O. Bolshova, Т.М. Malinovska, N. Sprynchuk, D. Kvacheniuk, І.V. Lukashuk, V. Pakhomova, О.А. Vyshnevska, О.Ya. Samson
According to modern concepts, hypothalamic dysfunction (HD) is a neuroendocrine syndrome caused by dysfunction of the hypothalamic-pituitary system and is manifested mainly by hormonal and metabolic disorders and vegetative-vascular disorders. Adolescent obesity, associated in many cases with HD, and with a high risk of developing vitamin D (vitD) deficiency. Obesity in association with HD and vitD deficiency causes serious health problems, and the vitD/parathyroid hormone (PTH) axis plays a potential role in their etiopathogenesis. Purpose - to study the relationship between vitD, vitamin D-binding protein (VDBP) and parathyroid hormone levels in adolescents with obesity against the background of HD. Materials and methods. The serum level of vitD was determined by the immunochemiluminescence method on microparticles (Abbott, USA) in 87 children and adolescents with overweight/obesity against the background of HD aged 10-16 years. The VDBP level was determined using enzyme-linked immunospecific assay (ELISA) with commercial standard kit Elabsciense Biotechnology Co., Ltd (USA). The PTH level - by immunochemiluminescence assay with commercial standard kit Monobind (USA). Results. Insufficiency of vitD was noted in 32.2%, deficiency - in 56.3% of patients. The severity of obesity was associated with the levels of vitD: a decrease in the level of vitD in children and adolescents with overweight (69.30±5.14 nmol/l) and the I stage of obesity (52.60±4.17 nmol/l), a significant deficiency of vitD in persons with the II and III stages of obesity (36.20±3.75 nmol/l, 23.10±3.12 nmol/l respectively). A significant decrease of vitD level in obese patients was accompanied by a significant increase of the PTH level. In the III stage of obesity, the level of PTH was twice as high as the level of PTH in practically healthy children and adolescents with normal MT and in patients with excess body weight (p<0.05). With a body mass index (BMI) >30 kg/m2, there was a significant decrease in the content of vitD, associated with a significant increase in the level of PTH and a sharp decrease in the level of VDBP. The level of VDBP had a positive correlation with vitD level and a negative relationship with BMI. A significant decrease in the content of VDBP (58.71±18.43 ng/ml)) was established in comparison with a group of practically healthy children and adolescents with normal body weight (141.65±25.34 ng/ml) (р<0.05). Conclusions. The results indicate the presence of certain changes in the PTH/vitD/VDBP axis in children and adolescents with excess body weight/obesity against the background of HD, which are an integral part of the complex manifestation of the disease. Maintaining an adequate vitD status can contribute to the prevention of such disorders. 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 institutions. The informed consent of the
{"title":"Vitamin D, vitamin D-binding protein and parathyroid hormone in children and adolescents with obesity and dysfunction of the hypothalamus","authors":"O. Bolshova, Т.М. Malinovska, N. Sprynchuk, D. Kvacheniuk, І.V. Lukashuk, V. Pakhomova, О.А. Vyshnevska, О.Ya. Samson","doi":"10.15574/pp.2023.94.97","DOIUrl":"https://doi.org/10.15574/pp.2023.94.97","url":null,"abstract":"According to modern concepts, hypothalamic dysfunction (HD) is a neuroendocrine syndrome caused by dysfunction of the hypothalamic-pituitary system and is manifested mainly by hormonal and metabolic disorders and vegetative-vascular disorders. Adolescent obesity, associated in many cases with HD, and with a high risk of developing vitamin D (vitD) deficiency. Obesity in association with HD and vitD deficiency causes serious health problems, and the vitD/parathyroid hormone (PTH) axis plays a potential role in their etiopathogenesis. Purpose - to study the relationship between vitD, vitamin D-binding protein (VDBP) and parathyroid hormone levels in adolescents with obesity against the background of HD. Materials and methods. The serum level of vitD was determined by the immunochemiluminescence method on microparticles (Abbott, USA) in 87 children and adolescents with overweight/obesity against the background of HD aged 10-16 years. The VDBP level was determined using enzyme-linked immunospecific assay (ELISA) with commercial standard kit Elabsciense Biotechnology Co., Ltd (USA). The PTH level - by immunochemiluminescence assay with commercial standard kit Monobind (USA). Results. Insufficiency of vitD was noted in 32.2%, deficiency - in 56.3% of patients. The severity of obesity was associated with the levels of vitD: a decrease in the level of vitD in children and adolescents with overweight (69.30±5.14 nmol/l) and the I stage of obesity (52.60±4.17 nmol/l), a significant deficiency of vitD in persons with the II and III stages of obesity (36.20±3.75 nmol/l, 23.10±3.12 nmol/l respectively). A significant decrease of vitD level in obese patients was accompanied by a significant increase of the PTH level. In the III stage of obesity, the level of PTH was twice as high as the level of PTH in practically healthy children and adolescents with normal MT and in patients with excess body weight (p<0.05). With a body mass index (BMI) >30 kg/m2, there was a significant decrease in the content of vitD, associated with a significant increase in the level of PTH and a sharp decrease in the level of VDBP. The level of VDBP had a positive correlation with vitD level and a negative relationship with BMI. A significant decrease in the content of VDBP (58.71±18.43 ng/ml)) was established in comparison with a group of practically healthy children and adolescents with normal body weight (141.65±25.34 ng/ml) (р<0.05). Conclusions. The results indicate the presence of certain changes in the PTH/vitD/VDBP axis in children and adolescents with excess body weight/obesity against the background of HD, which are an integral part of the complex manifestation of the disease. Maintaining an adequate vitD status can contribute to the prevention of such disorders. 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 institutions. The informed consent of the ","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124550981","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}
Hypertensive problems are present in 10% of all pregnancies. Hypertensive disorders in pregnancy constitute one of the reasonsfor maternal death and perinatal too in the world.Women with hypertension are always at higher risk for preterm birth than women without disorder. The article is dedicated to analyzing pregnancy and its consequences, including perinatal outcomes, in women with arterial hypertension. The analysis was conducted at two powerful medical centers - the Princess Anna maternity hospital in city Warsaw, Poland, and the KNP KMPB No. 5 in city Kyiv, Ukraine. The prolonged war in Ukraine has complicated the timely diagnosis and proper treatment of pathological conditions. To assess this problem, two groups were created: control and experimental, and a total of 366 pregnant patients were studied. In Warsaw, 206 patients were analyzed, while in the Kyiv maternity hospital, 160 patients were analyzed. During the analysis, one of the conclusions drawn was that chronic hypertension during pregnancy is strongly associated with pregnancy complications and negatively affected by other complicating factors such as maternal age, previous pregnancy complications, and obesity. Separate groups were identified and calculated for complications in each center separately. The degree of depression among pregnant women undergoing examination was also taken into account, and those who needed help from specialists were referred to psychologists. The authors declare no conflicts of interest.
