A.A. Baranov, L.S. Namazova-Baranova, V. Smirnov

PROSPECTS FOR INNOVATIVE RESEARCH IN PEDIATRICS

Scientific Center for Children's Health, Russian Academy of Medical Sciences, 119991, Moscow, Lomonosovsky prosp., 2, building 1

The priority scientific areas of biomedical research are presented within the platform "Pediatrics", which is a new strategy aimed at scientific achievements, their rapid translation into practice, personalization of pediatrics, the use of information technologies in the management of the treatment process and training medical personnel in parallel with scientific work and clinical practice.

Key words: priority research areas, platform "Pediatrics", information technologies in pediatrics

A. A. Baranov, L. S. Namazova-Baranova, V. I. Smirnov PROSPECTS FOR INNOVATIVE RESEARCH IN PEDIATRICS

Federal State budgetary Institution "Scientific Center of Child Healthcare" of the Russian Academy of Medical Sciences, №2/62 Lomonosov avenue, Moscow, 119991, Russian Federation

The priority directions of medical and biological researches within the platform of Pediatrics which is the new strategy aimed at scientific achievements, their fast translation into practice, personalization in Pediatrics, use of information technologies in management of medical process and preparation of medical stuff, in parallel with scientific work and clinical practice are presented.

Keywords: the priority scientific directions, the platform of Pediatrics, information technologies in pediatrics

Over the past two decades, our country has experienced a period of fundamental changes in the socio-political system, which could not but affect the healthcare system. Along with the emergence of opportunities for early detection, pathogenetic therapy and effective rehabilitation of many childhood diseases, there is an increasing need to improve the skills of medical personnel, the widespread use of international information resources, allocation of additional funds by the state for the widespread introduction of new biomedical technologies. Innovative activity in pediatrics is one of the main conditions for improving the system of children's health care in Russian Federation. On May 22, 2012, the President of Russia V.V. Putin.

At the initiative of the Government of the Russian Federation, in order to improve the health status of the child population of the country, priority

For correspondence: Baranov Alexander Alexandrovich, acad. RAS and RAMS, Vice-President of RAMS, dir. FGBU NTsZD RAMS, e-taP: [email protected]

directions of research. they were called medical platforms. The recognition by the state of the need to introduce modern information and production technologies is reflected in the initiation and creation of the Pediatrics platform and the decree of the President of Russia "On the National Strategy for Action in the Interests of Children for 2012-2017".

The Pediatrics platform is a new strategy aimed at scientific advances, their rapid translation into practice, the personalization of pediatrics, the use of information technology in the management of the treatment process and the training of medical personnel in parallel with scientific work and clinical practice.

It is time to use a systematic approach, to introduce modern information technologies of the organization scientific research, set new goals and objectives (including the creation of new competitive medicines, medical devices and devices for children), identify new opportunities for integration and creation of joint research teams with the involvement of institutions not only of the Russian Academy of Medical Sciences and the Ministry of Health of Russia, but also institutions Russian Academy Sciences (RAS), the Russian Academy of Education (RAO), the Ministry of Education and Science (Ministry of Education and Science) of Russia, etc.

Therefore, the first step in recreating the system of planning and coordinating scientific research in

within the framework of the newly formed platform "Pediatrics" is the creation of a single pediatric portal as the main part of the formation of a national system of scientific research and technological development in pediatrics (Fig. 1). The main structural components of the portal are 3 large information blocks: an information system for collective work, a system for maintaining scientific and clinical databases, an information system for recording and monitoring the results of scientific, clinical, scientific, practical and technological work in pediatrics.

To implement these information systems, an innovation and technology center (ITC) of the portal is being created, which is the main structure for supporting research teams (Fig. 2). Its infrastructure includes the following resources: a geographically distributed local area network that unites all ITC facilities into a single information space, a data processing center, a training and communication center and an information project center. The basis of the created network is a high-performance switching factory of the core level and switches of the distribution and access levels, connected using fiber optic backbones at a speed of 10 Gbps.

The activities of the ITC are aimed at combining scientific data, implementing innovative technologies in priority areas of pediatrics, creating and improving relationships with business and with each other, including through a system of shared use centers.

ITC organizes activities in the innovation chain between idea and implementation through the formation of a system for the commercialization of results scientific activity, technology and development work, promotes the accumulation of scientific and technical information and knowledge-intensive innovative business.

To solve the tasks set, over the next few years, within the framework of the pediatrics platform, it is planned to implement 3 priority areas, for each of which fundamental, applied and experimental

Rice. 2. Infrastructure of the innovative and technological center of a single pediatric portal.

tal research:

1) reduction in mortality and disability in children born with very low and extremely low body weight;

2) improvement of early diagnosis, treatment and rehabilitation of children with rare (orphan) diseases;

3) improvement of diagnostics, treatment, rehabilitation of children with severe progressive, disabling and life-threatening diseases.

