MEDICAL

Phenylketonuria - an inherited disease of fermentopathy associated with the violation of metabolism of amino acids, mainly phenylalanine. Accompanied by the accumulation of phenylalanine and its toxic products, which leads to severe CNS lesions, manifested in the form of impaired intellectual development.

The main symptoms of phenylketonuria

Within early childhood and include vomiting, peeling skin rash, irritability, and stuffy ( "Mouse"), body odor due to abnormal composition of urine and sweat. Symptoms of the central nervous system may be different, usually a compulsive movement poddergivaniya, convulsions. The most severe complication of the disease – mental retardation, which in the absence of treatment is practically inevitable.

Treatment of phenylketonuria

Treatment of this disease is reduced mainly to diet therapy. Since the confirmation of the diagnosis of phenylketonuria diet is introduced with a sharp restriction of the content of phenylalanine. Since this amino acid in large quantities is contained in the protein from the diet excludes all animal protein products. It’s meat, milk, fish, mushrooms.

The initial treatment kids get food, which is completely absent phenylalanine. As long and complete exclusion from the diet of phenylalanine can lead to the disintegration of the endogenous (self) protein and depletion of the child. Because the need for protein is compensated by protein hydrolysates or amino acid mixtures. Once the concentration of phenylalanine in the blood drops to normal, begin to gradually introduce products of animal origin. Child’s diet consists of vegetables, fruits, fat, carbohydrate products, with strict regard to their content of phenylalanine. Should ensure that this amino acid in the body in sufficient quantities for normal growth and development, but does not contribute to its accumulation in tissues.

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Scarlet fever - an acute infectious disease characterized by general intoxication, fever, inflammation of the tonsils and dot rash all over his body.

Cause. The disease is caused by the bacterium – streptococci producing erythrogenic toxin.

The sources of infection are ill with scarlet fever, but may be patients with angina.

Infection occurs by airborne droplets.

The development of the disease. Gate of infection and the main foci of the pathogen are the tonsils. Produced by streptococcal erythrogenic toxin causes acute inflammation of the upper layers of the skin. As with angina, lack of effective treatment of scarlet fever may be the cause of so-called metatonsillar diseases – rheumatic fever, myocarditis, glomerulonephritis.

After a postponed scarlet fever develop lifelong immunity to the disease.

Ill with scarlet fever mostly children.

Symptoms and signs of scarlet fever

The incubation period lasts from 1 to 12 days.

Disease begins acutely. Quickly with a fever the body temperature rises to 38-39 degrees. Observed weakness, headache, sore throat when swallowing. By the end of the first day of illness on the neck and upper torso appears abundant spot rash of speakers above the merging of red spots on the skin 1-2 mm, which is rapidly spreading throughout the body, reminding goose reddened skin. Rash most intense in the skin folds of the elbow and armpit. Often it is accompanied by itching.

Typically the patient’s face. Pink rash located on the forehead and temples, a bright blush on the cheeks and the nose, upper lip and chin, pale. In the pale background of nasolabial triangle catches the eye cherry color lips.

For scarlet fever characterized by an increase in morbidity and compacted uglochelyustnyh lymph nodes (determined when probing at the angles of the mandible on the left and right): they increased in size, elastic, not soldered together, and skin.

Palatine arch, tongue, tonsils and soft palate of bright red color. At the tonsils may be abscesses or areas of accumulation of pus.

The body temperature remained elevated and rash keeps 2-4 days, then gradually disappear. With 5-6 days of illness at the former site of peeling skin rash occurs, which lasts 2-3 weeks.

Complications. Inflammation of the middle ear, sinuses, rheumatic fever, glomerulonephritis.

Treatment is carried out mainly at home, just as patients with angina.

Hospitalizations are subject patients with severe and moderate form of the disease, as well as patients in a family with children from 3 months. to 7 years old and students of the first two classes, not bolevshie scarlet fever.

Preventing disease. Ill with scarlet fever should be isolated in a separate room, it should allocate a separate dining utensils, towels.

Isolation of the patient stops after recovery, but not earlier than 10 days from the onset of the disease. Visiting children who recover from scarlet fever, preschools and the first two classes of schools allowed after additional insulation in the home within 12 days after recovery.

