Pediatrician (St. Petersburg)

Scientific and practical peer-reviewed medical journal.

Published since 2010, 6 issues per year.

The Chief-editor: professor Dmitriy Olegovitch Ivanov.


  • Saint Petersburg state pediatric medical university of the Ministry of Healthcare of the Russian Federation,
  • Eco-Vector, LLC

The audience of the journal: the Journal focuses on researchers, doctors: pediatricians, pediatric surgeons, anesthesiologists and all specialists in related areas of medicine, psychologists and researchers in the field of the fundamental medicine.

The Journal’s subject area:

The journal publishes the original articles about conducted clinical, clinical-experimental and fundamental scientific works, reviews, lectures, descriptions of cases from practice, as well as auxiliary materials on all actual issues of Pediatrics, child psychology, medical and biological research in medicine and related fields of knowledge.

The main journal’s scope is focused on key issues of the studying of the child's body: the etiology and pathogenesis, epidemiology, clinical features, latest diagnostic techniques and treatment of diseases in children, as well as studying of childhood diseases in adults. The main goal is to provide new knowledge on improving the prevention, diagnosis and treatment of children’s various diseases to improve the education and skills of medical and scientific health-care professionals.


RSCI, Cyberleninka, Indexcopernicus, Google Scholar, Ulrich's Periodicals directory.

The project has been implemented with the financial support of the Committee on Science and Higher School of the Government of Saint Petersburg.

Distribution: by subscription in print and online

Current Issue

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Vol 14, No 2 (2023)

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Gestation outcomes in various options of help for pregnant women with Rh-immunization
Vetrov V.V., Ivanov D.O., Reznik V.A., Romanova L.A., Kurdynko L.V., Nikolaev A.V., Sadykova G.K., Menshikova S.V., Ovsyannikov P.A., Vyugov M.A., Avrutskaya V.V., Vladimirova N.Y., Chermnykh S.V., Zheleznaya A.A., Koroteev A.L., Вarinov V.A.

BACKGROUND: To date, several options for helping pregnant women with rhesus immunization are known: (a) “active tactics” in carrying out methods of efferent therapy in the form of basic operations (plasmapheresis, hemosorption) in combination with adjuvant methods (immunoglobulin, blood photomodification with ultraviolet, laser beams, ozone therapy) to pregnant women; (b) “wait-and-see active tactics” with observation of the pregnant woman, followed by intrauterine intravascular transfusions of washed donor red blood cells; (c) “mixed active tactics” with a sequential combination, alternation of these methods. In Russia, only option 2 with fetal transfusions of washed donor red blood cells is accepted as the basis and paid for. The objective of the study is to conduct a comparative analysis of pregnancy outcomes in women with rhesus immunization using different management options.

MATERIALS AND METHODS: A total of 392 women were followed up at seven different institutions in Russia and at the Donetsk Center for Maternal and Child Health (DNR), of whom 345 pregnant women (Group 1) received efferent therapy, 33 women (Group 2) had fetuses intrauterine bypass surgery, and 14 pregnant women (Group 3) had mixed efferent therapy and fetal PEEP bypass surgery.

RESULTS: The analysis showed that the most favorable results for the main clinical indicators (premature, operative delivery, fetal hypoxia at birth, etc.) were in Group 1 and 3 women, in which the perinatal mortality was 14.5/1000 and 0/1000, respectively, which was significantly lower than in Group 2 (176.5/1000). It was also found that in Groups 2 and 3 women, the mean intervals between repeated transfusions of washed donor red blood cells were 8.8 ± 0.2 and 21.4 ± 3.8 days (p < 0.01), which may be explained by the detoxifying effect of efferent therapy methods, preservation of fetal red blood cells and transfused donor red blood cells to the fetus with prolonged gestation and obtaining healthier and more viable progeny.

CONCLUSIONS: 1. Severe Rh conflict is a manifestation of a syndrome of systemic effects of aggressive metabolites of specific and nonspecific nature. 2. The etiopathogenetic measure in the prevention and treatment of HDF/HDN in rhesus conflict is efferent therapy methods for the mother, and transfusion of washed donor rhesus-negative red blood cells to the fetus is effective, but a temporary, palliative measure, as is the case in multiple organ failure. 3. In the treatment protocols, efferent therapy methods must be present to prevent fetal red cell destruction and, equally importantly, to prevent destruction of Rh-negative donor red cells transfused to the fetus.

