O. Obukhova, T. Ryabichenko, G. Skosyreva, A.O. Izyumov, Elena P. Timofeeva, Alya P. Shvayuk, Nadezhda N. Stankevich, M. L. Voevoda
BACKGROUND: The problem of the pathogenesis of the multisystem inflammatory syndrome (MIS-C), associated with SARS-CoV-2, remains relevant, but is still far from being resolved. In this regard. AIM: The aim our research was to study and evaluate the levels of autoantibodies to native and denatured DNA in the blood serum of children who underwent MIS-C, associated with SARS-CoV-2, in comparison with the initial period of the pathological process. MATERIALS AND METHODS: 101 children aged 2 to 17 years old were examined, 77 of them was with a confirmed diagnosis of MIS-C associated with SARS-CoV-2. We have formed 3 groups: group 1 — children with MIS-C upon admission to the hospital; group 2 — children who underwent MIS-C after a course of rehabilitation; group 3 — comparison group. All children underwent determination of the concentrations of IgG-autoantibodies to native and denatured DNA in blood serum, which was performed by EIA ELISA using commercial test systems of Vector-Best LLC (Russia) according to the manufacturer’s instructions. Statistical processing of the obtained results was carried out using the Statistica v. 10.0 application package. Statistical processing used the Newman–Keuls multiple comparison test. RESULTS: It was noted that both in the initial period of MIS-C and after rehabilitation, an increased content of autoantibodies to nDNA and dDNA was determined compared to the control group. At the same time, there was a significant excess of the levels of indicators in the post-rehabilitation period compared with the initial period of MIS-C. During a clinical examination of children who underwent MIS-C, most of them noted the appearance of pain in the joints. The results obtained indicate the persistence of inflammatory reactions with the development of an autoreactive component. This requires both the search for risk markers for the development of MIS-C and further monitoring of children who have undergone MIS-C to prevent autoimmune complications, including arthritis, damage to the vascular endothelium with the possible formation of thrombotic complications. CONCLUSIONS: In the acute period of MIS-C and after rehabilitation, increased levels of the average content of autoantibodies to nDNA and dDNA were noted compared to the control. Individual values of autoantibodies to nDNA and dDNA exceeded normative levels of the indicator were found in a significantly larger number of children in the post-rehabilitation period after MIS-C, and this excess was more pronounced compared to the acute period of the process. When assessing the clinical condition of children after MIS-C, most of them showed pain in the joints during exercise, abdominal and neurological disorders, and decreased tolerance to physical activity, which indicates persistent inflammatory reactions.
{"title":"Autoreactive processes in children in the initial period of multisystem inflammatory syndrome associated with SARS-CoV-2 and after rehabilitation","authors":"O. Obukhova, T. Ryabichenko, G. Skosyreva, A.O. Izyumov, Elena P. Timofeeva, Alya P. Shvayuk, Nadezhda N. Stankevich, M. L. Voevoda","doi":"10.17816/ped626015","DOIUrl":"https://doi.org/10.17816/ped626015","url":null,"abstract":"BACKGROUND: The problem of the pathogenesis of the multisystem inflammatory syndrome (MIS-C), associated with SARS-CoV-2, remains relevant, but is still far from being resolved. In this regard. \u0000AIM: The aim our research was to study and evaluate the levels of autoantibodies to native and denatured DNA in the blood serum of children who underwent MIS-C, associated with SARS-CoV-2, in comparison with the initial period of the pathological process. \u0000MATERIALS AND METHODS: 101 children aged 2 to 17 years old were examined, 77 of them was with a confirmed diagnosis of MIS-C associated with SARS-CoV-2. We have formed 3 groups: group 1 — children with MIS-C upon admission to the hospital; group 2 — children who underwent MIS-C after a course of rehabilitation; group 3 — comparison group. All children underwent determination of the concentrations of IgG-autoantibodies to native and denatured DNA in blood serum, which was performed by EIA ELISA using commercial test systems of Vector-Best LLC (Russia) according to the manufacturer’s instructions. Statistical processing of the obtained results was carried out using the Statistica v. 10.0 application package. Statistical processing used the Newman–Keuls multiple comparison test. \u0000RESULTS: It was noted that both in the initial period of MIS-C and after rehabilitation, an increased content of autoantibodies to nDNA and dDNA was determined compared to the control group. At the same time, there was a significant excess of the levels of indicators in the post-rehabilitation period compared with the initial period of MIS-C. During a clinical examination of children who underwent MIS-C, most of them noted the appearance of pain in the joints. The results obtained indicate the persistence of inflammatory reactions with the development of an autoreactive component. This requires both the search for risk markers for the development of MIS-C and further monitoring of children who have undergone MIS-C to prevent autoimmune complications, including arthritis, damage to the vascular endothelium with the possible formation of thrombotic complications. \u0000CONCLUSIONS: In the acute period of MIS-C and after rehabilitation, increased levels of the average content of autoantibodies to nDNA and dDNA were noted compared to the control. Individual values of autoantibodies to nDNA and dDNA exceeded normative levels of the indicator were found in a significantly larger number of children in the post-rehabilitation period after MIS-C, and this excess was more pronounced compared to the acute period of the process. When assessing the clinical condition of children after MIS-C, most of them showed pain in the joints during exercise, abdominal and neurological disorders, and decreased tolerance to physical activity, which indicates persistent inflammatory reactions.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"19 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439261","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. Erkudov, K. U. Rozumbetov, Azat T. Matchanov, Andrey P. Pugovkin, Symbat N. Nisanova, Madina A. Kalmuratova, Andrey V. Kochubeev, Sergey S. Rogozin