The need to expand scientific research in these areas is determined by the current conditions for the formation of the country's pediatric service. The relevance of the implementation of the first direction has increased significantly since 2012 due to the transition to new criteria for registering live births (from the 22nd week of pregnancy and birth weight from 500 g). The number of children born very preterm, with very low birth weight (VLBW) and extremely low birth weight (ELBW) at birth will increase significantly. These children need long-term and qualified rehabilitation, selection of personalized treatment regimens and prevention of infectious complications. About 16,000 children with ELMT from 500 to 1000 g are born annually in the country, of which about 5,000 are alive. The survival rate of children with ELMT is slightly more than half, and in developed countries it is 80-85%. Real success has been achieved only in a number of specialized clinics and perinatal centers equipped with modern equipment and highly qualified personnel, where the results of nursing are close to the average European ones. The basis for a qualitative breakthrough in nursing children with VLBW and ELBW was the use of new methods of respiratory therapy for newborns.

nyh - controlled artificial lung ventilation, trigger and high-frequency oscillatory ventilation, as well as the improvement of parenteral nutrition methods based on the analysis of the nutritional, metabolic and hemodynamic status of such children.

It should be noted that disability among newborns with ELBW remains very high - from 10 to 50% in proportion to the decrease in gestational age, which is due to many early and late complications of the neo- and perinatal periods. At the same time, up to 91.5% of children with VLBW and ELBW suffer from combined perinatal pathology. The slow dynamics of improving the survival of underweight children in the country is still associated both with insufficient funding for programs for nursing children with ELBW, and with a large complex of scientific and technological problems that the direction of the scientific program "Pediatrics" is designed to solve.

In order to scientifically substantiate the effectiveness of new technologies for intensive care, nursing, rehabilitation, prevention of disability and social adaptation of children with ENMT and their introduction into clinical practice, there is a need to use the experience of the Neonatal Rehabilitation Center established at the SCCH RAMS, operating on a functional basis and solving specific tasks of reducing mortality. and disability of children with VLBW and ELBW, including the creation of a register of such children within the framework of collective use centers.

Therefore, in the direction of the Pediatrics platform, it is planned to develop a set of measures for diagnosing, predicting the course and outcomes of ischemic-hypoxic lesions of the central nervous system (CNS) in children with VLBW and ELBW to optimize their treatment and rehabilitation. The pathogenetic mechanisms of hypoxic damage to tissues and organs in children have not yet been studied enough, which requires the development of methods and preparations for targeted correction of the mechanisms of formation of ischemic tolerance of the brain, including for the individualized correction of cerebral ischemia and neuronal apoptosis in order to prevent the delayed consequences of perinatal brain damage and reduce the level of disability by 30%. For this purpose, diagnostic and prognostic criteria for the severity of perinatal neurological disorders are already being developed based on the levels of neurochemical biomarkers and data from modern neuroimaging methods.

To assess the dynamics of the neuropsychic development of premature infants born with ELBW and VLBW, it is necessary to develop appropriate diagnostic tools, since a common cause of social adaptation disorders in such children is a severe psychomotor development delay due to a perinatal CNS lesion, which leads to asynchrony in their psychophysical development and difficulties of socialization. Under these conditions, a mild stimulating effect on the main analyzers with the help of various

hog toys of different colors, shapes, textures and with different sounds will reveal the actual and potential mental capabilities of children, detect deviations at an early stage, create sets of tests and didactic aids to assess their cognitive development, develop individual treatment programs and psychological and pedagogical assistance. The use of such a systematic approach will make it possible to ensure the activation of the pace of mental development of 40% of children and the increase in the pedagogical competence of 75% of parents in matters of education.

Given that newborns with VLBW and ELBW have various forms of combined perinatal pathology, when respiratory disorders quickly form against the background of severe brain hypoxia due to forced long-term use of artificial lung ventilation, significant drug loads and aggressive oxygen therapy, the next most important task of this direction of the platform "Pediatrics" is the identification of predictors of the formation of bronchopulmonary dysplasia (BPD) in low birth weight premature infants with respiratory distress syndrome and its consequences for the development of individualized therapy. A system for calculating risk factors for the formation of BPD will be developed, the implementation of which will reduce the disability of such patients due to pulmonary pathology by 30%.