Children attending preschool and the first two classes of schools, not bolevshie scarlet fever and is in contact with the patient, are not permitted in the community within 7 days after isolation of the patient, and in case of communication with the patient throughout the period of the disease – within 17 days from the beginning of contact.

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Sudden infant death syndrome (SIDS, lat. Mors subita infantum) – sudden death from respiratory arrest apparently healthy infant or child, in which the autopsy has not determined the cause of death. SIDS is sometimes called the "death in the cradle, because she can not preceded by any signs, often a child dies in his sleep. First introduced the term SIDS in 1969.Study of the problem is with the 50-ies, with the second half of the 80-ies the study of SIDS has intensified.

Factors associated with risk of sudden infant death syndrome

The exact causes of SIDS has not been established. Strictly speaking, to refer any cases of SIDS infant death unclear etiology, which causes some physicians and researchers critical of the allocation of SIDS as a separate disease.

Contributing factors:

Causes of sudden infant death syndrome

It has been suggested that SIDS may be caused by disruptions in the functioning of the autonomic nervous system, particularly those sections that are associated with breathing and heart (Shaannon & Kelli, 1987), in particular, the lack of serotonin.

In the 1980’s there was a hypothesis that some SIDS cases related to the fact that the underdeveloped pacemaker breathing, decaying under the influence of random failure of a singular stimulus, not in a position to resume movement. In adults, a system of multiple drivers of a rhythm of breathing, blood circulation, and others arranged much more complicated and more reliable.

Prevention

Recommendations for IM Vorontsov et al, 1997 (these recommendations are part of academic medical literature):

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Mumps - a disease which people often referred to as guinea pig – an acute infectious viral disease that is included in the same group of "children" infections, measles, chicken pox or measles.

The peculiarity of mumps in the fact that it affects primarily glandular tissue of the body. Therefore, the characteristic manifestations of mumps is inflammation of the gland: inflammation of the parotid glands, sometimes also of the salivary glands under the tongue and in the lower jaw, and in rare cases, and pancreas.

Mumps often ill children in the period between the third and seventh year of life, and mumps affects boys twice as often than girls.

Pathogen Mumps – mumps virus, included in the same group of viruses that measles virus.

Mumps virus is not affected by mutations in the external environment is unstable: when heated to 70 degrees is inactivated in 10 minutes, quickly dies, and under ultraviolet irradiation, the impact of disinfectants.

However, at low temperatures (-10-70 degrees) of mumps virus can remain effective for a long time.

Mumps virus is transmitted, usually by airborne droplets, but it is also possible in utero infection (although rare), as well as contagion through objects contaminated with saliva of the patient, for example, toys or household items.

It should be remembered that the patient is contagious, epidemic parotitis in the last days of the incubation period, and 9-11 days after the acute stage of illness. The greatest risk of infection through contact with a sick pig appears from the third to fifth day after the first symptoms of mumps.

Mumps, like all the "children" of infection, contagious disease that is contagious. Susceptibility to mumps virus is slightly lower than susceptible to measles or chickenpox, but still quite high, it is about 50%. However, in pregnant guinea pig is more common than measles, accounting 0,8-10 cases per 10000.

Most sick children – 90% of cases of mumps recorded in children younger than 15 years. At the same time the boys suffer almost twice as likely as girls, the same ratio persists in adult men and women.

With regard to mumps in adults, it normally occurs heavier than children, and with a greater probability of occurrence of complications.

Complications of mumps can be diseases such as orchitis (inflammation of the testicles in boys and adult men), oophoritis (inflammation of the ovaries in girls and adult women), pancreatitis (inflammation of the pancreas), meningoencephalitis (inflammation of the pia mater and brain), hearing loss and deafness.

In the development of complications and the role played by the weakening of the protective forces of the organism, as well as state bodies themselves and the systems that are targeted by the virus of mumps. Especially dangerous is mumps for adolescent boys during puberty, as in this case, there is a risk of inflammation of the ovary or testis. Every tenth of the affected boys in this disease becomes infertile. Therefore, for the boys, who at the time of puberty has not yet had the mumps, particularly important inoculation against mumps.

