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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2021-11-188-200</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-6307</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ШКОЛА ПЕДИАТРА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PEDIATRICIAN SCHOOL</subject></subj-group></article-categories><title-group><article-title>Дифференциальный диагноз  инфекционных водянистых диарей  (взгляд из глубины веков до настоящего времени). Современные подходы к регидратации</article-title><trans-title-group xml:lang="en"><trans-title>Differential diagnosis of infectious watery diarrhea (view from time immemorial to the present).  Modern approaches to rehydration</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4200-4598</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharova</surname><given-names>I. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захарова Ирина Николаевна - доктор медицинских наук, профессор, заведующая кафедрой педиатрии имени академика Г.Н. Сперанского.</p><p>125993, Москва, ул. Баррикадная, д. 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Irina N. Zakharova, Dr. Sci. (Med.), Professor, Head of the Department of Pediatrics named after Academician G.N. Speransky.</p><p>2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993</p></bio><email xlink:type="simple">zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5684-7575</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бережная</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Berezhnaya</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бережная Ирина Владимировна - кандидат медицинских наук, доцент кафедры педиатрии имени академика Г.Н. Сперанского.</p><p>125993, Москва, ул. Баррикадная, д. 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Irina V. Berezhnaya, Cand. Sci. (Med.), Associate Professor of the Department of Pediatrics named after Academician G.N. Speransky, RMACPE; berezhnayairina26@yandex.ru</p><p>2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993</p></bio><email xlink:type="simple">berezhnayairina26@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1695-0978</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Камилова</surname><given-names>А. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Kamilova</surname><given-names>A. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Камилова Алтиной Турсунбаевна - доктор медицинских наук, профессор, заведующая отделом гастроэнтерологии.</p><p>100179, Ташкент, ул. 2-й Чимбай, проезд Талант, д. 3</p></bio><bio xml:lang="en"><p>Altinoy T. Kamilova, Dr. Sci. (Med.), Professor, Head of the Department of Gastroenterology, Republican Specialized Scientific and Practical Medical Center of Pediatrics.</p><p>3, 2nd Chimbay St., Talant Proezd, Tashkent, 100179</p></bio><email xlink:type="simple">okamilova@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дмитриева</surname><given-names>Д. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Dmitrieva</surname><given-names>D. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитриева Диана Кирилловна - ординатор кафедры поликлинической и неотложной педиатрии.</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Diana K. Dmitrieva, Resident of the Department of Outpatient and Emergency Pediatrics.</p><p>1, Ostrovityanov St., Moscow, 117997</p></bio><email xlink:type="simple">dmitrievadi@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8962-8176</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ахмедова</surname><given-names>Д. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Akhmedova</surname><given-names>D. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ахмедова Дилором Ильхамовна - доктор медицинских наук, профессор, директор, РСНПМЦП; заведующая кафедрой госпитальной педиатрии №2, Ташкентский педиатрический медицинский институт; председатель Ассоциации педиатров Узбекистана, член Европейской Ассоциации педиатров EPA/UNEPSA и Европейской Академии педиатров.</p><p>100179, Ташкент, ул. 2-й Чимбай, проезд Талант, д. 3; 100140, Ташкент, ул. Богишамол, д. 223</p></bio><bio xml:lang="en"><p>Dilorom I. Akhmedova, Dr. Sci. (Med.), Professor, Director, Republican Specialized Scientific and Practical Medical Center of Pediatrics; Head of the Department of Hospital Pediatrics No. 2, Tashkent Pediatric Medical Institute; Chairman of Association of Pediatricians of Uzbekistan, member of EPA/UNEPSA and European Academy of Pediatrics.</p><p>3, 2nd Chimbay St., Talant Proezd, Tashkent, 100179; Bagishamal St., Tashkent, 100140</p></bio><email xlink:type="simple">diloromahmedova@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российская медицинская академия непрерывного профессионального образования</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuous Professional Education</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Республиканский специализированный научнопрактический медицинский центр педиатрии</institution><country>Узбекистан</country></aff><aff xml:lang="en"><institution>Republican Specialized Scientific and Practical Medical Center of Pediatrics</institution><country>Uzbekistan</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Российский национальный исследовательский медицинский университет имени Н.