{"title":"An analysis of perinatal outcomes in pregnant women with arterial hypertension in Poland and Ukraine during times of conflict","authors":"K. Spichak, D. Govsieiev","doi":"10.15574/pp.2023.94.70","DOIUrl":"https://doi.org/10.15574/pp.2023.94.70","url":null,"abstract":"Hypertensive problems are present in 10% of all pregnancies. Hypertensive disorders in pregnancy constitute one of the reasonsfor maternal death and perinatal too in the world.Women with hypertension are always at higher risk for preterm birth than women without disorder. The article is dedicated to analyzing pregnancy and its consequences, including perinatal outcomes, in women with arterial hypertension. The analysis was conducted at two powerful medical centers - the Princess Anna maternity hospital in city Warsaw, Poland, and the KNP KMPB No. 5 in city Kyiv, Ukraine. The prolonged war in Ukraine has complicated the timely diagnosis and proper treatment of pathological conditions. To assess this problem, two groups were created: control and experimental, and a total of 366 pregnant patients were studied. In Warsaw, 206 patients were analyzed, while in the Kyiv maternity hospital, 160 patients were analyzed. During the analysis, one of the conclusions drawn was that chronic hypertension during pregnancy is strongly associated with pregnancy complications and negatively affected by other complicating factors such as maternal age, previous pregnancy complications, and obesity. Separate groups were identified and calculated for complications in each center separately. The degree of depression among pregnant women undergoing examination was also taken into account, and those who needed help from specialists were referred to psychologists. The authors declare no conflicts of interest.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114550480","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}
O. Mukvich, L.I. Omelchrnko, I.N. Matviyenko, T. Ignatova, N. Vdovina
Purpose - to learn the features of clinical condition and state of endothelial function as the marker of the development of cardiovascular pathology in children who suffered from COVID-19. Materials and methods. The research group consisted of 70 children aged 7-14 without chronic pathology who suffered from COVID-19 and had laboratory confirmation of the disease. Assessment of the functioning of the vessels’ endothelium was done by studying the dynamics of blood flow in the brachial artery and changes of it diameter at rest and during reactive hyperemia after an occlusion test. Statistical assessment of the obtained data was carried out by the application package «Statistica 10.0 for Windows» using the method of variational statistics. Student’s t-test was calculated to assess the reliability of mean values differences. Results. The state of endothelial function show that 85.4% of children after COVID-19 infection had signs of endothelial dysfunction, mainly hypoergic (32.9%) and paradoxical (30%) forms, while normoergic function of the endothelium was found only in 14.6% of children. In the same time in the group of children who did not suffer from COVID-19, was found that the normorergic form registrated in 80.0%, hyperergic endothelial dysfunction was found in 13.3% of children, and hypoergic - in 6.7% of children. Paradoxical endothelial dysfunction was not found in any child from this group. Conclusions. COVID-19 infection has negative consequences on the endothelium function and contributes to the development of endothelial dysfunction regardless of the severity of the disease course. Our results obtained the need of future study to develop an affordable and low-cost algorithm for routine use and identification of children with markers of lesion of cardiovascular system. 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
目的-了解COVID-19患儿的临床状况特点及内皮功能状态作为心血管病理发展的标志。材料和方法。研究小组由70名7-14岁无慢性病理的儿童组成，他们患有COVID-19，并经实验室确诊。通过研究静息时和闭塞试验后反应性充血时肱动脉血流动态和内径变化来评价血管内皮功能。采用变分统计方法，使用«Statistica 10.0 for Windows»应用程序包对获得的数据进行统计评估。计算学生t检验来评估均值差异的信度。结果。内皮功能状态显示，85.4%的患儿感染后出现内皮功能障碍，主要表现为低能型(32.9%)和矛盾型(30%)，内皮功能正常的患儿仅占14.6%。与此同时，在未患COVID-19的儿童组中，发现80.0%的儿童为正能型，13.3%的儿童为超能型内皮功能障碍，6.7%的儿童为低能型。本组儿童未发现矛盾性内皮功能障碍。结论。COVID-19感染对内皮功能有负面影响，无论病程的严重程度如何，都有助于内皮功能障碍的发展。我们的研究结果表明，未来的研究需要开发一种可负担且低成本的算法，用于常规使用和识别具有心血管系统病变标志物的儿童。这项研究是按照《赫尔辛基宣言》的原则进行的。研究方案经参与机构当地伦理委员会批准。获得患者的知情同意进行研究。作者未声明存在利益冲突。
{"title":"Endothelial function disorders in children with COVID-19 infection: results of own study","authors":"O. Mukvich, L.I. Omelchrnko, I.N. Matviyenko, T. Ignatova, N. Vdovina","doi":"10.15574/pp.2023.94.106","DOIUrl":"https://doi.org/10.15574/pp.2023.94.106","url":null,"abstract":"Purpose - to learn the features of clinical condition and state of endothelial function as the marker of the development of cardiovascular pathology in children who suffered from COVID-19. Materials and methods. The research group consisted of 70 children aged 7-14 without chronic pathology who suffered from COVID-19 and had laboratory confirmation of the disease. Assessment of the functioning of the vessels’ endothelium was done by studying the dynamics of blood flow in the brachial artery and changes of it diameter at rest and during reactive hyperemia after an occlusion test. Statistical assessment of the obtained data was carried out by the application package «Statistica 10.0 for Windows» using the method of variational statistics. Student’s t-test was calculated to assess the reliability of mean values differences. Results. The state of endothelial function show that 85.4% of children after COVID-19 infection had signs of endothelial dysfunction, mainly hypoergic (32.9%) and paradoxical (30%) forms, while normoergic function of the endothelium was found only in 14.6% of children. In the same time in the group of children who did not suffer from COVID-19, was found that the normorergic form registrated in 80.0%, hyperergic endothelial dysfunction was found in 13.3% of children, and hypoergic - in 6.7% of children. Paradoxical endothelial dysfunction was not found in any child from this group. Conclusions. COVID-19 infection has negative consequences on the endothelium function and contributes to the development of endothelial dysfunction regardless of the severity of the disease course. Our results obtained the need of future study to develop an affordable and low-cost algorithm for routine use and identification of children with markers of lesion of cardiovascular system. 