Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1603
L. Bogmat, N. Shevchenko, T. Holovko, V. Nikonova, I. Bessonova, E.L. Akhnazariants, A.O. Fadieieva
Background. A decrease in the age of onset of rheumatic diseases in children, an increase in the total duration of the disease, the development of persistent functional and organic disorders of organs and systems determine the need to study comorbid conditions already in childhood in order to optimize their diagnosis and comprehensive therapy. The purpose was to study the frequency and main patterns for the formation and further progression of comorbidities in children with rheumatic diseases (juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE)). Materials and methods. An analytical review of the literature on the prevalence and diagnosis of comorbid lesions in adult patients with rheumatic diseases and in children was carried out; 250 children aged 3–18 years with JIA and 67 children with SLE with a juvenile onset were dynamically monitored for the presence of comorbid conditions of the cardiovascular system, kidneys, lungs, eyes, bone tissue, blood lipid disorders. Results. The frequency and nature of comorbidity in children with JIA and SLE have been determined. Preservation of the process activity is the main factor in the progression of comorbid pathology and the formation of irreversible damage to organs and systems with the development of their failure and violations of the quality of life of patients. Conclusions. Based on the presented materials, it is possible to develop programs to prevent the formation and progression of irreversible damage to systems and organs that occur under comorbid conditions in children with rheumatic diseases and to effectively socialize these children.
{"title":"Comorbidity in children with rheumatic diseases: literature review and 10-year experience of own research","authors":"L. Bogmat, N. Shevchenko, T. Holovko, V. Nikonova, I. Bessonova, E.L. Akhnazariants, A.O. Fadieieva","doi":"10.22141/2224-0551.18.4.2023.1603","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1603","url":null,"abstract":"Background. A decrease in the age of onset of rheumatic diseases in children, an increase in the total duration of the disease, the development of persistent functional and organic disorders of organs and systems determine the need to study comorbid conditions already in childhood in order to optimize their diagnosis and comprehensive therapy. The purpose was to study the frequency and main patterns for the formation and further progression of comorbidities in children with rheumatic diseases (juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE)). Materials and methods. An analytical review of the literature on the prevalence and diagnosis of comorbid lesions in adult patients with rheumatic diseases and in children was carried out; 250 children aged 3–18 years with JIA and 67 children with SLE with a juvenile onset were dynamically monitored for the presence of comorbid conditions of the cardiovascular system, kidneys, lungs, eyes, bone tissue, blood lipid disorders. Results. The frequency and nature of comorbidity in children with JIA and SLE have been determined. Preservation of the process activity is the main factor in the progression of comorbid pathology and the formation of irreversible damage to organs and systems with the development of their failure and violations of the quality of life of patients. Conclusions. Based on the presented materials, it is possible to develop programs to prevent the formation and progression of irreversible damage to systems and organs that occur under comorbid conditions in children with rheumatic diseases and to effectively socialize these children.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"37 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":"121899688","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1604
H. V. Beketova, O. Volosovets, I. Horiacheva, O. Soldatova, O. Nazar
This article discusses the issues of modern ethical standards in pediatrics, considers the essence of the concept “a good pediatrician”. The key components of the practical professional activity of a pediatrician, such as honesty and integrity, reliability and responsibility, respect for others, compassion and sensitivity, self-improvement, self-awareness and knowledge of the professional limits of providing medical care, connections and cooperation, altruism and protection the interests of the patient and members of his/her family are considered by the authors. Information is provided regarding the basic ethical principles, duties and competencies of the practical professional activity of a pediatrician in the American healthcare system and the ethical principles of a doctor’s activity in Ukraine. The standards of behavior of a pediatrician are described, according to which he can be evaluated both by medical students, residents and colleagues, as well as by parents, which is necessary for providing quality medical care to children and adolescents. The reasons for the formation of conflict situations in the pediatrician’s practice and approaches to their effective resolution are considered, as well as the role of confidentiality and collegiality.
