Fundamentals of clinical medicine in pediatrics. Child Health Scientific Pediatrics
Pediatrics - according to the definition of the founder of Russian pediatrics S.F. Khotovitsky, given in 1847 - "there is a science about the distinctive features in the structure, functions and diseases of the child's body and based on those features the preservation of health and the treatment of diseases in children."
In other words, the main task of pediatrics is to preserve or return (in case of illness) the state of health of the child, allowing him to fully realize his innate life potential.
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” states the Constitution of the World Health Organization (WHO).
More than 100 years ago, the outstanding Russian pediatrician M.S. Maslov (1961) defined the tasks of pediatrics as follows: “Being the science of the growing and developing human body, pediatrics, based on an in-depth study of the characteristics of the child's body in different age periods, sets as its main goal the creation of the best conditions for its comprehensive development and the greatest resistance to harmful factors. . Therefore, the main direction of pediatrics is preventive.
The tasks of preventive medicine are the restoration of health in healthy people according to the formula: healthy parents - a healthy lifestyle and work - a healthy child (A.M. Razumov).
Researchers have proven that a child is a constantly developing organism from birth to adulthood.
Children in their development experience 6 “critical” periods, during which the probability of damage to the body and the development of diseases is highest:
1. The most dramatic period is the stage of intrauterine development of the embryo (1st trimester of pregnancy) and fetus (3rd trimester of pregnancy). At this time, there is a high probability of death of the nascent organism, the occurrence of congenital anomalies and intrauterine infections.
2. Neonatal period (0-28 days of life). By the time of birth, the developed vital organs and systems of the child provide him with an independent existence.
3. The period of infancy - from 28 days to 1 year. A very important and responsible time. By the age of one, the baby is already a conscious being, actively responding to everything around. The weight of the child is already 3 times more than at birth, and the height has increased by 25 cm.
4. Toddler age - from 1 to 3 years. During this period, basic skills and functions are mastered - speech develops, the child begins to understand a lot, dresses himself, is more and more interested in the world around him. A lot during this period depends on the correct upbringing of the child.
The early preschool period - from 3 to 7 years old - is characterized by the formation of the higher nervous system, most biochemical parameters, accelerated growth, the formation of chronic diseases, and neuroticism. It is very important to help the child develop correctly and harmoniously.
5. School age is a responsible time for the formation of a human personality. It is necessary to help the child to develop character, to choose a business to his liking and to determine a profession for the future life. And here the teacher and parents can have a good assistant - a pediatrician.
6. Adolescence - from 15 to 18 years - an extremely responsible period of growing up. In the body of a teenager, a significant restructuring of many functional systems occurs, puberty begins. It is accompanied by significant shifts in the endocrine system, with normal or even slow development of other systems - the central nervous system, cardiovascular, etc. Such "scissors" can cause various functional disorders - blood pressure instability, headaches, pain in rapidly growing bones , cardiac weakness during physical overload, etc.
The pediatrician is the most important doctor for the baby and his mother, as he takes responsibility for the health of your child. A pediatrician is a doctor, a consultant, and even a teacher for parents. The task of the pediatrician is to teach the mother to understand her baby, to know the features of his age period. A mother who knows how to correctly assess the condition of her child is the best assistant for a pediatrician. In the process of communication between the pediatrician and the parents of the baby, mutual understanding and trust play a decisive role.
A regular doctor who knows the individual characteristics of your child will be able to give clear and specific recommendations. The child and mother should not be afraid to go to the doctor once again, because this particular visit can be especially important.
Pediatrics occupies a special place in medicine.
It is the pediatrician who evaluates the neuropsychic and physical development of a small patient, evaluates his school maturity.
As part of the appointment, the doctor determines which health group the children belong to, selects the most favorable recommendations regarding the feeding of the child and his upbringing; takes measures to prevent chronic diseases.
An examination by a pediatrician for a child can be planned and unscheduled.
Scheduled inspection:
Before the birth of the child: when registering at the antenatal clinic for pregnancy, the expectant mother is sent to the pediatrician for prenatal care;
- after discharge from the maternity hospital, the child is observed by a pediatrician and patronage honey. sister 4 times during the first month;
- up to 1 year old, every month on the day of a healthy child, a child visits a children's clinic, where he is examined by a pediatrician, anthropometric data, neuropsychic development are assessed, recommendations are given for rational feeding of the child, and scheduled preventive vaccinations are carried out. According to a certain schedule, the child is consulted by narrow specialists, undergoes laboratory and ultrasound diagnostics;
- from 1 year to 2 years - the regularity of examinations 1 time in 3 months (1y 3 months; 1y 6 months; 1y 9 months; 2 years).
- from 2 to 3 years - the frequency of examinations - 2 times a year;
- after 3 years, the child undergoes a planned medical examination once a year. in order to detect tuberculosis infection, all children under 18 years of age undergo an annual Mantoux test, and from the age of 15 - chest x-ray.
Unscheduled examination by a pediatrician for any symptoms:
Increase in body temperature; - catarrhal phenomena (cough, shortness of breath, hoarseness of voice); - headache, pain in the abdomen, pain in the joints, lower back, spine; - rash on the skin; change in stool (diarrhea, constipation); - disturbance of consciousness; - lethargy, increased fatigue or excitability, restless behavior; - belching, vomiting, flatulence, intestinal colic; - violation of the development of speech; - violation of physical development; - fading or cessation of skills that the child has already acquired, etc.
Diseases in children proceed differently than in adults; in the treatment of children, different dosages of drugs are used than in adults. Some drugs are not acceptable for treatment in pediatrics. Children are more likely to experience complications from diseases than adults.
All questions of interest will be gladly answered by pediatrician Yaroslavtseva Elena Viktorovna. Record by phone 722-722.
1. Introduction…………………………………………………………………………..2
2. The emergence of pediatrics………………………………………………………….3
3. The founder of pediatrics - S.F. Hotovitsky………………………………3
4. XIX - XX centuries. Achieving a high level of development of pediatrics………..........5
5. N.F. Filatov is one of the founders of Russian pediatrics………….5
6. Works by N.P. Gundobin on age-related anatomical and physiological characteristics in children………………………………………………………………..6
7. The contribution of A.A. Kisel to the development of Soviet pediatrics after the Great Socialist Revolution…………………………………………………………………………………………..7
8. Emergence of the Center for Pediatric Research (G.N. Speransky)…..9
9. Opening of Institutes for the protection of children's and adolescents' health in Leningrad, Research for the protection of maternal and child health in Moscow………………………………………………………………………… ……10
10. History of pediatrics in the Western Urals………………………………………..11
11. XX century. Differentiation and integration of the main branches of pediatric medicine (pediatric surgery, neuropathology, psychiatry, ophthalmology, neonatology, perinatology, allergology, etc.)…………………………..14
12. Preventive focus and stages of treatment in pediatric activities………………………………………………………………………….18
13. Bibliographic list…………………………………………………….21
Introduction.
Medicine is a practical activity and a system of scientific knowledge about the preservation and strengthening of people's health, the treatment of the sick and the prevention of diseases, the achievement of longevity by human society in terms of health and performance.
Medicine has developed in close connection with the whole life of society, with the economy, culture, worldview of people.
Like any other field of knowledge, medicine is not a combination of ready-made, once and for all truths, but the result of a long and complex process of growth and enrichment.
The history of medicine is not limited to the study of the past. The development of medicine continues more and more rapidly before our eyes. Past, present, future are links in the chain of historical development. The study helps to better understand the present, gives a scale for its evaluation. At the same time, the knowledge of the patterns of the previous development of any phenomenon and the understanding of its current state help to better understand and scientifically foresee (predict) the ways of its development in the future.
