Purpose — to develop a method for predicting intrauterine fetal infection in pregnant women with CHB, infected and uninfected HIV, which provides the high accuracy of prognosis, is simple and accessible in practice and is achieved by analyzing multiple risk factors for mother-to-fetus transmission. Materials and methods. The course and consequences of pregnancy were analyzed in 211 women with chronic hepatitis B (CHB), not infected with HIV and in 18 — with CHB infected with HIV. The replicative activity of the virus and the activity of the inflammatory process in the liver were evaluated. We studied the dynamics of indicators depending on the trimester of pregnancy, the degree of immunosuppression caused by HIV. The frequency of risk factors was determined by «case-control» studies, and the frequency of identified risk factors was calculated in the groups of mothers in whom CHB was transmitted to the child and in those in which it did not occur. The degree of influence of individual risk factors was determined by the value of relative risk (RR), determined by their 95% confidence interval (95% CI), the reliability of the results (p) according to the Student's t-test. Differences at p<0.05 were considered probable. Results. It is established that risk factors that contribute to intrauterine infection of the fetus are: maternal — viral load HBV >105 copies/ml in the third trimester, HIV infection, immunosuppression caused by HIV (CD4+ Т-lymphocytes <500 cells/μL), low adherence to antiretroviral therapy, maternal bad habits; fetal — intrauterine growth restriction, fetal distress; obstetric — premature placental abruption, preterm delivery, placental dysfunction, prolonged anhydrous interval, prelabor rupture of membranes. In pregnant women with CHB, each risk factor was assessed in points depending on the RR: those factors whose relative risk was highest — 5 points, those whose score was lower — 4 and 3 points, respectively, and those whose score was the lowest — in 2 points. In order to predict the risk of fetal infection, a working prognostic chart with a score from 2 to 5 was developed. It was found that the risk of HBV infection in women with HIV-negative status is high with a score of 19–34, moderate — at 18–11, low — <10 points. In women with HIV-positive status — high risk of fetal intrauterine infection at a score of 24–46, moderate — at 13–23, low — <12 points. Conclusions. The use of the proposed prognostic map in the practice of medical institutions with a score of total risk factors for each pregnant woman will facilitate early prediction of fetal infection in pregnant women with CHB, taking into account their HIV status, which will allow to diagnose timely congenital infections and provides outpatient observation for these children. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed con
{"title":"Risk assessment of intrauterine infection in pregnant women with chronic hepatitis B","authors":"M. Matvisiv","doi":"10.15574/pp.2021.87.12","DOIUrl":"https://doi.org/10.15574/pp.2021.87.12","url":null,"abstract":"Purpose — to develop a method for predicting intrauterine fetal infection in pregnant women with CHB, infected and uninfected HIV, which provides the high accuracy of prognosis, is simple and accessible in practice and is achieved by analyzing multiple risk factors for mother-to-fetus transmission. Materials and methods. The course and consequences of pregnancy were analyzed in 211 women with chronic hepatitis B (CHB), not infected with HIV and in 18 — with CHB infected with HIV. The replicative activity of the virus and the activity of the inflammatory process in the liver were evaluated. We studied the dynamics of indicators depending on the trimester of pregnancy, the degree of immunosuppression caused by HIV. The frequency of risk factors was determined by «case-control» studies, and the frequency of identified risk factors was calculated in the groups of mothers in whom CHB was transmitted to the child and in those in which it did not occur. The degree of influence of individual risk factors was determined by the value of relative risk (RR), determined by their 95% confidence interval (95% CI), the reliability of the results (p) according to the Student's t-test. Differences at p<0.05 were considered probable. Results. It is established that risk factors that contribute to intrauterine infection of the fetus are: maternal — viral load HBV >105 copies/ml in the third trimester, HIV infection, immunosuppression caused by HIV (CD4+ Т-lymphocytes <500 cells/μL), low adherence to antiretroviral therapy, maternal bad habits; fetal — intrauterine growth restriction, fetal distress; obstetric — premature placental abruption, preterm delivery, placental dysfunction, prolonged anhydrous interval, prelabor rupture of membranes. In pregnant women with CHB, each risk factor was assessed in points depending on the RR: those factors whose relative risk was highest — 5 points, those whose score was lower — 4 and 3 points, respectively, and those whose score was the lowest — in 2 points. In order to predict the risk of fetal infection, a working prognostic chart with a score from 2 to 5 was developed. It was found that the risk of HBV infection in women with HIV-negative status is high with a score of 19–34, moderate — at 18–11, low — <10 points. In women with HIV-positive status — high risk of fetal intrauterine infection at a score of 24–46, moderate — at 13–23, low — <12 points. Conclusions. The use of the proposed prognostic map in the practice of medical institutions with a score of total risk factors for each pregnant woman will facilitate early prediction of fetal infection in pregnant women with CHB, taking into account their HIV status, which will allow to diagnose timely congenital infections and provides outpatient observation for these children. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed con","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130687146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evaluation of the type of nutrition, which is one of the important components that ensure the physical growth, development and health of a child in the first year of life, and that forms metabolic processes at an older age, has been the subject of research and discussion of domestic and foreign scientists over the past decades. Purpose — to study the influence of the nature of feeding on the incidence and physical development of infants. Materials and methods. During the year, 250 children (118 girls and 132 boys) of the first year of life were under observation, who received various types of feeding (breast milk and milk formulas, differing in composition). The main (I) group (n=130) included children (62 girls and 68 boys) who were breastfed; and in the comparison group — children receiving artificial feeding: in group II (n=60) (27 girls and 33 boys) received a standard mixture with a prebiotic; in group III (n=60) (29 girls and 31 boys) — a standard mixture without a prebiotic. Physical development was assessed according to the generally accepted measurement technique in terms of absolute values, monthly increases in anthropometric indicators and mass-growth indices. Outpatient records of children, protocols of examination of a 1-year-old child were studied (accounting and reporting documentation was analyzed). The criteria for inclusion in the main group of infants were: breastfeeding for at least 9 months; the age of children from up to 1 year of age. The second comparison group included children who were fed mixed with the addition of probiotic means. Results. In girls of the second group, who were artificially fed with the addition of a probiotic — 7100.0±95.9 g, the weight gain in the first year of life was significantly higher than the weight gain of girls who received breast milk and standard formula — 6671.0±72.6 g and 6733.3±91.8 g, respectively. Despite the fact that there were no significant differences in the medians of body weight and height in children of the main group and the comparison groups, it was found that children in the main group were overweight/obese at 12 months had two or more times less indicators than children who received artificial nutrition. Children who are breastfed began to sit independently much earlier, on average 7.6±0.05 months after birth, and children of the other two groups who are bottle-fed, on average, 8.0±0.13 and 8.1±0.12 months, respectively (p<0.05). When studying the structure of the most common diseases of children in the first year of life, depending on the type of feeding, it was revealed that the greatest percentage both in group I (group) and in group II (claim) are children with acute intestinal infections — in group I (group 1)) group in 7.7±2.34% of children, in subgroup II (claim) in 11.7±2.93% of children (p=0.3905). Conclusions. The results obtained indicate a positive effect of breastfeeding on anthropometric indicators and the formation of basic skills in young children. The inci
{"title":"Nutritional problems and factors of forming the health of children of the first year","authors":"Saida Nuraddin Rustamaova","doi":"10.15574/pp.2021.87.23","DOIUrl":"https://doi.org/10.15574/pp.2021.87.23","url":null,"abstract":"Evaluation of the type of nutrition, which is one of the important components that ensure the physical growth, development and health of a child in the first year of life, and that forms metabolic processes at an older age, has been the subject of research and discussion of domestic and foreign scientists over the past decades. Purpose — to study the influence of the nature of feeding on the incidence and physical development of infants. Materials and methods. During the year, 250 children (118 girls and 132 boys) of the first year of life were under observation, who received various types of feeding (breast milk and milk formulas, differing in composition). The main (I) group (n=130) included children (62 girls and 68 boys) who were breastfed; and in the comparison group — children receiving artificial feeding: in group II (n=60) (27 girls and 33 boys) received a standard mixture with a prebiotic; in group III (n=60) (29 girls and 31 boys) — a standard mixture without a prebiotic. Physical development was assessed according to the generally accepted measurement technique in terms of absolute values, monthly increases in anthropometric indicators and mass-growth indices. Outpatient records of children, protocols of examination of a 1-year-old child were studied (accounting and reporting documentation was analyzed). The criteria for inclusion in the main group of infants were: breastfeeding for at least 9 months; the age of children from up to 1 year of age. The second comparison group included children who were fed mixed with the addition of probiotic means. Results. In girls of the second group, who were artificially fed with the addition of a probiotic — 7100.0±95.9 g, the weight gain in the first year of life was significantly higher than the weight gain of girls who received breast milk and standard formula — 6671.0±72.6 g and 6733.3±91.8 g, respectively. Despite the fact that there were no significant differences in the medians of body weight and height in children of the main group and the comparison groups, it was found that children in the main group were overweight/obese at 12 months had two or more times less indicators than children who received artificial nutrition. Children who are breastfed began to sit independently much earlier, on average 7.6±0.05 months after birth, and children of the other two groups who are bottle-fed, on average, 8.0±0.13 and 8.1±0.12 months, respectively (p<0.05). When studying the structure of the most common diseases of children in the first year of life, depending on the type of feeding, it was revealed that the greatest percentage both in group I (group) and in group II (claim) are children with acute intestinal infections — in group I (group 1)) group in 7.7±2.34% of children, in subgroup II (claim) in 11.7±2.93% of children (p=0.3905). Conclusions. The results obtained indicate a positive effect of breastfeeding on anthropometric indicators and the formation of basic skills in young children. The inci","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132690740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Numerous studies in recent years have shown that the prevalence of dental disease, periodontal tissue and dental anomalies remains high among children, despite the development and implementation of new prevention and treatment regimens. Thus, the prevalence of dental caries in children in the period of temporary occlusion reaches 80–90%, in the period of permanent occlusion — 70–80%. The prevalence of chronic catarrhal gingivitis in children 12–15 years of age is 70–80%, reaching 95–98% in some regions, and localized and generalized periodontitis – 4.1–16.4%. It is known that the pathogenesis of dental diseases is closely related to the presence of a bad habit — smoking, mostly there is a strict correlation between the intensity and experience of smoking and the emergence and development of pathological changes in various organs and systems, including the oral cavity. Maintaining proper oral hygiene is an important factor influencing the occurrence of periodontal disease. It is known that the formation of oral care skills is formed in childhood, so the study of oral