{"title":"Ethical standards in pediatrics: who is a “good pediatrician”?","authors":"H. V. Beketova, O. Volosovets, I. Horiacheva, O. Soldatova, O. Nazar","doi":"10.22141/2224-0551.18.4.2023.1604","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1604","url":null,"abstract":"This article discusses the issues of modern ethical standards in pediatrics, considers the essence of the concept “a good pediatrician”. The key components of the practical professional activity of a pediatrician, such as honesty and integrity, reliability and responsibility, respect for others, compassion and sensitivity, self-improvement, self-awareness and knowledge of the professional limits of providing medical care, connections and cooperation, altruism and protection the interests of the patient and members of his/her family are considered by the authors. Information is provided regarding the basic ethical principles, duties and competencies of the practical professional activity of a pediatrician in the American healthcare system and the ethical principles of a doctor’s activity in Ukraine. The standards of behavior of a pediatrician are described, according to which he can be evaluated both by medical students, residents and colleagues, as well as by parents, which is necessary for providing quality medical care to children and adolescents. The reasons for the formation of conflict situations in the pediatrician’s practice and approaches to their effective resolution are considered, as well as the role of confidentiality and collegiality.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"61 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":"123464378","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1600
Y. Tsyunchyk
Background. An increase in life expectancy of patients with cystic fibrosis contributes to the formation of severe pathology of the hepatobiliary system, leading to the development of fatal biliary cirrhosis. The purpose was to prospectively assess the predictive value of a combination of serum liver enzymes, ultrasound liver parameters and transient elastography for diagnosis of clinically significant liver fibrosis. Materials and methods. We enrolled 108 children aged 0–17 years with cystic fibrosis. The fibrosis stage was determined using transient elastography on FibroScan® 502 (Echosens, France). The activity of enzymes (alanine transaminase, aspartate transaminase, alkaline phosphatase, gamma-glutamyl transferase, lactate dehydrogenase-5), ultrasound parameters of the liver at different stages of liver fibrosis have been investigated. Results. Liver fibrosis of varying severity was detected in 29.6 % of patients with cystic fibrosis (liver elasticity ranged from 5.9 to 49.0 kPa). Liver cirrhosis was observed in 14.8 % of children with cystic fibrosis. The dependence of an increase in the activity of alkaline phosphatase, gamma-glutamyl transpeptidase, lactate dehydrogenase-5 and an enlargement of the left lobe of the liver, a reduction in the k ratio of the sizes of the right and left lobes of the liver on the degree of fibrosis F1-F4 (р < 0.05) was found. Conclusions. The combined use of transient elastography FibroScan with increased activity of the alkaline phosphatase, gamma-glutamyl transpeptidase, lactatе dehydrogenase-5 and changing of ultrasound liver parameters could be used for early diagnosis of hepatobiliary lesions in cystic fibrosis. The age of a patient with cystic fibrosis over 6 years old, male gender and the presence of ΔF508 deletion in the genotype have a high positive predictive value for liver fibrosis and cirrhosis.
{"title":"The early diagnosis of hepatobiliary lesions in children with cystic fibrosis","authors":"Y. Tsyunchyk","doi":"10.22141/2224-0551.18.4.2023.1600","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1600","url":null,"abstract":"Background. An increase in life expectancy of patients with cystic fibrosis contributes to the formation of severe pathology of the hepatobiliary system, leading to the development of fatal biliary cirrhosis. The purpose was to prospectively assess the predictive value of a combination of serum liver enzymes, ultrasound liver parameters and transient elastography for diagnosis of clinically significant liver fibrosis. Materials and methods. We enrolled 108 children aged 0–17 years with cystic fibrosis. The fibrosis stage was determined using transient elastography on FibroScan® 502 (Echosens, France). The activity of enzymes (alanine transaminase, aspartate transaminase, alkaline phosphatase, gamma-glutamyl transferase, lactate dehydrogenase-5), ultrasound parameters of the liver at different stages of liver fibrosis have been investigated. Results. Liver fibrosis of varying severity was detected in 29.6 % of patients with cystic fibrosis (liver elasticity ranged from 5.9 to 49.0 kPa). Liver cirrhosis was observed in 14.8 % of children with cystic fibrosis. The dependence of an increase in the activity of alkaline phosphatase, gamma-glutamyl transpeptidase, lactate dehydrogenase-5 and an enlargement of the left lobe of the liver, a reduction in the k ratio of the sizes of the right and left lobes of the liver on the degree of fibrosis F1-F4 (р < 0.05) was found. Conclusions. The combined use of transient elastography FibroScan with increased activity of the alkaline phosphatase, gamma-glutamyl transpeptidase, lactatе dehydrogenase-5 and changing of ultrasound liver parameters could be used for early diagnosis of hepatobiliary lesions in cystic fibrosis. The age of a patient with cystic fibrosis over 6 years old, male gender and the presence of ΔF508 deletion in the genotype have a high positive predictive value for liver fibrosis and cirrhosis.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"1 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":"114203167","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1599