И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Республиканский специализированный научнопрактический медицинский центр педиатрии; Ташкентский педиатрический медицинский институт</institution><country>Узбекистан</country></aff><aff xml:lang="en"><institution>Republican Specialized Scientific and Practical Medical Center of Pediatrics; Tashkent Pediatric Medical Institute</institution><country>Uzbekistan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>10</day><month>08</month><year>2021</year></pub-date><volume>0</volume><issue>11</issue><fpage>188</fpage><lpage>200</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Захарова И.Н., Бережная И.В., Камилова А.Т., Дмитриева Д.К., Ахмедова Д.И., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Захарова И.Н., Бережная И.В., Камилова А.Т., Дмитриева Д.К., Ахмедова Д.И.</copyright-holder><copyright-holder xml:lang="en">Zakharova I.N., Berezhnaya I.V., Kamilova A.T., Dmitrieva D.K., Akhmedova D.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/6307">https://www.med-sovet.pro/jour/article/view/6307</self-uri><abstract><p>Сегодня, как и в древности, диарея (потеря жидкости и электролитов через кишечник) сопровождает много патологических состояний человека. Изучена патофизиология различных вариантов диареи, что позволило оптимизировать терапевтические подходы и сохранить жизнь многих людей. Наиболее опасные состояния возникают у пациентов раннего возраста с осмотическим и экссудативным типами диареи, так как в короткие сроки приводят к эксикозу. В случае установления диагноза необходимо в кратчайшие сроки начать регидратационную терапию. В статье представлены исторические аспекты, связанные с мировыми эпидемиями холеры. Освещена история создания растворов для внутривенной и оральной регидратации. Представлены таблицы расчета потерь и необходимого объема растворов для введения внутрь или парентерально. Приведены современные требования к регидратационным растворам и принципы проведения регидратации у детей. Особые трудности представляет оральная регидратация у детей раннего возраста в связи с ограниченным спектром лекарственных препаратов и требованиями к составу растворов для использования в педиатрии. По рекомендациям Всемирной организации здравоохранения и ESPGHAN, клиническим рекомендациям РФ необходимо использовать низкоосмолярные растворы. При использовании комплексных растворов, содержащих пробиотик и цинк, возрастает комплаентность терапии. Одной из последних разработок является раствор для регидратации, имеющий в своем составе солевую навеску для приготовления низкоосмолярного раствора, также пробиотик L. reuteri DSM 17938 – не менее 1 млрд жизнеспособных бактерий и цинка сульфат 0,004 г. Приведены результаты исследований данного раствора.</p></abstract><trans-abstract xml:lang="en"><p>Today, as in ancient times, diarrhea (loss of water and electrolytes along with stool) accompanies many pathological conditions in humans. The pathophysiology of various types of diarrhea has been studied, which made it possible to optimize therapeutic approaches and save the lives of many people. The most dangerous conditions occur in young patients with osmotic and exudative types of diarrhea, as they result in exicosis within a short time. In arriving at a diagnosis, rehydration therapy should be started as soon as possible. The article presents the historical aspects associated with the global pandemics of cholera. The history of the creation of solutions for intravenous and oral rehydration is covered. The authors presented tables for calculating fluid losses and the required volume of solutions for oral or parenteral administration. The modern requirements for rehydration solutions and the principles of rehydration in children are presented. Oral rehydration is particularly problematic for young children due to the limited range of drugs and requirements for the composition of solutions used in pediatrics. According to the recommendations of the World Health Organization and ESPGHAN, clinical recommendations of the Russian Federation, low-osmolar solutions should be used. When complex solutions containing probiotic and zinc are used, the therapy compliance increases. A rehydration solution, which contains a weighted amount of salt for the preparation of a low-osmolar solution, as well as the probiotic L. reuteri DSM 17938 at least 1 billion of viable bacteria and zinc sulphate 0.004 g is one of the latest solutions. The results of studies of this solution are provided.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>острые кишечные инфекции</kwd><kwd>холера</kwd><kwd>дегидратация</kwd><kwd>эксикоз</kwd><kwd>низкоосмолярные растворы</kwd><kwd>пребиотик</kwd><kwd>пробиотик</kwd><kwd>цинк</kwd><kwd>оральная регидратация</kwd><kwd>электролиты</kwd></kwd-group><kwd-group xml:lang="en"><kwd>acute intestinal infections</kwd><kwd>cholera</kwd><kwd>dehydration</kwd><kwd>exicosis</kwd><kwd>low-osmolar solutions</kwd><kwd>prebiotic</kwd><kwd>probiotic</kwd><kwd>zinc</kwd><kwd>oral rehydration</kwd><kwd>electrolytes</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Männikkö N. Etymologia: Cholera. Emerg Infect Dis. 2011;17(11):2104. https://doi.org/10.3201/eid1711.ET1711.</mixed-citation><mixed-citation xml:lang="en">Männikkö N. Etymologia: Cholera. 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