hygiene and the level of hygienic knowledge in adolescents with healthy periodontitis and catarrhal gingivitis in order to further develop a scheme of preventive measures remains one of the most important areas of pediatric dentistry. Purpose — to study the level of hygienic oral care and knowledge in teenagers and young adults who smoke. Materials and methods. The level of knowledge on the observance of individual oral hygiene in 87 people aged 15 to 24 years was studied. The main group included 40 adolescents and young people who smoked, in the comparison group we included 47 people of the same age without a bad habit of smoking. Results. It was found that the majority of all respondents have information on how to properly care for the hygiene of RP, respectively 67.54±3.75% — in the main group, 72.78±4.81% — in the comparison group. However, not all respondents have the full amount of information, as indicated by 23.43±7.51% of adolescents and young people in the main group and 17.86±6.42%. In addition, the individual assessment of their own oral care skills according to the respondents revealed that not all respondents regularly oral care. In the main group only 59.56±4.61% indicated regular oral care, which was 1.4 times less than in the comparison group 81.42±5.73% (p<0.001). Conclusions. It is necessary to conduct additional hygienic training, mandatory reinformation on the risks of dental diseases, in order to form a system of sustainable understanding and awareness of the need for adolescents and young people to observe individual oral hygiene. Particular attention should be paid to aspects of the emergence and rooting of bad habits, namely the bad habit of smoking, both traditional and alternative types of smoking, which adversely affects somatic and dental health, because it is known that without smoking it is impossible to achieve sustainable and long-term results of treat
{"title":"The level of sanitary and hygienic knowledge on oral hygiene in teenagers and young adults who smoke","authors":"I. Lisecka, M. Rozhko","doi":"10.15574/pp.2021.87.51","DOIUrl":"https://doi.org/10.15574/pp.2021.87.51","url":null,"abstract":"Numerous studies in recent years have shown that the prevalence of dental disease, periodontal tissue and dental anomalies remains high among children, despite the development and implementation of new prevention and treatment regimens. Thus, the prevalence of dental caries in children in the period of temporary occlusion reaches 80–90%, in the period of permanent occlusion — 70–80%. The prevalence of chronic catarrhal gingivitis in children 12–15 years of age is 70–80%, reaching 95–98% in some regions, and localized and generalized periodontitis – 4.1–16.4%. It is known that the pathogenesis of dental diseases is closely related to the presence of a bad habit — smoking, mostly there is a strict correlation between the intensity and experience of smoking and the emergence and development of pathological changes in various organs and systems, including the oral cavity. Maintaining proper oral hygiene is an important factor influencing the occurrence of periodontal disease. It is known that the formation of oral care skills is formed in childhood, so the study of oral hygiene and the level of hygienic knowledge in adolescents with healthy periodontitis and catarrhal gingivitis in order to further develop a scheme of preventive measures remains one of the most important areas of pediatric dentistry. Purpose — to study the level of hygienic oral care and knowledge in teenagers and young adults who smoke. Materials and methods. The level of knowledge on the observance of individual oral hygiene in 87 people aged 15 to 24 years was studied. The main group included 40 adolescents and young people who smoked, in the comparison group we included 47 people of the same age without a bad habit of smoking. Results. It was found that the majority of all respondents have information on how to properly care for the hygiene of RP, respectively 67.54±3.75% — in the main group, 72.78±4.81% — in the comparison group. However, not all respondents have the full amount of information, as indicated by 23.43±7.51% of adolescents and young people in the main group and 17.86±6.42%. In addition, the individual assessment of their own oral care skills according to the respondents revealed that not all respondents regularly oral care. In the main group only 59.56±4.61% indicated regular oral care, which was 1.4 times less than in the comparison group 81.42±5.73% (p<0.001). Conclusions. It is necessary to conduct additional hygienic training, mandatory reinformation on the risks of dental diseases, in order to form a system of sustainable understanding and awareness of the need for adolescents and young people to observe individual oral hygiene. Particular attention should be paid to aspects of the emergence and rooting of bad habits, namely the bad habit of smoking, both traditional and alternative types of smoking, which adversely affects somatic and dental health, because it is known that without smoking it is impossible to achieve sustainable and long-term results of treat","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"604 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123242472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Dronova, O. Dronov, O. Mokrik, P. Bakunets, Y. Bakunets
The great importance in the development of acute intestinal obstruction (AIO) is the change in intestinal kinetics during pregnancy. In pregnant women, the rhythmic function of the intestine slows down due to an increase in the threshold of excitability of its receptors to biologically active substances. The article provides an overview of modern literary sources on the problem of acute intestinal obstruction in pregnant women. According to foreign literature sources, the incidence of intestinal obstruction in pregnant women is 1:3600–1:66000, and complications of diseases of the digestive system rank 4th among the causes of maternal mortality during pregnancy — 9%. According to domestic scientific sources, the frequency with which intestinal obstruction occurs in pregnant women is 1:40000–1:50000 births, mortality reaches 35–50%, stillbirth — 60–75%. The development of the disease is caused by physiological changes in the body of a pregnant woman. With increasing gestational age there are changes in the anatomical arrangement of the abdominal organs. From the second trimester of pregnancy, the uterus extends beyond the pelvis and gradually occupies the entire abdominal cavity. The increase in the size of the uterus due to hypertrophy and hyperplasia of muscle fibers, amniotic fluid, fetal growth, leads to increased