L. Vakulenko, O. Obolonska, O. Nekhanevych, V. Golyk, T. Obolonska
Background. The adverse social situation in Ukraine and an increase in the number of injured children lead to a burden on trauma departments and rehabilitation centers. Looking for simple methods to help detect violations of compensatory mechanisms, one of which is the centralization of blood circulation, and impaired perfusion at the microcirculatory periphery level is of great current relevance. Materials and methods. A comprehensive clinical and functional examinations were applied to 44 children aged 10–15 years, 21 of them had home-related upper extremity fractures (main group), 23 otherwise healthy children served as the control group. All the children underwent the Box and Block Test (BBT), and the perfusion index (PI) from the extremities was recorded. Results. The BBT performance was characterized by a 1.6-fold decrease (p < 0.05) in the affected extremity of children aged 10–15 years under the rehabilitation treatment compared to that of the non-dominant extremity in healthy children and a 1.3-fold decrease (p < 0.05) in the healthy extremity compared to the dominant one. PI decreased to 2.52 ± 0.58 at rest in the main group children who underwent upper extremity rehabilitation treatment for injuries compared to 3.49 ± 0.34 (p < 0.05) in healthy children. PI reduced to 1.57 ± 0.56 in injured children at exercise loads versus 2.93 ± 0.91 (p < 0.05) in healthy children. The dynamics of recovery also differed and amounted to 2.82 ± 0.45 in the main group versus 4.00 ± 0.64 in the control group. Children with PI up to 1.5 ± 0.4 had significantly lower BBT scores at the beginning of exercise training. PI reduction to less than 1.5 allowed predicting a decrease in muscle functions, delayed wound healing, and the need for analgesia. With an increase in PI to 2.40 ± 0.54 during exercise training, children performed BBT better, while those who had a decrease in perfusion up to 0.98 ± 0.20 performed it twice as slowly (p < 0.05). As a study result, an association between the physical exercise load, changes in PI and BBT has been revealed. Conclusions. BBT scores were characterized by a 1.6-, 2.0- and 1.8-fold (p < 0.05) reduction during the first, second and third measurements, respectively, compared to those of healthy children. Characteristic feature of perfusion index was a statistically significant decrease before and during exercise training as well as slow dynamics of recovery. The correlations between perfusion index and BBT have proven the association of the rehabilitation processes and blood flow restoration.
{"title":"Association between upper extremity muscle function and perfusion in children for predicting the effectiveness of rehabilitation in the post-traumatic period","authors":"L. Vakulenko, O. Obolonska, O. Nekhanevych, V. Golyk, T. Obolonska","doi":"10.22141/2224-0551.18.4.2023.1599","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1599","url":null,"abstract":"Background. The adverse social situation in Ukraine and an increase in the number of injured children lead to a burden on trauma departments and rehabilitation centers. Looking for simple methods to help detect violations of compensatory mechanisms, one of which is the centralization of blood circulation, and impaired perfusion at the microcirculatory periphery level is of great current relevance. Materials and methods. A comprehensive clinical and functional examinations were applied to 44 children aged 10–15 years, 21 of them had home-related upper extremity fractures (main group), 23 otherwise healthy children served as the control group. All the children underwent the Box and Block Test (BBT), and the perfusion index (PI) from the extremities was recorded. Results. The BBT performance was characterized by a 1.6-fold decrease (p < 0.05) in the affected extremity of children aged 10–15 years under the rehabilitation treatment compared to that of the non-dominant extremity in healthy children and a 1.3-fold decrease (p < 0.05) in the healthy extremity compared to the dominant one. PI decreased to 2.52 ± 0.58 at rest in the main group children who underwent upper extremity rehabilitation treatment for injuries compared to 3.49 ± 0.34 (p < 0.05) in healthy children. PI reduced to 1.57 ± 0.56 in injured children at exercise loads versus 2.93 ± 0.91 (p < 0.05) in healthy children. The dynamics of recovery also differed and amounted to 2.82 ± 0.45 in the main group versus 4.00 ± 0.64 in the control group. Children with PI up to 1.5 ± 0.4 had significantly lower BBT scores at the beginning of exercise training. PI reduction to less than 1.5 allowed predicting a decrease in muscle functions, delayed wound healing, and the need for analgesia. With an increase in PI to 2.40 ± 0.54 during exercise training, children performed BBT better, while those who had a decrease in perfusion up to 0.98 ± 0.20 performed it twice as slowly (p < 0.05). As a study result, an association between the physical exercise load, changes in PI and BBT has been revealed. Conclusions. BBT scores were characterized by a 1.6-, 2.0- and 1.8-fold (p < 0.05) reduction during the first, second and third measurements, respectively, compared to those of healthy children. Characteristic feature of perfusion index was a statistically significant decrease before and during exercise training as well as slow dynamics of recovery. The correlations between perfusion index and BBT have proven the association of the rehabilitation processes and blood flow restoration.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"122 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":"117082418","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1606