A promising direction is also the improvement of the feeding system for very preterm infants based on the assessment of their actual metabolic and nutritional status with the creation of modern specialized products. It has been established that inadequate feeding of premature infants with VLBW and ELBW is a significant factor in the violation of their physical and psychomotor development, as well as a high risk of developing diseases of the cardiovascular system, diabetes mellitus and obesity in later life. In this regard, it is necessary to replenish the deficiency of breast milk nutrients in order to fully and effectively meet the high needs of very premature babies in nutrients and energy; creation of a system that provides the possibility of exclusive breastfeeding of very preterm infants; work on the creation (together with the Russian CJSC Nutritek Trading Company) of new domestic breast milk fortifiers and liquid specialized products for nursing mothers with the addition of pro- and prebiotics, long-chain polyunsaturated fatty acids and vitamin and mineral complexes. The implementation of these measures will reduce budget costs by 20% (compared to the purchase of foreign analogues of baby food).

Another important direction is the creation of personalized immunization programs for children born with VLBW and ELBW, taking into account their immune status. Until now, the world has not

there are evidence-based immunization programs for seriously ill children and children born with VLBW and ELBW. Therefore, it is necessary to create immunization algorithms based on individual indicators immune response of children to vaccination. At the same time, it is planned to create a new calendar of active and passive immunization of premature babies with ELBW and VLBW, which will result in the prevention of their morbidity and the creation of conditions for adequate habilitation.

Given that infectious pathology in children with ENMT and VLBW is the main cause of late neonatal mortality and a factor that significantly complicates their rehabilitation, work has begun on the creation of a new generation of biologically safe drug with anti-infective properties (pilot production). The expected results are: reduction of early neonatal mortality by 20-30%; prevention of delayed mortality from infectious pathology in premature infants with ELBW and VLBW, reduction of iatrogenic complications by 30-40%. For complex rehabilitation, it is planned to create a system of hydrocolour therapy for children with ELBW and VLBW who have undergone perinatal pathology, which will provide a gentle stimulating effect on the analyzer system and brain repair processes, as well as a 30% reduction in disability.

As mentioned above, very premature babies have a delay in the development of psychomotor skills, the degree of which is determined not only by immaturity, but also by the severity of the perinatal pathology. in this regard, differentiated models of medical, psychological, and pedagogical support for these children throughout the entire period of childhood acquire particular relevance. A model is already being developed (including the structure and content of medical, psychological and pedagogical assistance to children born with VLBW and ELBW), which will contain three modules: "24-hour hospital", "Day hospital", "Children's clinic", as well as a computer program predicting the delay in neuropsychic development, behavioral disorders, deviations in physical development. Their implementation will lead to an improvement in the quality of life of children born with VLBW and ELBW, a decrease in the frequency of disabling conditions and effective socialization of children.

The second no less significant area of ​​the Pediatrics platform is the improvement of early diagnosis, treatment and rehabilitation of children with rare (orphan) diseases. the latter include forms of hereditary pathology, the frequency of which does not exceed 10 cases per 100,000 population. The use of new methods of early prenatal diagnosis, based on the achievements of molecular biology and genetics, innovative imaging methods, allows for pre- and neonatal screening of congenital and hereditary diseases in children, which determines the high medical and social significance of this area of ​​the Pediatrics platform.

To date, more than 6 thousand rare diseases are known, but only about 300 of them can be effectively controlled by the corresponding orphan drugs. At the same time, according to the Decree of the Government of Russia No. 403 of April 26, 2012, the List of progressive rare (orphan) diseases that lead to a reduction in the life expectancy of citizens or their disability includes 24 nosologies, 4 more (cystic fibrosis, multiple sclerosis, pituitary dwarfism and disease Gaucher) until 2015 are included in the list of the so-called 7 nosologies. Over the past years, children with orphan diseases have traditionally received highly effective comprehensive care at the SCCH RAMS, the experience of which should be implemented in all regions of the country. At the same time, it is necessary to make additional efforts to improve biomedical research on diseases that have been called "orphan", primarily for the development of methods for molecular diagnostics, new pharmacological preparations and dosage forms for such children, as well as specialized food products of domestic production. The latter is especially important, since the prevention of these forms of pathology can be started even in the prenatal period with the correction of nutrition and a set of measures. primary prevention. Obviously, the development of methods for the prevention and detection of rare diseases should be preceded by the creation of the National Russian Register of Patients with Rare (Orphan) Diseases. in addition, it is planned to solve such problems as the creation of a system for the early diagnosis of rare diseases in children, the scientific substantiation of personalized therapy with genetically engineered biological drugs for rare autoimmune diseases in children (for example, multiple sclerosis, juvenile idiopathic arthritis, Crohn's disease, ulcerative colitis, nephrotic syndrome), the scientific rationale for the complex psychological diagnosis of nephropathic cystinosis determines high level disability and significant state costs for the maintenance and treatment of such children. It is planned to create a diagnosticum based on determining the activity of cellular metabolism enzymes and their dynamics against the background of the use of cysteamine bitartrate, which will ensure timely detection and monitoring of the effectiveness of its treatment with a 50% reduction in direct and indirect government costs for children with cystinosis.