For mumps seasonal ups and downs of morbidity. The maximum incidence occurs in March-April, and the minimum – in August-September. Recurrent mumps incidence rises observed every 1-2 years.

Sometimes mumps occurs in the form of epidemics, which is especially true for children’s institutions. Such outbreaks of mumps continue, usually from 70 to 110 days, passing in the form of 4.5 waves, the intervals between them are approximately equal to the incubation period of mumps.

Mumps – a disease that occurs in the world everywhere. Of course, with the introduction of vaccination in many countries the incidence of mumps has fallen significantly.

After the disease mumps any degree develops persistent resistance to reinfection – lifelong immunity. Immunity to mumps is found in 80-90% of the adult population, which indicates how widespread the disease mumps. Moreover, the presence of antibodies to mumps does not depend on whether there was a human acute parotitis: 25% of mumps infections are asymptomatic and unnoticed by the patient and his relatives.

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Rickets - a disease caused by deficiency of vitamin D. Vitamin D is produced by the skin under the action of ultraviolet rays, but also in certain foods: fish oil, egg yolk, dairy products.Vitamin D actively promotes the absorption of calcium from the intestine and its proper distribution in the body, which is very important for the development of bone tissue of the central nervous system and other organs.

Deficiency of vitamin D in the body may occur during the cold season, when insufficient solar ultraviolet radiation, as well as undigested vitamin D from the intestine (this often happens when dysbacteriosis and various fermentopathy).

Often rickets occurs in young children, ie in the first three years of life. Happens and rickets in older children and even adults. During rickets distinguish several stages. At the initial stage of vitamin D deficiency in children up to a year marked decrease in appetite, increased sweating (especially the palms, feet and scalp), anxiety, irritability, worsening of sleep, baldness neck. These symptoms may be seen, parents and the doctor during examination of the child to draw attention to the edges of the malleability of a large fontanel, decreased muscle tone.

If during the initial appearance of signs of rickets did not take measures for prevention and treatment, a few weeks developing the next stage – during the crisis period. At this stage of the disease begin bone deformation: a change in shape of the skull (occiput flattening, elongation of the skull in the upper direction, the appearance of the frontal tubercles); deformity of the chest (depression – chest cobbler or bulging – "chicken breasts"), the curvature of the leg bones, especially if the baby is already walking – there are X-or O-shaped curvature, as is the restriction of the pelvis, the emergence of bony outgrowths in the form of "brasletok", "strings of pearls", "rachitic rosary", which is visible on radiographs.

In addition to slowing the growth of bone deformities of teeth, there have been serious violations of various organs: the disrupted heart and lungs, there is a dysfunction of the gastrointestinal tract (often – constipation), vegetative-vascular changes (very severe sweating, marbling of the skin). Children with rickets in the height of the stage begin to lag behind in development.

In the analysis of urine when rickets is the high content of phosphorus in the blood analyzes – reduced amount of phosphorus, calcium – normal or elevated. The diagnosis is mainly put on the totality of clinical manifestations.

At some point, the height of the signs of rickets are, the child begins to feel better, but the traumas of rickets may remain for life in the form of deformed bones: bow legs, a deformed shape of the skull, a narrow irregularly shaped basin that for girls – future mothers is fraught with complications during pregnancy and childbirth. In addition, children who had undergone rickets in stage height, very long time recovering and are at risk of developing chronic diseases or are frequently sick.

It is therefore not necessary to bring the situation to the height of rickets, and engage in prevention before onset of clinical manifestations in the autumn-winter-spring period or when the initial signs of rickets. Among the activities that prevent development of rickets – the establishment of proper nutrition, correction of intestinal dysbacteriosis, the introduction of pharmaceutical forms of vitamin D.

Proper nutrition means feeding breast milk, as much as much as possible, the timely introduction of complementary foods (not earlier than 4-5 months), use only adapted for the lactation aid formula, the introduction of the diet of egg yolks, butter, liver, meat. Correction of violations of the intestinal microflora is also very important, because the assimilation of vitamins and minerals from the intestine is largely carried out this mikroflooroy.