A. Abaturov, V. Babуch
The role of miRNA in the development of cholangiopathies is given in the scientific review. This article discusses the role of miRNA in primary sclerosing cholangitis and primary biliary cholangitis. To write the article, information was searched using Scopus, Web of Science, MedLine, PubMed, Google Scholar, Embase, Global Health, The Cochrane Library databases. The authors state that in hepatobiliary diseases, namely cholangiopathies, micro-RNAs affect the regulation of hepatocyte, cholangiocyte proliferation, cell cycle, inflammatory processes, fibrosis, chemoresistance and cell survival. Researchers have determined that patients with primary sclerosing cholangitis have significantly increased levels of miR-26a, miR-30b, miR-126, miR-122, miR-194, miR-1281 in blood serum and miR-412, miR-640, miR-1537 and miR-3189 in the bile of relatively healthy individuals. It is known that the number of differentially expressed miRNAs in patients with primary biliary cholangitis reaches 97, of which the most diagnostically significant is miR-139-5p. Scientists note that increased miR-139-5p expression in hepatocytes correlates with increased production of TNF-α and repression of c-FOS gene transcription. It is stated that the researchers proposed an alternative hypothesis of miRNA-mediated induction of the inflammatory reaction of the bile ducts in primary biliary cholangitis. The hypothesis is presented that the activity of the generation of miR-106b-5p, miR-20a-5p, and miR-93-5p, which perform key regulatory functions in it, is the basis of the functioning of the miRNA-mRNA network in primary biliary cholangitis. Thus, the data of modern research indicate that cholangiopathies are accompanied by a change in the spectrum of production of various micro-RNAs that regulate the activation of inflammation, regeneration, proliferation, apoptosis of hepatocytes and cholangiocytes. A decrease or increase in the level of some micro-RNA expression is critical in the pathological processes that occur in primary sclerosing cholangitis and primary biliary cholangitis, but micro-RNAs can be not only markers, but also targets of these processes.
在科学综述中给出了miRNA在胆管病变发生发展中的作用。本文讨论了miRNA在原发性硬化性胆管炎和原发性胆道胆管炎中的作用。为了撰写这篇文章，我们使用Scopus、Web of Science、MedLine、PubMed、Google Scholar、Embase、Global Health、Cochrane Library等数据库进行了信息搜索。作者指出，在肝胆疾病，即胆管病变中，微rna影响肝细胞、胆管细胞增殖、细胞周期、炎症过程、纤维化、化疗耐药和细胞存活的调节。研究人员已经确定，原发性硬化性胆管炎患者血清中的miR-26a、miR-30b、miR-126、miR-122、miR-194、miR-1281水平以及相对健康个体胆汁中的miR-412、miR-640、miR-1537和miR-3189水平显著升高。已知原发性胆道胆管炎患者中差异表达的mirna数量达到97个，其中诊断意义最大的是miR-139-5p。科学家们注意到，肝细胞中miR-139-5p表达的增加与TNF-α产生的增加和c-FOS基因转录的抑制相关。据报道，研究人员提出了mirna介导的原发性胆管炎中胆管炎症反应的另一种假说。假设miR-106b-5p、miR-20a-5p和miR-93-5p的生成具有关键的调节功能，其活性是原发性胆管炎中miRNA-mRNA网络功能的基础。因此，现代研究数据表明，胆管病变伴随着各种调控肝细胞和胆管细胞炎症激活、再生、增殖、凋亡的微rna产生谱的变化。在原发性硬化性胆管炎和原发性胆管炎的病理过程中，一些微rna表达水平的降低或升高是至关重要的，但微rna不仅可以是这些过程的标志物，也可以是这些过程的靶点。
{"title":"The role of miRNAs in the development of cholangiopathies. Part 1","authors":"A. Abaturov, V. Babуch","doi":"10.22141/2224-0551.18.4.2023.1606","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1606","url":null,"abstract":"The role of miRNA in the development of cholangiopathies is given in the scientific review. This article discusses the role of miRNA in primary sclerosing cholangitis and primary biliary cholangitis. To write the article, information was searched using Scopus, Web of Science, MedLine, PubMed, Google Scholar, Embase, Global Health, The Cochrane Library databases. The authors state that in hepatobiliary diseases, namely cholangiopathies, micro-RNAs affect the regulation of hepatocyte, cholangiocyte proliferation, cell cycle, inflammatory processes, fibrosis, chemoresistance and cell survival. Researchers have determined that patients with primary sclerosing cholangitis have significantly increased levels of miR-26a, miR-30b, miR-126, miR-122, miR-194, miR-1281 in blood serum and miR-412, miR-640, miR-1537 and miR-3189 in the bile of relatively healthy individuals. It is known that the number of differentially expressed miRNAs in patients with primary biliary cholangitis reaches 97, of which the most diagnostically significant is miR-139-5p. Scientists note that increased miR-139-5p expression in hepatocytes correlates with increased production of TNF-α and repression of c-FOS gene transcription. It is stated that the researchers proposed an alternative hypothesis of miRNA-mediated induction of the inflammatory reaction of the bile ducts in primary biliary cholangitis. The hypothesis is presented that the activity of the generation of miR-106b-5p, miR-20a-5p, and miR-93-5p, which perform key regulatory functions in it, is the basis of the functioning of the miRNA-mRNA network in primary biliary cholangitis. Thus, the data of modern research indicate that cholangiopathies are accompanied by a change in the spectrum of production of various micro-RNAs that regulate the activation of inflammation, regeneration, proliferation, apoptosis of hepatocytes and cholangiocytes. A decrease or increase in the level of some micro-RNA expression is critical in the pathological processes that occur in primary sclerosing cholangitis and primary biliary cholangitis, but micro-RNAs can be not only markers, but also targets of these processes.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"79 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":"125095394","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1595