Pediatrician (St. Petersburg). 2023;14(2):5-16
pages 5-16 views

Original studies

Features of the microbial landscape of the stomach in children, feeding through the gastrostomy or nasogastric tube
Kuznetsova Y.V., Zavyalova A.N., Lisovskii O.V., Gavshchuk M.V., Al-Hares M.M., Dudurich V.V., Pak A.A.

BACKGROUND: In children with dysphagia, an increase in body weight is observed after the placement of a feeding tube, however, subsequently, a regression of body weight is noted, symptoms of an erosive and ulcerative lesion of the gastrointestinal tract appear.

AIM: To identify the features of the gastric microbiome in children fed through a gastrostomy or a tube.

MATERIALS AND METHODS: A study of aspirates of gastric contents in 21 patients was carried out using metagenomic sequencing. The participants were divided into 2 groups: group 1 — 11 children fed through the gastrostomy for less than 1 year; group 2 — 10 children, fed through the gastrostomy for more than 1 year.

RESULTS: In group 1, from 8 to 19 phyla were identified, median 12.0. In the second group from 4 to 13, median 7.5, the differences are statistically significant (p < 0.05). The samples of both groups were dominated by the phyla Firmicutes, Proteobacteria, Bacteroidota, Actinobacteria, Fusobacteria. The number of representatives of the Bacteroidia and Fusobacteriia classes was significantly reduced in patients with long-term nutrition through the gastrostomy. At the same time, a small number of classes were observed in patients with a gastrostomy in the stomach for about 80 months, as well as in patients with identified gastric pathology. There were about 66 genera for each specimen. At the same time, in children fed through a gastrostomy for less than 1 year, the median is 69.5 OTU. In children fed through a gastrostomy for more than 1 year, even with its regular replacement, the median is significantly less — 41 OTU. A significant decrease in microbial biodiversity was revealed with an increase in the standing time of the gastrostomy, the median value of the Shannon index in group 1 was 1.95, in group 2 1.69 (p ≤ 0.05).

CONCLUSIONS: In patients with a long stay of the feeding tube in the stomach, the number of anti-inflammatory symbionts of the genus Prevotella, Parabacteroides is reduced. The contamination of the stomach with Helicobacter pylori was 50%, which further increased the predisposition of the gastric mucosa to inflammation.

Pediatrician (St. Petersburg). 2023;14(2):17-27
pages 17-27 views
Cortisol concentration as a marker of adaptation processes in children with infectious mononucleosis at different periods of the disease
Fedorova A.V., Brus T.V., Vasiliev A.G., Timchenko V.N., Tagirov N.S.

BACKGROUND: Infectious mononucleosis is an acute infectious disease caused by Epstein–Barr virus. This virus replicates in B-lymphocytes but may be as well found in the epithelial cells of pharynx and parotid ducts. Its typical symptoms include fever, lymphadenopathy and herpetic angina, the endocrine system may also be involved in the pathologic process.

AIM: The aim of the study is the change in cortisol levels in children of different sex and age during the peak and convalescence of infectious mononucleosis caused by the Epstein–Barr virus.

MATERIALS AND METHODS: Under observation were 94 children aged 1 to 17 years, among them from 1 to 5 years — 22%, from 5 to 10 years — 39%, from 10 to 15 years — 27%, from 15 to 17 years — 12%, with a diagnosis of Epstein–Barr virus – mononucleosis moderate severity. The diagnosis was made on the basis of clinical, anamnestic and laboratory data. Studies confirming the diagnosis were carried out in the laboratory of St. Petersburg State Pediatric Medical University. In addition to routine examinations (clinical minimum), determination of M- and G- antibody titers to the Epstein–Barr virus, detection of the Epstein–Barr virus genome in the blood by PCR, and determination of cortisol levels by enzyme-linked immunosorbent assay in blood serum.