BACKGROUND: Since the mid 20th century, the Southern Aral Sea Region is notorious as a region of ecological disaster, where anthropogenic influence led to the desiccation of the Aral Sea. Aridization of these territories is the cause of accumulation of endocrine disrupting chemicals — pesticides and toxic metals in soil and water. AIM: The aim of this study was to assess the changes in hormonal profile under the influence of environmental factors in prepubertal children living at different distances from the epicenter of the Aral ecological disaster. MATERIALS AND METHODS: The study included 58 male children aged 11–13 years. All children from birth lived in two regions of the Aral Sea Region and were divided into two groups depending on their place of residence. The group “North” (unfavorable conditions) consisted of 27 children from Muynak, Kungrad, Karauzyak, Takhtakupyr districts. The “Nukus” group (relatively favorable conditions) included 31 volunteers from Nukus city. All children were determined the concentration of IGF-1 — Insulin-like growth factor 1, GH — growth gormone, TT — total testosterone, E2 — estradiol, FSH — follicle-stimulating hormone, LH — luteinizing hormone, TSH — thyroid-stimulating hormone, TT3 — total triiodothyronine in blood sample. The statistical significance of the differences of the mentioned hormones in children from the “North” and “Nukus” groups was checked using the Mann–Whitney test. RESULTS: This analysis revealed statistically significantly higher values of TT, FSH and LH in children from the “Nukus” group compared to their peers from the “North” group. The concentrations of IGF-1, GH, E2, TTG and T3 in blood plasma in volunteers from both groups were not statistically significantly different. CONCLUSIONS: The environment of the Aral ecological disaster region with increased content of organochlorine compounds, pesticides and heavy metals changes the endocrine status in local prepubertal children. This is expressed in a moderate decrease in the activity of androgens (but not estrogens) and gonadotropic hormones. This research work can be considered as a pilot study, which determines the need for further monitoring of endocrine disorders in children and adults living in negative environmental conditions.
{"title":"Hormonal profile changes under the influence of environmental factors in children residing in the Aral environmental disaster region","authors":"V. Erkudov, K. U. Rozumbetov, Azat T. Matchanov, Andrey P. Pugovkin, Symbat N. Nisanova, Madina A. Kalmuratova, Andrey V. Kochubeev, Sergey S. Rogozin","doi":"10.17816/ped625943","DOIUrl":"https://doi.org/10.17816/ped625943","url":null,"abstract":"BACKGROUND: Since the mid 20th century, the Southern Aral Sea Region is notorious as a region of ecological disaster, where anthropogenic influence led to the desiccation of the Aral Sea. Aridization of these territories is the cause of accumulation of endocrine disrupting chemicals — pesticides and toxic metals in soil and water. \u0000AIM: The aim of this study was to assess the changes in hormonal profile under the influence of environmental factors in prepubertal children living at different distances from the epicenter of the Aral ecological disaster. \u0000MATERIALS AND METHODS: The study included 58 male children aged 11–13 years. All children from birth lived in two regions of the Aral Sea Region and were divided into two groups depending on their place of residence. The group “North” (unfavorable conditions) consisted of 27 children from Muynak, Kungrad, Karauzyak, Takhtakupyr districts. The “Nukus” group (relatively favorable conditions) included 31 volunteers from Nukus city. All children were determined the concentration of IGF-1 — Insulin-like growth factor 1, GH — growth gormone, TT — total testosterone, E2 — estradiol, FSH — follicle-stimulating hormone, LH — luteinizing hormone, TSH — thyroid-stimulating hormone, TT3 — total triiodothyronine in blood sample. The statistical significance of the differences of the mentioned hormones in children from the “North” and “Nukus” groups was checked using the Mann–Whitney test. \u0000RESULTS: This analysis revealed statistically significantly higher values of TT, FSH and LH in children from the “Nukus” group compared to their peers from the “North” group. The concentrations of IGF-1, GH, E2, TTG and T3 in blood plasma in volunteers from both groups were not statistically significantly different. \u0000CONCLUSIONS: The environment of the Aral ecological disaster region with increased content of organochlorine compounds, pesticides and heavy metals changes the endocrine status in local prepubertal children. This is expressed in a moderate decrease in the activity of androgens (but not estrogens) and gonadotropic hormones. This research work can be considered as a pilot study, which determines the need for further monitoring of endocrine disorders in children and adults living in negative environmental conditions.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"37 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440785","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}