The history of medicine clearly shows the shifts and fundamental changes that took place in it in connection with changes in the life of society. Particularly profound changes in medicine took place in our country after the Great October Socialist Revolution and the radical transformations associated with it in all areas of social life and culture.
The treatment of childhood diseases has long been associated with the practice of childbirth and the development of ideas about contagious diseases. This is evidenced by the ores of outstanding doctors of the ancient world (Soran from Ephesus, Galen) and the Middle Ages (Abu Bakr ar-Razi, who gave a classical description of smallpox and measles, Ibn Sina and others). Special writings on children's illnesses began to appear at the end of the 15th - beginning of the 16th century.
Pediatrics as a branch of medicine has emerged recently. The independent profession of a pediatrician is also relatively young. However, short articles and proposals on feeding children, caring for them, and treating them are found in the ancient manuscripts of the Armenian state of Urartu, as well as Ancient Egypt, India, China, Babylon, Assyria. Even in the time of Hippocrates, there are references to the stable growth and development of children. In the 15th and 16th centuries, books were published that described childhood illnesses, but they lacked recommendations. Starting from the 17th century, pediatrics increasingly attracted the attention of physicians, and already in the 18th century, educational literature appeared. All this was a consequence of the high mortality of children. Pediatric hospitals are starting to open. The first such hospital was opened in 1802 in Paris for children from 2 to 15 years old. Subsequently, it trained specialists in childhood diseases. In 1834, a pediatric hospital was opened in St. Petersburg. In 1865, the departments of children's diseases, the Medical and Surgical Academy were opened. And K. A. Rauhfus built several children's hospitals in different cities of Russia. Over time, a course on childhood diseases began to be taught at universities.
Pediatrics as an independent science began to take shape in the 1830s-1860s.
Pediatrics is a branch of medicine that deals with the treatment of children. It is based not only on diseases of the early period of children's life, but also on all aspects of their life and development. Pediatrician is considered its founder Stepan Fomich Khotovitsky(1796-1885). Having become an ordinary professor in the department of obstetrics, women's and children's diseases, he was the first to read (since 1836) a separate course of children's diseases from 36 lectures and in 1847 he published it in an expanded form under the title "Pediatrics". It was the first original manual on pediatrics in Russia in the process of development, in which the child's body was studied taking into account its anatomical and physiological features, which qualitatively change in the process of development.
The study of the child's body showed that the child is not an adult in miniature, his body is characterized by both quantitative and qualitative differences from an adult.
The development of the clinic of internal diseases, associated with the introduction of methods of percussion, auscultation and pathological and anatomical studies, led to the creation of a system for examining a child, which made it possible to detail the symptoms of childhood diseases.
The first hospital for children was opened in Paris in 1802. It became the leading center in Europe in the first half of the 19th century. for the training of specialists in the field of childhood diseases.
The second in Europe (and the first in Russia) special children's hospital with 60 beds was founded in St. Petersburg in 1834 (now the Children's Infectious Diseases Hospital No. 18 named after N. F. Filatov).
In 1842, the first Moscow Children's Hospital for 100 beds was opened - the world's first hospital for young children (now the Children's Clinical Hospital No. 13 named after N.F. Filatov).
The third children's hospital in Russia - the Elizabethan Clinical Hospital for Young Children - was opened in St. Petersburg in 1844. Its main difference from all children's hospitals that existed at that time was that it specialized in the treatment of children up to the age of three.
Children's hospitals were maintained mainly through charitable funds and private donations - government subsidies were negligible.
At the end of XIX - beginning of XX century. domestic pediatrics reaches a particularly high level, which is greatly facilitated by the fruitful work of such pediatric scientists as N. F. Filatov and N. P. Gundobin. They studied and described a large number of childhood diseases, published a number of textbooks, teaching aids and works.
At Moscow University, the first clinic for childhood diseases was established in 1866. The teaching of pediatrics began with a theoretical (1861), and then a practical (-1866) course at the Department of Obstetrics, Women's and Children's Diseases, which was read by N. A. Tolsky (1832-1891 ), and ended with the organization in 1888 of an independent department of childhood diseases. Since 1891, N. F. Filatov was in charge of it.
Nil Fedorovich Filatov(1847-1902) - one of the founders of Russian pediatrics, the creator of a major scientific school - developed the clinical and physiological direction. He was the first to identify and describe chicken pox (1872) and scarlatinal rubella (1885), discovered an early sign of measles - pityriasis peeling of the epithelium on the oral mucosa (Filatov-Velsky-Koplik spots). His works "Semiotics and Diagnosis of Childhood Illnesses", "Lectures on Acute Infectious Diseases in Children" and "A Short Textbook of Childhood Illnesses" were reprinted many times. Filatov's lectures recorded and published by his students S. Vasiliev, V. Grigoriev and G. Speransky were very popular.
In 1892, N. F. Filatov organized the Moscow Society of Pediatric Doctors. The formation and development of pediatrics as an independent scientific discipline is associated with the activities of many outstanding doctors in the world. Among them are K. A. Raukhfus, D. A. Sokolov, A. N. Shkarin, N. S. Korsakov, V. B. Zhukovsky, G. N. Speransky, I. V. Troitsky (Russia), K. Pirke (Austria), M. Pfaundler (Germany), V. Utinel and J. Cruchet (France), G. Koplik and J. Getchinson (England) and many others.
In 1902, leading pediatricians from various European countries came up with the idea of combining their efforts and created the League to Combat Infant Mortality, which, despite the vigorous activity of individual doctors, was still high. The first International Congress for the Protection of Infancy was held in Berlin in 1911. This was the beginning of international cooperation in the field of pediatrics.
In 1911, the journal Pediatrics was published. A society for the fight against infant mortality and a society of pediatricians appeared, congresses of children's doctors were organized, at which questions were decided on how to help newborns. M. S. Maslov wrote books on chronic disorders and digestion, diseases of the kidneys, liver, diathesis, etc., which made a great contribution to pediatrics.
The task of pediatrics is to ensure that the state of health of the child allows him to maximize his innate life potential.
Pediatrics is divided into: preventive, clinical, scientific, social and environmental.
Clinical pediatrics is a set of measures based on the diagnosis, treatment and recovery of a sick child.
The works of N. F. Filatov “Semiotics and Diagnosis of Childhood Diseases”, “Lectures on Infectious Diseases”, “Lectures on Gastrointestinal Diseases in Children”, “Clinical Lectures”, and other works formed the basis of Russian pediatric literature and quickly put it into one row with the foreign one, which then already had many years of existence. These books went through a number of editions and had a great influence on the development of pediatrics and on the training of pediatricians.
The works of N. P. Gundobin and his numerous students significantly expanded the knowledge of pediatricians about age-related anatomical and physiological characteristics in children.
Such a work by N. P. Gundobin and his students as "Peculiarities of childhood" has not lost its scientific significance in our time.
After N.P. Gundobin, the department of pediatrics at the Military Medical Academy was headed by A.P. Shkarin. He organized a dairy kitchen, a consultation for infants and a department for infants at the clinic, which made it possible to expand the development of questions of the physiology and pathology of children of this age.
However, the conditions of tsarist Russia did not ensure the rapid growth and flourishing of pediatrics and hygiene. Preventive children's institutions, nurseries and kindergartens, created, as a rule, with charitable funds, were isolated; the network of children's hospitals and polyclinics slowly grew, the living and educational conditions for children of the poor continued to be very difficult.
