CHILD`S HEALTH最新文献

{"title":"The role of miRNAs in the development of cholangiopathies. Part 2","authors":"A.E. Abaturov, V.L. Babуch","doi":"10.22141/2224-0551.18.5.2023.1619","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1619","url":null,"abstract":"The role of miRNA in the development of cho­langiopathies is considered in the scientific review. This article discusses the role of miRNA in biliary atresia, polycystic liver disease, and cholangiocarcinoma. To write the article, information was searched using Scopus, Web of Science, MedLine, PubMed, Google Scholar, EMBASE, Global Health, The Cochrane Library databases. The results of experimental studies indicate that the influence of miRNA causes the development of biliary atresia. It is found that, according to the results of ­miRNA expression profiling of extrahepatic bile ducts and gallbladder, miR-133a/b, ­miR-30b/c, miR-200a, miR-195, miR-365 and miR-320 are involved in the pathogenesis of biliary atresia. The article states that the scientists demonstrated a high level of ADD3 mRNA expression in the liver tissue of patients with biliary atresia. ADD3 overexpression promotes the adhesion and accumulation of epithelial cells in the bile ducts, which can lead to obstruction of the bile ducts and cholestasis. In turn, an excess of bile acids stimulates the proliferation of cholangiocytes and causes the development of liver fibrosis. Given that hyperproli­feration of epithelial cells of the bile ducts due to an impaired cell cycle is a key feature of cystogenesis in polycystic liver disease, researchers hypothesized that miRNAs, changing the cell cycle, may contribute to hepatic cystogenesis. The authors showed that polycystic liver disease is accompanied by a decrease in the expression of miR-15a, whose target is the mRNA of the cell division cycle 25A regulator. Numerous miRNAs are involved in the development of cholangiocarcinoma, changes in the expression and content of which in blood serum were noted in patients with this form of neoplasms. Thus, after a comprehensive review using the latest information search databases, it was found that in the modern scientific literature, the authors determine the association of micro-RNA generation activity and the development of cholangiopathies, namely: biliary atresia, polycystic liver disease, cholangiocarcinoma.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"353 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135258775","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}

{"title":"Personalized genotype-associated diagnosis of the progression of atopic march in children","authors":"V.O. Dytiatkovskyi","doi":"10.22141/2224-0551.18.5.2023.1614","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1614","url":null,"abstract":"Background. Atopic march (AM) is the progression of atopic lesions (AL) from monoorganic phenotypes (MOPh), usually atopic dermatitis (AD), to a combination with allergic rhinitis/rhinoconjunctivitis (AR/ARC) and bronchial asthma (BA) in the full-scope polyorganic phenotype (POPh) AD + AR/ARC + BA. At the same time, AD is the initial and basic AM MOPh. The basis of AL and AM is the human genotype, in particular, single nucleotide variants (SNV) of genes that predispose to the development of AL phenotypes. Namely, these are SNV of thymic stromal lymphopoietin (TSLP) and orоsomucoid-1-like protein 3 (ORMDL3): SNV rs_11466749 TSLP and rs_7216389 ORMDL3. The purpose of this study was to detect the associations and risks of developing AM POPh AD + AR/ARC and AD + AR/ARC + BA related to baseline MOPh AD and to each other in children with different SNV rs_11466749 TSLP and rs_7216389 ORMDL3 genotypes. Materials and methods. Two hundred and thirty-two children aged 3 to 18 years took part in the study. The main group consisted of 127 patients with 3 studied AM phenotypes: one MOPh AD (n = 58) and two POPh: AD + AR/ARC (n = 43) and AD + AR/ARC + BA (n = 26). The control group included 105 children without AL, suffering from gastrointestinal diseases. All children in the study groups underwent a buccal swab of the DNA material, which then was studied using the real-time polymerase chain reaction with restriction fragment length polymorphism to determine the genotypes of SNV candidates: A/A, A/G, G/G rs_11466749 TSLP and C/C, C/T, T/T rs_7216389 ORMDL3. Pearson’s χ2 criterion and Fisher’s exact test, Bravais-Pearson contingency coefficient (r), logistic regression analysis with determination of odds ratio (OR) with 95% confidence interval (95% CI), receiver operating characteristic (ROC) analysis with calculation of the area under the ROC curve with a 95% CI and operating characteristics — sensitivity and specificity were used for statistical processing. The critical level of statistical significance of the results during testing of all hypotheses was p < 0.05, the tendency to probability was determined at p = 0.05–0.1. Results. The following statistically significant differences were detected in the occurrence of genotypes related to the control group: for POPh AD + AR/ARC: SNV rs_7216389 ORMDL3: C/C — 14.0 %, T/T — 39.5 to 27.6 and 15.2 %, respectively (p = 0.08 and p < 0.05); for POPh AD + AR/ARC + BA: SNV rs_11466749 TSLP: A/A — 77.0 %, A/G — 11.5 to 50.5 and 45.7 %, respectively (p < 0.05 and p < 0.01). Among the phenotypes of the main group, the following statistically significant differences in the genotypes incidence had been detected: AD + AR/ARC related to AD: G/G rs_11466749 TSLP — 9.3 to 1.7 % (p = 0.08), T/T rs_7216389 ORMDL3 — 39.5 to 19.0 % (p < 0.05); AD + AR/ARC + BA related to AD: SNV rs_11466749 TSLP: A/A — 77.0 to 55.2 % (p = 0.06), A/G — 11.5 to 43.1 % (p < 0.01), G/G — 11.5 to 1.7 % (p = 0.09). The following associations were found bet","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"129 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135257897","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}