intraabdominal pressure, displacement of the small intestine and lumbar colon up, thereby creating conditions for compression of intestinal loops, nodules, development. The modern classification, clinic, diagnostics and methods of treatment of this surgical pathology are presented. The author presents his own clinical case of acute intestinal obstruction in a 51-year-old pregnant woman with the sixth desired pregnancy, which occurred as a result of assisted reproductive technologies and a large intergenetic interval. Both surgeon and obstetrician-gynecologist treat intestinal obstruction in pregnant women. Conservative treatment is carried out simultaneously with diagnostic procedures. No effect of conservative therapy for 2 hours is an indication for surgery. The main purpose of surgery is to eliminate the causes of intestinal obstruction and restore bowel function. The scope of surgery is determined in each case individually and depends on the type of AIO and the age of the disease. The chosen tactics of the preoperative period, the volume of surgery, anesthesia and adequate management of the postoperative period can cure acute surgical pathology, maintain the desired pregnancy, avoid the development of obstetric and surgical purulent-septic complications. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: sharp bowel obstruction, pregnancy, extracorporal impregnation, large intergenic interval.
{"title":"Clinical case of sharp bowel obstruction during pregnancy for a patient with an extracorporal impregnation and large intergenic interval","authors":"V. Dronova, O. Dronov, O. Mokrik, P. Bakunets, Y. Bakunets","doi":"10.15574/pp.2021.87.77","DOIUrl":"https://doi.org/10.15574/pp.2021.87.77","url":null,"abstract":"The great importance in the development of acute intestinal obstruction (AIO) is the change in intestinal kinetics during pregnancy. In pregnant women, the rhythmic function of the intestine slows down due to an increase in the threshold of excitability of its receptors to biologically active substances. The article provides an overview of modern literary sources on the problem of acute intestinal obstruction in pregnant women. According to foreign literature sources, the incidence of intestinal obstruction in pregnant women is 1:3600–1:66000, and complications of diseases of the digestive system rank 4th among the causes of maternal mortality during pregnancy — 9%. According to domestic scientific sources, the frequency with which intestinal obstruction occurs in pregnant women is 1:40000–1:50000 births, mortality reaches 35–50%, stillbirth — 60–75%. The development of the disease is caused by physiological changes in the body of a pregnant woman. With increasing gestational age there are changes in the anatomical arrangement of the abdominal organs. From the second trimester of pregnancy, the uterus extends beyond the pelvis and gradually occupies the entire abdominal cavity. The increase in the size of the uterus due to hypertrophy and hyperplasia of muscle fibers, amniotic fluid, fetal growth, leads to increased intraabdominal pressure, displacement of the small intestine and lumbar colon up, thereby creating conditions for compression of intestinal loops, nodules, development. The modern classification, clinic, diagnostics and methods of treatment of this surgical pathology are presented. The author presents his own clinical case of acute intestinal obstruction in a 51-year-old pregnant woman with the sixth desired pregnancy, which occurred as a result of assisted reproductive technologies and a large intergenetic interval. Both surgeon and obstetrician-gynecologist treat intestinal obstruction in pregnant women. Conservative treatment is carried out simultaneously with diagnostic procedures. No effect of conservative therapy for 2 hours is an indication for surgery. The main purpose of surgery is to eliminate the causes of intestinal obstruction and restore bowel function. The scope of surgery is determined in each case individually and depends on the type of AIO and the age of the disease. The chosen tactics of the preoperative period, the volume of surgery, anesthesia and adequate management of the postoperative period can cure acute surgical pathology, maintain the desired pregnancy, avoid the development of obstetric and surgical purulent-septic complications. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: sharp bowel obstruction, pregnancy, extracorporal impregnation, large intergenic interval.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126385938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Siromaha, Yu.V. Davidova, A. Lymanska, N. Povoroznik, V. Lazoryshynets
Features of diagnosis of the cardiovascular system in a pregnant or parturient woman affect the correct choice of strategy for their medical care. Examination of a woman with pathology of the heart and great vessels at the gravidity stage requires comprehensive support of the pregnancy heart team with the obligatory involvement of specialists in a particular pathology. The paper presents the vision of the National Team of Obstetric Cardiology and Cardiac Surgery for diagnostic algorithms for different types of cardiac pathology in pregnant women. The advantages of certain methods of examination of pregnant women with pathology of the heart and main vessels, as well as limitations and precautions performing certain instrumental imaging techniques during pregnancy are discussed. The specificity of diagnostics during pregnancy, presented in this paper, is based on current recommendations of the European Society of Cardiology, a few studies by individual authors and the own experience of members of a multidisciplinary team operating on the basis of two academic institutions — M.M. Amosov National Institute of Cardiovascular Surgery (ANICVS) and the Institute of Pediatrics, Obstetrics and Gynecology named by O.M. Lukyanova. The paper presents 7.5 years of experience in such cooperation. An expert screening examination of the cardiovascular system was performed on 2818 patients (4448 visits), 162 of whom required specialized examination and treatment at the ANICVS during the period from December 2013 to April 2021. Due developed and implemented diagnostic program both at the outpatient and inpatient stages of medical care for pregnant and parturient women with severe cardiac pathology, as well as coordinated and professional work of members of the multidisciplinary team, the survival rate in this complex group of patients was 97.3% among pregnant and parturient women and 93.3% among babies. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: pregnancy, cardiac pathology, features of diagnostic algorithm, risk stratification.