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115551631","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 sustainable development of the society of any country is largely determined by the health of pregnant women, which determines the viability and health of the offspring at all stages of ontogenesis. Purpose - to conduct an analysis, change trends, and an integrated assessment (IA) of the main predictors of high-risk pregnancy (HRP) in Ukraine in 2010-2021. Materials and methods. A comprehensive retrospective analysis, a general characterization of the dynamics and regional features of the integral assessment of the main predictors of HRP based on the data of the State Statistics Service of Ukraine and the Medical Statistics Center of the Ministry of Health of Ukraine, was carried out. Structured by individual components of the IA of the main predictors of HRP, it was carried out according to the generally accepted methodology of comprehensive assessment of the health status of the population based on integral indicators. The interpretation of the results of IA was based on the fact that the higher the integral indicator, the greater the risk of developing HRP. The methods of a systemic approach, structural-logical, epidemiological analysis were used. mathematical, modeling. Results. Analytical data show that in recent years in Ukraine, the levels of maternal and perinatal morbidity and mortality have remained high despite a multidirectional trend, a significant part of which could have been prevented by identifying and minimizing predictors of HRP. The analysis of the state of the main predictors of the development of HRP revealed high levels of the birth rate of young (5.21‰) and older (7.86 ‰) women with an increase in their total contribution to the total birth rate from 9.5% in 2010 to 16.29% in 2021, the rate of growth is 71.5%, insufficient with a negative trend of coverage of pregnant women by dispensary supervision and examination by a therapist (90.7% in 2010 and 87.82% in 2021, the rate of loss is 3.9% and 90.83%, 89.51% and 9.9% respectively). During this period, the frequency of diseases and complications of the gestational period remains high - anemia (26.4% in 2010, 24.75% in 2021, growth rate - 6.5%), diseases of the circulatory system (6.2-6.34% and 2.3%), diseases of the genitourinary system (14.05-14.03% and -2.4%), diabetes (0.17-0.96% and 452.9%), diseases of the thyroid gland (9.65, 9.2% and 1.76%), preeclampsia and eclampsia (2.31-2.1% and -9.1%), preeclampsia (6.65-6.7% and 0.8%) and venous complications (2.84-4.98% and 69.0%). The complex IA of the main predictors of HRP was carried out by dividing the regions into 3 groups - the Group I with a high risk of IA development (IA - 131.1-111.9%), the Group II with an average risk of IA development (106.5-92.0%) and the III group with a lower than average risk of HRP development (89.6-60.3%). The city of Kyiv is included in the 1st group of regions that require a detailed study and correction of the determinants of HRP, Vinnytsia, Poltava, Dnipropetrovsk, Kyiv, Chernihiv and
{"title":"Trends in major predictors of high-risk pregnancy","authors":"T. Tatarchuk, R. Marushko, O. Dudina","doi":"10.15574/pp.2023.94.22","DOIUrl":"https://doi.org/10.15574/pp.2023.94.22","url":null,"abstract":"The sustainable development of the society of any country is largely determined by the health of pregnant women, which determines the viability and health of the offspring at all stages of ontogenesis. Purpose - to conduct an analysis, change trends, and an integrated assessment (IA) of the main predictors of high-risk pregnancy (HRP) in Ukraine in 2010-2021. Materials and methods. A comprehensive retrospective analysis, a general characterization of the dynamics and regional features of the integral assessment of the main predictors of HRP based on the data of the State Statistics Service of Ukraine and the Medical Statistics Center of the Ministry of Health of Ukraine, was carried out. Structured by individual components of the IA of the main predictors of HRP, it was carried out according to the generally accepted methodology of comprehensive assessment of the health status of the population based on integral indicators. The interpretation of the results of IA was based on the fact that the higher the integral indicator, the greater the risk of developing HRP. The methods of a systemic approach, structural-logical, epidemiological analysis were used. mathematical, modeling. Results. Analytical data show that in recent years in Ukraine, the levels of maternal and perinatal morbidity and mortality have remained high despite a multidirectional trend, a significant part of which could have been prevented by identifying and minimizing predictors of HRP. The analysis of the state of the main predictors of the development of HRP revealed high levels of the birth rate of young (5.21‰) and older (7.86 ‰) women with an increase in their total contribution to the total birth rate from 9.5% in 2010 to 16.29% in 2021, the rate of growth is 71.5%, insufficient with a negative trend of coverage of pregnant women by dispensary supervision and examination by a therapist (90.7% in 2010 and 87.82% in 2021, the rate of loss is 3.9% and 90.83%, 89.51% and 9.9% respectively). During this period, the frequency of diseases and complications of the gestational period remains high - anemia (26.4% in 2010, 24.75% in 2021, growth rate - 6.5%), diseases of the circulatory system (6.2-6.34% and 2.3%), diseases of the genitourinary system (14.05-14.03% and -2.4%), diabetes (0.17-0.96% and 452.9%), diseases of the thyroid gland (9.65, 9.2% and 1.76%), preeclampsia and eclampsia (2.31-2.1% and -9.1%), preeclampsia (6.65-6.7% and 0.8%) and venous complications (2.84-4.98% and 69.0%). The complex IA of the main predictors of HRP was carried out by dividing the regions into 3 groups - the Group I with a high risk of IA development (IA - 131.1-111.9%), the Group II with an average risk of IA development (106.5-92.0%) and the III group with a lower than average risk of HRP development (89.6-60.3%). The city of Kyiv is included in the 1st group of regions that require a detailed study and correction of the determinants of HRP, Vinnytsia, Poltava, Dnipropetrovsk, Kyiv, Chernihiv and","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128850019","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}
K. Belka, Y. Kuchyn, D.O. Hovseev, D. Sazhyn, I. V. Sirenko