O. Volosovets, S.V. Tsemashko, I.O. Loginova, S. Kryvopustov, T. Shevtsova, O.V. Ilyin, O.F. Chernii, L.M. Helescul, O.V. Holik
Background. Ukraine is currently experiencing a rapid decline in fertility due to the COVID-19 pandemic and martial law. The purpose was to study birth rate fluctuations and changes in the structure of early neonatal morbidity and mortality at Kyiv City Maternity Hospital 6 during the COVID-19 pandemic and martial law and to compare the obtained findings with national statistical data. Materials and methods. A retrospective analysis and assessment of birth rate fluctuations, early neonatal morbidity, and mortality were carried out for 2020–2022 using both the health care industry statistics and the data obtained from Kyiv City Maternity Hospital 6. Results. Increased morbidity and high psycho-emotional stress levels among pregnant women contributed to a more frequent occurrence of neonatal disorders associated primarily with intrauterine hypoxia and perinatal infection. The improvements in newborn care and concurrent reduction in the preterm birth rate at the maternity hospital providing level II perinatal care services have been associated with a decreased rate of early neonatal mortality over the past three years. Conclusions. The use of modern fetal monitoring technologies, the timely diagnosis and treatment of perinatal pathology, and improvements in the organization of newborn care help preserve child health and prevent mortality.
{"title":"Analysis of birth rate, neonatal morbidity, and mortality during the COVID-19 pandemic and martial law in Ukraine","authors":"O. Volosovets, S.V. Tsemashko, I.O. Loginova, S. Kryvopustov, T. Shevtsova, O.V. Ilyin, O.F. Chernii, L.M. Helescul, O.V. Holik","doi":"10.22141/2224-0551.18.4.2023.1595","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1595","url":null,"abstract":"Background. Ukraine is currently experiencing a rapid decline in fertility due to the COVID-19 pandemic and martial law. The purpose was to study birth rate fluctuations and changes in the structure of early neonatal morbidity and mortality at Kyiv City Maternity Hospital 6 during the COVID-19 pandemic and martial law and to compare the obtained findings with national statistical data. Materials and methods. A retrospective analysis and assessment of birth rate fluctuations, early neonatal morbidity, and mortality were carried out for 2020–2022 using both the health care industry statistics and the data obtained from Kyiv City Maternity Hospital 6. Results. Increased morbidity and high psycho-emotional stress levels among pregnant women contributed to a more frequent occurrence of neonatal disorders associated primarily with intrauterine hypoxia and perinatal infection. The improvements in newborn care and concurrent reduction in the preterm birth rate at the maternity hospital providing level II perinatal care services have been associated with a decreased rate of early neonatal mortality over the past three years. Conclusions. The use of modern fetal monitoring technologies, the timely diagnosis and treatment of perinatal pathology, and improvements in the organization of newborn care help preserve child health and prevent mortality.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"31 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":"123903872","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1598
M. Aryayev, L. Senkivska
Background. The purpose was to analyze and summarize the accumulated short-term and long-term safety data in children with growth hormone deficiency (GHD) treated using recombіnant human growth hormone (rhGH) based on the results of a physical examination, assessment of vital signs, laboratory parameters, and follow-up. Materials and methods. The study was conducted at the Odesa Regional Children’s Clinical Hospital from 2012 to 2022, with 92 children treated for GHD using rhGH at an average dose of 0.033 mg/kg/day. The evaluation of the safety of this therapy was based on assessing the incidence of adverse events (AEs) as a negative consequence of medical care. We analyzed both short-term and long-term outcomes. Results. When studying the short-term safety of rhGH therapy according to physical examination data, AEs were found in 18 (19.57 %) children, including intracranial hypertension (1), arthralgia (1), prepubertal gynecomastia (1), anemia (3), manifestation of latent adrenal insufficiency (3), latent thyroid insufficiency (2), impaired glucose tolerance (7). 20.6 (7.0 ÷ 34.2) % of patients with unacceptable adherence to rhGH therapy reported painful injections compared to 4.3 (–1.6 ÷ 10.2) % of children with acceptable compliance (χ2 = 5.15; р = 0.02). None of the children experienced serious adverse events such as scoliosis progression, slipped capital femoral epiphysis, edema, and impaired vital functions. AEs in terms of hematological and biochemical parameters were usually transient, often in combination with intercurrent diseases, and were not associated with rhGH. In long-term safety, there was no association between rhGH therapy and the risk of cancer, cardiac, and cerebrovascular diseases. Still, three children (3.26 %) had type 2 diabetes, with overweight in one case and obesity in two. Conclusions. In general, in the short-term context, rhGH therapy for children with GHD is safe. The pain at the injection site is a clinically significant AE as a cognitive emotional barrier to the adherence to rhGH therapy. From the point of view of the long-term safety of rhGH therapy, the fact that type 2 diabetes was detected in 3 (3.26 %) children with increased body weight and obesity is essential.