{"title":"Impact of stress on adolescents during puberty (part 1)","authors":"L.A. Strashok, L.I. Rak, H.M. Danylenko, A.V. Yeshchenko, V.L. Kashina-Yarmak, E.M. Zavelya, M.Yu. Isakova","doi":"10.22141/2224-0551.18.5.2023.1616","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1616","url":null,"abstract":"The first part of the presented article deals with the actual problem of stress impact of on the body in adolescence. Puberty is characterized by significant anatomical and physiological, neuroendocrine and psychological changes. During the war in Ukraine, there are many significant factors that provoke stresses, which are superimposed on the stress of puberty. Stressors can lead to significant psychological pressure, physical problems and, as a result, an impact on the physical health and well-being of children and adolescents. A significant stress factor is a change of residence and lifestyle. The article presents the data of own research on the study of the impact of military operations in Ukraine on the psycho-emotional state and health of internally displaced school-aged children and adolescents. An increase in the tense psycho-emotional state with an increase in negative emotions among migrant adolescents compared to the pre-war period is shown. The adolescents’ optimistic view of the future indicated a certain potential for resilience. Increased sensitivity to stressful events in adolescents is due to the maturation of stress-sensitive parts of the brain and rela­ted changes in hormonal reactivity. The course of a stress reaction is coordinated by an interaction of the stress-realizing and stress-li­miting systems. The first part of the article details the neuroendocrine changes in the hypothalamus of an adolescent provoked by a combination of stress and puberty. The effects of corticotropin-releasing hormone, gonadotropin-releasing hormone and gonadotropin-inhibitory hormone, dopamine, serotonin, gamma-aminobutyric acid, and others have been described. In adolescence, the adaptive stress reactions are superimposed on the process of adaptation to sexual maturation, physical growth and psychosocial development. The relationship of hormones and neurotransmitters of the hypothalamus with other neuroendocrine factors is presented in the second part of the article.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135258643","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}

{"title":"The effect of vitamin D supplementation on the frequency and course of recurrent respiratory diseases in children","authors":"Yu.V. Marushko, S.I. Yesipova, T.V. Hyshchak","doi":"10.22141/2224-0551.18.5.2023.1612","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1612","url":null,"abstract":"Background. Recurrent and prolonged course of respiratory infections leads to the formation of chronic foci of inflammation, the persistence of viruses, impaired physical and psychomotor development, and a decrease in the child’s immunity. Given the participation of vitamin D (VD) in the regulation of the body’s immune response, the study of its role in the development and course of recurrent respiratory diseases in children remains re­levant. The purpose is to study the effect of vitamin D supplementation on the frequency and course of recurrent respiratory diseases in children. Materials and methods. We examined 52 children with recurrent respiratory infections aged 4 to 10 years. Children were examined before and after VD supplementation according to the study criteria: the average frequency of acute respiratory infection (ARI) episodes per year, the severity of the clinical manifestations of ARI episode, its average duration, the frequency of antibiotic prescriptions and outpatient visits to the doctor. Results. It was found that at the beginning of the exa­mination, the level of 25(OH)D in the blood serum ranged from 11.1 to 29.9 ng/ml, 22 (42.3 %) children had VD deficiency. An analysis of the frequency of ARI episodes per year showed that children with VD deficiency were ill more often than children with a sufficient level of VD (p < 0.001). According to the results of the study, it was found that VD supplementation contributes to a decrease in the frequency of ARI episodes from 8.7 ± 1.7 to 6.8 ± 1.2 times a year (p < 0.001), a decrease in the average number of symptoms of an episode of acute respiratory infections per year from 5.5 ± 0.5 to 4.5 ± 0.5 and their manifestations from 9.2 to 7.41 points (p < 0.001), a decrease in the duration of ARI episode from 6.0 ± 1.7 to 5.7 ± 1.5 days (p = 0.003), as well as a decrease in the number of outpatient visits from 5 to 4 (p = 0.004) and antibiotic prescriptions from 61 to 38 (p < 0.001). Conclusions. VD supplementation improves the course of respiratory diseases in children. The study was carried out in accordance with the Declaration of Helsinki principles. The study protocol was adopted by the ethics committee of the institution indicated in the work. The informed consent of the children’s parents was obtained.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135257766","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}