{"title":"Features of diagnosis of pathology of the heart and main vessels in pregnant women. Experience of the national multidisciplinary team","authors":"S. Siromaha, Yu.V. Davidova, A. Lymanska, N. Povoroznik, V. Lazoryshynets","doi":"10.15574/pp.2021.86.17","DOIUrl":"https://doi.org/10.15574/pp.2021.86.17","url":null,"abstract":"Features of diagnosis of the cardiovascular system in a pregnant or parturient woman affect the correct choice of strategy for their medical care. Examination of a woman with pathology of the heart and great vessels at the gravidity stage requires comprehensive support of the pregnancy heart team with the obligatory involvement of specialists in a particular pathology. The paper presents the vision of the National Team of Obstetric Cardiology and Cardiac Surgery for diagnostic algorithms for different types of cardiac pathology in pregnant women. The advantages of certain methods of examination of pregnant women with pathology of the heart and main vessels, as well as limitations and precautions performing certain instrumental imaging techniques during pregnancy are discussed. The specificity of diagnostics during pregnancy, presented in this paper, is based on current recommendations of the European Society of Cardiology, a few studies by individual authors and the own experience of members of a multidisciplinary team operating on the basis of two academic institutions — M.M. Amosov National Institute of Cardiovascular Surgery (ANICVS) and the Institute of Pediatrics, Obstetrics and Gynecology named by O.M. Lukyanova. The paper presents 7.5 years of experience in such cooperation. An expert screening examination of the cardiovascular system was performed on 2818 patients (4448 visits), 162 of whom required specialized examination and treatment at the ANICVS during the period from December 2013 to April 2021. Due developed and implemented diagnostic program both at the outpatient and inpatient stages of medical care for pregnant and parturient women with severe cardiac pathology, as well as coordinated and professional work of members of the multidisciplinary team, the survival rate in this complex group of patients was 97.3% among pregnant and parturient women and 93.3% among babies. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: pregnancy, cardiac pathology, features of diagnostic algorithm, risk stratification.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126031798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allergic dermatoses are allergic skin diseases, the most common of which are: simple and allergic contact dermatitis, atopic dermatitis, various forms of eczema, acute and chronic allergic urticaria, Quincke's edema, toxicodermias, multiforme exudative erythema (Stevens–Johnson syndrome), acute epidermal necrolysis (Lyell's syndrome). The clinical course of all allergic dermatoses is accompanied by itch, although its severity varies depending on the nosology. An important focus of treatment of allergic dermatoses is to control of skin itch, as it is the leading symptom. According to the international program documents EAACI (European Academy of Allergy and Clinical Immunology), AAAAI (American Academy of Allergy, Asthma & Immunology), PRACТALL (Practical Allergology Consensus Report) in treatment of allergic dermatoses the leading place takes anti-itch therapy, which requires an individual approach and daily care of skin. Systemic anti-itch therapy includes using of the following drugs: antihistamines, glucocorticosteroids, membrane's stabilizators (kromons), leukotriene receptor antagonists, anti-IgE. External anti-itch therapy consists of local application of emollients, topical glucocorticosteroids, topical calcineurin inhibitors, topical anti-histamines, reparants and epithelializing medications. Purpose — to increase knowledge about features of etiopathogenetically-based anti-itch therapy of allergic dermatoses in children. Conclusions. Treatment of itch of allergic dermatoses is diverse, complex and multi-stage, requires an individual approach to each patient, and includes: environmental control to eliminate allergenic and non-allergenic factors, systemic and local pharmacotherapy, skin care. Modern anti-itch therapy of allergic dermatoses should be etiopathogenetic and affect on local and system mechanisms of allergic inflammation with itch, it should be differentiated according to the stage of the disease, the phase of inflammation and the severity of skin manifestations and to be based on the rational use of drugs. No conflict of interest was declared by the author. Key words: children, allergy, allergic dermatoses, itch, anti-itch therapy.