{"title":"Adverse events of replacement therapy in children with growth hormone deficiency","authors":"M. Aryayev, L. Senkivska","doi":"10.22141/2224-0551.18.4.2023.1598","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1598","url":null,"abstract":"Background. The purpose was to analyze and summarize the accumulated short-term and long-term safety data in children with growth hormone deficiency (GHD) treated using recombіnant human growth hormone (rhGH) based on the results of a physical examination, assessment of vital signs, laboratory parameters, and follow-up. Materials and methods. The study was conducted at the Odesa Regional Children’s Clinical Hospital from 2012 to 2022, with 92 children treated for GHD using rhGH at an average dose of 0.033 mg/kg/day. The evaluation of the safety of this therapy was based on assessing the incidence of adverse events (AEs) as a negative consequence of medical care. We analyzed both short-term and long-term outcomes. Results. When studying the short-term safety of rhGH therapy according to physical examination data, AEs were found in 18 (19.57 %) children, including intracranial hypertension (1), arthralgia (1), prepubertal gynecomastia (1), anemia (3), manifestation of latent adrenal insufficiency (3), latent thyroid insufficiency (2), impaired glucose tolerance (7). 20.6 (7.0 ÷ 34.2) % of patients with unacceptable adherence to rhGH therapy reported painful injections compared to 4.3 (–1.6 ÷ 10.2) % of children with acceptable compliance (χ2 = 5.15; р = 0.02). None of the children experienced serious adverse events such as scoliosis progression, slipped capital femoral epiphysis, edema, and impaired vital functions. AEs in terms of hematological and biochemical parameters were usually transient, often in combination with intercurrent diseases, and were not associated with rhGH. In long-term safety, there was no association between rhGH therapy and the risk of cancer, cardiac, and cerebrovascular diseases. Still, three children (3.26 %) had type 2 diabetes, with overweight in one case and obesity in two. Conclusions. In general, in the short-term context, rhGH therapy for children with GHD is safe. The pain at the injection site is a clinically significant AE as a cognitive emotional barrier to the adherence to rhGH therapy. From the point of view of the long-term safety of rhGH therapy, the fact that type 2 diabetes was detected in 3 (3.26 %) children with increased body weight and obesity is essential.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"14 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":"133325307","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1602
D. Nechytailo, T. Nechytailo, T. Mikhieieva
Background. An imbalance of the autonomic nervous system, or a syndrome of autonomic dysfunction, is a pathological condition characterized by a violation of the autonomic regulation of the functions of internal organs, blood vessels, and metabolic processes. This is a polymorphic pathology in which various organs and systems in children suffer, but the dominant role in the clinical picture is given to the cardiovascular disorders that is manifested by an increase of blood pressure. The purpose of the study: to assess the state of the autonomic nervous system and the level of anxiety in children with primary hypertension. Materials and methods. Forty-three children of high school age were examined. The main group included 21 children with a confirmed diagnosis of primary hypertension, and the control group — 22 children with a normal blood pressure level. The state of the autonomic nervous system was assessed using the Wayne A.M. questionnaire. The level of anxiety was evaluated according to the State-Trait Anxiety Inventory (STAI). Results. Evaluation of the level of anxiety revealed that the average level of reactive anxiety in children of the main group on the STAI was 37.3 points, which indicated a moderate level, while in the children of the control group it was low (26.6 points). The average level of personal anxiety in children of the main group was 42.6 points, which actually indicated an increase in the general level of anxiety, in the control group this indicator was low and amounted to 28.7 points (p < 0.005). Conclusions. In children with hypertension, autonomic dysfunction with a predominance of sympathicotonia is more likely to be observed, which indicates a deep pathogenetic connection between an increase in blood pressure and disorders of the autonomic nervous system. Children with hypertension probably have a higher level of personal anxiety compared to those with normal blood pressure, which must be taken into account in the treatment and prevention of this disease.