After the Great October Socialist Revolution, a galaxy of outstanding scientists made a great contribution to the development of Soviet pediatrics. Among them are the names of professors of the Moscow School. This is Alexander Andreevich Kisel (1859-1931), a student of N. I. Bystrov and S. P. Botkin, who did a lot to study rheumatism, chronic non-rheumatic polyarthritis, tuberculosis, and malaria.
The most famous in the 20th century were the schools of G.N. Speransky and A.A. Kisel. Academicians of the Russian Academy of Medical Sciences M.Ya. Studenikin, VA. Tabolin, Yu.F. Dombrovskaya and their schools have successfully conducted research into diseases of children of all ages. The studies of the pediatric surgeon Yu.F. Isakov and his students, showing mastery in all areas of surgical intervention for diseases of children.
Alexander Andreevich Kisel (1859-1938) worked for 48 years in the children's Olginskaya hospital in Moscow, was the head of the department of children's diseases of the higher women's courses, then at MMI the scientific director of the Central Institute for the Protection of Children's Health. He is the author of over 600 works. Known for his studies of childhood tuberculosis (tuberculosis), the development of an active method of combating it, the organization of anti-tuberculosis work, and the promotion of a preventive direction, Kisel introduced the concept of "Chronic tuberculosis intoxication" and established its signs, proved the rheumatic nature of chorea. He paid great attention to the strict observance of the hygienic regime at home and at school - the cleanliness of the premises, air, food, etc. According to his recommendations, forest schools began to be created. Kisel paid special attention to the labile child psyche, physical education, the upbringing of positive emotions, the development of a sense of beauty: “In our upbringing,” he said, “little place is given to the development of a sense of beauty in a child.”
Kisel urged doctors to rely on a broad preventive measure of a state nature, developing a social and preventive direction, and not only in relation to sick, but also to healthy children. “Preventive measures,” he wrote, “are especially desirable in relation to those children who still have a completely healthy appearance or who have very slight changes.” "Our goal is to prevent the disease." He also emphasized the need for tireless preventive and curative work between attacks or exacerbations of diseases. “The disease harms a person mainly not during short attacks, exacerbations (for example, with malaria), but during very long periods (between attacks), which can last not only for months, but even for years,” A.A. Kissel.
Establishment of a major center for pediatric research.
Peru G. N. Speransky owns a textbook on this pathology - "Textbook of Diseases of Young Children", which for many years served as the main guide for doctors in departments of newborns and pathology of young children. For many years, G. N. Speransky was the editor of the Pediatrics journal and headed the All-Union Scientific Society of Pediatric Doctors.
Georgy Nesterovich Speransky (1873-1969) - one of the founders of pediatricians in the USSR, corresponding member of the USSR Academy of Sciences, academician of the USSR Academy of Medical Sciences, Hero of Socialist Labor, laureate of the Lenin Prize. After graduating from the medical faculty of Moscow University, he worked in the clinic of childhood diseases with N.F. Filatov, one of the organizers of the system for the protection of motherhood and infancy, on his initiative, the Institute of Pediatrics of the USSR Academy of Medical Sciences was created; since 1932 Speransky - Head of the Department of Pediatrics of the Central Institute for the Improvement of Physicians. He is the author of more than 200 scientific papers, he justified the methods of feeding and caring for children, antenatal prevention, treatment of diseases of the fetus and newborns. A number of Speransky's works are devoted to respiratory and gastrointestinal diseases of children, he developed a classification of these diseases. On his initiative, the journal "Pediatrics" and the journal on the study of early childhood were organized, of which he was the editor.
Speransky - Chairman of the All-Union Society of Pediatricians. The scientist was an honorary member of a number of scientific societies. Among the books of G.N. Speransky - "Nutrition of a healthy and sick child" (1959), "Hardening of a child of early and preschool age" (1964).
A.A. Kisel and G.P. Speransky brought up a large school of pediatricians, among them V.G. Tabolin, V.A. Vlasov, Z.A. Lebedeva, A.A. Kolotunin and many others.
In 1922, N. A. Semashko headed the country's first department of social hygiene at the Medical Faculty of Moscow University (since 1930 - Moscow Medical Institute, since 1990 - I. M. Sechenov Medical Academy) and led it in for 27 years.
N. A. Semashko was the initiator and editor-in-chief of the first edition of the Great Medical Encyclopedia (1927-1936).
For ten years (1926-1936) he headed the children's commission of the All-Russian Central Executive Committee (VTsIK).
In 1925, a Institute for the Protection of Motherhood and Infancy, which due to the huge need for pediatricians in 1935, it was reorganized into the Leningrad Pediatric Medical Institute.
In 1927, the Institute for the Health of Children and Adolescents was founded in Moscow, later transformed into the Moscow Research Institute of Pediatrics and Pediatric Surgery of the Ministry of Health of the RSFSR. Later research institutes were opened in Kiev, Kharkov, Rostov-on-Don, Kazan, Sverdlovsk, Gorky, Minsk, Tbilisi, Baku, Alma-Ata and other cities.
In 1979, the All-Union Research Center for Maternal and Child Health of the USSR Ministry of Health was opened in Moscow. He leads all basic scientific research on maternal and newborn health. Successes in the development of the system of health care for children in the USSR are due to the achievements of domestic pediatric science.
The focus of scientists has always been research on the scientific foundations of the organization of medical and preventive care for children, the study of the dynamics of physical and psychomotor development, as well as the incidence of children, the scientific development of forms and methods of pediatric care, including premature babies and newborns, children with recurrent and chronic respiratory diseases, allergic diseases, diseases of the kidneys, stomach and intestines, metabolic disorders. These studies served as the basis for the development and implementation of anti-epidemic measures of the system of pulmonological, allergological, medical and genetic services, and the creation of specialized centers.
History of Pediatrics in the Western Urals begins in 1920, when the Faculty of Medicine of Perm University elected Pavel Ivanovich Pichugin, Privatdozent from Kazan, as the head of the Department of Children's Diseases, and on February 23, 1920, the first lecture on children's diseases was read to fourth-year students of the Faculty of Medicine. In those years, Perm did not have not only a children's hospital, but even an outpatient clinic, and along with the teaching activities of P.I. Pichugin took up the organization of the clinical base of the department.
On October 7, 1923, the children's outpatient clinic created by Pichugin began to work. 34 years old Department of Children's Diseases, headed by P.M. Pichugin, worked on the problems of childhood tuberculosis, constitutional anomalies, chronic eating disorders, rheumatism, and helminthic diseases. P.I. Pichugin brought up several generations of pediatricians. The clinic of children's diseases he created, according to the conclusion of the People's Commissariat of Health, was one of the best medical institutions of that time. By 1929, 25 pediatricians had already been trained, who had completed their residency with P.I. Pichugin.
Under the guidance of Professor P.I. Pichugin published more than 50 scientific papers, 3 Ph.D. . Pichugin is one of the first Soviet textbooks on pediatrics.
From 1954 to 1972, associate professor Lev Borisovich Krasik was in charge of the Department of Children's Diseases. L.B. Krasik was born on May 28, 1904; in 1926 he graduated from the medical faculty of Perm University and was accepted as an intern at the Department of Children's Diseases. On September 1, 1931, he became a staff assistant at a children's clinic. On March 9, 1938, he defended his Ph.D. thesis on venous pressure in children; on December 23, 1938, he was awarded the academic title of associate professor. It was a difficult time: high morbidity, mortality in children, especially from epidemic and tuberculous meningitis. The department provided great assistance to the region, the work required great laboratory knowledge. There were no labs. Lev Borisovich studied blood, urine, cerebrospinal fluid himself, teaching laboratory assistants and doctors. Simultaneously with the medical work, he performed a lot of pedagogical work - classes, lectures.