RESULTS: In all age groups, the cortisol concentration during the peak period was higher than during the convalescence period. At the same time, in girls in groups from 6 to 10 years old and from 11 to 16 years old, this difference was significant (1045.19 ± 111.10 versus 740.97 ± 120.68 nM/l and 977.31 ± 81.40 versus 735.48 ± 113.04 nM/l respectively). In boys of all age groups, the differences were significant and amounted to 1211.30 ± 128.36 versus 864.63 ± 126.90 nM/l in the group from 1 to 5 years old, and 1066.76 ± 39.01 versus 817,90 ± 101,52 nM/l in the age group from 6 to 10 years old, in the age group from 11 to 16 years 950.14 ± 101.54 versus 779.61 ± 125.68 nM/l.

CONCLUSIONS: Changes in cortisol levels in children during the peak of infectious mononucleosis depend on the severity of the disease, the presence and nature of complications. The level of cortisol determines various options for adaptation to infectious mononucleosis.

Pediatrician (St. Petersburg). 2023;14(2):29-36
pages 29-36 views
Presence of uveitis as indicator of juvenile idiopathic arthritis severity: results of a retrospective cohort study
Yakovlev A.A., Gaidar E.V., Belozerov K.E., Kaneva M.A., Kononov A.V., Sorokina L.S., Isupova E.A., Chikova I.A., Masalova V.V., Dubko M.F., Nikitina T.N., Kalashnikova O.V., Chasnyk V.G., Kostik M.M.

BACKGROUND: Juvenile idiopathic arthritis is the most common rheumatic disease in children. A frequent extra-articular manifestation of juvenile idiopathic arthritis is uveitis, which is a serious clinical diagnostic problem in routine pediatric practice. Among the known risk factors for uveitis are the early age of the juvenile idiopathic arthritis onset, oligoarticular subtype, seropositivity by antinuclear factor.

AIM: to evaluate the influence of presence of uveitis on the course of juvenile idiopathic arthritis.

MATERIALS AND METHODS: A single-center retrospective study included 520 patients with uveitis. The analysis was carried out among patients who developed (n = 116) and did not develop (n = 404) uveitis. The minimum follow-up period was 2 years, for patients who did not develop uveitis.

RESULTS: Uveitis was diagnosed in 116 (22.3%) children with juvenile idiopathic arthritis. Most often, uveitis occurred in patients with oligoarthritis and psoriatic arthritis. When comparing the features of the articular status of patients with juvenile idiopathic arthritis who developed and did not develop uveitis, a lower frequency of involvement of the cervical spine, temporomandibular, shoulder, elbow, wrist, proximal and distal interphalangeal joints, hip, talus-heel joint, as well as a smaller number of active joints in children with uveitis was found. Patients with uveitis received methotrexate therapy more often, cumulative doses of corticosteroids were lower, the frequency of prescribing genetically engineered biological drugs was approximately the same in both groups. Remission of arthritis was achieved more often, but the proportion of children who developed an exacerbation was higher. When calculating the risk factors of uveitis by binary logistic regression, it was found that the main predictors of uveitis were oligoarthritis, the number of active joints <8, seropositivity by antinuclear factor and recurrent course of arthritis. The difference in the frequency of achieving remission may be due to more aggressive systemic therapy in the presence of uveitis.

CONCLUSIONS: Children with uveitis have a more severe course of juvenile idiopathic arthritis and may require more aggressive immuno-suppressive therapy. Further studies are required to determine the prognostic role of uveitis in the course and outcomes of juvenile idiopathic arthritis.

Pediatrician (St. Petersburg). 2023;14(2):37-47
pages 37-47 views
Increased mRNA grelin receptor expression in rat cubs brain structures in models of separation from mother and social isolation
Pyurveev S.S., Lebedev A.A., Sexte E.A., Bychkov E.R., Dedanishvili N.S., Tagirov N.S., Shabanov P.D.

BACKGROUND: Stress exposure at an early age can have serious long-term consequences for the development of the human body, leading to adaptive disorders, increased anxiety, depression and other mental disorders in people. The effect of stressors in the first weeks after birth affects the proliferation, differentiation and migration of neurons, in particular, the neurogenesis of hippocampal cells. Repetitive stress can lead to changes in the structure and function of the brain, including deterioration of memory and skill acquisition, reduced resistance to stress in the future, decreased immune system function and increased risk of depression and other mental illnesses.

AIM: The aim was to study the effect of social isolation weaning on the level of ghrelin receptor mRNA expression in the brain structures of Wistar rats.