{"title":"Features of pathogenesis of itch and anti0itch therapy in children with allergic dermatosis (literature review)","authors":"O. Mochulska","doi":"10.15574/pp.2021.86.57","DOIUrl":"https://doi.org/10.15574/pp.2021.86.57","url":null,"abstract":"Allergic dermatoses are allergic skin diseases, the most common of which are: simple and allergic contact dermatitis, atopic dermatitis, various forms of eczema, acute and chronic allergic urticaria, Quincke's edema, toxicodermias, multiforme exudative erythema (Stevens–Johnson syndrome), acute epidermal necrolysis (Lyell's syndrome). The clinical course of all allergic dermatoses is accompanied by itch, although its severity varies depending on the nosology. An important focus of treatment of allergic dermatoses is to control of skin itch, as it is the leading symptom. According to the international program documents EAACI (European Academy of Allergy and Clinical Immunology), AAAAI (American Academy of Allergy, Asthma & Immunology), PRACТALL (Practical Allergology Consensus Report) in treatment of allergic dermatoses the leading place takes anti-itch therapy, which requires an individual approach and daily care of skin. Systemic anti-itch therapy includes using of the following drugs: antihistamines, glucocorticosteroids, membrane's stabilizators (kromons), leukotriene receptor antagonists, anti-IgE. External anti-itch therapy consists of local application of emollients, topical glucocorticosteroids, topical calcineurin inhibitors, topical anti-histamines, reparants and epithelializing medications. Purpose — to increase knowledge about features of etiopathogenetically-based anti-itch therapy of allergic dermatoses in children. Conclusions. Treatment of itch of allergic dermatoses is diverse, complex and multi-stage, requires an individual approach to each patient, and includes: environmental control to eliminate allergenic and non-allergenic factors, systemic and local pharmacotherapy, skin care. Modern anti-itch therapy of allergic dermatoses should be etiopathogenetic and affect on local and system mechanisms of allergic inflammation with itch, it should be differentiated according to the stage of the disease, the phase of inflammation and the severity of skin manifestations and to be based on the rational use of drugs. No conflict of interest was declared by the author. Key words: children, allergy, allergic dermatoses, itch, anti-itch therapy.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117030388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The problem of neonatal sepsis continues to be one of the leading places in neonatal practice. The issues of early diagnostics of cardiovascular disorders in neonates with sepsis by means of up-to-date methods of examination remain relevant. They can be used as screening methods with the purpose to verify possible development of cardiovascular dysfunction. Purpose — to study the meaning of certain clinical and paraclinical markers of myocardial dysfunction in neonates with sepsis. Materials and methods. In order to realize the objective we have observed 69 neonates with signs of generalized infectious-inflammatory process. Group I (32 patients — 46,4%) included neonates with the term of gestation 37–42 weeks, group II included 37 preterm neonates (53,6%) with the term of gestation under 36 week inclusive. Results. It was found that in mothers who gave birth prematurely, compared to mothers of newborns of group I, premature rupture of membranes occurred more often, but 1.5 times less often — indications of infectious diseases of the genitourinary system of the pregnant woman. Generalized infectious-inflammatory process during the neonatal period of term infants is accompanied by electrocardiographic signs of left ventricular overload associated with female sex (r=0,30), delivery by cesarean section (r=0,27), and assessment of neonatal condition by a 5=minute Apgar score (r=-0,33). Conclusions. Increased values of lactate dehydrogenase activity in the blood serum of both term and preterm neonates are associated with left ventricular over-load in the term ones, and right ventricular overload in the preterm infants. Changes found in electrophysiological heart activity promote the necessity of a routine use of electrocardiography in neonates with signs of septic process. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: neonatal sepsis; myocardial dysfunction.
{"title":"Certain clinical and paraclinical markers of sepsis-induced myocardial dysfunction in newborn","authors":"О. Koloskova, N. Kretsu, T. Bilous","doi":"10.15574/pp.2021.86.41","DOIUrl":"https://doi.org/10.15574/pp.2021.86.41","url":null,"abstract":"The problem of neonatal sepsis continues to be one of the leading places in neonatal practice. The issues of early diagnostics of cardiovascular disorders in neonates with sepsis by means of up-to-date methods of examination remain relevant. They can be used as screening methods with the purpose to verify possible development of cardiovascular dysfunction. Purpose — to study the meaning of certain clinical and paraclinical markers of myocardial dysfunction in neonates with sepsis. Materials and methods. In order to realize the objective we have observed 69 neonates with signs of generalized infectious-inflammatory process. Group I (32 patients — 46,4%) included neonates with the term of gestation 37–42 weeks, group II included 37 preterm neonates (53,6%) with the term of gestation under 36 week inclusive. Results. It was found that in mothers who gave birth prematurely, compared to mothers of newborns of group I, premature rupture of membranes occurred more often, but 1.5 times less often — indications of infectious diseases of the genitourinary system of the pregnant woman. Generalized infectious-inflammatory process during the neonatal period of term infants is accompanied by electrocardiographic signs of left ventricular overload associated with female sex (r=0,30), delivery by cesarean section (r=0,27), and assessment of neonatal condition by a 5=minute Apgar score (r=-0,33). Conclusions. Increased values of lactate dehydrogenase activity in the blood serum of both term and preterm neonates are associated with left ventricular over-load in the term ones, and right ventricular overload in the preterm infants. Changes found in electrophysiological heart activity promote the necessity of a routine use of electrocardiography in neonates with signs of septic process. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: neonatal sepsis; myocardial dysfunction.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"97 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113981359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose — to create an algorithm for early diagnosis and differential diagnosis of conditions accompanied by thrombocytopenia (TP) during pregnancy, as well as an algorithm for the treatment of immune thrombocytopenia during pregnancy based on analysis of clinical, laboratory data and obstetric and perinatal results of such pregnant women. Materials and methods. We analyzed 155 histories of pregnancy and childbirth of women with TP, who underwent inpatient treatment and/or gave childbirth in the obstetric clinic of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova NAMS of Ukraine» from January 2008 to August 2018. According to the inclusion criteria, 111 histories were selected for further analysis. Pregnant women are divided according to the etiological principle of TP into three groups: with gestational thrombocytopenia, immune thrombocytopenia, secondary thrombocytopenia. The first group included 32 women (28.8%), the second — 65 (55.6%), the third — 14 (12.6%). During the selected period of time there were 99 births, 100 babies were born, 1 twin birth. Results and conclusions. The number of platelets progressively decreases during pregnancy with a minimum in childbirth. The algorithm of examination, the decision on the initiation or intensification of treatment, the choice of monitoring tactics for TP during pregnancy, the calculation of obstetric and perinatal risks, preparation for childbirth and the choice of method depend on the cause of TP and differ significantly. Developed «Algorithm for diagnosis and differential diagnosis in the detection of thrombocytopenia during pregnancy» and «Algorithm for the treatment of immune thrombocytopenia during pregnancy» are aimed at the prevention of obstetric and perinatal complications in pregnant women with thrombocytopenia. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: thrombocytopenia, pregnancy, diagnostic algorithm, treatment algorithm.
