a group of diseases found predominantly or exclusively during childhood and associated with characteristics peculiar to the body at that stage of development.
Intensive growth and development make for the special anatomic and physiological nature of the body of the child and the special nature of his pathology. Even diseases found predominantly in adults run a distinct course in children, depending also on the age of the child. Medical practice distinguishes two periods in the development of the child—intrauterine and extrauterine. The latter is conventionally divided into the following periods: neonatal (first 18-24 days), infant (to one year), early childhood (one to three years), preschool (three to seven years), early school age (seven to 12 years), older school age (12-15 years), and adolescent (15-17 years), Specific groups of illnesses are characteristic of each age group.
In the neonatal period the body adapts to the new conditions of life. The functional systems of the body are in an easily disrupted state of unstable equilibrium. During this period changes appear in the infant’s body that are associated with disturbances in the development of the fetus during the intrauterine period (for example, fetal asphyxia or diseases of the mother, including listeriosis, toxoplasmosis, rubella, and influenza, as well as the effect on the mother’s body of certain chemical substances, such as alcohol or radiant energy). Defects of development, prematurity, the sequelae of birth trauma (for example, intracranial hemorrhage), hemolytic disease of the newborn, and certain hereditary diseases manifest themselves in the first days after birth. The great sensitivity of newborns to coccal and viral infections causes the frequent appearance of purulent septic diseases of the skin and navel and of acute viral and bacterial diseases of the respiratory organs.
The rapid growth and intensive metabolism of the child’s body during infancy determine the infant’s considerable food requirement (2-2.5 times the caloric value per kilogram body weight required by an adult). Thus, the strain on the functionally imperfect digestive system of the infant is greatly increased, giving rise to the frequent development at this age of gastrointestinal diseases (dyspepsia), bacterial and viral diseases of the gastrointestinal tract (dysentery, enterocolitis, virus diarrheas), and chronic nutritional disturbances (infant dystrophy), especially when the child’s regime is disrupted. Improper feeding and insufficient air and sunlight may lead to the development of rickets. Because of the infant’s great oxygen demand, the functional strain on his respiratory organs is increased (the number of breaths per minute and the quantity of air passed is relatively greater than in the adult). The tenderness and vulnerability of the mucous membranes of the respiratory organs also cause frequent illness. Pneumonias of bacterial and viral origin are not uncommon at this age. In early childhood and preschool age groups, incidence of the following acute childhood infections increases: measles, whooping cough, chicken pox, scarlet fever, and diphtheria; susceptibility to tuberculosis is also greater. This may be explained by the decrease in the antibody titer received by the infant from its mother, as well as by the increasing contact of children with their age-mates and others around them. Diseases in the development of which allergy plays a large role (bronchial asthma, rheumatism, eczema, nephritis) become more frequent. In children of early school age, along with the acute infectious diseases, one may observe endocrine disturbances and increased incidence of rheumatism and diseases of the heart and nervous system. In children of older school age and adolescence, endocrine disturbances and sexual anomalies may appear at puberty. Most often found are psycho-neuroses, rheumatism, and cardiovascular disturbances (in particular, vascular dystonias). Exacerbation of tuberculosis is possible.
Prevention of childhood diseases includes antenatal protection of the fetus, prevention of birth traumas, conscientious care of the newborn, proper regime of nutrition and habituation, control of infectious diseases (prophylactic inoculation against tuberculosis, smallpox, diphtheria, measles), and provisions for normal physical development (physical education, sports, and strengthening the body from earliest infancy).
The science that studies childhood diseases is called pediatrics.
REFERENCESBelousov, V. A. Uchebnik detskikh boleznei. Moscow, 1963.
Tur, A. F. Propedevtika detskikh boleznei, 5th ed. Leningrad, 1967.
R. N. RYLEEVA and M. IA. STUDENIKIN