The effectiveness of the checklist in reducing mortality and major postoperative complications is proven, but its implementation is not easy and requires not so much technical as organizational and cultural changes. In conscious patients undergoing surgery under neuraxial or regional anesthesia, completing the checklist may have psychological or mental consequences (anxiety, fear, etc.), as the procedure involves discussing the risks of complications, anesthetic and surgical tactics. Purpose - to assess the perception and compliance of conscious patients during cesarean section with the procedure of filling out the «Safe Surgery» checklist; to identify possible negative psychological effects of this procedure. Materials and methods. The study included 100 patients after planned or urgent caesarean section (except for 1 category of urgency). The study was conducted on the basis of an anonymous survey (online Google form) of patients in the postoperative period (1-2 hours after surgery). Patients were asked to rate the impact of completing the Safe Surgery Checklist on their comfort and anxiety levels, and whether they believed that routine use of such technologies increased their safety. Results. The results of this study indicate that the majority of patients responded positively to the use of the WHO checklist implemented in the operating room. More than half of the surveyed patients (56%) were worried about a possible error during the preparation or carrying out of the surgical intervention. Almost all patients - 13 (92.9%) who had experienced medical errors before, worried that a medical error during this intervention could harm their health (OR=13; 95% CI: 1.6-103.7; p=0.006). The procedure of filling out the checklist alleviated the feeling of loss in 66% of patients and did not cause discomfort in 96% of respondents. 68% of patients agreed that the procedure of filling out the checklist reduced anxiety. The vast majority of patients (90%) agreed that the procedure of filling out the «Safe Surgery» checklist increases their level of safety in the operating room. 96% of patients believed that the checklist should be used before every surgical intervention and 96% would like it to be used during future surgical interventions. Conclusions. Patients who were conscious during Caesarean section positively perceived the procedure of filling out the «Safe Surgery» checklist and believed that the use of such a checklist increases safety during surgery. Most patients also reported no discomfort and reduced fear and anxiety during the Safe Surgery Checklist procedure. 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 institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
{"title":"Implementation of the «Safe Surgery» checklist: perception by patients during Caesarean section operation","authors":"K. Belka, Y. Kuchyn, D.O. Hovseev, D. Sazhyn, I. V. Sirenko","doi":"10.15574/pp.2023.94.29","DOIUrl":"https://doi.org/10.15574/pp.2023.94.29","url":null,"abstract":"The effectiveness of the checklist in reducing mortality and major postoperative complications is proven, but its implementation is not easy and requires not so much technical as organizational and cultural changes. In conscious patients undergoing surgery under neuraxial or regional anesthesia, completing the checklist may have psychological or mental consequences (anxiety, fear, etc.), as the procedure involves discussing the risks of complications, anesthetic and surgical tactics. Purpose - to assess the perception and compliance of conscious patients during cesarean section with the procedure of filling out the «Safe Surgery» checklist; to identify possible negative psychological effects of this procedure. Materials and methods. The study included 100 patients after planned or urgent caesarean section (except for 1 category of urgency). The study was conducted on the basis of an anonymous survey (online Google form) of patients in the postoperative period (1-2 hours after surgery). Patients were asked to rate the impact of completing the Safe Surgery Checklist on their comfort and anxiety levels, and whether they believed that routine use of such technologies increased their safety. Results. The results of this study indicate that the majority of patients responded positively to the use of the WHO checklist implemented in the operating room. More than half of the surveyed patients (56%) were worried about a possible error during the preparation or carrying out of the surgical intervention. Almost all patients - 13 (92.9%) who had experienced medical errors before, worried that a medical error during this intervention could harm their health (OR=13; 95% CI: 1.6-103.7; p=0.006). The procedure of filling out the checklist alleviated the feeling of loss in 66% of patients and did not cause discomfort in 96% of respondents. 68% of patients agreed that the procedure of filling out the checklist reduced anxiety. The vast majority of patients (90%) agreed that the procedure of filling out the «Safe Surgery» checklist increases their level of safety in the operating room. 96% of patients believed that the checklist should be used before every surgical intervention and 96% would like it to be used during future surgical interventions. Conclusions. Patients who were conscious during Caesarean section positively perceived the procedure of filling out the «Safe Surgery» checklist and believed that the use of such a checklist increases safety during surgery. Most patients also reported no discomfort and reduced fear and anxiety during the Safe Surgery Checklist procedure. 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 institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124308523","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.V. Podolskyy, Y. Antypkin, V. Podolskiy, T. Umanets, L. Livshits, T. Kaminska, D.A. Emir-Useinova
Purpose - to characterize the epigenetic factors of COVID-19 in women of childbearing age, residents of Kharkiv region who have had coronavirus infection, identified as a result of clinical and epidemiological studies. Materials and methods. This research investigates the potential epigenetic risk factors for COVID-19 onset and progression in women of childbearing age in the Kharkiv region. An original, comprehensive questionnaire designed to capture a wide range of health and socio-biological risk factors was disseminated among 100 women who had contracted the virus. Follow-up examinations and interviews were conducted with 26 of these women. The questionnaire covered a broad spectrum, including general information, social status, working conditions, smoking and alcohol use habits, sexual health history, and a interview. Results. The study revealed that a notable proportion of the surveyed women experienced adverse working conditions. 