Taking into account that in Russia there are no domestic food products for patients with phenylketonuria, galactosemia, cystic fibrosis detected by neonatal screening, it is planned to pilot production of specialized food products for such children and pregnant women, which will reduce budget costs by 20-40% (according to compared with the purchase of foreign analogues).

The next direction of the platform "Pediatrics" is to improve the diagnosis, treatment, rehabilitation of children with severe progressive disabling and life-threatening diseases. This innovative activity has

of fundamental importance for the organization of fundamental international research aimed at creating new diagnostic and prognostic technologies, medicines using genetic engineering and biotechnology methods and the selection of personalized treatment for children with chronic forms of pathology.

Particularly important within the framework of this direction of the Pediatrics platform is the development of a modern effective system for medical examination of the country's child population based on information technology, including a comprehensive solution to the issues of preserving and strengthening the reproductive, defense and labor potential, improving the system of providing medical care children in educational institutions, scientific substantiation and introduction of health-saving technologies for children, increasing the medical activity of the family.

At present, for the intensification of information technologies, it seems expedient to develop specialized information products and Internet resources for making clinical decisions by step-by-step diagnostics of symptoms and syndromes in order to prevent the progression of chronic diseases in children based on multivariate analysis.

The lack of a unified system for monitoring morbidity and controlling the use of medical resources in children with chronic diseases predetermines the need to form national registers of such patients. This will undoubtedly help improve the quality of medical care for patients and reduce the disability of children in the Russian Federation. Related to this is also the development of information systems for diagnosing the state of cognitive functions in children of different age groups, which will allow monitoring the effectiveness of all types of treatment for cognitive impairment, including medication.

In modern conditions, the creation of domestic preventive products for optimizing the nutrition of children of preschool and school age in order to prevent obesity and metabolic disorders, which within the framework of the Pediatrics platform will be implemented through the creation of specialized preventive sour-milk products for children from 3 years (pilot production of JSC "Wimm-Bill-Dann").

Within this direction, it will also create software for infusion therapy, enteral and parenteral nutrition in children with surgical pathology, especially significant in neonatal surgery. Conducting adequate parenteral and enteral nutrition in surgical patients will reduce the number of postoperative complications, reduce the time spent in bed and the number of drugs used.

Lack of modern domestic orthopedic devices for the lower extremities

on the basis of composite materials for children with lesions of the musculoskeletal system determines the need to create highly functional orthopedic systems, the pilot production of which is planned jointly with PROP MP ORTEZ LLC. Their use will increase the effectiveness of the results of complex rehabilitation: reduction of the terms of rehabilitation treatment; ensuring the movement of children, self-service in the process of rehabilitation; improving the quality and functionality of orthopedic devices, reducing the disability of children. Already, studies are underway on new domestic bone tissue restorers based on three-dimensional structures, including stem and progenitor cells, combined hydrogels, and bioresorbable calcium phosphate ceramics. Obviously, in addition to strengthening the reparative properties of bone tissue, replacing bone defects, creating a depot of drugs in bone tissue, this will reduce the cost and increase the efficiency of restoring the structural and functional characteristics of bone tissue lost as a result of trauma or congenital anomaly.

Given that single-port surgery technologies in Russia are beginning to be actively used in children early age International development of instruments for operations with single-port access in children (together with the production of "Karl Storz") seems promising, which will significantly increase the effectiveness of surgical treatment, reduce the trauma of surgical intervention and reduce the length of stay for children in the hospital. With the use of these technologies, the introduction of reconstructive plastic surgery in children with abdominal and thoracic pathology can be expanded, which will speed up rehabilitation and reduce the number of postoperative complications.

In order to optimize the immunization program for children with various chronic diseases and irregular vaccination schedule, a diagnostic panel of the immunological response of a particular patient and a computer personalized immunization program will be developed. This will increase the coverage of preventive vaccinations by an average of 15%, achieve a 2-8-fold decrease in the incidence of vaccine-preventable infections in children, depending on the form of the infection being prevented.

Taking into account the lack of software and methodological support for the work of a deaf teacher with young children with an auditory analyzer pathology, original information products will be developed to organize the interaction of a deaf teacher with specialists (pediatrician, audiologist, neurologist) at all stages of treatment of children with an auditory analyzer pathology and ensure the prevention of secondary violations in mental development a child with hearing impairment, as well as reducing the disability of such patients.