Because of drugs prevention and treatment of rickets can be distinguished vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). There are oil and aqueous solutions. It may be noted the main points of the use of vitamin D:

One of the modern approaches to the treatment and prevention of rickets – the appointment of a course dose (200 tys.ED) one-time fee with the repetition of six months. This creates a depot of vitamin D in the liver and the body as their need to use it, as a result maintained a good balance of vitamin D.

It is no consultation with your physician to begin to give the child the drug prophylactically vitamin D when installed in the autumn overcast weather. The prevention of rickets to hold all children up to 3 years, especially in premature, immunocompromised, children of the first months of life, born in the autumn-winter-spring period. But if there are signs of incipient rickets, should always consult a doctor to adjust the treatment.

In the summer time, provided that the street warm and sunny, the use of vitamin D is not recommended. Under the action of ultraviolet rays in the skin produces its own vitamin D. It is not necessary that the child was under direct sunlight, enough for it to be maximally open (short-sleeved shirt, panama hat, short pants, and in warm weather can be quite naked, but with headgear).

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Umbilical sepsis - an infectious disease of newborn due to the penetration of pathogenic microbes from the umbilical wound in the blood.

Causes of umbilical sepsis

Among the agents in recent years are the most important staphylococci. Atrium serves as an umbilical wound. Infection can occur during the processing of the umbilical cord and from the beginning of the demarcation of the umbilical cord stump to complete epithelialization of umbilical lesions (usually from 2-3 to 10-12 days, and the processing of the remainder of umbilical cord metal bracket – up to 5-6 days). Primary septic focus is rarely a single in the umbilical fossa, most centers are found in different combinations: in the umbilical arteries and hollow or umbilical vein and arteries.

Umbilical sepsis may occur with the formation of local ulcers – pyosepticemia where during sepsis depends on the location of ulcers, and without metastatic ulcers – septicemia, often with a more rapid course, pronounced general symptoms.

Varieties of umbilical sepsis

The main symptoms of umbilical sepsis

Characteristic vomiting, diarrhea, and complete abandonment of the child from the breast, rapid weight loss, dehydration, skin lose their elasticity and become dry, sometimes earthy colors, often determined by local suppuration at the umbilicus, deep phlegmon and abscesses in various sites.

Treatment of umbilical sepsis

Emergency hospitalization in specialized departments of pathology of newborns, if necessary, surgical intervention – in the surgical department (of Commerce) for newborns.

Prevention of umbilical sepsis

Prevention of intra-and post-natal infection

Timely detection of diseases

Implementation of measures for antenatal protection of the fetus, since the number of complications during pregnancy reduces resistance to various fetal exogenous shocks, such as maternal diseases as influenza, angina, pyelitis, pustular disease, etc., can be a source of infection of the fetus and child.

Strict observance of asepsis and antisepsis in the care of newborns, especially during his stay in the nursing home. Compliance staff maternity hygiene.

Persons, even with minor purulent processes should not be allowed to care for a newborn.

Children born to mothers with symptoms of puerperal sepsis, or various local purulent processes, it is necessary to prevent a separate room, and they should not touch any other children or with their mothers.

You can not attach to the breast children suffering mother suppurative mastitis.

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Hernia - a protrusion of an organ under the skin or in any other space. The most common are abdominal hernia, which include umbilical hernia.

Omphalocele called such in which the hernial protrusion is formed in the navel.

In differentiated hernia: hernial ring – a hole through which internal organs out of the abdominal cavity, in this case, the umbilical ring, hernial sac – part of the membrane (peritoneum), which concluded precipitated abdominal cavity and the hernial contents, which can be any organ of the abdominal cavity .

In different age periods of umbilical hernia significantly different from each other, so decided to distinguish between umbilical hernia in children and umbilical hernia in adults.

Umbilical hernia in children

Umbilical hernia in children are a consequence of a defect of the anterior abdominal wall. All the factors causing the increase of intraabdominal pressure can lead to rupture. Umbilical hernias occur in children often, especially among girls, there are usually in the first months of life.