7.7% reported regular and 11.5% occasional exposure to chemically harmful environments. About 19.2% indicated consistent and 34.6% intermittent work-related nervous strain. Furthermore, 7.7% of the respondents identified persistent physical hazards at their workplace, while 23.1% experienced occupational harm. Among male partners, 3.8% always and 23.1% occasionally had contact with harmful vapours or chemicals at work. Epigenetic risk factors were determined using a clinical genealogical map. Occupational harm was absent before and after COVID-19 infection in 19.2% and 15.4% of women, respectively. Regarding harmful habits, 26.9% and 23.1% of women did not engage in tobacco smoking before and after COVID-19 infection, respectively, whereas 3.8% and 7.7% consumed alcohol. Past illnesses, such as rubella and Botkin's disease, were identified as potential epigenetic factors in 3.8% of women. Conclusions. It has been established that among the identified epigenetic risk factors that may directly or indirectly affect the spread of coronavirus infection in women residents of the Kharkiv region, the following require special attention of the doctor: contact with physical and chemical agents, past diseases and conditions, and bad habits, which may be important for the spread of the disease in women. It has been found that among the epigenetic factors of COVID-19, past illnesses and conditions are important - rubella was experienced by 3.8% of women before COVID-19, Botkin’s disease - 3.8%, and 3.8% of women before and after the disease. 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
{"title":"Characteristic of epigenetic factors of COVID-19 of fertile aged women residents of the Kharkiv region of Ukraine who have undergone coronavirus infection","authors":"V.V. Podolskyy, Y. Antypkin, V. Podolskiy, T. Umanets, L. Livshits, T. Kaminska, D.A. Emir-Useinova","doi":"10.15574/pp.2023.94.65","DOIUrl":"https://doi.org/10.15574/pp.2023.94.65","url":null,"abstract":"Purpose - to characterize the epigenetic factors of COVID-19 in women of childbearing age, residents of Kharkiv region who have had coronavirus infection, identified as a result of clinical and epidemiological studies. Materials and methods. This research investigates the potential epigenetic risk factors for COVID-19 onset and progression in women of childbearing age in the Kharkiv region. An original, comprehensive questionnaire designed to capture a wide range of health and socio-biological risk factors was disseminated among 100 women who had contracted the virus. Follow-up examinations and interviews were conducted with 26 of these women. The questionnaire covered a broad spectrum, including general information, social status, working conditions, smoking and alcohol use habits, sexual health history, and a interview. Results. The study revealed that a notable proportion of the surveyed women experienced adverse working conditions. 7.7% reported regular and 11.5% occasional exposure to chemically harmful environments. About 19.2% indicated consistent and 34.6% intermittent work-related nervous strain. Furthermore, 7.7% of the respondents identified persistent physical hazards at their workplace, while 23.1% experienced occupational harm. Among male partners, 3.8% always and 23.1% occasionally had contact with harmful vapours or chemicals at work. Epigenetic risk factors were determined using a clinical genealogical map. Occupational harm was absent before and after COVID-19 infection in 19.2% and 15.4% of women, respectively. Regarding harmful habits, 26.9% and 23.1% of women did not engage in tobacco smoking before and after COVID-19 infection, respectively, whereas 3.8% and 7.7% consumed alcohol. Past illnesses, such as rubella and Botkin's disease, were identified as potential epigenetic factors in 3.8% of women. Conclusions. It has been established that among the identified epigenetic risk factors that may directly or indirectly affect the spread of coronavirus infection in women residents of the Kharkiv region, the following require special attention of the doctor: contact with physical and chemical agents, past diseases and conditions, and bad habits, which may be important for the spread of the disease in women. It has been found that among the epigenetic factors of COVID-19, past illnesses and conditions are important - rubella was experienced by 3.8% of women before COVID-19, Botkin’s disease - 3.8%, and 3.8% of women before and after the disease. 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126016383","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 study the effect of complex treatment of periodontal tissue diseases on the indices of antioxidant and prooxidant systems of oral fluid in adolescents and young adults. Materials and methods. The biochemical parameters of oral fluid before and after treatment were studied in 114 adolescents and young adults (15 to 24 years old), who were divided into groups: the Group I included 26 people who smoked traditional cigarettes; the Group II - 22 people who smoked electronic cigarettes (vapes); the Group III - 23 people who smoked tobacco heating devices (IQOS); the Group IV - 43 people without a smoking habit. The following biochemical parameters were studied: the activity of superoxide dismutase and catalase enzymes, dyne conjugates and products that react to thiobarbituric acid, before and after treatment with the proposed complex: general - Quertin, Supervit and BioGaya ProDentis; topical - Stomolik and Holisal and conventional treatment. Results. In the Group I patients, the activity of superoxide dismutase in the oral fluid decreased by 1.4 times compared to the Group IV patients (p<0.05); in the Group II and III patients - by 1.2 times compared to non-smokers (p<0.05). In the Group I, the activity of the catalase enzyme decreased significantly (2.6 times) compared to the Group IV (p<0.05); in the Group II and III - by 1.8 times compared to non-smokers (p<0.05). The analysis of the data showed that in the Group I, the number of products reacting to thiobarbituric acid increased 2.5 times compared to the Group IV (p<0.05); in the Groups II and III - 1.9 times compared to the Group IV (p<0.05). The amount of diene conjugates in the oral fluid increased in both the Group I and Groups II and III patients, respectively, by 1.4 and 1.2 times compared with the Group IV patients (p<0.05). After treatment, there was an increase in antioxidant defense and inhibition of lipid peroxidation in oral fluid, with better results in the subgroups in which the proposed complex treatment was used, as well as in adolescents and young adults without smoking habits. Conclusions. In teenagers and young adults smokers, there is an increase in lipid peroxidation and a decrease in the antioxidant properties of oral fluid. Comparison of the results of biochemical parameters before and after treatment of periodontal tissue diseases in the observation groups by different methods indicates the advantages of the proposed complex treatment and allows us to conclude that it is highly effective. 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.