Distance technologies will ensure the continuity of the educational process. Web content will allow remote early diagnosis, monitoring of the patient's condition, and assessment of adherence to therapy. In order to objectify the assessment of the health status of children, a National catalog of utility indices for children with chronic diseases will be created; automated complex for evaluating utility indices.

The imperfection of methods for organizing medical and comprehensive rehabilitation care for children in orphanages necessitates the creation of special information systems to prevent morbidity and improve the quality of life of orphans. This will also make it possible to objectify the definition of the category "disabled child" when conducting a medical and social examination, developing individual rehabilitation programs and evaluating the effectiveness of rehabilitation measures in order to improve the quality of life of children with potentially disabling chronic forms of pathology.

Thus, within the framework of these areas of the Pediatrics platform, fundamental and applied original research will be carried out. Despite the large role of RAMS institutions in the organizational and methodological assistance to the children's health care system, it was noted that in the coming years, in order to increase the training of specialists by the planned 5-10% annually, as well as to increase the volume of pediatric care for children and improve its quality and efficiency in the Russian Federation organization of the Center is necessary continuing education pediatricians and nurses, which provides the platform "Pediatrics". In this regard, in order to implement innovative activities and a complex of fundamental research within the framework of the Pediatrics platform, comprehensive support is needed for the system of continuous education of pediatricians and nurses, not only on the basis of the SCCH RAMS, but also in other specialized universities of the Ministry of Health of Russia.

In general, the success of the implementation of the scientific platform "Pediatrics" and the prospects for its development are largely determined by the support of the state and overcoming interdepartmental disunity. The presented priority scientific areas constitute the basic biomedical platform "Pediatrics", the results of which should generate innovative knowledge and products, therefore, to create an optimal system of interdepartmental interaction within the framework of the scientific platform "Pediatrics", the support of the Presidium of the Russian Academy of Medical Sciences is necessary.

The platform is managed by the National Center for Health and Human Development of the Russian Academy of Medical Sciences, and a single pediatric portal is being created here as the main part of the formation of a national system of scientific research and technological developments in pediatrics. 19 research institutes and scientific centers of the Russian Academy of Medical Sciences, 48 ​​pediatric departments agreed to participate in the implementation of the Pediatrics platform medical schools countries and 6 universities of postgraduate education, a number of scientific institutions of the Russian Academy of Sciences, Russian Academy of Education,

Ministry of Education and Science of Russia. Currently, more than 300 proposals for scientific research have been received, of which about 100 are scientists and doctors of the SCCH RAMS.

The implementation of the Pediatrics platform will make it possible to build a new scientific environment in domestic pediatrics, to implement a competitive mobilization project, to reasonably and accurately manage the available small resources, compensating for them with intellect, will and creative young energy.

Considering that methodological pluralism is a characteristic feature of modern science the most rapid growth and discoveries should be expected in the areas of interpenetration of sciences and mutual enrichment of their methods and methods of research. This process of combining the efforts of various sciences is increasingly developing as the main path for the development of medical (including pediatric) science of the future.

Information and Communication Technologies (ICT) in recent decades serve as one of the main catalysts for the economic and social development of the country. In bioinformation technologies, developments at the intersection of micro-, nano- and biotechnologies will be the most relevant. Among them are the identification of the basic mechanisms of the brain and memory, integrated systems for preventing risks to children's health, as well as systems for continuous monitoring of the most important physiological parameters of the body, including the fundamental constants of the health of children and adolescents, taking into account the regional characteristics of the territories of the Russian Federation. Since ICT is characterized by the fastest rate of implementation of scientific results in production, in the next decade, the emergence of a large number scientific advances that pave the way for effective applications.

It is necessary to pay attention to the development of technologies of living systems, which are designed to form solutions to the problems of prevention and treatment of common and dangerous diseases, as well as a radical increase in the effectiveness of their prevention. At the same time, developments in the field of biosensors, biomedicine, cellular, biocatalytic and biosynthetic technologies are the most important for medical science in Russia.

In the field of cellular technologies, more attention should be directed to fundamental studies of the molecular and cellular mechanisms of cell transformation, and the discovery of the molecular mechanisms of tissue regeneration. Practical use These technologies are expected in the field of regeneration of tissues and organs based on stem cells, production of immunocompetent cells, systems for express diagnostics of hypoxic and ischemic brain damage.

Biosensor technologies are interdisciplinary areas and cover molecular chemistry, genetics and physics. They have a huge impact on improving the quality of human life.

Lovek, offering early diagnosis of diseases, identification of harmful substances in food and the environment.