Pediatrics was taught at three faculties: medical, sanitary and stomatological. The best students entered the clinical residency in pediatrics, later they formed the staff of the department. Under the guidance of Associate Professor L.B. Krasik completed 5 PhD theses (G.K. Knyazkova, N.M. Avdeeva, A.M. Nikitina, S.G. Sofronova, N.F. Churina). The scientific topics of the department were related to liver diseases, early diagnosis of tuberculosis, rheumatism, pathology of premature babies and other problems.
With the active assistance of L.B. Krasik opened the children's sanatorium "Svetlana" and "Eaglet".
Under his leadership, collections of scientific papers and methodological manuals on various sections of pediatrics were published. Lev Borisovich Krasik was an unusually disciplined, punctual person, he devoted himself to work, and strictly demanded the same from the staff of the department. Over the long years of his leadership, hundreds of pediatricians have been trained at the department, highly qualified personnel have been trained who have completed clinical residency, who have become teachers and organizers of children's healthcare in Perm and the region, leading specialists in various fields of pediatrics. Lev Borisovich, after his retirement, continued advisory work, worked on improving the medical examination of the child population. Lev Borisovich died on March 17, 1982.
In 1971, a pediatric faculty was opened at the Perm Medical Institute, in connection with which the question arose of forming a number of pediatric departments. The Department of Children's Diseases of the Faculty of Medicine from 1972 to 1983 was headed by Professor A.I. Egorov, who was responsible for organizing the course of propaedeutics of childhood diseases and the Department of Faculty Pediatrics. Employees of the Department of Propaedeutics of Children's Diseases, the base of which was the first clinic of children's diseases in the Western Urals, honor and preserve traditions. The department created stands and albums dedicated to the history of the clinic and its founder, Professor P.I. Pichugin.
The department constantly cooperates with practical public health and provides scientific advisory and methodological assistance to hospitals, sanatoriums, schools and preschool institutions of the city and region. Much attention is paid to postgraduate training of specialists. Scientific work is carried out in close cooperation with the Perm Technical University, the Clinical Institute of Pediatric Ecopathology, departments and divisions of PSMA.
The results of scientific research are actively introduced into the work of practical healthcare and the educational process. Since 1983, more than 500 scientific papers have been published by the staff of the department.
At the dawn of the 20th century began differentiation and integration of the main branches of medicine. Within pediatrics, during the 20th century, independent disciplines emerged: pediatric surgery, pediatric neuropathology, pediatric psychiatry, pediatric ophthalmology, neonatology, perinatology, and many others.
In pediatrics, the physiological characteristics of the body, the role of age factors and the influence of the environment on the development and growth of the child are studied much more widely.
Much attention is paid by Soviet pediatricians to a comprehensive study of age-related physiology, the development of higher nervous activity, age-related morphology, the patterns of the formation of the body's reactivity and physical development, and issues of age-related hygiene.
The system of educating children of preschool age, developed by Soviet pediatricians and physiologists, received worldwide recognition, it served as the basis for building the work of children's institutions in our country and in a number of foreign countries.
The study of the issues of feeding a healthy and sick child should be considered a very valuable achievement of Soviet pediatrics. On the basis of scientific research, new milk formulas intended for feeding young children have been developed and introduced, enriched food concentrates, dietary products for children with various diseases have been proposed.
The development of the fundamentals of the physiology and pathology of early childhood has made it possible to substantiate and implement a set of effective measures to reduce infant mortality, many important features of intrauterine development, the relationship between the mother and fetus, and the influence of various external and internal environmental factors on the developing fetus have been clarified.
Allergic diseases in children are being studied; principles for diagnosing pollinosis, food allergy and drug allergy were developed. New methods of allergological diagnostics (skin tests and provoking tests), as well as the principles of specific hyposensitization, have been proposed and implemented.
The principles of nutrition, regimen, physical education and sanatorium treatment of children with allergic diseases have been developed.
Undoubted success has been achieved in the development of evidence-based methods of complex treatment, intensive care and resuscitation of children with severe pneumonia and respiratory failure, including controlled breathing, bronchoscopy, homeostasis correction.
Pediatric surgeons took an active part in the development of these methods, on whose initiative intensive care units and intensive care units were created.
A system of staged treatment of rheumatism in children has been created, and its prevention has been widely introduced into practice, which has significantly reduced the incidence and frequency of heart defects. The wide introduction of scientific recommendations for the fight against rheumatism in children was ensured through the creation of cardiology rooms. Methods for the early detection of the initial forms of arterial hypertension are being developed, its frequency and prevalence are being established in connection with various environmental conditions.
The structure of the incidence of infectious diseases in children has changed significantly. The use of the latest achievements in immunology, virology, pathological physiology made it possible to establish patterns of the infectious process, immune responses and allergies in acute childhood infections. A great achievement in recent years has been the elucidation of the effectiveness of leukocyte interferon as a therapeutic agent for viral diseases. New vaccines are being introduced to prevent infectious diseases (measles, mumps). A new direction in pediatrics is the development of non-infectious childhood immunology, which studies the formation, development and violation of the specific immunological reactivity of the child.
Childhood surgery has achieved great success: methods for correcting congenital malformations have been developed, mortality from purulent surgical diseases has sharply decreased, methods of intensive care and resuscitation are being developed.
The development of childhood nephrology and urology is closely linked with the achievements of immunology, biochemistry, genetics, and general pathology. There is a change in the nature of renal pathology in children, a decrease in the incidence of acute streptococcal nephritis and a relative increase in the frequency of recurrent protracted and chronic kidney diseases, often leading to the development of chronic renal failure.
Significantly more often than before, hereditary and congenital kidney diseases, metabolic nephropathy, nephrotic syndrome in young children are detected. The attention of pediatric nephrologists is attracted by various forms of glomerulonephritis, the diagnosis of which is carried out on the basis of functional immunological and histomorphological methods. Specialized care for children with kidney diseases has been developed, nephrological hospitals and sanatoriums are being organized.
The problems of pediatric gastroenterology are being developed in a number of scientific centers - the Institute of Pediatrics of the USSR Academy of Medical Sciences, the Gorky Research Institute of Pediatrics, the 2nd Moscow Order of Lenin Medical Institute named after N.I. new data on the pathogenesis of gastroduodenitis, the syndrome of impaired intestinal absorption.
The study of anemia in children has made it possible to achieve significant success not only in their treatment but also in prevention. A major achievement of domestic pediatrics is the development of methods for immunotherapy of hemoblastoses in children, which made it possible to significantly increase the duration of remission.
The main achievements of pediatric endocrinology are the elucidation of the pathogenesis and the development of therapeutic tactics in diabetic ketoacidosis, the elucidation of the pathogenesis of obesity in children, obtaining data on endocrine interactions between mother and fetus, and the study of hereditary and acquired thyroid diseases.
Scientific research in the field of childhood neuropathology is aimed at developing methods for diagnosing and treating organic diseases of the nervous system, and in recent years have focused on the problems of intracranial birth trauma and hereditary diseases of the nervous system.
Medical genetics had a significant influence on the development of pediatrics, thanks to which a large group of hereditary diseases of children became known.