MATERIALS AND METHODS: 60 male rats (8 litters) with a body weight of 230–250 g were used in the work and three experimental groups were formed: control (n = 20); “maternal deprivation” (n = 20); “social isolation” (n = 20). On the 90th day of life, the animals were decapitated, the brain was quickly extracted, placed in the cold and brain structures (hypothalamus, amygdala, prefrontal cortex) were isolated, immediately frozen in liquid nitrogen and stored at a temperature of –80°C until PCR analysis was performed. The data obtained were normalized to the expression level of the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene and calculated in relative units with respect to the expression value of the GRLN-R gene for each structure separately by method 2 (-DeltaDelta C(T)).

RESULTS: In rats raised in conditions of social isolation, compared with the indicators of the control group and the group of animals with maternal deprivation (p < 0.05), an increase in the expression of the GHSR1A gene was noted in the hypothalamus. Whereas in rats after the stress of maternal deprivation in the amygdala there was an increase in the expression of the GHSR1A gene compared with the indicators in the control group of rats.

CONCLUSIONS: 1. In rats that survived weaning from the mother from the 2nd to the 12th postnatal day, a significant statistically significant increase in the expression of the GHSR1A gene was revealed in the hypothalamus in comparison with the control group and the social isolation group. 2. In rats raised in conditions of social isolation from their relatives, a significant statistically significant increase in the expression of the GHSR1A gene in the amygdala was revealed in comparison with the control group and the weaning group.

Pediatrician (St. Petersburg). 2023;14(2):49-58
pages 49-58 views


Bronchial obstruction syndrome in children with connective tissue dysplasia
Tsymbal A.A., Arsentev V.G., Shabalov A.M., Shabalov N.P., Pakhomova M.A., Vasil'yev I.E.

A systematic analysis of the data available in modern literature concerning the problem of connective tissue dysplasia in children and adolescents, and the results of studying the course of bronchial obstruction syndrome in patients with this pathology, was carried out. Mechanisms of connective tissue dysplasia is imperfect, elucidation of the genetic causes of hereditary connective tissue disorders has not yet led to cardinal improvements in diagnosis, prevention and treatment. Connective tissue dysplasia is characterized by the presence of changes in the bronchopulmonary system: tracheobronchial dyskinesia (expiratory collapse of the trachea and large bronchi), tracheobronchomalacia and tracheobronchomegaly, apical bullae, confirmed by radiographic and spontaneous pneumothorax (more common in young men), the presence of thoracodiaphragmatic syndrome, which includes an asthenic form of the chest, deformities chest and / or spine, change in standing height and excursions of the diaphragm. The etiological and pathogenetic factors in the development of bronchiectasis remain ambiguous. Patients with connective tissue dysplasia require special attention and deeper study. The presence of thoracodiaphragmatic and bronchopulmonary syndrome in children contributes to a longer course of broncho-obstructive syndrome, a brighter, vegetative color of seizures is described. It is noted that these patients need more aggressive and long-term therapy.

Pediatrician (St. Petersburg). 2023;14(2):59-68
pages 59-68 views
Features of modern monitoring of the condition of adolescents with asthma
Nesterenko Z.V., Lagno O.V.

The article reviews the literature, including current data of domestic and foreign researchers on the features of the clinical course, the difficulties of diagnosing and monitoring adolescents with asthma due to the mild severity of symptoms, psycho-emotional characteristics of this age, the difficulty of forming adherence to therapy, underestimating one’s condition, difficulties in communication with the doctor, parents. Taking into account the specific adolescent characteristics, when drawing up a therapeutic program by a specialist, it is necessary to take into account the lifestyle of a teenager, his needs, which will help to ensure monitoring of the quality of therapy, the formation of adherence to treatment, and the prevention of disease progression. Insufficient control of asthma symptoms necessitates the improvement of medical care for adolescent patients. One of the modern directions in this area is the use of remote telecommunication and information technologies, which are readily and successfully mastered by adolescents, which can significantly improve the quality of observation, the level of adherence and control the process of clinical development of asthma.

Pediatrician (St. Petersburg). 2023;14(2):69-77
pages 69-77 views
The role of dermatoscopy in skin neoplasms diagnostics in children and adolescents
Kulyova S.A., Khabarova R.I.