{"title":"Influence of complex treatment of periodontal tissue diseases on the indices of antioxidant and prooxidant systems in teenagers and young adults","authors":"I. Lisetska","doi":"10.15574/pp.2023.94.113","DOIUrl":"https://doi.org/10.15574/pp.2023.94.113","url":null,"abstract":"Purpose - to study the effect of complex treatment of periodontal tissue diseases on the indices of antioxidant and prooxidant systems of oral fluid in adolescents and young adults. Materials and methods. The biochemical parameters of oral fluid before and after treatment were studied in 114 adolescents and young adults (15 to 24 years old), who were divided into groups: the Group I included 26 people who smoked traditional cigarettes; the Group II - 22 people who smoked electronic cigarettes (vapes); the Group III - 23 people who smoked tobacco heating devices (IQOS); the Group IV - 43 people without a smoking habit. The following biochemical parameters were studied: the activity of superoxide dismutase and catalase enzymes, dyne conjugates and products that react to thiobarbituric acid, before and after treatment with the proposed complex: general - Quertin, Supervit and BioGaya ProDentis; topical - Stomolik and Holisal and conventional treatment. Results. In the Group I patients, the activity of superoxide dismutase in the oral fluid decreased by 1.4 times compared to the Group IV patients (p<0.05); in the Group II and III patients - by 1.2 times compared to non-smokers (p<0.05). In the Group I, the activity of the catalase enzyme decreased significantly (2.6 times) compared to the Group IV (p<0.05); in the Group II and III - by 1.8 times compared to non-smokers (p<0.05). The analysis of the data showed that in the Group I, the number of products reacting to thiobarbituric acid increased 2.5 times compared to the Group IV (p<0.05); in the Groups II and III - 1.9 times compared to the Group IV (p<0.05). The amount of diene conjugates in the oral fluid increased in both the Group I and Groups II and III patients, respectively, by 1.4 and 1.2 times compared with the Group IV patients (p<0.05). After treatment, there was an increase in antioxidant defense and inhibition of lipid peroxidation in oral fluid, with better results in the subgroups in which the proposed complex treatment was used, as well as in adolescents and young adults without smoking habits. Conclusions. In teenagers and young adults smokers, there is an increase in lipid peroxidation and a decrease in the antioxidant properties of oral fluid. Comparison of the results of biochemical parameters before and after treatment of periodontal tissue diseases in the observation groups by different methods indicates the advantages of the proposed complex treatment and allows us to conclude that it is highly effective. 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133864243","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}
Yury G. Antipkin, L. Kirilova, O. Miroshnikov, N.E. Horban
The problem of sleep disorders in children is one of the most urgent in the practice of a pediatrician and has become especially acute during wartime, given the chronic effects of a significant number of stressors. The need to develop practical recommendations for improving the quality of sleep in children during wartime necessitated a comparative study of the frequency and structure of sleep disorders in children during wartime and peacetime. Purpose - to determine the frequency and structure of nighttime sleep disorders in children with neurodevelopmental disorders and healthy children in wartime and peacetime. Materials and methods. An online survey of parents of 529 children aged 1-7 years (26.8% of healthy children and 73.2% of children with neurodevelopmental disorders) was conducted in 2022 during wartime. A survey of parents of 1352 children under the age of 7 was conducted in 2002 in peacetime (as part of the Family and Children of Ukraine project), with a case-control comparison. Results. The overall prevalence of nighttime sleep disorders among all children in wartime was 93.6% in healthy children and 94.8% in children with neurodevelopmental disorders. Difficulties falling asleep were noted in 51.4% of healthy children and 56.8% of children with neurodevelopmental disorders; frequent nighttime awakenings - in 35.9% and 39.0% of children, respectively. Sleep disorders: snoring - in 16.2% and 18.9% of children; apnoea - in 9.9% and 14.9% of children. Parasomnias: night terrors - in 19.7% and 18.6% of children; sleepwalking - in 2.8% and 4.4% of children. Comparison of the frequency of nighttime sleep disorders in healthy children in peacetime (2002) and wartime (2022): half of healthy children had difficulty going to bed (51.4% vs. 47.2%); early waking (49.8% vs. 12.7%); frequent waking at night (47.3% vs. 35.9%); snoring (33.6% vs. 16.2%); increased daytime sleepiness - 5 times more often in 2002 (30.3% vs. 6.3%); every fourth child has nightmares (25.6% vs. 26.8%); prolonged falling asleep (23.5% vs. 51.4% in 2022). Conclusions. The overall prevalence of nighttime sleep disorders among all children in wartime was 94.5%. In children with neurodevelopmental disorders, early awakenings (29.2% vs. 12.7%), sleep apnoea (14.9% vs. 9.9%), increased daytime sleepiness (14.9% vs. 6.3%), and catalepsy (8.3% vs. 4.2%) were more common compared to healthy children. In wartime, the incidence of early wake-ups (49.8% vs. 12.7% in 2022), snoring (33.6% vs. 16.2% in 2022), and increased daytime sleepiness (30.3% vs. 6.3% in 2022) decreased among healthy children, but the incidence of falling asleep problems increased by 2 times (51.4% vs. 23.5% in the 2002). Children with neurodevelopmental disorders are a more vulnerable group that reacts negatively to the stressful conditions of martial law by increasing the frequency of nighttime sleep disorders. The research was carried out in accordance with the principles of the Helsinki Declaration. The study
儿童睡眠障碍问题是儿科医生工作中最紧迫的问题之一，在战争期间，由于大量压力源的慢性影响，睡眠障碍问题变得尤为严重。为改善战时儿童睡眠质量提出切实可行的建议的必要性使得对战时和和平时期儿童睡眠失调的频率和结构进行比较研究成为必要。目的-确定战时和和平时期神经发育障碍儿童和健康儿童夜间睡眠障碍的频率和结构。材料和方法。2022年，对529名1-7岁儿童(占健康儿童的26.8%，占神经发育障碍儿童的73.2%)的父母进行了在线调查。2002年在和平时期对1352名7岁以下儿童的父母进行了调查(作为乌克兰家庭和儿童项目的一部分)，并进行了病例对照比较。结果。战时所有儿童夜间睡眠障碍的总体患病率在健康儿童中为93.6%，在神经发育障碍儿童中为94.8%。51.4%的健康儿童和56.8%的神经发育障碍儿童存在入睡困难;频繁夜间醒来——分别为35.9%和39.0%的儿童。睡眠障碍:打鼾——16.2%和18.9%的儿童打鼾;9.9%和14.9%的儿童有呼吸暂停。睡眠异常:夜惊——19.7%和18.6%的儿童;梦游——2.8%和4.4%的儿童。和平时期(2002年)和战时(2022年)健康儿童夜间睡眠障碍发生频率的比较:半数健康儿童入睡困难(51.4%对47.2%);早醒(49.8% vs 12.7%);夜间频繁醒来(47.3% vs. 35.9%);打鼾(33.6% vs. 16.2%);白天嗜睡增加——2002年增加了5倍(30.3%比6.3%);四分之一的孩子做过噩梦(25.6%比26.8%);入睡时间延长(23.5%，2022年为51.4%)。结论。战时所有儿童夜间睡眠障碍的总体患病率为94.5%。在患有神经发育障碍的儿童中，与健康儿童相比，早醒(29.2%对12.7%)、睡眠呼吸暂停(14.9%对9.9%)、白天嗜睡增加(14.9%对6.3%)和猝厥(8.3%对4.2%)更为常见。战时，健康儿童早醒(49.8%，2022年为12.7%)、打鼾(33.6%，2022年为16.2%)、白天嗜睡增加(30.3%，2022年为6.3%)的发生率下降，但入睡问题的发生率增加了2倍(51.4%，2002年为23.5%)。患有神经发育障碍的儿童是一个更脆弱的群体，他们对戒严令的压力状况反应消极，夜间睡眠障碍的频率增加。这项研究是按照《赫尔辛基宣言》的原则进行的。研究方案经所有参与机构的当地伦理委员会批准。获得患者的知情同意进行研究。