The progress of genomic and post-genomic technologies for creating drugs will be determined by the solution of such research problems as establishing the relationship between mutations in the genome and the drug resistance profile of pathogenic microorganisms; disclosure of the causes of multifactorial genetic diseases and predispositions to them, in particular those associated with impaired gene expression; establishment of correlations between genetic polymorphisms and variants of the functioning of various body systems. In practical terms, the most promising are the search for new molecular targets for the creation of new drugs and early markers of diseases, the creation of vaccines against a wide range of diseases; delivery systems for biologically active compounds to target organs, including those using nanoparticles (aerosols, liposomes, phagosomes).

Bioinformatics technologies will be used to solve such urgent scientific problems as elucidation of the molecular mechanisms of interaction between cellular and viral genomes; determination of the physiological properties of the organism by the genome; modeling of metabolic and signaling pathways in the cell; molecular design

bio- and nanostructures (drugs, functional nanodevices using biopolymers, etc.).

In the field of bioengineering, promising areas of research are the creation of methods for early and differential diagnostics using genomic and postgenomic (tran-cryptomics) data; elucidation of the molecular and cellular mechanisms of the immune response, including innate immunity.

To realize these prospects, timely measures are needed to reorganize biomedical science, including through the development of translational and evidence-based medicine, which will allow developing and evaluating the effectiveness of new diagnostic methods, medical technologies and innovative drugs, identifying obstacles to their implementation, and also contributing to the immediate promotion of of these developments before implementation in clinical practice in order to improve the quality of treatment and quality of life.

Namazova-Baranova Leyla Seymurovna, Dr. med. Sciences, prof., corresponding member. RAMS, deputy. dir. according to scientific work, dir. Research Institute of Preventive Pediatrics and Rehabilitation Treatment, SCCH RAMS, e-mail: [email protected]; Smirnov Vladimir Ivanovich, Ph.D. economy sciences, deputy dir. By information technology Research Institute of Preventive Pediatrics and Rehabilitation Treatment of the SCCH RAMS; e-mail: [email protected]

Embed code on the site

Often, the admission of children to clinics is not easy. One is restless, and the other may simply be afraid of doctors. And the examination and diagnosis of small patients must be carried out quickly. Technology helps doctors do this.

In recent years, new models of medical diagnostic equipment have been developed and produced in our country with the support of the Ministry of Health of the Russian Federation. In September 2017, the diagnostic complex "Healthy Child" appeared in the medical and diagnostic department of the University Children's Clinical Hospital.

This computerized installation was created by specialists from the Tulinovsky Instrument-Making Plant. With its help, the doctor can not only measure the height and weight of the child from any age - there are electronic scales for newborns in the kit. The complex also includes a blood pressure monitor, a manual dynamometer, an electronic caliper (measures body fat), an electronic tape measure, an electronic thermometer, an electrocardiograph, a spirotest, a computer plantograph (for foot diagnostics), and a visual-motor reaction panel. All measurements are included in a general report that can be printed, archived and sent to other departments of the clinic or medical institutions.

Chief Physician of the University Children's Clinical Hospital Ekaterina Pronina noted:

“This equipment has a number of advantages, especially given the possibility of its use in the rapidly developing area of ​​Personalized Medicine. It is convenient to use, multifunctional, saves time for doctors who examine and diagnose patients, and allows data exchange, which is important when introducing electronic medical records. This expands the capabilities of the doctor, makes his work easier, especially since modern children love all kinds of technical devices. And in general, it will improve the quality of medical services in our clinic.”

Copy to clipboard

Home > Document

MODERNIZATION AND INNOVATIVE TECHNOLOGIES IN PEDIATRICS.

For the period 2005-2010. maternal mortality in the Russian Federation decreased by 27.6% (from 25.4 to 18.4 per 100,000 live births), infant mortality by 31.8% (from 11.0 to 7.5 per 1,000 live births). The maximum rate of decline in indicators has been observed for the last 5 years (6-7% annually). Innovative organizational technologies for organizing medical care for children : - development of procedures (9 children's procedures have been introduced) and standards for the provision of medical care; - creation of a system for monitoring the health status of newborns and infants; - creation of a three-level system, coordination of its activities, including telemedicine; In 2010 in 30 constituent entities where the three-tier system providing medical care to pregnant women and newborns, maternal and infant mortality in 2010 is 15.7% and 11.25 respectively lower than in regions where such technologies have not been introduced.