The Communist Party and the Soviet state paid great attention to protecting the health of the younger generation, considering this as the most important task of the state. The USSR has established state systems for the protection of the health of children and adolescents, and the protection of motherhood and childhood. It is characteristic that in pre-revolutionary Russia there were only 600 children's doctors, and in 1976 there were more than 96 thousand of them. The Constitution of the USSR guarantees the implementation of special measures for labor protection and women's health; creation of conditions allowing women to combine work with motherhood; legal protection, material and moral support for motherhood and childhood.
In the pediatric service, the leading principle of the organization of Soviet health care is especially clearly implemented, as preventive focus. In the organization of child protection, clinical examination is especially mandatory, which embodies the synthesis of preventive and curative medicine.
A constant and continuous process of introducing scientific achievements into the practice of children's health care is carried out simultaneously with the improvement of the entire system of organization of children's health care. In the early stages of the organization of medical care for children, children's consultations were created, which in 1948 were merged with children's outpatient clinics into a single children's clinic. Specialized care is being developed, specialized departments are being organized, in which diagnostics, treatment, nursing of sick children are firmly established at a high level, intensive care and resuscitation departments are being created, this is combined with the strengthening of the main link in all medical and preventive work - the children's polyclinic.
The tendency of the staged treatment of sick children with chronic diseases is noticeably increasing: polyclinic - hospital - sanatorium. Of particular importance in preventive work among the child population is the development of a network of medical genetic services.
Much attention is paid to the training of paramedical personnel for children's hospitals. Textbooks and monographs are published. Many works of Soviet pediatricians have been translated into foreign languages. In the 60s. 20th century A ten-volume manual on pediatrics was published, which reflects the main achievements of Soviet pediatric science and healthcare practice.
Conclusion.
Soviet clinical medicine is developing in clinical-physiological and preventive directions. At a new, higher level of development, there are previously discovered diagnostic methods and technical equipment of a clinician.
The achievements of Soviet medicine are great in all manifestations - in its connections with natural science, its philosophical dialectical-materialist concepts, the successes of science, the creation of numerous large scientific medical schools, wide practical, preventive activities, the development of social initiatives, the activities of societies, congresses, medical periodicals, involvement of workers in the cause of protecting the health of the people.
Medical science and health care are inextricably linked with each other. The state character of Soviet health care largely determines the possibilities and ways of developing medical science.
Bibliographic list.
1. P.E. Zabludovsky et al. History of Medicine. Textbook. M .: "Medicine", 1981.
2. Yu.P. Lisitsin History of Medicine. Textbook. M.: "GEOTAR-MED" 2004.
3. T.S. Sorokina "History of Medicine". Textbook for students of higher medical educational institutions. M .: "Academy" 2005.
4. B.V. Petrovsky "Great Medical Encyclopedia", volume 18,
M .: Publishing House "Soviet Encyclopedia", 1982.
5. Shabalov N.P. "Pediatrics". Textbook. S.-P.; Special Lit 2002
The profession of "pediatrician" is one of the most difficult and responsible in medicine, because it involves interaction with the smallest patients who are not yet able to explain what and where they hurt, they are very vulnerable, fragile and vulnerable. In order to adequately cope with their work, doctors have to look for an individual approach to each child, which is not at all easy. This profession requires good communication skills, because a good pediatrician always knows what to say to parents to calm them down, and how to support patients so that they are not afraid of the upcoming treatment and believe in their speedy recovery.
Pediatrics is a branch of medicine that studies childhood diseases, physiology and anatomy of the child's body. It also implies the development of new methods of treatment and prevention, and has several varieties.
The term "pediatrics" itself came to us from the Greek language, and it was formed from two words - paidos, which means "child" or "child", and iatreia - "treatment". Its main goal is to save or return the normal state of health to the child.
Today, pediatric medicine includes many areas: oncology, hematology, surgery, therapy, and many others. In turn, the pediatrician is responsible for therapy. His duties also include examining sick children, diagnosing, treating, as well as carrying out preventive measures to protect the child from the occurrence of various diseases.
Pediatrics is conditionally divided into several categories: clinical, scientific, social, environmental and preventive.
Varieties of pediatrics:
- Clinical Pediatrics. It implies the diagnosis, treatment and further rehabilitation of the patient. It is with her most often faced by children and their parents.
- Scientific pediatrics. It sets the formulation of paradigms that other pediatricians can use in their work, in fact, deals with the theoretical component.
- Social Pediatrics. It is aimed at optimizing the organization of healthcare management, the practice of medical care, conducting preventive measures among the population, establishing relationships between public organizations and foundations, and so on.
- Ecological Pediatrics. It is necessary to study the influence of natural factors on children's health, including climatic and geographical ones, in different regions.
- Preventive Pediatrics. It is aimed at the prevention of diseases and disability.
Pediatrics, as a separate branch of medicine, appeared not so long ago, but nevertheless, the first advice regarding child care is found in ancient works, and other prominent scientists and physicians. As a separate science, pediatrics began to be distinguished only in the second half of the 19th century.
The first printed manuals describing childhood diseases began to appear in the 15th-17th century, in Europe. Two centuries later, the first hospitals for children were created, where doctors worked exclusively dealing with childhood diseases. By the end of the 19th century, a school was founded in Paris that trained qualified pediatricians. In the 20th century, other countries also picked up this idea and began to create their own pediatric schools.
The first Russian pediatrician was named S.F. Khotovitsky. He not only practiced, but also made a significant contribution to the promotion of pediatrics in Russia. In 1836, he taught a course in childhood diseases at the St. Petersburg Medical and Surgical Academy. He also published the first manual on childhood diseases called "Pediatrika" in 1847.
In 1834, the first hospital for children appeared in St. Petersburg, which was called "Nikolaevskaya", and in 1842 the children's hospital "Olginskaya" was opened in Moscow. In 1869, the first department of childhood diseases in Russia was opened at the Medico-Surgical Academy.
The work of a pediatrician is very important and responsible, since it is this doctor who monitors the health of small people from the first days of their life. He monitors the development, tells parents how to properly care for the child in order to avoid the occurrence of a variety of unpleasant diseases, and also provides the necessary medical care, both at home and in his office.
Pediatricians specialize in children of different ages and are divided into those who deal exclusively with newborns, that is, babies up to 28 days old, and those who take care of older children, including adolescents.
In order to become a really good pediatrician, it is not enough just to have a medical education and understand their specialty, because these doctors have to work with the smallest patients, who most often cannot explain what and where they hurt. It is necessary to be attentive and responsible, sincerely love children, have a stress-resistant character and patience. A good pediatrician is not only a reliable doctor, but also a good person who knows how to find an approach to his patients.
In his work, it is important to know all the features of the child's body and the clinic of their diseases, to understand the properties and characteristics of various medicines, to know Latin at the proper level, and also to have good communication skills. Only with these qualities, a pediatrician will be able to do an excellent job and help his patients.
MINISTRY OF HEALTH PROTECTION OF UKRAINEKHARKIV STATE MEDICAL UNIVERSITY
Department of Propaedeutics Pediatrics №2
Pediatrics as a science, its place, stages of development
Completed:
3rd year student,
1 Faculty of Medicine,
Kachan B.B.
Lecturer: Associate Professor Shmulich V.K.
Kharkov - 2007
Plan:
Pediatrics as a science
The place of pediatrics in world science and the stages of its development
4. References
1. Pediatrics as a science
Pediatrics (from Greek rais, genus n paidos - child, iatreia
- doctoring) studies the patterns of development of children, the causes and mechanisms of diseases, ways of their recognition, treatment and prevention. Therefore, it can be defined as medicine of the period of growth, formation and development of the human body, which is the most responsible in human life. This is the so-called progressive stage in the human life cycle. That is why the humanism of this specialty and the responsibility of a person who has chosen pediatrics as his profession are unusually great.