{"title":"Differential diagnosis of thrombocytopenia during pregnancy: clinical and diagnostic algorithms","authors":"O. M. Naumchik, I. Davydova, A. Limanska","doi":"10.15574/pp.2021.86.28","DOIUrl":"https://doi.org/10.15574/pp.2021.86.28","url":null,"abstract":"Purpose — to create an algorithm for early diagnosis and differential diagnosis of conditions accompanied by thrombocytopenia (TP) during pregnancy, as well as an algorithm for the treatment of immune thrombocytopenia during pregnancy based on analysis of clinical, laboratory data and obstetric and perinatal results of such pregnant women. Materials and methods. We analyzed 155 histories of pregnancy and childbirth of women with TP, who underwent inpatient treatment and/or gave childbirth in the obstetric clinic of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova NAMS of Ukraine» from January 2008 to August 2018. According to the inclusion criteria, 111 histories were selected for further analysis. Pregnant women are divided according to the etiological principle of TP into three groups: with gestational thrombocytopenia, immune thrombocytopenia, secondary thrombocytopenia. The first group included 32 women (28.8%), the second — 65 (55.6%), the third — 14 (12.6%). During the selected period of time there were 99 births, 100 babies were born, 1 twin birth. Results and conclusions. The number of platelets progressively decreases during pregnancy with a minimum in childbirth. The algorithm of examination, the decision on the initiation or intensification of treatment, the choice of monitoring tactics for TP during pregnancy, the calculation of obstetric and perinatal risks, preparation for childbirth and the choice of method depend on the cause of TP and differ significantly. Developed «Algorithm for diagnosis and differential diagnosis in the detection of thrombocytopenia during pregnancy» and «Algorithm for the treatment of immune thrombocytopenia during pregnancy» are aimed at the prevention of obstetric and perinatal complications in pregnant women with thrombocytopenia. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: thrombocytopenia, pregnancy, diagnostic algorithm, treatment algorithm.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116839771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim is to evaluate the effectiveness of Phytolysin Active prescription in therapy of urinary tract infections in pregnant women. Materials and methods. The efficacy of Phytolysin Active (1 capsule per day for 21 days) in the complex treatment for urinary tract infection was studied in comparison with the group of pregnant women using traditional antimicrobial therapy. The first group consisted of 27 pregnant women who received complex treatment (antibiotic therapy + Phytolysin Active), the second consisted of 25 women who used exclusively antibiotic therapy. Among pregnant women in the first group, symptomatic gestational cystitis was observed in 9 (33.3%) cases, and in the second group in 8 (32%) patients. Results. The effectiveness of combination therapy with the use of Phytolysin Active was proved by significant improvement in general well-being and disappearance of cystitis symptoms in 8 (88.9%) women compared with 5 (62.5%) patients in the treatment group who used exclusively antimicrobial drugs. After treatment with the addition of Phytolysin Active to antibiotic therapy, Escherichiaсoli pathogen, which is most often diagnosed in this pathology, was observed in 1 (3.7%) women compared to 5 (20%) cases in the second group. Also, 25 (92.6%) women of the first group had no recurrence of urinary tract infections for 3 months. Conclusions. Complex treatment of asymptomatic bacteriuria in pregnant women with the use of the drug Phytolysin Active is more effective than the use of antibiotic therapy alone, which is proved by the high rate of the pathogen elimination and absence of infection recurrence for 3 months. The synergistic action of two active components of Phytolysin Active (Polpharma) – cranberry proanthocyanidins and lactobacillus acidophilus – improves the effectiveness of treatment and prevents relapse. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution. The informed consent of women was obtained for the research. The authors declare no conflicts of interest. Key words: pregnancy, urinary tract infections, treatments, herbal medicine, cranberry, lactobacilli.
