Vol 16, No 3 (2017)

Neuroblastoma is the most common extracranial solid tumor of pediatrics, with the most favorable prognosis in children under 1 year. In the Dmitry Rogachev National Research Centre of Pediatric  Hematology, Oncology and Immunology radical endosurgical treatment of the neuroblastoma abdominal  localization received 39 patients. Local relapses were not observed with the median follow-up time of 36  months. Due to the positive results of endosurgical procedures laparoscopic approach may be the procedure of choice for localized forms of abdominal neuroblastoma without image-defined risk factors.

The treatment of acute respiratory distress syndrome (ARDS) in children with oncohematological diseases remains one of the most difficult problem of the intensive care. The present study was performed to assess  the potential of the usage of superimposed highfrequency jet ventilation (SHFJV) in the treatment of ARDS  in children with oncohematological diseases. High-frequency ventilation was performed with TwinStream™  (Carl Reiner, Austria) apparatus in the superimposed high-frequency jet ventilation mode. 13 cases of ARDS treatment were analysed. High-frequency ventilation was indicated in cases of a confirmed ARDS or the  inefficacy of conventional mechanical ventilation: peak airway pressure (Ppeak) > 30 mm Hg, FiO2 – 100%, SpO2 < 92%, pCO2 > 50 mm Hg. SHFJV was conducted for 2–12 days (5±3 days on average). 10 patients  (76,9%) showed an improvement in lung X-ray, increased levels of РаО2 > 100 mm Hg, РаО2/FiO2 > 200,  a reduced fraction of inspired oxygen (FiO2), the optimization of SHFJV parameters with a subsequent  switch-over to traditional ALV techniques and extubation. Five out of 13 patients died. The first results of  SHFJV application in oncohematological pediatric patients with severe ARDS showed the efficacy of this  alternative method used when adequate gas exchange cannot be achieved with traditional methods of lung ventilation.

Optimization of the choice of rehabilitation methods in children with the oploskonus myoclonus syndrome on the basis of the analysis of stabilometric parameters. The study included 48 children of  both sexes in the age range from 3 to 7 years with the diagnosis of «opsclonus-myoclonus syndrome».  All patients were separated into 4 groups according to applied rehabilitation methods: in the first group  (12 patients) patients received craniosacral therapy, in the II group - modified Vojta therapy (13  patients), in the third group patients underwented an isolated course of Galileo vibration therapy (10  patients), in the fourth group patients received modified Vojta therapy together with Galileo vibration  therapy (13 patients). Patients underwented the course of craniosacral therapy demonstrated the  increases rates of speed (V) in 1.48 times and statokinesiogram square in 1.94 times after fifth  procedure as compared with data before. In the second group 1.32 times speed decrease (V) and 1.56 statokinesiogram square decrease (S) were marked. In the third group there were 1.73 times  statokinesiogram square increase (S) and the  displacement of pressure center midposition in frontal plane (X) to the left after implementation of 10  manipulation. In the fourth group 1.42 times speed decrease (V) and 2.7 times statokinesiogram square  decrease (S) were marked after implementation of 10 manipulation, as well as displacement of pressure  center midposition (X) in frontal plane to the right and tendency to displacement of pressure center in  sagittal plane to the front after conducted manipulations. Modified Vojta therapy together with Galileo  vibration therapy can be applied in the capacity of most effective rehabilitation methods for children with opsoclonus-myoclonus syndrome leading to useful increase of stabilometric parameteres.

This clinical case demonstrates the diagnostic value of capsule endoscopy for the detection of polyposis of gastro-intestinal tract (Peutz–Jeghers syndrome). We report the case of a 5-year-old male presenting with a  chronic iron refractory iron deficiency anemia. Multiple polyps of the stomach and small intestine with an  erosive and hemorrhagic component were identified by the method of capsule endoscopy.

Immune thrombocytopenia (ITP) is characterized by changes in both quantity and quality of platelets. As a result, severity of bleeding does not always correllate with the degree of thrombocytopenia, The quality of platelets on treatment becomes difficult to evaluate. The most promising method to investigate quality of platelets in ITP is flow cytometry. Here we describe a clinical case of monitoring of a pediatric ITP patient status on romiplostim treatment for 50 weeks using flow cytometry for platelet functional activity control.

The article presents a review of the data about a new oral anticoagulant dabigatran etexilate (DE), which is the pro-drug, but in the body converts after oral administration in the active compound, a direct low-molecular weight thrombin inhibitor dabigatran. The major properties of dabigatran and DE, pharmacokinetic parameters of the preparation and its interactions with the other drugs are examined. Efficiency and safety of this preparation's clinical use in different pathological states are discussed also. The review of pharmacodynamics and the methods for measurement of the DE anticoagulant activity are  presented. The possible advantages of DE compare to other anticoagulants are discussed, also as the questions of clinical trials of DE for using in pediatric population.