All articles by Smbatyan S. M.
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2023 № 1 Bronchitis in children’s populations of different countries, risk factors
The issues of etiology, clinical presentation, distribution, diagnosis and treatment of bronchitis, as one of the most common respiratory diseases among children, are of considerable research interest. Risk factors for bronchitis are considered meteorological indicators (wind speed and direction, anomalies in relative humidity and atmospheric pressure, a decrease or increase in temperature), environmental pollution (tobacco smoke, NO2 and PM10), immune dysfunctions, preterm birth, exclusive breastfeeding for ≤ 4 months of life. Currently, a significant place in the research literature is occupied by the issues of acute, protracted bacterial and plastic bronchitis in children. Acute bronchitis is mainly caused by a viral infection, mainly rhinovirus, enterovirus, influenza A and B viruses, parainfluenza, coronavirus, human metapneumovirus and respiratory syncytial virus, with bacteria detected in 1–10% of cases. Protracted bacterial bronchitis, isolated as a clinical diagnosis since 2006, can occur in up to 88,5% of cases in children with chronic wet cough, wheezing and airway deformities, more often in children under 6 years of age and males. Prolonged bacterial bronchitis is mainly caused by the bacteria Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. It is believed that recurrent bronchitis (>3 episodes/year) and the presence of H. influenzae infection in the lower respiratory tract may be significant risk factors for bronchiectasis Plastic bronchitis, a rare disease, in the
pediatric population is associated with cardiothoracic surgery (Fontaine operation), infections (viruses influenza, Mycoplasma pneumoniae, tuberculosis, adenoviruses, in particular serotype 7), inflammatory and allergic diseases, acute chest syndrome and iatrogenic processes. -
2022 № 9 The role of risk factors in childhood on the formation of chronic obstructive pulmonary disease
An analysis of literature on COPD in children has shown that COPD arises from an accelerated decline in lung function, an inability to achieve normal lung function after childhood, or a combination of the two. Risk factors for the development of COPD are considered negative environmental influences; maternal smoking, intrauterine development disorders, prematurity, low birth weight, bronchopulmonary dysplasia, as well as frequent or severe respiratory infections in childhood (especially respiratory syncytial virus and rhinovirus) that prevent the full growth and development of the lungs; asthma in childhood; early allergic sensitization and/or a rare genetic disorder (alpha‑1 antitrypsin deficiency), childhood chronic cough, parental history of respiratory disease, and low educational attainment. Particularly vulnerable are children from socio-economically low strata of the population, in particular,
from among the indigenous population of multi-ethnic countries. In low- and middle-income countries, diagnosing COPD is difficult, and the disease may go undiagnosed. Bronchial asthma in childhood can be considered as an independent risk factor for COPD in adulthood. At the same time, the asthma-COPD overlap syndrome is widespread, the risk of which is especially high among individuals with persistent and severe childhood asthma, which is highly dependent on genetics. Targeted programs are needed to reduce the risk of adverse pulmonary outcomes in disadvantaged children, as well as the integration of specialized outreach services into primary health care. The WHO COPD core package includes protocols for assessing, diagnosing and managing COPD, as well as modules on healthy lifestyles, including smoking cessation and self-help, and development of rehabilitation services.