Diagnostic (including population) technologies:

- prenatal diagnosis Since 2010, a pilot project has been implemented in 29 regions on prenatal diagnosis at 3 months of pregnancy. Prenatal diagnosis includes ultrasound and biochemical screening. Biochemical screening is carried out using test systems, partially produced by the domestic enterprise Immunoscreen (founder of the Scientific Research Institute of Biological Instrumentation of the FMBA). It is necessary to develop and launch the production of modern test systems for biochemical screening of pregnant women for hereditary diseases in the first trimester of pregnancy. - neonatal screening The development of neonatal screening with total coverage of newborns will reduce the disability and mortality of children from hereditary and congenital diseases: phenylketonuria, cystic fibrosis, hypothyroidism, galactosemia, adrenogenital syndrome. Given the increase in the birth rate, the number of examined newborns will increase. Currently, the development of the production of domestic test systems for the diagnosis of adrenogenital syndrome and cystic fibrosis, which was launched by the Immunoscreen enterprise, requires support. It is necessary to develop formulations of specialized dry mixes intended for the pathogenetic treatment of children with disorders of protein and amino acid metabolism. In the Russian Federation Currently, therapeutic mixtures are produced by ZAO Nutritek in a limited range (phenylketonuria, galactosemia). - audiological screening In 2008-2010, more than 2 million newborns and children of the first year of life were covered by audiological screening, more than 7 thousand children with hearing impairment were identified. Conducting audiological screening of newborns, early detection of neurosensory deafness with subsequent surgical treatment allowed more than 1,700 children to regain their hearing in 2009-2010. Full coverage of all children in need in this high-tech type of assistance will require additional funding. Since 2010, a pilot project has been implemented to remotely tune the speech processor of a cochlear implant using telecommunication technologies, implemented on the territory of 10 constituent entities of the Russian Federation (Chelyabinsk, Nizhny Novgorod, Novosibirsk region, Krasnodar, Krasnoyarsk, Khabarovsk Territories, etc.) The widespread introduction of a system for remote adjustment of the cochlear implant speech processor will provide timely and affordable rehabilitation assistance to children after cochlear implant surgery. - Diagnosis of tuberculosis in children using DIASKINTEST. Implemented new technique detection of tuberculosis in risk groups through the use of a new skin test "DIASKINTEST" in a comprehensive examination ( produced by CJSC "Generium"). As a result of the studies, it was found that the drug is safe and does not cause unusual reactions in children, adolescents and adults. The use of diaskintest makes it possible to single out a group of children with allergic reactions to tuberculin and to almost halve the number of children who are prescribed chemotherapy. High-tech (innovative) treatment and prevention technologies - fetal surgery Surgical correction of malformations and diseases of the fetus during pregnancy. So far, these operations are carried out only in a few centers, and the system of timely diagnosis and transfer of pregnant women for this type of treatment needs to be improved. - neonatal surgery(abdominal, thoracic, cardiac surgery, neurosurgery, orthopedics) Development of new methods for the correction of congenital malformations on the basis of organized departments of neonatal surgery. - X-ray endovascular cardiac surgery for congenital heart defects - endoprosthesis replacement for malignant bone tumors in children, rheumatic diseases Every year, 250-300 children are diagnosed with a malignant neoplasm of the skeletal system for the first time, of which 150-200 children need organ-preserving operations. It is necessary to develop and produce domestic telescopic endoprostheses. - new surgical medical technologies New methods of early surgical treatment (within the first hours and days from the moment of injury) have been developed for unstable injuries of the spine of the thoracic and lumbar localization. Endovideosurgical technologies have been introduced for spinal pathology, which significantly reduces surgical trauma, reduces blood loss by 50%, and reduces the time of hospitalization and rehabilitation by 30%. A comprehensive orthopedic-neurosurgical treatment of orthopedic deformities and contractures of limbs and joints in children with cerebral palsy using dorsal rhizotomies has been developed. Surgical treatment of congenital kyphoscoliosis at an early age. It is necessary to organize the production of endocorrectors for young children (manufactured by ZAO Konmed, Moscow, Krasnoyarsk). Innovative technologies nursing children with extremely low body weight: Since 2012, the Russian Federation is planning a full-scale transition to a new newborn registration mechanism, taking into account children with extremely low birth weight (less than 1000 grams). In the population, children with extremely low body weight (ELBW) make up no more than 1% of newborns (on average, 0.4 - 0.5%), but neonatal morbidity and mortality in this group are extremely high. Almost all equipment for nursing premature babies is extremely expensive. 90% of this equipment is imported. It is expedient to intensify work on the creation of domestic equipment. Improving drug therapy for newborns and young children, children and adolescents: - creation of dosage forms in small dosages for young children; - creation of domestic medicines for children; - creation of domestic preparations for parenteral nutrition; - creation of modern new domestic vaccines. Over the past 2 years, the production of domestic drugs has been established. For example: CJSC "Generium" produces growth hormone, interferons, blood coagulation factors. The production of improved dosage forms of the domestic growth hormone "Rastan" has been successfully introduced. The development and production of domestic genetically engineered drugs for the treatment of "orphan" diseases (mucopolysaccharidosis, Fabry disease, etc.) is extremely relevant. From isolated cases to 200 patients with various rare hereditary diseases are registered in the country. Development of domestic high-tech equipment, medical products: It is extremely important to develop and start production of the so-called "artificial skin" for premature babies - transparent, moisture- and breathable films that do not irritate the skin, which serve to protect against irritation with a plaster when fixing tubes and catheters. Development of domestic baby food products, including specialized mixtures for very premature babies, breast milk fortifiers, dietary foods: It is necessary to develop a wider range of domestic quality products for baby food. Partially, mixtures for children under one year old are produced by CJSC Nutritek. Domestic vaccines for children without preservatives against influenza and hepatitis B have been created. Creation of vaccines against "new" socially significant infections 1.1. Pneumococcus 1.2. Human papillomavirus Improving technology to improve the safety and effectiveness of vaccines against infections included in the National calendar. 2.1. Tuberculosis 2.1.1. Creation of a subunit tuberculosis vaccine 2.1.2. Improving the technology of BCG vaccine 2.2. Diphtheria-pertussis-tetanus 2.2.1 Acellular pertussis component 2.2.2 Genetically engineered diphtheria toxoid 2.2.3 Tetra- and penta-vaccines 2.3. Measles-rubella-mumps