The pediatrician is in constant communication with the child and his parents, as well as with grandparents. A pediatrician must be a good psychologist and teacher. This will allow him to gain authority from parents and relatives so that their joint efforts can be directed to the correct development, and in case of illness - to the rapid recovery of the child. The origins of many diseases of an adult begin in childhood. Therefore, what will be the childhood and the conditions for the growth and upbringing of the child, such will be the state of health of an adult.
The teaching of pediatrics at the pediatric faculties of medical institutes begins with the third year, which studies the propaedeutics of childhood diseases. This is actually the first department that gives the student professional training. Since pediatrics studies the period of growth and development of the child, it becomes clear that at each age stage of his life, the child is characterized by special morphological, physiological and psychological qualities. Therefore, knowledge of the clinical anatomy and physiology of children of different ages is the basis for understanding the originality of research methods and evaluating the results. In addition, taking into account the main anatomical and physiological features allows you to determine the specific organization of the environment and lifestyle, as well as the nutrition of children of different age periods.
The department of propaedeutics of childhood diseases also studies the semiotics of the main lesions of various systems and the body as a whole. Since the systematic presentation of the nosolic forms of childhood diseases is already the subject of the main course of pediatrics, when studying propaedeutics, diagnostic issues are considered in two more general aspects. Firstly, it is symptomatic diagnostics, based on knowledge of the age norm and research method, and pursuing the goal of ascertaining the presence of a pathology symptom; secondly, it is a syndrome diagnosis, i.e., a statement of the pathophysiological relationship between several symptoms of the disease and a reflection in this connection of functional insufficiency (decompensation) of a given physiological system.
The objective of the course also includes the student's mastery of childcare techniques and medical manipulations and procedures in the scope of the skills of a nurse.
In older courses, pediatrics will be taught not only at the departments of pediatrics, but also at special departments (children's infections, pediatric surgery, pediatric neurology, pediatric otolaryngology, pediatric ophthalmology, etc.)
The effectiveness of self-education and the subsequent growth of qualifications are largely determined by how well it was possible to master the basic medical and biological disciplines at the university stage of education. They are the foundation for subsequent clinical training and improvement. Opportunities for self-education of a pediatrician are great and varied. This is, first of all, constant work on scientific literature and, first of all, reading scientific pediatric journals, manuals and monographs. A very important role in improving the knowledge of pediatricians is played by their participation in the work of local branches of the All-Union Scientific Society of Children's Doctors, created in all republics, regions and large cities of the country. To be a member of this society is a matter of professional honor for every Soviet pediatrician.
Pediatrics is not only a field of medical science, but also the name of the main medical specialty in the state system of children's health care. Pediatricians bring to life the main achievements of medical science and carry out practical measures to ensure and control the harmonious development of children, to recognize, treat and prevent their diseases. The workplaces of pediatricians are children's institutions (nursery, nursery-gardens, kindergartens, schools, orphanages, pioneer camps), children's clinics, children's hospitals (general and specialized), pediatric ambulance teams, children's wards of maternity hospitals, various consultation rooms and dispensaries, children's sanatoriums.
2. The place of pediatrics in world science and the stages of its development
The beginning of the teaching about the child is usually attributed to the 4th century BC, by the time the book “On the Nature of the Child” was written by the father of medicine, Hippocrates. Following Hippocrates, Celsus, Galen and Soranus (I and II centuries) write about children, about their care and upbringing. In the next 15 centuries, what was stated by Galen and Soran was repeated. Treatment of children in these years was carried out according to the same principles as adults, or was not carried out at all. Only in the XV-XVIII centuries, interest in the treatment of children and its features is awakened again. This is due to the very high infant mortality, the emergence of charitable organizations and the creation in some European countries of orphanages or shelters for foundlings and street children. There is a large number of works devoted to the upbringing and nursing of children. In 1650, the scientific work of the English physician Glisson on rickets was published, followed by a series of publications by Sydenham, Habergen, Jenner devoted to the study of infectious diseases in children. Approximately 100 years after Glisson's work, the first manual of pediatrics in 28 chapters is published. It was written in 1764 by the Swedish physician Niel Rosen von Rosenstein. After 30 years, his manual was published in Russia in Russian.
After the opening of the first children's hospitals, there was an intensive increase in the number of scientific research in the field of pediatrics and the formation of schools of pediatricians. The first children's hospital in the world was the Paris Hospital for Children, which opened in 1802. Somewhat later, the German School of Pediatrics appeared. Its centers are Vienna and Berlin. German pediatricians chose the biochemical and microbiological aspects of childhood diseases, as well as nutrition issues as the main direction of their research. In the second half of the 19th century, scientific and clinical centers of pediatrics also began to function in England, Switzerland, Italy, the Scandinavian countries and the USA.
In Russia, the sequence of events was very close to that which took place in Europe. Peter I in 1727 issued a decree "On the construction of hospitals in Moscow for the placement of illegitimate babies and on giving them and their breadwinners a monetary salary." M. V. Lomonosov in his letter “On the reproduction and preservation of the Russian people” points out the need to create folk almshouses for illegitimate children and publish instructions on curing childhood diseases. However, educational homes were opened only in 1763 in Moscow and in 1771 in St. Petersburg, thanks to the perseverance and energy of I. I. Betsky, who himself drafted these houses and wrote instructions on caring for children and their upbringing.
The beginning of the formation of pediatrics as an independent scientific discipline takes place within the framework of other, closely related medical specialties. This is therapy and, above all, obstetrics. Of the therapists, professors of Moscow University S. G. Zybelin and G. I. Sokolsky were the first to read questions of childhood diseases. A. Tolsky. In the lectures and the book by Maksimovich-Ambodik "The Art of Fiddling, or the Science of Womanhood," valuable thoughts were presented about the characteristics of children and methods of nursing them.
Professor-obstetrician of the Medical-Surgical Academy in St. Petersburg (now the Military Medical Academy) Stepan Fomich Khotovitsky was at the same time the first Russian pediatrician. During 1831 -1847 1G. he taught an independent course on childhood diseases, in 1842 he opened children's wards in the clinic for obstetrics, women's and children's diseases, and in 1847 he published the first Russian textbook on pediatrics - Pediatrics.
The first children's hospital in Russia was opened in St. Petersburg in 1834. It currently bears the name of N. F. Filatov. . F Filatova), and 2 years later, in 1844, the world's first hospital specifically for young children was opened in St. Petersburg (now the L. Pasteur Hospital).
The date of birth of the first Russian department of pediatrics can be considered 1865, when a separate course of childhood diseases was entrusted to be read by Professor V. M. Florinsky at the Medico-Surgical Academy. Since 1870, Nikolai Ivanovich Bystroe (1841 - 1906) worked at this department. In 1885, N. I. Bystroye organized and was the first chairman of the Society of Pediatric Doctors of St. Petersburg. He trained many students who later became professors and founded other departments of pediatrics in the country.
In Moscow, reading a course of lectures on pediatrics began in 1861, associate professor of the department of obstetrics, and later Professor Nikolai Alekseevich Tolsky (1830-1891). After 5 years, he opened a small children's clinic (11 beds) as part of the faculty therapeutic clinic of the university. Thus, in Moscow, simultaneously with St. Petersburg, the Department of Pediatrics appears.