{"title":"Food intolerance in premature babies: possibilities of additional diagnostics","authors":"T.K. Mavropulo, A.A. Khorosh","doi":"10.22141/2224-0551.18.5.2023.1617","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1617","url":null,"abstract":"Due to the immaturity of the digestive system and gastrointestinal motility the preterm infants have a critical challenge in establishing adequate enteral nutrition, which is a frequent cause of gastrointestinal complications such as food intolerance and necrotizing enterocolitis. Modern clinical methods of assessing the maturity of the intestines and the child's readiness for enteral nutrition are subjective, this slows down the expansion of enteral nutrition, increases the duration of parenteral nutrition, and accordingly , period of a child`s hospitalizing. Objective methods of diagnosis are needed, which would contribute to the effective diagnosis and monitoring of food intolerance in preterm infants. Therefore, the purpose of our review was to search and summarize literature data on objective methods of diagnosing impaired food tolerance in premature baby, which could to provide daily monitoring, would be safe, cost-effective and easily accessible. Results and their discussion. Accordingly, three leading and most promising methods of examining the newborns gastrointestinal tract were analyzed. The were ultrasound examination (absence or reverse diastolic blood flow in the umbilical artery, high pulsation index in the fetal venous duct, indicators of blood flow in the upper mesenteric artery of the newborn), near-infrared spectroscopy (estimation of oxygen saturation of splanchnic tissue), and auscultation of intestinal sounds (phonoenterogram). Each of these methods has advantages and disadvantages, but to solve these existing problems, there has been recently an increasing amount of research on the bowel sounds using (namely their computerized assessment) as a new diagnostic tool. New research and further study of intestinal murmurs in premature newborns of different gestational ages with the development of clear criteria for data interpretation are needed to assess the maturity of the gastrointestinal tract, to create a diagnosis plan of food intolerance, and to develop an algorithm for early intervention.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135258778","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}

{"title":"The program of multidisciplinary online support of children with spina bifida in Ukraine during the war","authors":"O.R. Boyarchuk, M.V. Koshmaniuk","doi":"10.22141/2224-0551.18.5.2023.1615","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1615","url":null,"abstract":"Background. The Russian aggression against Ukraine has exacerbated the challenges faced by children with spina bifida (SB). Access to healthcare is severely impacted due to security concerns, restricted mobility, and mass displacement. To address these issues and improve access to medical care, we launched a project titled “The program of multidisciplinary online support of children with spina bifida in Ukraine”. The aim: to present the program of multidisciplinary online support of patients with SB and their families during the war for improving healthcare for this vulnerable group of patients at a time of limited opportunities. Methods. The project ran from June to December 2022 and involved collaboration of the NGO “Lights of Spirit”, doctors, and specialists including a lawyer, a psychologist, a social worker, a teacher. This multidisciplinary team worked together to provide comprehensive assistance to families with children having SB. Results. Overall, 149 families with children with SB and hydrocephalus from nearly all regions of Ukraine participated in the project. Initially, 82 online consultations were conducted. Nineteen online meetings were organized for parents with the involvement of a physical therapist, an occupational therapist, and a psychologist and 87 families took part in these meetings. Parents and children with SB received online consultations from doctors of the multidisciplinary team, as well as examination, treatment, necessary care products, and medicine tailored to their individual needs. The project also provided educational, informational, and psychological support. Conclusions. The program of multidisciplinary online support of children with SB in Ukraine during the Russian invasion confirmed its significance, necessity, and effectiveness. It facilitated the formation of partnerships between patients, parents, and clinicians. The project showed the problems of prevention and care of children with SB and also prospects for future development in this field.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135258779","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}