XX CONGRESS OF PEDIATRICS OF RUSSIA
with international participation
"CURRENT PROBLEMS OF PEDIATRICS"

February 16 - 18, 2018

Moscow, Krasnopresnenskaya embankment, 12
World Trade Center

Dear Colleagues!

February 16-18, 2018 was held XX Congress of Pediatricians of Russia with international participation "Actual problems of pediatrics", within which also passed VI All-Russian Conference "Emergency Pediatric Surgery and Traumatology", VII Eurasian forum on rare diseases, VIII Forum of Pediatric Nurses And XI International Forum of Pediatric Surgeons.

Press Release and Congressional Resolution (pdf)>>>

Congress program (pdf)>>>

Collection of materials of the Congress (pdf) (Abstracts!)>>>

Information letter >>>

Order of the Ministry of Health of the Russian Federation No. 16 dated January 18, 2018 "On holding the XX Congress of Pediatricians of Russia with international participation "Actual problems of pediatrics" >>>

greetings

Greetings from the Minister of Health of the Russian Federation V.I. Skvortsova (pdf)>>>

Greetings from His Holiness Patriarch Kirill of Moscow and All Rus' (pdf)>>>

ORGANIZERS

• Ministry of Health of the Russian Federation
• Federal Service for Surveillance in Healthcare
• Federal Service for Supervision of Consumer Rights Protection and Human Welfare
• Union of Pediatricians of Russia
• the Russian Academy of Sciences
• European Pediatric Association EPA/UNEPSA
• National Medical Research Center for Children's Health of the Ministry of Health of Russia
• Department of Health of the City of Moscow
• First Moscow State medical University named after I.M. Sechenov of the Ministry of Health of Russia
• Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of Russia
• Russian Academy of Pediatrics
• Research Institute of Emergency Pediatric Surgery and Traumatology of the Moscow Department of Health
• LLC "New Information Technologies"

SCIENTIFIC PROGRAM OF THE CONGRESS

• On the implementation of the Decree of the President of the Russian Federation dated May 29, 2017 No. 240 “On the announcement of the Decade of Childhood in the Russian Federation”;
• Scientific and practical problems of development of pediatrics
• Audit of the quality of medical care for children
• Medical care for children educational organizations: school medicine
• Nutrition for a healthy and sick child
• Vaccination in pediatrics, family vaccination
• perinatal medicine. neonatal surgery
• Emergency conditions in pediatrics and pediatric surgery
• Problems of childhood disability
• Pediatric education: problems and solutions
• The role of nurses in medical care for children
• International cooperation in the field of child health
• History of Russian Pediatrics

• competition "Children's doctor of 2017";
• competition "Children's Nurse 2017";
• competition "Medical organization of the pediatric profile in 2017";
• competition for the best artistic and historical essay on the history of Russian pediatrics.

At the closing ceremony of the Congress - February 18, 2018 - the results of the Competition of scientific works of young scientists were summed up.

Address of the Organizing Committee of the Congress: 119991, Moscow, Lomonosovsky prospect, 2, building 1, National Medical Research Center for Children's Health of the Ministry of Health of Russia; e-mail: