgan failure, restoration of oxidant-antioxidant balance, reduction in the incidence of pyo-septic complications. Ceruloplasmin is found out to have an apparent detoxicating and antiinflammatory effect, it activities the bodily antioxidant defence, favors normalization of the condition of the immunity lymphocytic link.

[Effect of vitamin D metabolites on the markers of protein, calcium and phosphorus turnover in children with chronic renal failure]. / Vliianie metabolitov vitamina D na pokazatelibelkovogo i fosforno- kal'tsievogo obmena u detei s khronicheskoi pochechnoi nedostatochnost'iu.

Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of the patients with renal failure and osteodystrophy on the Vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid turnover and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with the vitamin D metabolites. Vitamin D metabolites didn't influence on the retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.

[Effects of vitamin D metabolites on indicators of protein, phosphorus and calcium metabolism in children with chronic renal failure]. / Vliianie metabolitov vitamina D na pokazateli belkovogo i fosforno-kal'tsevogo obmena u detei s khronicheskoi pochechnoi nedostatochnost'iu.

Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of patients with renal failure and osteodystrophy on vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid metabolism and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with vitamin D metabolites. Vitamin D metabolites didn't influence retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.

[Impact of interference currents on lipid peroxidation in children with chronic pyelonephritis]. / Vliianie interferentsionnykh tokov na pokazateli perekisnogo okisleniia lipidov u detei, bol'nykh khronicheskim pielonefritom.

Interference currents improve peroxide homeostasis of erythrocytic membranes by a stabilizing action on cytomembranes. Normalization of the biochemical processes at the cell level entails a decline of clinical symptoms of chronic pyelonephritis in children.

[New possibilities in prevention and correction of postoperative suppurative-septic complications and multiple organ failure in oncological surgery]. / Novye vozmozhnosti profilaktiki i korrektsii posleoperatsionnykh gnoino-septicheskikh oslozhnenii i poliorgannoi nedostatochnosti v onkokhirurgii.

The functional status of the oxidative-antioxidative system was studied in 72 patients after vast cancer operations. Traditional surgical treatment and its combination with intraoperative irradiation were shown to lead to tense antioxidative defense and to suppressed T-cell immunity and to call for antioxidative and immunomodulating therapy. High intraoperative blood loss complicated by hemorrhagic shock injured the oxidative-antioxidative system greatly. The magnitude of this damage correlated with the rate of prehypoxia. Addition of the potent antioxidant Ceruloplasmin to the drug regimen normalized a recovery period, helped to correct posthypoxic multiorgan insufficiency, to recover oxidative-antioxidative balance, and to decrease the incidence of pyoinflammatory complications. Patients with endogenous intoxication showed activated lipid peroxidation, decreased functional activity of antioxidative defense components and of T-cell immunity in homeostasis. The use of Ceruloplasmin and Laprot had pronounced antiinflammatory and detoxifying effects on the patient's body and activated its antioxidative defense.

[Effect of perftoran on the oxidant-antioxidant system in patients with severe trauma and blood loss]. / Vliianie perftorana na sostoianie oksidantno-antioksidantnoi sistemy u bol'nykh s tiazheloi travmoi i krovopoterei.

Diminution of reperfusion and re-oxygenation lesions is an important task in the treatment of patients with severe injury and blood loss. From this standpoint the influence of perforan on the condition of the oxidant-antioxidant system was studied in patients with severe combined trauma. The application of perftoran in the early post-trauma period was found to intensify the processes of lipid peroxidation and, simultaneously, to normalize the parameters of the antioxidant-protection system.

[Antioxidants ceruloplasmin and lactoferrin in the prevention and treatment of postoperative complications in cancer patients]. / Antioksidanty tseruloplazmin i laktoferrin v profilaktke i lechenii posleoperatsionnykh oslozhnenii u onkologicheskikh bol'nykh.

Ceruloplasmin and laprote based on natural protein antioxidants were used in the treatment and prevention of postoperative complications in 174 patients after extensive interventions for cancer. Development of pyoseptic complications during the postoperative period is associated with activation of lipid peroxidation, decreased functional activity of the antioxidant component of detoxication, suppressed T-cellular immunity, and development of polyorgan failure in the presence of endogenous toxemia. Systemic treatment with laprote (50 pts) and ceruloplasmin (33 pts) after surgical cleansing and draining of purulent focus stimulated activation of antioxidant defense, decreased the intensity of oxidative processes, normalized the lymphocytic component of immunity, and promoted resolution of polyorgan, primarily hepatic failure. Local therapy with laprote (60 pts) promoted rapid regression of local pyoinflammatory processes. Intraoperative blood loss complicated by hemorrhagic shock had a deep impact on the oxidative/antioxidant system, which correlated with the severity of hypoxia. Addition of ceruloplasmin, a potent antioxidant, to therapy of these patients (n = 31) optimized the course of recovery by stimulating the resolution of posthypoxic polyorgan failure, recovery of the oxidant/antioxidant balance, and decreasing the incidence of postoperative pyoinflammatory complications.