Signs of an umbilical hernia: in an upright position and straining the child in the area of the navel protrusion appears round or oval, which is usually independently reduce a horizontal position at the back. If the hernial ring broad, hernia and reduce a freely go back. In the narrow hernial ring rupture can reduce a difficulty that is regarded as a partial denial. Complete abuse are rare.

Umbilical hernia in adults

Umbilical hernia in adults is only 3-5% of all abdominal hernias. They arise mostly in women older than 30 years, since pregnancy and childbirth weakens umbilical ring. Large hernias are often multilocular hernial sac, the contents of which may be the stomach and intestines.

Manifestations of umbilical hernia depends on its size, the size of hernial ring, severity of adhesions and associated obesity. Hernias come in and reduce a nevpravlyaemymi when the hernial sac fuse with surrounding tissues with adhesions.

Often a small umbilical hernia is not delivered to patients concern if the hernial ring wide enough and free to reduce a hernia. Large hernias with a relatively narrow gates make it difficult to advance the contents of the intestines, so patients suffer from constipation, occasional pain, they often nausea and even vomiting. Especially these phenomena are expressed in irreducible hernia. The condition of patients is often aggravated by obesity.

Infringement of umbilical hernia

Umbilical hernia adults have a tendency to infringe, especially in old age. The reason is that the longer there is a hernia, the more there are conditions for its infringement.

Infringed may rupture of any magnitude. The sign of abuse is a sudden pain in the hernial protrusion and irreducible previously reduce a hernia. If the infringement of intestinal loops, there are signs of acute intestinal obstruction.

Treatment of umbilical hernia

Treatment of umbilical hernias in children often is conservative way (without surgery): Strengthening the abdominal wall with the help of gymnastics and massage. By sealing hernia plaster should be treated with caution, as the irritation of the skin from the patch can cause widespread infection. Usually to 3-5 years in umbilical hole decreases and independently closed. If not, then the treatment should be prompt.

Treatment of umbilical hernia in adults should be operational. Conservative treatment is possible only with uncomplicated hernias and when there are serious contraindications to surgery (any acute illness and exacerbation of chronic diseases, severe cardiovascular and respiratory systems, the later stages of pregnancy).

Conservative treatment is to limit physical exertion and wearing bandages. In addition, all patients suffering from umbilical hernia, and with obesity, it is recommended to lose weight.

The operation involves the separation and the opening of the hernial sac, immersing its contents into the abdominal cavity and plastic materials (closing and strengthening) of hernial ring by developed techniques.

Remember: the earlier you consult a doctor with an umbilical hernia, the easier it will be treated.

Popularity: 50% [?]

Sudamen (potnichka, heat zoster, thermal sudamen) - rash of small blisters filled with clear or turbid liquid, causing a painful itch. Appears when prolonged exposure to environmental factors – heat, humidity in tropical climates may take the form of the epidemic. Sudamen is often observed in infants and young children, people of complete suffering from exudative diathesis.

Histological picture is characterized by occlusion of the duct openings of sweat glands keratin plugs, stretching of the ducts in the epidermis and sometimes in the dermis. When the red prickly heat around the ducts of sweat glands marked inflammatory infiltrate.

In prickly heat, mainly in closed areas apparently not changed the skin, mainly on the back and neck, suddenly appeared a large number of small diameter of 1-2 mm vesicles with clear watery contents (crystal sudamen). Revealed vesicles, quickly dry up, leaving behind a slight peeling. Crystal sudamen is more common in debilitated, febrile, and much sweating children. When there are itchy red prickly heat, closely spaced, or not coalescing nodules, nodules, vesicles, and vesicles surrounded by an inflammatory halo. When you join secondary infection bubbles become smaller vnutriepidermalnye white pustules (white sudamen) or yellow (yellow sudamen) colors.

Preventive measures

In order to prevent the emergence sudamen must adhere to simple rules.

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Poliomyelitis - acute viral disease with lesions of the nervous system. At present, it occurs very rarely in connection with the fact that adopted compulsory vaccination of children at an early age against the virus, the causative agent. However, you may experience sporadic incidents of illness in people with aborted immunity after vaccination or from those who in childhood received medotvod of vaccination (in conjunction with other illnesses or allergic reactions). People previously vaccinated formed lifelong immunity to the three major polio virus and the emergence of the disease impossible.