Information about the natural nevogenesis of pigmented skin lesions, evolutionary and morphological features in pediatric patients is still rare in the medical literature despite the progress in dermatooncology. Clinical examination or analysis with the “naked eye” of skin neoplasms carries a certain diagnostic information content. However, this method is much less informative compared to the use of an epiluminescent microscope. Dermoscopy of skin neoplasms is a non-invasive highly informative diagnostic method. Nowadays, the technique is widely used in the clinical practice of pediatric oncodermatologists. This painless diagnosis is ideal for a primary analysis of the morphological picture melanocytic or other skin neoplasms, malignancy risk assessment and determining the tactics of managing pediatric patients. The necessity for differential diagnosis the spectrum of skin neoplasms dictates a trend towards improving research methods and an age-adapted approach. The method of skin microscopy can be attributed to the methods of choice among those currently available. The history of method, diagnostic informativeness and detailed morphological characteristics of melanocytic skin neoplasms in children and adolescents are presented.

Pediatrician (St. Petersburg). 2023;14(2):79-91
pages 79-91 views
Organization of the stomy patient nutrition. Choice of food substrate
Zavyalova A.N., Novikova V.P., Orel V.I., Gavshchuk M.V., Kuznetsova Y.V., Davletova L.A., Al-Hares M.M.

Feeding through an artificial fistula is used to organize the nutrition of patients with prolonged severe dysphagia. Gastrostomy is the most common operation to provide nutrition when oral intake is not possible. According to the information system of the St. Petersburg Territorial Compulsory Medical Insurance Fund, from 01.01.2015 to 10.20.2020, 2391 operations of imposing a nutritional fistula were paid. The choice of a food substrate for feeding an ostomy patient is difficult. Previously, pureed diets of mixed products were used; since 2000, in large hospitals, these diets have been replaced by branded enteral nutrition. The development of malnutrition, up to kwashiorkor and sarcopenia, has been noted in patients receiving an unbalanced pureed diet for a long time. The real properties of the blended diet do not allow it to be introduced into the gastrostomy without dilution with water. Blockage of gastrostomy tubes, due to the density of nutrition, is one of the frequent problems of such nutrition. On the contrary, branded enteral nutrition is fluid, well balanced in terms of the main food nutrients, vitamins and minerals, with a given energy value in small volumes of liquid. With long-term nutrition with commercial mixtures, intestinal dysbiosis develops with a loss of microbiota biodiversity. In the case of feeding a patient with a blended table, microbial biodiversity is preserved, a number of gastroenterological complaints and allergies or food intolerances to artificial nutrition ingredients are stopped. The choice of food substrate for the patient, its combination of wiped table and branded food is under study.

Pediatrician (St. Petersburg). 2023;14(2):93-104
pages 93-104 views

Clinical observation

Difficulties of differential diagnosis of multisystem inflammatory syndrome associated with SARS-CoV-2 in a teenager (clinical case)
Konstantinova Y.E., Vilnits A.A., Chuprova S.N., Konev A.I., Pshenichnaya K.I., Filippova D.S.

The new coronavirus infection does not lose its relevance, which is due to the ubiquity of the virus, the variety of strains, clinical manifestations and their consequences of COVID-19. In children, one of the severe complications of new coronavirus infection is the multisystem inflammatory syndrome associated with SARS-CoV-2 (MIS-C), which is characterized by a hyperinflammatory response with damage to two or more organs and systems. MIS-C requires differential diagnosis with other diseases with similar symptoms: bacterial infections, sepsis, toxic shock syndrome, Kawasaki syndrome, hemophagocytic syndrome. As an example, the article considers a clinical case of MIS-C in a 13-year-old girl 4 weeks after undergoing new coronavirus infection (confirmed). At the onset of the disease, the leading manifestations were systemic inflammatory response syndrome (fever, increased markers of inflammation) with damage to the cardiovascular system, skin and mucous membranes, lymphadenitis, thrombocytopenia. According to the severity of the condition, the child required observation and treatment in the intensive care unit. The absence of the expected effect of the recommended MIS-C therapy (intravenous immunoglobulin and pulse therapy with methylprednisolone) on the first day did not allow to exclude bacterial infection complicated by sepsis in the above clinical situation, therefore, it was suggested that the combined course of MIS-C and bacterial infection of unspecified etiology, which probably led to a more severe course of the disease. In the outcome of the MIS-C the child had the formation of a long-term depressive state (diagnosed by a psychiatrist), for which the patient received drug therapy and psychological assistance.