{"title":"Cardiovascular disorders in children with COVID-19","authors":"V.V. Yevtushenko, I.Yu. Seriakova, S.O. Kramarov, N.S. Kyrytsia, V.O. Shadrin, O.O. Voronov","doi":"10.22141/2224-0551.18.5.2023.1613","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1613","url":null,"abstract":"Background. The purpose of the work is to study the prevalence of cardiac disorders in hospitalized children with coronavirus disease (COVID-19). Materials and methods. A retrospective, cohort, monocenter study of the medical records of children who underwent inpatient treatment between September and December 2021 at the Kyiv City Children’s Clinical Infectious Disease Hospital was conducted. For our study, we selected the medical records of patients with polymerase chain reaction-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the presence of at least one result of cardiac activity examination by electrocardiography (ECG) and/or echocardiography. The first study of cardiac activity by ECG and/or echocardiography was carried out in the first three days of inpatient treatment. Standard methods of descriptive statistics were used for data processing. Non-parametric statistical methods (Mann-Whitney test, chi-square, Pearson’s exact test) were used for mathematical analysis. The research was carried out in accordance with the Declaration of Helsinki principles. The study was approved by the bioethics committee of the hospital. Results. Among 305 children hospitalized with a diagnosis of U07.1 (2019-nCoV acute respiratory disease), there were selected 195 medical histories of patients aged 15 days to 18 years (median of 5.37 years), who were examined for cardiac activity by ECG and/or echocardiography. The most common changes were rhythm disturbances in the form of sinus tachycardia (20.8 %), bradycardia (11.9 %) and sinus arrhythmia (7.9 %), ventricular conduction disorders (25.7 %), deviation of the electrical axis of the heart (10.9 %) and repolarization disorders (31.7 %). During echocardiographic examination, structural abnormalities in the form of myocardial hypertrophy were detected in 3.1 % of patients, dilated heart chambers in 2 %, and pericardial effusion in 9.2 %. Among the functional changes, we observed: a decrease in left ventricular contractility in 4.1 % of cases, in cardiac output in 28.6 %, and an increase in total peripheral resistance in 41.8 %. Heart rhythm disturbances in the form of sinus tachycardia, deviation of the electrical axis of the heart, a decrease in the amplitude of the ECG waves, repolarization disorders, and pericardial effusion were associated with an increased risk of death in children with COVID-19. Clinical cases of cardiovascular complications in the form of jugular vein thrombosis and infectious endocarditis illustrate the role of the cardiovascular system in the pathogenesis of coronavirus disease. Conclusions. SARS-CoV-2 infection is often associated with damage to the cardiovascular system. In most pediatric patients, this occurs in the form of subclinical changes registered during laboratory or instrumental studies, but the development of manifest forms such as myocarditis, endocarditis, pericarditis, heart attack, coronary disease, thrombotic complications, and hear","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135258781","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}

{"title":"A case of tetanus in a previously immunized person","authors":"V.O. Rybak, V.H. Sudakevych, T.V. Nasalskyi, I.I. Dobryanska, V.V. Yevtushenko, S.O. Kramarov, N.S. Kyrytsia, O.O. Voronov, I.V. Skrytskyi","doi":"10.22141/2224-0551.18.5.2023.1618","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1618","url":null,"abstract":"Tetanus is an acute infectious disease of humans and animals caused by anaerobic wound bacteria. The nervous system structural damage caused by toxin of the pathogen leads to tonic tension of the skeletal muscles and periodic generalized convulsions. If proper medical care is not provided in time, tetanus ends fatally. The incidence of tetanus is relatively low due to the widespread vaccination, but this infection can also occur in previously immunized individuals. The infection is widespread mainly in countries with a low economic level and weak health system. The tetanus poses a risk for all population segments, but the newborns and pregnant women are most vulnerable. Accor­ding to the Center for Public Health, 14 cases of tetanus were registered in Ukraine in 2022. The clinical picture of tetanus, as defined by the World Health Organization, includes painful muscle contractions, risus sardonicus (persistent spasm of facial muscles) and trismus (inability to open the mouth). Such patients have a history of trauma or damage to soft tissues, skin or mucous membranes. However, tetanus is a disease with multiple lesions, because in addition to the nervous system, the cardiovascular, respiratory and other systems are involved in the process. In the treatment, it is important to promptly introduce specific human tetanus immunoglobulin, perform debridement, antibiotic therapy and situational therapy. However, it should be borne in mind that the most effective and important direction is tetanus vaccination. The article presents a clinical case of tetanus in an 18-year-old pre-immunized patient who was admitted to a district hospital as a result of an injury. The purpose of publishing this case is to remind physicians to be alert for tetanus. In addition, the authors wanted to emphasize the risk of developing the disease even in previously vaccinated patients. The presence of prior vaccination and a high level of antitoxic antibodies cannot rule out a diagnosis of tetanus.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"229 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135258774","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}