Consider the clinical manifestations of disease in cases where infection did occur, and immunity should have no rights. Sam polio virus is easily spread by water and contamination is possible through water, food and unwashed hands. Age of onset significantly affects the severity of symptoms: children carry the disease worse than adults. Initially, when infecting virus affects the gastrointestinal tract: developing small intestinal disorders, fever and slight malaise. Virus is absorbed from the intestine into the bloodstream, after which (on average 2-3 weeks) symptoms central nervous system (CNS).

The most favorable form of CNS lesions – a non-paralysis. It is characterized by fever, dizziness, headache, rush of blood to the skin. Then aching back and limbs, sometimes pain in all muscles; determined stiffness and tension of the neck muscles. After several weeks of existence of such symptoms, the patient fully recovers.

A worst case scenario is possible if the second form of CNS lesions – with the development of paralysis. In this form of aching limbs and backs are replaced by paralysis of individual muscles of the trunk, limbs, neck, ie expressed their weakness and inability to arbitrary motion. Perhaps as the development of massive symmetric paralysis of the neck, arms and legs, and "spotty" paralysis – with an asymmetrical lesion of individual muscles throughout the body. Usually paralysis reaches its maximum in a day since its inception. During this time, it may be "rising" or "downward" dissemination of the body – that is, from the legs to the neck or back. Paralysis of muscles of limbs literally lead to disability rights – the inability to move independently and maintain themselves. In addition, they can lead to dislocations in the joints. This occurs due to weakening of muscles supporting the joint, as well as pathological redistribution of muscle tone in his field. In addition to paralysis of skeletal muscles, may develop paralysis of the diaphragm, throat, tongue, intercostal muscles. These expressions are especially dangerous because of the possible pathology of respiration and swallowing. Such patients need time to translate into an artificial lung ventilation and to provide food through a stomach tube.

In the treatment of poliomyelitis are the most important absolute peace, which will reduce the probability of osteo-articular complications. Seek his bed rest and the use of supportive corset. In addition, physiotherapeutic procedures used to prevent stiffness of joints – hot compresses to the area of painful muscles, therapeutic exercise under the supervision of a physician. Second, apply an anti-inflammatory action of drugs, analgesics and tranquilizers.

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Leytsinoz was first described in 1954 in English and American literature, it is more known as maple syrup urine disease because of the smell of urine, which is similar to the smell of maple syrup from the tree.

Causes leytsinoza

This is a hereditary disease associated with metabolic disorders such amino acids as leucine, isoleucine, valine: child’s body does not assimilate these amino acids. The characteristic smell of urine associated with the presence of a substance formed from leucine.

Symptoms leytsinoza

The disease begins to appear 3-14 days after birth: the baby refuses to eat, quietly crying, may be frequent regurgitation, and even vomiting. If you do not seek medical help, may develop twitching of individual muscle groups, muscle tone increases in connection with which the whole body is stretched and the legs are crossed.

At serious disease can occur, interruption of breathing and consciousness, and if in the first weeks of life, treatment is not carried out, a bad prognosis. These children are severely behind in weight and psychomotor development.

Diagnosis is made by typical symptoms of the disease, the smell of urine and the content of leucine, isoleucine, valine in the urine.

Treatment leytsinoza

It consists in reducing the level of leucine, isoleucine and valine in plasma, which applies a special diet, in which instead of a protein is assigned a particular medicine, consisting of a mixture of 18 amino acids in the same proportion as in human milk. Fats in a mixture present in the form of corn oil, and carbohydrates are replaced by dextrin-maltose. It also adds minerals and vitamins. As soon as the child’s general condition is improving, there is an appetite, normalizes muscle tone, in the diet of a small amount of cow’s milk. Fruits and vegetables that also contain protein, but in small quantities are allowed to give your child is already 3 months. In 6-8 months in the diet is introduced gelatin, which does not contain these amino acids. With 9.5 months of daily servings of milk is 120 ml.

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