The described case showed difficulties in the formulation of the final diagnosis due to the presence in the patient of several symptoms and syndromes characteristic of various diseases, the absence of an identified etiological agent and the absence of the expected positive effect with standard therapy of the disease. In addition, a pathology was revealed in the catamnesis, which required dynamic observation of the child by several specialized specialists.

Pediatrician (St. Petersburg). 2023;14(2):105-116
pages 105-116 views
Fetal valproate syndrome (review and case report)
Melashenko T.V., Palchik A.B.

Toxic damages in fetuses and newborns rank highly in perinatal pathology structure, though their true importance is not understood thoroughly. Among toxic encephalopathies of newborns the accent should be given to the conditions caused by administration of medicines by a pregnant woman. The use of medicines, especially neurotropic, during pregnancy is often forced. The widespread prevalence of epilepsy in women of reproductive age leads, in certain cases, to anticonvulsants administration during pregnancy. The dominance of valproic acid in epilepsy treatment in recent decades requires studying its teratogenic effect in newborns — fetal valproate syndrome. The fetal valproate syndrome has casuistic nature and polymorphic phenomenology.

The clinical case study is presented of a newborn with fetal valproate syndrome (born to a mother who took valproic acid in dose 14 mg/kg per day or 750 mg per day while pregnant, due to Janz syndrome), confirmed by valproic acid presence in the blood of a newborn (47.36 µmol/l), with the main clinical manifestation of incomplete cleft palate (hard and soft) without other typical disturbances.

Most anticonvulsants have a teratogenic effect, and may cause malformations and toxic encephalopathies in fetus and newborns. The similarity of clinical manifestations of intrauterine exposure to various anticonvulsants is associated with the presence of common metabolic links (epoxy and dihydrodiol derivatives of phenytoin, phenobarbital and carbamazepine). In spite of similarity of some teratogenic effect mechanisms, the anticonvulsants nature introduces specific clinical manifestations of these disorders.

Pediatrician (St. Petersburg). 2023;14(2):117-125
pages 117-125 views
Congenital organic hyperinsulinism associated with a variant in the ABCC8 gene. Description of a family case
Ivanov D.O., Ditkovskaya L.V., Turkunova M.E., Suspitsin E.N.

Hypoglycemia is the most common metabolic disorder occurring in early childhood, which can be the first, and sometimes the only symptom of a whole range of diseases. Etiology determines the characteristic clinical features of the course of hypoglycemic syndrome. Diagnosis is complicated by the fact that the clinical manifestations of hypoglycemia are variable and little specific. The main cause of persistent hypoglycemia in children of the first years of life is congenital hyperinsulinism.

Congenital hyperinsulinism is a hereditary disease characterized by inadequate hypersecretion of insulin by beta cells of the pancreas. Manifesting as a rule in the neonatal period, congenital hyperinsulinism is a great threat, both in terms of survival of patients with late diagnosis, and in terms of the risks of severe neurological complications with inadequate therapy of emerging hypoglycemia.

The article describes a family case of congenital organic hyperinsulinism associated with a rare heterozygous mutation in the ABCC8 gene, the early diagnosis of which allowed avoiding severe complications of the disease and timely prescribing adequate treatment. The clinical variability of the course of the disease in related patients was shown, which required a personalized approach to diagnosis and treatment.

Thus, early detection of hypoglycemia, clarification of its etiology, including with the help of molecular genetic analysis, timely drug therapy and monitoring of the state of carbohydrate metabolism, are important aspects in the treatment and supervision of patients with congenital hyperinsulinism and the prevention of severe neurological complications in them.

Pediatrician (St. Petersburg). 2023;14(2):127-135
pages 127-135 views

History of medicine

The experience of medical support for the evacuation of the civilian population, children and adolescents across the Road of Life in 1941–1942
Arsentev V.G., Tsymbal A.A., Shabalov N.P., Tsymbal A.N., Kalyadin S.B., Pakhomova M.A.