{"title":"Comparative analysis of the prevalence and structure of night sleep disorders in children with neurodevelopmental disorders in wartime and peacetime","authors":"Yury G. Antipkin, L. Kirilova, O. Miroshnikov, N.E. Horban","doi":"10.15574/pp.2023.94.77","DOIUrl":"https://doi.org/10.15574/pp.2023.94.77","url":null,"abstract":"The problem of sleep disorders in children is one of the most urgent in the practice of a pediatrician and has become especially acute during wartime, given the chronic effects of a significant number of stressors. The need to develop practical recommendations for improving the quality of sleep in children during wartime necessitated a comparative study of the frequency and structure of sleep disorders in children during wartime and peacetime. Purpose - to determine the frequency and structure of nighttime sleep disorders in children with neurodevelopmental disorders and healthy children in wartime and peacetime. Materials and methods. An online survey of parents of 529 children aged 1-7 years (26.8% of healthy children and 73.2% of children with neurodevelopmental disorders) was conducted in 2022 during wartime. A survey of parents of 1352 children under the age of 7 was conducted in 2002 in peacetime (as part of the Family and Children of Ukraine project), with a case-control comparison. Results. The overall prevalence of nighttime sleep disorders among all children in wartime was 93.6% in healthy children and 94.8% in children with neurodevelopmental disorders. Difficulties falling asleep were noted in 51.4% of healthy children and 56.8% of children with neurodevelopmental disorders; frequent nighttime awakenings - in 35.9% and 39.0% of children, respectively. Sleep disorders: snoring - in 16.2% and 18.9% of children; apnoea - in 9.9% and 14.9% of children. Parasomnias: night terrors - in 19.7% and 18.6% of children; sleepwalking - in 2.8% and 4.4% of children. Comparison of the frequency of nighttime sleep disorders in healthy children in peacetime (2002) and wartime (2022): half of healthy children had difficulty going to bed (51.4% vs. 47.2%); early waking (49.8% vs. 12.7%); frequent waking at night (47.3% vs. 35.9%); snoring (33.6% vs. 16.2%); increased daytime sleepiness - 5 times more often in 2002 (30.3% vs. 6.3%); every fourth child has nightmares (25.6% vs. 26.8%); prolonged falling asleep (23.5% vs. 51.4% in 2022). Conclusions. The overall prevalence of nighttime sleep disorders among all children in wartime was 94.5%. In children with neurodevelopmental disorders, early awakenings (29.2% vs. 12.7%), sleep apnoea (14.9% vs. 9.9%), increased daytime sleepiness (14.9% vs. 6.3%), and catalepsy (8.3% vs. 4.2%) were more common compared to healthy children. In wartime, the incidence of early wake-ups (49.8% vs. 12.7% in 2022), snoring (33.6% vs. 16.2% in 2022), and increased daytime sleepiness (30.3% vs. 6.3% in 2022) decreased among healthy children, but the incidence of falling asleep problems increased by 2 times (51.4% vs. 23.5% in the 2002). Children with neurodevelopmental disorders are a more vulnerable group that reacts negatively to the stressful conditions of martial law by increasing the frequency of nighttime sleep disorders. The research was carried out in accordance with the principles of the Helsinki Declaration. The study ","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125270133","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}
A.M. Naumchik, I. Davydova, А.Yu. Lymanska, V. S. Oliynyk
Immune thrombocytopenia (ITP) is one of the most common causes of thrombocytopenia (TP) in pregnancy and is the main cause of severe TP among pregnant women. Autoimmune pathogenesis determines the danger of hemorrhagic complications both for the pregnant and for the fetus and newborn. Differential diagnosis between gestational and immune thrombocytopenia is necessary, as this determines further tactics. The goal of ITP treatment is to achieve a safe level of platelets according to the gestational age and clinical situation. For treatment, different lines of therapy are used alternately with step-by-step control of effectiveness. Purpose - to analyze the worldwide and personal experience of pregnancy management in severe ITP refractory to treatment. We present a case of pregnancy management and delivery with a severe immune thrombocytopenia, diagnosed at 25 weeks of pregnancy with hemorrhagic syndrome, unresponsive to treatment. All pharmacological tools were used. Delivery by caesarean section with appropriate preoperative and intraoperative transfusion preparation. Recombinant human thrombopoietin was used in the postoperative period. The newborn has thrombocytopenia without hemorrhagic syndrome. Conclusions. Correct diagnosis of conditions accompanied by thrombocytopenia during pregnancy determines the correct and effective treatment tactics. Pregnancy and childbirth in women with severe thrombocytopenia belong to the group of extremely high risk. Antenatal management and delivery of such pregnant women should be carried out by a multidisciplinary team with the participation of a hematologist, a specialist in internal medicine, under careful control of laboratory indicators and clinical changes, with control of the fetal antenatal condition. It is necessary to control the platelet level of the newborn in the postnatal period. 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 institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