In those same years, the activities of the most prominent physician and public figure Karl Andreevich Raukhfus (1835-1915) were developing in St. Petersburg. According to his designs, hospitals were built in St. Petersburg (now the hospital bears his name) and in Moscow (now the hospital named after I. V. Rusakov) . These were the first hospitals in the country designed according to the requirements of hospitalization of children with various pathologies. The first of these hospitals, K. A. Rauhfuss, led until the end of his life. He has trained a large number of dedicated pediatricians. His works on heart defects in children and the organization of pediatric care were included in the fundamental three-volume guide to pediatrics, created by a team of European authors, edited by Gerhardt (1877).
A significant contribution to the development of domestic pediatric science was made by the successor of N. I. Bystrov in the Department of Pediatrics of the Medico-Surgical Academy, a student of N. A. Tolsky, Professor Nikolai Petrovich Gundobin (1860-1908). In a short time, he and his students accumulated a large scientific material on the anatomical and physiological characteristics of children, and on this basis, N. P. Gundobin released a fundamental work that has not lost its value to this day - “Features of Childhood”. In addition to this book, he wrote the popular manual "General and Private Therapy of Childhood Diseases", which went through several editions.
The brightest trace in the history of our pediatric science was left by the activity of the most talented doctor and teacher, the successor of N. A. Tolsky in the Department of Pediatrics of Moscow University, Nil Fedorovich Filatov
^
S F Hotovitsky I I Rapid
(1847-1902) His erudition, medical logic and observation gained deep respect and gathered dozens of talented students around him. He was the first to describe the clinic of scarlatinal rubella and glandular fever (infectious mononucleosis), as well as an early sign of measles - pityriasis peeling of the mucous membrane of the lips and mouth strips. He was one of the first to understand the significance of atelectasis in the occurrence of pneumonia and described heart lesions in scarlet fever in children. The most vivid memory of the activities of this outstanding clinician are his books, which are still read and popular. These are "Semiotics and Diagnosis of Childhood Diseases", "Lectures on Acute Childhood Infections". "Clinical lectures", "A short textbook of childhood diseases". All of them were translated into many European languages and brought additional
^ N. A. Totsky K. L. Raukhfus
Before the Great October Socialist Revolution, there was no state care for children in Russia. The first more or less accurate data on the survival of children in 1845 I indicate that out of 1,000 children born, only 367 survived to 15 years old, and in some regions of the country - even more. less. The causes of infant mortality, according to the conclusion of the Botkin Commission in 1886, were "intestinal infections, poor quality, inconsistent, untimely feeding and a complete lack of child care"
Infant mortality (the number of deaths per 1,000 children born during the first year) in 1913 reached horrendous proportions - 273 can be highly valued ... and the life of a child ”There were 23 children's consultations throughout Russia, and they were mainly located in large cities (Moscow, St. time, only 750 beds. The mortality rate of women in childbirth and mothers was extremely high. This clearly illustrates the complete non-involvement of the state under tsarism in protecting the health of children and the people as a whole
In the draft Program of the Russian Social Democratic Labor Party, developed by V. I. Lenin in 1894 and adopted in 1903 at the II Congress of the RSDLP, the main provisions for the protection of motherhood and childhood were outlined. The practical implementation of these measures began after the Great October Socialist Revolution. In November 1917, the People's Commissariat for State Charity was created, which included a special collegium, whose responsibilities include the development of urgent measures for the protection of motherhood and childhood. January 31 (February 13), 1918 the corresponding resolution, in the development of which N. K. Krupskaya and A. M. Kollontai took part, and was advised and edited by V. I. Lenin. It read - “All large and small institutions of the Commissariat of State Charity serving the child, from educational houses in the capitals to modest village nurseries, all of them, from the date of publication of this decree, merge into one state organization and are transferred to the jurisdiction of the department for the protection of motherhood and infancy, so that , making an inextricable link with institutions serving pregnancy and motherhood, to accept from them the bragging glory of Russian clinical thought. In the USSR, a prize for the best works in pediatrics named after N. F. Filatov was established. A monument to N. F. Filatov with the inscription "To a friend of children" was erected in Moscow.
Children's clinics and pediatric departments were created gradually in many cities and regions of Russia. In Kazan, the Department of Pediatrics was headed by Professor N. A. Tolmachev, in Kiev - by Professor V. E. Chernov, in Kharkov - by Professor I. V. Troitsky, in Odessa - by Professor V. F. Yakubovich, in Yuriev (now Tartu) - by Professor V P. Zhukovsky, in Saratov - Professor I. N. Bystrenin.
An important feature of pediatrics in the last pre-revolutionary decade was the growing interest in the youngest age. In 1908, in Moscow, on the initiative of G.N. Speransky, the first consultation for infants was opened, and in 1910, the first hospital for infants, in 1913, a department for infants in the Morozov Children's Hospital (now Children's Clinical Hospital No. 1). Since that time, the proportion of young children in all children's clinics and hospitals in Russia has increased significantly.
Thus, the pre-revolutionary period in the development of pediatrics is significant primarily for those names of outstanding domestic scientists and doctors who, with their talent, ensured the accumulation of knowledge about age-related physiology and diseases of childhood and won world recognition and priority for Russian science in many areas of pediatrics. During this period, the main scientific schools emerged and, at the same time, the unity of Russian pediatrics was determined, its social and humanistic moral platform was formed, and its focus was on solving a wide range of problems of protecting the health of mother and child. A peculiar result of the development of pediatrics in the country was the First All-Russian Congress of Pediatric Doctors, which took place in 1911, at which issues of care for newborns were considered. Through the efforts of leading pediatricians and public figures, various charitable societies and movements were created, the purpose of which was to provide assistance to the country's child population in distress. So, in 1904, the St. Petersburg Union for the Fight against Child Mortality was created, in 1909 - the Society for the Fight against Child Mortality in Moscow, in 1913 - the All-Russian Guardianship for the Protection of Motherhood and Infancy.
From the first days of the Soviet state, a purposeful, huge-scale activity was launched to create the world's first state system of assistance to mothers and children. This took place in a situation of civil war and the most severe devastation, when the government had to solve thousands of seemingly more important problems on which the very fate of the socialist republic depended. On the 6th day of the establishment of Soviet power, a law on social insurance is signed, according to which women are guaranteed paid maternity leave, and mothers are given the right to leave work every three hours to breastfeed their children. The Party Program adopted by the VIII Congress of the RCP(b) defined tasks for the development of the protection of motherhood and childhood. The main principle of the development of Soviet health care was proclaimed - its preventive orientation In February 1919, the Council for the Protection of Children was created under the leadership of A. V. Lunacharsky, special children's funds were formed, free meals were organized for children in schools and child care institutions hospitals.
The VIII Extraordinary Congress of Soviets on December 5, 1936 adopted the Constitution of the USSR, which contained a number of articles relating directly to health care, in particular, to the protection of the interests of mother and child. During the Great Patriotic War, the Decree of the Presidium of the Supreme Soviet of the USSR “On increasing state assistance to pregnant women, mothers of many children and single mothers, strengthening the protection of motherhood and childhood, establishing the honorary title “Mother Heroine” and establishing the Order of Mother’s Glory” and the medal “Medal motherhood” In 1960, the Central Committee of the CPSU and the Council of Ministers of the USSR adopted a resolution “On measures to further improve medical care and protect the health of the population of the USSR”. In the Party Program adopted at the 22nd Congress of the CPSU, care for the health of the entire population was further developed.
A big event was the adoption by the session of the Supreme Soviet of the USSR on December 19, 1969 of the law of the Union of Soviet Socialist Republics “On approval of the fundamentals of the legislation of the USSR and the union republics on health care.” During 1970-1971, the legislation of the union republics was brought into line with this law. This was another stage of improvement of legislation. In Act V, its section is devoted to the protection of motherhood and childhood.
In the new Constitution adopted in 1977, the matter of protecting the health of the people was further developed, including legal, material and moral support for motherhood and childhood, including the provision of paid holidays and other benefits to pregnant women and mothers.
The resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR “On measures to further improve public health” dated 10/15/77 was a manifestation of the care of the Party and the Government. The honorary title “People's Doctor of the USSR” was established. A new manifestation of concern for the health of children and adolescents is the resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR "On measures to strengthen state assistance to families with children" (1981).
1 Decree of the People's Commissariat of State Charity of the RSFSR on the protection of infancy in the country - In Sat Formation and development of health care in the early years of Soviet power - M Medicine, 1966.
3. Conclusions
At present, our country has many research institutes and many pediatric departments in medical institutes, which employ a large number of doctors and candidates of medical sciences, researchers.
Of great importance for the intensification of pediatric research in our country is the opening in Moscow of the All-Union Center for the Protection of Maternal and Child Health.
Pediatrics in recent decades has been an exceptionally dynamic field of knowledge; the growth of information, the revision of pre-existing points of view, the introduction of new methods of research and treatment occur at an increasing speed. This is primarily due to both the rapid development of the fundamental theoretical sciences of the medical profile (physiology, biochemistry, genetics, immunology), and the development of purely clinical concepts, the accumulation and generalization of collective medical experience.
Bibliography:
Mazurin A.V., Vorontsov I.M. "Propaedeutics of childhood diseases" - Medicine, 1985 - 432 p.
N.P. Shabalov "Children's diseases" textbook 5th edition in two volumes. "Peter" - 2002 - 832 s
Pediatrics- a section of clinical medicine specializing in child health issues: methods for the prevention, diagnosis and treatment of pathology in children and adolescents from the moment of birth until they reach the age of 18. The term "pediatrics" comes from two Greek roots: paidos - "child, child" and iatreia - "healing". The allocation of pediatrics to an independent medical science is due to the specifics of the anatomical and physiological development of children in different age periods, as well as the fact that children have some diseases that never occur in adults.
Modern pediatrics has absorbed the fullness of knowledge about the child: the anatomical and physiological features and patterns of development of the child's body in different age periods, the causes and mechanisms of childhood diseases, methods for their prevention, detection and treatment. Taking into account the age characteristics of the development of children, pediatrics of newborns (neonatology), pediatrics of infants, early childhood, preschool, primary school and adolescence are distinguished.
The urgent tasks of pediatrics are to improve the health of children and adolescents, reduce child morbidity and mortality, control the spread of infectious diseases, and improve the quality of life of children with chronic diseases. The sphere of scientific and practical interests of pediatrics is closely intertwined with biological (age-related physiology and human anatomy, hygiene, genetics, virology) and pedagogical sciences (general and correctional pedagogy, child and special psychology, speech therapy, defectology).
Services in the field of pediatrics in Moscow include consultations with children's specialists, patronage of the child, various diagnostic and therapeutic procedures, immunoprophylaxis. All those who apply for pediatric care have access to the services of calling a pediatrician to the home of a sick child; it is also possible to conduct an ECG, baby massage, and sampling at home. Pediatric departments issue medical certificates for visiting a kindergarten or school, health resort cards and other necessary documentation.
A pediatrician is a generalist who possesses a large amount of knowledge not only in the field of pediatrics, but also in various fields. The pediatrician monitors the development of a healthy child, advises on rational nutrition and care, conducts preventive and dispensary examinations, as well as treatment and diagnostic procedures for sick children. The pediatrician interacts with pediatric specialist doctors (pediatric cardiologists, pediatric ENT doctors, pediatric gastroenterologists, pediatric ophthalmologists, pediatric surgeons, pediatric orthopedists, pediatric neurologists, pediatric urologists, etc.).
Pediatrics is closely related to the medical disciplines involved in reproductive health - primarily obstetrics and gynecology. Today, thanks to fetal monitoring, in many cases it is possible to identify in advance the risk of a child with congenital anomalies. Prenatal diagnostics includes genetic studies, non-invasive (fetal ultrasound, fetal echocardiography, fetal CTG) and invasive prenatal diagnostics (cordocentesis, amniocentesis, chorion biopsy, etc.). Advances in the development of pediatrics make it possible to cure many congenital malformations in newborns, to eliminate various anomalies even at the stage of intrauterine development of a child, to nurse premature babies with extremely low body weight (less than 1000 g).
The main direction in pediatrics is preventive care. The standards for maintaining and strengthening the health of children in pediatrics include vaccination according to the National and individual vaccination schedule, preventive (dispensary) examinations in accordance with age.
Today, digital radiography, computed and magnetic resonance imaging, functional, ultrasound, endoscopic, laboratory and radionuclide methods are used to make an accurate diagnosis in pediatrics. The main requirements for diagnostic procedures in pediatrics are safety, minimally invasiveness and accuracy of studies.
Pediatrics as a field of pediatric medicine is heterogeneous: it develops separate areas that allow providing highly professional specialized care to a sick child. All diseases of childhood that pediatricians have to deal with can be divided into congenital malformations, diseases and organ dysfunctions, infections, injuries, and tumors. A serious challenge for pediatrics are the so-called orphan (rare) diseases, the frequency of which is no more than 10 cases per 100,000 population. Unfortunately, today more and more often in pediatrics there are "non-children's" diseases: neurological, cardiovascular, gynecological pathology, endocrine disorders, malignant neoplasms.
In this regard, neonatology, pediatric dermatology, pediatric allergology, pediatric otorhinolaryngology, pediatric urology, pediatric neurology, pediatric ophthalmology, pediatric endocrinology, pediatric orthopedics and traumatology, pediatric surgery, pediatric dentistry, pediatric oncology are distinguished in the structure of pediatrics. At the same time, it should be taken into account that local diseases practically do not occur in pediatrics: in any pathology, the functioning of a number of organs and systems is disrupted to one degree or another, and the overall reactivity of the child's body and the organization of care affect the outcome of the course of the disease.
The generally accepted standards for the provision of medical care in pediatrics include an individual approach to each child, the use of the latest achievements in medical science and practice, and the conduct of precisely justified and most sparing treatment. All methods of treatment used in pediatrics must be adapted to the anatomy and physiology of the child's body. The main principles of pediatrics are the minimum pharmacological load, the stage-by-stage and continuity of treatment, the widespread use of natural and physiotherapeutic factors, the achievement of a complete not only clinical, but also functional recovery of the child. In recent years, unique minimally invasive surgical techniques (endoscopic, microsurgical, catheter, laser operations) have been introduced into pediatrics.
Currently, pediatrics in Moscow is represented by state children's clinics and hospitals, private medical centers, specialized children's clinics of research institutes. Pediatric institutions strive to create comfortable conditions for small patients and their parents to stay within their walls, to surround them with maximum care and attention.
In connection with the development of private medicine, today parents have the opportunity to choose both a clinic and a specialist in the field of pediatrics. In the section "Pediatrics" on the site "Beauty and Medicine" you can get acquainted with the leading children's clinics of the capital, read reviews about medical specialists, find contacts of the institution of interest, find a pediatrician to whom you will no doubt entrust the health of your baby. The rating and reputation of pediatric clinics in Moscow is determined by the site visitors themselves, therefore, in turn, we will be glad to hear your opinion.