{"title":"Hormonal profiles and adjustment disorders in adolescent girls with menstrual abnormalities and comorbid pathology","authors":"V.O. Dynnik, О.О. Dynnik, H.О. Havenko, Yu.V. Volkova, O.G. Verchoshanova","doi":"10.22141/2224-0551.18.5.2023.1611","DOIUrl":"https://doi.org/10.22141/2224-0551.18.5.2023.1611","url":null,"abstract":"Background. The reproductive health of girls has acquired great social significance in connection with the problem of quantitative and qualitative reproduction of the population. The purpose of the study was to determine the hormonal status of adolescent females with menstrual disorders and various somatic pathologies and to investigate the state of adaptive-compensatory capacities in these patients. Materials and methods. The hormonal background was studied in 391 girls aged 12–17 years: 175 with abnormal uterine bleeding (AUB) and 216 with oligomenorrhea (OM). All patients were examined by a multidisciplinary team. Results. A comorbid pathology was found in the absolute majority of girls with menstrual abnormalities. Endocrine disorders were noted more often (pϕ < 0.001–0.00001). Indicators of hormone concentration in patients with menstrual disorders had no significant differences depending on the type of comorbidity. Probable changes in the content of some hormones were observed depending on the type of menstrual disorders. A significant increase in the level of luteinizing hormone (pu < 0.02) and a decrease in estradiol (pu < 0.02) were observed in patients with OM compared to those with AUB. The assessment of the adjustment state revealed that in girls with menstrual disorders, the average cortisol content did not differ from that of controls, and insulin was higher than in the comparison group (pu < 0.001). Ho­wever, high cortisol values (above 90 percentile) were noted in 8–13 % of patients with AUB and OM. The stress index (C/In) as a marker of a nonspecific stress response was lower than in the comparison group (pu < 0.0001), and it was probably higher in girls with OM than in adolescents with AUB (pu < 0.004). Conclusions. An interdisciplinary approach is a mo­dern strategy in the treatment of menstrual disorders in adolescence. A decrease in the stress index was found in girls with menstrual disorders, which may indicate a decrease in adaptive capacity. Moreover, adolescents with OM are more adjusted to menstrual disorders than girls with AUB.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135258777","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}

{"title":"Acute hepatitis of unknown origin in children: analysis of probable etiologies","authors":"O. Boyarchuk, V.V. Pavlyshak","doi":"10.22141/2224-0551.18.4.2023.1605","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1605","url":null,"abstract":"Background. An outbreak of hepatitis of unknown origin in children aged 1 month — 16 years was first reported by the WHO in April 2022. It was accompanied by a high frequency of acute liver failure, and up to 5 % of children required liver transplantation. The purpose of the review was to determine probable etiological factors and mechanisms of acute hepatitis of unknown origin based on a systematic analysis of literary sources. Materials and methods. We conducted a search for studies on cases or case series of acute hepatitis of unknown origin in the PubMed between January 2022 and February 2023. A combination of the following terms was used for the search: “unknown hepatitis”, “hepatitis of unknown origin”, “non-A-E hepatitis”, “hepatitis of unknown etiology” and “children”. Results. According to the search results, 312 publications were found. After the selection, 14 publications were included in the review. A systematic analysis of 1,188 cases of acute hepatitis of unknown origin, which corresponded to the identified case, showed a high variability of causative agents. However, most children were tested positive for adenovirus (almost 57 %), and 14 % of children had a positive PCR for SARS-CoV-2. Among other viruses detected in children, viruses of the herpes family should be noted, especially human herpesvirus 7 (34.2 %), human herpesvirus 6 (20 %), Epstein-Barr virus (18.2 %), cytomegalovirus (9.2 %). Rhinovirus (40.7 %), enterovirus/rhinovirus (28.7 %), parainfluenza virus (15.4 %), streptococcal infection, and other pathogens were also found. Conclusions. Viruses, genetic predisposition and other factors that change the body’s immune response play an important role in the development of an outbreak of severe hepatitis. Systematic analysis has shown that human adenovirus most often acts as a helper for adeno-associated virus 2, which plays a major role in initiating an immune response in genetically predisposed individuals, causing acute hepatitis and acute liver failure. SARS-CoV-2 infection probably also plays a certain role in immune activation and in the development of hyperinflammation, as do other viruses that act as helpers for adeno-associated virus 2. Continued collection of detailed clinical, microbiological, and epidemiological data on probable cases, as well as well-planned and coordinated follow-up studies are necessary to identify risk factors and other etiological factors associated with this disease.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125669881","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}