{"title":"Clinical case of severe immune thrombocytopenia during pregnancy","authors":"A.M. Naumchik, I. Davydova, А.Yu. Lymanska, V. S. Oliynyk","doi":"10.15574/pp.2023.94.142","DOIUrl":"https://doi.org/10.15574/pp.2023.94.142","url":null,"abstract":"Immune thrombocytopenia (ITP) is one of the most common causes of thrombocytopenia (TP) in pregnancy and is the main cause of severe TP among pregnant women. Autoimmune pathogenesis determines the danger of hemorrhagic complications both for the pregnant and for the fetus and newborn. Differential diagnosis between gestational and immune thrombocytopenia is necessary, as this determines further tactics. The goal of ITP treatment is to achieve a safe level of platelets according to the gestational age and clinical situation. For treatment, different lines of therapy are used alternately with step-by-step control of effectiveness. Purpose - to analyze the worldwide and personal experience of pregnancy management in severe ITP refractory to treatment. We present a case of pregnancy management and delivery with a severe immune thrombocytopenia, diagnosed at 25 weeks of pregnancy with hemorrhagic syndrome, unresponsive to treatment. All pharmacological tools were used. Delivery by caesarean section with appropriate preoperative and intraoperative transfusion preparation. Recombinant human thrombopoietin was used in the postoperative period. The newborn has thrombocytopenia without hemorrhagic syndrome. Conclusions. Correct diagnosis of conditions accompanied by thrombocytopenia during pregnancy determines the correct and effective treatment tactics. Pregnancy and childbirth in women with severe thrombocytopenia belong to the group of extremely high risk. Antenatal management and delivery of such pregnant women should be carried out by a multidisciplinary team with the participation of a hematologist, a specialist in internal medicine, under careful control of laboratory indicators and clinical changes, with control of the fetal antenatal condition. It is necessary to control the platelet level of the newborn in the postnatal period. 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 institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121672331","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}
O. Starets, T. Khimenko, N. Kotova, S.I. Ismayilova, O. Kanarova
Breastfeeding (BF) benefits all babies; it also benefits preterm infants, so it is crucial that mothers receive skilled and expanded lactation support. Purpose - to identify factors associated with the absence or early cessation of BF, to evaluate the short-term consequences of the absence of BF in preterm infants and to identify the relationship between feeding practices (BF vs formula feeding - FF) and adherence to preventive measures recommended for preterm children, related with food. Materials and methods. An anonymous online survey of parents (self-reported) of preterm infants was conducted using the Google Forms service. The study involved 390 children divided into two groups. The main group (MG) included 290 children who were on mechanical ventilation, and the control group (CG) included 70 children on BF. Results. Early termination of BF of a preterm baby or start from FF is associated with the following factors: maternal age under 18 or older than 38 years old (OR=3.47; 95% CI: 0.84-2.40), male gender of the child (OR=2.43; 95% CI: 1.41-4.18), birth from a multiple pregnancy (OR=1.94; 95% CI: 1.01-3.73), prolonged (more than 7 days) mechanical lung ventilation (OR=2.52; 95% CI: 1.36-4.66) and prolonged (more than 14 days) tube feeding of the child (OR=1.96; 95% CI: 1.14-3.36). Children of MG aged 6 months of adjusted age were significantly more likely to have delayed psychomotor development. Conclusions. When counseling parents on the nutrition of a child born pretermin the first year of life, it should be taken into account that in the absence of BF, parents start introducing the first complementary foods to the child later (р<0.001), including those rich in iron (р=0.01), and parents of a BF child more often neglect the recommendations for adding iron and vitamin D (OR=2.09 vs OR=1.92). The lack of BF of preterm babies for at least the first 6 months of life is associated with an increased risk of developing atopic dermatitis and acute respiratory diseases in the first year of life (OR=2.14 and OR=2.24, respectively). 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 the participating institution. No conflict of interests was declared by the authors.
{"title":"Risk factors and short-term consequences of the absence or early cessation of breastfeeding in infants born preterm","authors":"O. Starets, T. Khimenko, N. Kotova, S.I. Ismayilova, O. Kanarova","doi":"10.15574/pp.2023.93.57","DOIUrl":"https://doi.org/10.15574/pp.2023.93.57","url":null,"abstract":"Breastfeeding (BF) benefits all babies; it also benefits preterm infants, so it is crucial that mothers receive skilled and expanded lactation support. Purpose - to identify factors associated with the absence or early cessation of BF, to evaluate the short-term consequences of the absence of BF in preterm infants and to identify the relationship between feeding practices (BF vs formula feeding - FF) and adherence to preventive measures recommended for preterm children, related with food. Materials and methods. An anonymous online survey of parents (self-reported) of preterm infants was conducted using the Google Forms service. The study involved 390 children divided into two groups. The main group (MG) included 290 children who were on mechanical ventilation, and the control group (CG) included 70 children on BF. Results. Early termination of BF of a preterm baby or start from FF is associated with the following factors: maternal age under 18 or older than 38 years old (OR=3.47; 95% CI: 0.84-2.40), male gender of the child (OR=2.43; 95% CI: 1.41-4.18), birth from a multiple pregnancy (OR=1.94; 95% CI: 1.01-3.73), prolonged (more than 7 days) mechanical lung ventilation (OR=2.52; 95% CI: 1.36-4.66) and prolonged (more than 14 days) tube feeding of the child (OR=1.96; 95% CI: 1.14-3.36). Children of MG aged 6 months of adjusted age were significantly more likely to have delayed psychomotor development. Conclusions. When counseling parents on the nutrition of a child born pretermin the first year of life, it should be taken into account that in the absence of BF, parents start introducing the first complementary foods to the child later (р<0.001), including those rich in iron (р=0.01), and parents of a BF child more often neglect the recommendations for adding iron and vitamin D (OR=2.09 vs OR=1.92). The lack of BF of preterm babies for at least the first 6 months of life is associated with an increased risk of developing atopic dermatitis and acute respiratory diseases in the first year of life (OR=2.14 and OR=2.24, respectively). 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 the participating institution. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114305014","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：