{"title":"Improvement of effectiveness in treatment for urinary tract infection in pregnant women","authors":"I. Davydova, A. Lymanskaya","doi":"10.15574/pp.2021.86.7","DOIUrl":"https://doi.org/10.15574/pp.2021.86.7","url":null,"abstract":"The aim is to evaluate the effectiveness of Phytolysin Active prescription in therapy of urinary tract infections in pregnant women. Materials and methods. The efficacy of Phytolysin Active (1 capsule per day for 21 days) in the complex treatment for urinary tract infection was studied in comparison with the group of pregnant women using traditional antimicrobial therapy. The first group consisted of 27 pregnant women who received complex treatment (antibiotic therapy + Phytolysin Active), the second consisted of 25 women who used exclusively antibiotic therapy. Among pregnant women in the first group, symptomatic gestational cystitis was observed in 9 (33.3%) cases, and in the second group in 8 (32%) patients. Results. The effectiveness of combination therapy with the use of Phytolysin Active was proved by significant improvement in general well-being and disappearance of cystitis symptoms in 8 (88.9%) women compared with 5 (62.5%) patients in the treatment group who used exclusively antimicrobial drugs. After treatment with the addition of Phytolysin Active to antibiotic therapy, Escherichiaсoli pathogen, which is most often diagnosed in this pathology, was observed in 1 (3.7%) women compared to 5 (20%) cases in the second group. Also, 25 (92.6%) women of the first group had no recurrence of urinary tract infections for 3 months. Conclusions. Complex treatment of asymptomatic bacteriuria in pregnant women with the use of the drug Phytolysin Active is more effective than the use of antibiotic therapy alone, which is proved by the high rate of the pathogen elimination and absence of infection recurrence for 3 months. The synergistic action of two active components of Phytolysin Active (Polpharma) – cranberry proanthocyanidins and lactobacillus acidophilus – improves the effectiveness of treatment and prevents relapse. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution. The informed consent of women was obtained for the research. The authors declare no conflicts of interest. Key words: pregnancy, urinary tract infections, treatments, herbal medicine, cranberry, lactobacilli.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126417296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose — to identify environmental factors that influence on negative behavior in school-age adolescents. Materials and methods. A survey of 256 adolescents in primary schools examined the health status, psychological state of the family and school. 337 adolescents were examined, 101 were at risk group, 80 were adolescent from social rehabilitation boarding schools and 156 were in control group to identify the reasons that prompted adolescents to behave negatively. Results. We found decreased health indicators of adolescents from risk group, a psychological condition in their families was unsatisfactory in a large proportion of adolescents: 13.3% was nervous, 11% was depressed, 7.6% was anxious, 8.8% s aggressive. The same pattern was observed in school conditions — 26.5% of adolescents indicated anxiety-nervous state, 16.2% — depressed, 9.8% — aggressive. Depth researches of into the causes of adolescents' psychological deterioration and their tendency to negative behavior revealed a number of biological and medico-social factors, which include complications of delivery, that was found in the first year of life, raising children in the family, organizing schooling, the prevalence of harmful habits, unhealthy lifestyles and unfavorable family conditions (single-parent families, alcohol abuse parents, child neglect). Conclusions. This study showed that adolescents who are prone to socio-negative behavior have a difficult history of life, a number of social and biological factors that adversely affect their health, psychological development and adaptation in society. To prevent this phenomenon it is necessary to create a state program of preventive education of young people, formation of the concept of healthy lifestyle for each teenager. Teens from families at risk group should be taken on special controls. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: adolescents, risk factors, health, psychological status.
{"title":"Influence of biological and medico0social factors on the formation of schoolchildren's predisposition to negative behavior","authors":"V. Nedelko, G. V. Skiban, L. Pinchuk","doi":"10.15574/pp.2021.86.49","DOIUrl":"https://doi.org/10.15574/pp.2021.86.49","url":null,"abstract":"Purpose — to identify environmental factors that influence on negative behavior in school-age adolescents. Materials and methods. A survey of 256 adolescents in primary schools examined the health status, psychological state of the family and school. 337 adolescents were examined, 101 were at risk group, 80 were adolescent from social rehabilitation boarding schools and 156 were in control group to identify the reasons that prompted adolescents to behave negatively. Results. We found decreased health indicators of adolescents from risk group, a psychological condition in their families was unsatisfactory in a large proportion of adolescents: 13.3% was nervous, 11% was depressed, 7.6% was anxious, 8.8% s aggressive. The same pattern was observed in school conditions — 26.5% of adolescents indicated anxiety-nervous state, 16.2% — depressed, 9.8% — aggressive. Depth researches of into the causes of adolescents' psychological deterioration and their tendency to negative behavior revealed a number of biological and medico-social factors, which include complications of delivery, that was found in the first year of life, raising children in the family, organizing schooling, the prevalence of harmful habits, unhealthy lifestyles and unfavorable family conditions (single-parent families, alcohol abuse parents, child neglect). Conclusions. This study showed that adolescents who are prone to socio-negative behavior have a difficult history of life, a number of social and biological factors that adversely affect their health, psychological development and adaptation in society. To prevent this phenomenon it is necessary to create a state program of preventive education of young people, formation of the concept of healthy lifestyle for each teenager. Teens from families at risk group should be taken on special controls. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: adolescents, risk factors, health, psychological status.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114432217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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