{"title":"Peculiarities of autonomic regulation and anxiety level in schoolchildren with primary hypertension","authors":"D. Nechytailo, T. Nechytailo, T. Mikhieieva","doi":"10.22141/2224-0551.18.4.2023.1602","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1602","url":null,"abstract":"Background. An imbalance of the autonomic nervous system, or a syndrome of autonomic dysfunction, is a pathological condition characterized by a violation of the autonomic regulation of the functions of internal organs, blood vessels, and metabolic processes. This is a polymorphic pathology in which various organs and systems in children suffer, but the dominant role in the clinical picture is given to the cardiovascular disorders that is manifested by an increase of blood pressure. The purpose of the study: to assess the state of the autonomic nervous system and the level of anxiety in children with primary hypertension. Materials and methods. Forty-three children of high school age were examined. The main group included 21 children with a confirmed diagnosis of primary hypertension, and the control group — 22 children with a normal blood pressure level. The state of the autonomic nervous system was assessed using the Wayne A.M. questionnaire. The level of anxiety was evaluated according to the State-Trait Anxiety Inventory (STAI). Results. Evaluation of the level of anxiety revealed that the average level of reactive anxiety in children of the main group on the STAI was 37.3 points, which indicated a moderate level, while in the children of the control group it was low (26.6 points). The average level of personal anxiety in children of the main group was 42.6 points, which actually indicated an increase in the general level of anxiety, in the control group this indicator was low and amounted to 28.7 points (p < 0.005). Conclusions. In children with hypertension, autonomic dysfunction with a predominance of sympathicotonia is more likely to be observed, which indicates a deep pathogenetic connection between an increase in blood pressure and disorders of the autonomic nervous system. Children with hypertension probably have a higher level of personal anxiety compared to those with normal blood pressure, which must be taken into account in the treatment and prevention of this disease.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"33 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":"131353630","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1597
Y. Marushko, O. Khomych
Background. Diagnosis of pneumonia is difficult and requires a comprehensive examination. Respiratory acoustics is currently a promising diagnostic method. The purpose was to evaluate the possibility of pneumonia detection by the average signal power, frequency and amplitude of the acoustic signal using the Trembita-Corona acoustic monitoring device. Materials and methods. Onу hundred and ninety-three children aged from 1 month to 18 years were examined. The children were divided into two groups: group I — 98 patients with community-acquired pneumonia, group II — 95 healthy children. All children were examined using the Trembita-Corona acoustic monitoring device. Results. The sensitivity of the method for detecting pneumonia using the acoustic monitoring device Trembita-Corona according to the average signal power in the 4th, 5th and 6th octaves is from 90.8 to 99 %, and the specificity is from 87.4 to 100 %. The sensitivity of the method for detecting pneumonia using the acoustic monitoring device Trembita-Corona according to the frequency of the acoustic signal in the 3rd and 5th octaves is more than 60 %, and the specificity is more than 63 % in the 3rd octave and 100 % in the 5th octave, respectively. The sensitivity of the method for detecting pneumonia using the acoustic monitoring device Trembita-Corona according to the amplitude of the acoustic signal in the 4th, 5th and 6th octaves is 88.9, 99.9 and 86.9 %, respectively, and the specificity is 100 % in the 4th and 5th octaves and 87.4 % in the 6th octave. Conclusions. The acoustic monitoring device Trembita-Corona demonstrates high specificity, sensitivity and positive predictive value and negative predictive value at given prevalence.
{"title":"Sensitivity and specificity of the method of acoustic diagnosis of pneumonia using the acoustic monitoring device Trembita-Corona","authors":"Y. Marushko, O. Khomych","doi":"10.22141/2224-0551.18.4.2023.1597","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1597","url":null,"abstract":"Background. Diagnosis of pneumonia is difficult and requires a comprehensive examination. Respiratory acoustics is currently a promising diagnostic method. The purpose was to evaluate the possibility of pneumonia detection by the average signal power, frequency and amplitude of the acoustic signal using the Trembita-Corona acoustic monitoring device. Materials and methods. Onу hundred and ninety-three children aged from 1 month to 18 years were examined. The children were divided into two groups: group I — 98 patients with community-acquired pneumonia, group II — 95 healthy children. All children were examined using the Trembita-Corona acoustic monitoring device. Results. The sensitivity of the method for detecting pneumonia using the acoustic monitoring device Trembita-Corona according to the average signal power in the 4th, 5th and 6th octaves is from 90.8 to 99 %, and the specificity is from 87.4 to 100 %. The sensitivity of the method for detecting pneumonia using the acoustic monitoring device Trembita-Corona according to the frequency of the acoustic signal in the 3rd and 5th octaves is more than 60 %, and the specificity is more than 63 % in the 3rd octave and 100 % in the 5th octave, respectively. The sensitivity of the method for detecting pneumonia using the acoustic monitoring device Trembita-Corona according to the amplitude of the acoustic signal in the 4th, 5th and 6th octaves is 88.9, 99.9 and 86.9 %, respectively, and the specificity is 100 % in the 4th and 5th octaves and 87.4 % in the 6th octave. Conclusions. The acoustic monitoring device Trembita-Corona demonstrates high specificity, sensitivity and positive predictive value and negative predictive value at given prevalence.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"85 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":"131249823","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}
Pub Date : 2023-07-14DOI: 10.22141/2224-0551.18.4.2023.1596
A. Abaturov, A. Nikulina
Актуальність. Однонуклеотидні варіанти (single nucleotide variant — SNV) гена греліну (GHRL) супроводжуються продукцією дефектного протеїну препрогреліну, що може призводити до розвитку ожиріння та метаболічних порушень. Мета: вивчити асоціації гена SNV GHRL із розвитком різних фенотипів ожиріння в дітей. Матеріали та методи. Обстежено 252 пацієнтів з ожирінням віком 6–18 років. Основну групу (n = 152) становили діти з метаболічно нездоровим ожирінням (МНО). Контрольну групу (n = 100) представили діти з метаболічно здоровим ожирінням (MЗO). У 31 дитини основної та 21 дитини контрольної групи проведено повногеномне секвенування (CeGat, Німеччина). Рівень інтерлейкіну (IL) 1β у сироватці крові визначали методом імунохемілюмінесцентного аналізу, IL-6 — методом імуноферментного аналізу (Synevo, Україна). Результати. Асоціація з розвитком MНO була вищою для T-алеля SNV rs696217 гена GHRL у здорових осіб (t = 2,31; p < 0.05) та пацієнтів з ожирінням (t = 2,06; p < 0,05). Генотип GT SNV rs696217 був пов’язаний з інсулінорезистентністю (r = 0,40; p < 0,05) у групі MНO і зворотно корелював з умістом холестерину (r = –0,45) та холестерину ліпопротеїнів низької щільності (r = –0,39). Генотип TA SNV rs4684677 корелював із рівнем IL-6 (r = 0,74) у групі MЗO та з IL-1β (r = 0,35) у групі MНO, p < 0,05. Профілактика трансформації MЗO в MНO визначається T-алелем SNV rs34911341 (t = 2,29, p < 0,05). Висновки. Міссенс-варіанти rs696217, rs4684677 гена GHRL є SNV, високо асоційованими з ожирінням та розвитком метаболічних порушень.
{"title":"Асоціації варіантів гена GHRL із розвитком ожиріння та метаболічних порушень у дітей","authors":"A. Abaturov, A. Nikulina","doi":"10.22141/2224-0551.18.4.2023.1596","DOIUrl":"https://doi.org/10.22141/2224-0551.18.4.2023.1596","url":null,"abstract":"Актуальність. Однонуклеотидні варіанти (single nucleotide variant — SNV) гена греліну (GHRL) супроводжуються продукцією дефектного протеїну препрогреліну, що може призводити до розвитку ожиріння та метаболічних порушень. Мета: вивчити асоціації гена SNV GHRL із розвитком різних фенотипів ожиріння в дітей. Матеріали та методи. Обстежено 252 пацієнтів з ожирінням віком 6–18 років. Основну групу (n = 152) становили діти з метаболічно нездоровим ожирінням (МНО). Контрольну групу (n = 100) представили діти з метаболічно здоровим ожирінням (MЗO). У 31 дитини основної та 21 дитини контрольної групи проведено повногеномне секвенування (CeGat, Німеччина). Рівень інтерлейкіну (IL) 1β у сироватці крові визначали методом імунохемілюмінесцентного аналізу, IL-6 — методом імуноферментного аналізу (Synevo, Україна). Результати. Асоціація з розвитком MНO була вищою для T-алеля SNV rs696217 гена GHRL у здорових осіб (t = 2,31; p < 0.05) та пацієнтів з ожирінням (t = 2,06; p < 0,05). Генотип GT SNV rs696217 був пов’язаний з інсулінорезистентністю (r = 0,40; p < 0,05) у групі MНO і зворотно корелював з умістом холестерину (r = –0,45) та холестерину ліпопротеїнів низької щільності (r = –0,39). Генотип TA SNV rs4684677 корелював із рівнем IL-6 (r = 0,74) у групі MЗO та з IL-1β (r = 0,35) у групі MНO, p < 0,05. Профілактика трансформації MЗO в MНO визначається T-алелем SNV rs34911341 (t = 2,29, p < 0,05). Висновки. Міссенс-варіанти rs696217, rs4684677 гена GHRL є SNV, високо асоційованими з ожирінням та розвитком метаболічних порушень.","PeriodicalId":338009,"journal":{"name":"CHILD`S HEALTH","volume":"69 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":"122527439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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