The organization of medical support during the evacuation of the population, including children and adolescents during the Great Patriotic War, especially in 1941–1942, is unique. Attention is drawn to the scale — the timing of the organization of evacuation, the number of evacuated people, methods — by water, aviation, land transport. Special attention in conditions of shortage deserves catering — all evacuees received a hot lunch and rations for the road in the form 1 kg of bread. Gradually, the prevention of infectious diseases was established, vaccination against dysentery was actively used, teams of epidemiologists and disinfection and washing teams were formed, medical support was provided. In total, from the beginning of the blockade to the end of 1942, about 1 million 100 thousand people were evacuated, of which 871 thousand Leningraders. And during the war, about 1 million 738 thousand people were taken out of Leningrad in an organized manner, of which 1 million 360 thousand Leningraders. Priority in mass evacuation was given to children and adolescents — the future of the country. All the sick and wounded, whose treatment required more than 45 days, were subject to evacuation. Thanks to the precise organization of care for evacuees on the way and during the period of overload from one mode of transport to another, difficulties were transferred to the wounded and sick relatively easily. Thanks to the planned work during the evacuation, mass outbreaks of infectious diseases were prevented by medical workers, mortality was reduced as much as possible and the possibility of restoring normal nutrition and life in the evacuation areas was ensured.

Pediatrician (St. Petersburg). 2023;14(2):137-145
pages 137-145 views

Clinical psychology

Organization of palliative care for children in the Children’s Hospice of the Leningrad Region
Garanina M.M., Pirogov D.G.

Palliative care is an actively developing area. A separate area of palliative care is palliative care for children and their families, that is, support for children and adolescents and incurable, progressive diseases up to the age of 18. The relevance and demand for palliative and hospice care is confirmed by the growing number of patients in the North-Western Federal District who need them. In 2018, the Leningrad Region opened the State Autonomous Health Institution of the Leningrad Region “Children’s Hospice” (hereinafter – the Children’s Hospice). The mission of the Children’s Hospice is to provide assistance where recovery is impossible, which is realized in an individual approach to each patient, taking into account his resources and environment, and not a diagnosis. The main goal is to improve the quality of life of children with incurable diseases and their families through providing them with multidisciplinary assistance. Children’s Hospice implements unique support programs for children with life-threatening or life-limiting diseases. The directions of development of the Children’s Hospice are outlined, related to the presence of myths and stereotypes in society, the remoteness of the districts of the Leningrad Region, the difficulties of interdepartmental interaction with regional healthcare institutions, the peculiarities of interaction of patients with specialists of various healthcare institutions and the occurrence of iatrogenic injuries, issues related to the anesthesia of patients. Promising growth points have been outlined that will optimize palliative care for children. In particular, conducting educational work, opening outpatient branches in certain districts of the Leningrad Region which will allow observing the time interval of the assistance provided.

Pediatrician (St. Petersburg). 2023;14(2):147-153
pages 147-153 views

Significant Date

World Kidney Day – 2023: kidney health for all — preparing for the unexpected, supporting the vulnerable
Savenkova N.D., Grigoreva O.P., Batrakov D.D., Petrakova A.V.

The article presents the history of World Kidney Day 2006—2023. The World Kidney Day, which started in 2006, has become an annual successful initiative of the International Society of Nephrologists, the International Federation of Kidney Foundations to inform the world community and politicians, healthcare about the importance of kidneys for general health, to raise awareness about the significance and consequences of congenital, hereditary and acquired kidney diseases, chronic kidney disease, to adopt a strategy, aimed at reducing the frequency, severity and impact of kidney diseases on health and life. The global nature of the problem of kidney disease in children and adults is evidenced by the fact that in 2011 the Political Declaration on Non-infectious diseases, approved at the summit of the World Healthcare Organization, included kidney disease under paragraph 19. Chronic kidney disease is the 6th cause of death in the world. The annual campaign of World Kidney Day 2006–2023 poses medical and socio-economic problems of global importance and reminds that kidney diseases affecting children and adults are common, dangerous and curable. World Kidney Day – 2023, under the motto: Kidney Health for all — preparedness for the unexpected, support for the vulnerable discusses the impact of disasters, in particular the COVID-19 pandemic, on the provision of specialized nephrological care to the population and its resources around the world.

Pediatrician (St. Petersburg). 2023;14(2):155-164
pages 155-164 views

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