T. V. Brus, Andrei G. Vasiliev, Aleftina A. Kravcova, Anna V. Vasilieva, Yurii S. Brus, Anastasia V. Bannova
BACKGROUND: The main examples of liver pathology of metabolic and toxic origin are non-alcoholic, alcoholic fatty liver disease and fatty degeneration of mixed origin. Currently, due to the lack of a clear understanding of the causes and pathogenesis of hepatopathy of non-infectious origin, there are no effective methods for the prevention and treatment of these conditions. A key role in studying the etiology and mechanisms of pathogenesis is played by the search for adequate experimental models of liver failure. AIM: To develop, test and evaluate an experimental model of mixed fatty liver disease. MATERIALS AND METHODS: The study was conducted on 30 male albino gray Wistar rats. Experimental rats, weighing 180–200 grams at the time of inclusion in the experiment, received granulated rodent food weighing 20 grams daily for 30 days, to which 6 g of crystalline fructose was introduced (at the rate of 30% of the total diet), and instead of drinking 10% ethyl alcohol solution was given freely available in the drinking bowl. RESULTS: In experimental group, there was a statistically significant increase in the level of aspartate aminotransferase, alanylaminotransferase, and alkaline phosphatase, which confirms the development of cytolytic and cholestatic syndromes. Autopsy liver specimens showed a histological picture of fatty degeneration of hepatocytes. CONCLUSIONS: To achieve this goal, a method was developed for modeling fatty liver of mixed origin. A high-carbohydrate and ethanol-rich diet led to the rapid development of pathological processes in the liver. The study demonstrated the feasibility of a detailed morphological study of the liver, taking into account medical history, laboratory indicators of cytolytic and cholestatic syndromes for the differential diagnosis of fatty liver of various etiologies.
{"title":"Biomodeling of mixed origin fatty liver disease","authors":"T. V. Brus, Andrei G. Vasiliev, Aleftina A. Kravcova, Anna V. Vasilieva, Yurii S. Brus, Anastasia V. Bannova","doi":"10.17816/ped625940","DOIUrl":"https://doi.org/10.17816/ped625940","url":null,"abstract":"BACKGROUND: The main examples of liver pathology of metabolic and toxic origin are non-alcoholic, alcoholic fatty liver disease and fatty degeneration of mixed origin. Currently, due to the lack of a clear understanding of the causes and pathogenesis of hepatopathy of non-infectious origin, there are no effective methods for the prevention and treatment of these conditions. A key role in studying the etiology and mechanisms of pathogenesis is played by the search for adequate experimental models of liver failure. \u0000AIM: To develop, test and evaluate an experimental model of mixed fatty liver disease. \u0000MATERIALS AND METHODS: The study was conducted on 30 male albino gray Wistar rats. Experimental rats, weighing 180–200 grams at the time of inclusion in the experiment, received granulated rodent food weighing 20 grams daily for 30 days, to which 6 g of crystalline fructose was introduced (at the rate of 30% of the total diet), and instead of drinking 10% ethyl alcohol solution was given freely available in the drinking bowl. \u0000RESULTS: In experimental group, there was a statistically significant increase in the level of aspartate aminotransferase, alanylaminotransferase, and alkaline phosphatase, which confirms the development of cytolytic and cholestatic syndromes. Autopsy liver specimens showed a histological picture of fatty degeneration of hepatocytes. \u0000CONCLUSIONS: To achieve this goal, a method was developed for modeling fatty liver of mixed origin. A high-carbohydrate and ethanol-rich diet led to the rapid development of pathological processes in the liver. The study demonstrated the feasibility of a detailed morphological study of the liver, taking into account medical history, laboratory indicators of cytolytic and cholestatic syndromes for the differential diagnosis of fatty liver of various etiologies.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139957834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. L. Bannova, D. Ivanov, Yuriy S. Alexandrovich, V. N. Timchenko, T. A. Kaplina, G. V. Kondratiev, Evgeniy Yu. Felker, Rustam N. Ibragimov, Marina V. Razgon, M. Revnova, M. Komissarova, V. P. Novikova
BACKGROUND: The problem of the complicated course of COVID-19 and deaths in children with severe comorbid pathology is relevant. Severe forms of the disease are often the cause of critical conditions and deaths, including decompensated respiratory failure, acute respiratory distress syndrome, septic shock, cardiac, hepatic, renal insufficiency, coagulation disorders, damage to the central nervous system. AIM: The aim is to analyze the features of the course of COVID-19 in children who require mandatory hospitalization in specialized hospitals for background pathology, to identify predictors of the development of severe forms of COVID-19 in order to choose the optimal ways of treating this pathology. MATERIALS AND METHODS: Under the supervision of the St. Petersburg State Pediatric Medical University in the department for children with new coronavirus infection COVID-19 with intensive care and intensive care wards in the period 2020–2022 with a confirmed diagnosis of “new coronavirus infection” there were 791 patients aged 0 to 17 years. The diagnosis was made on the basis of clinical and epidemiological data, the results of a comprehensive laboratory and instrumental study. The severity of the disease was determined in accordance with the methodological recommendations of the Ministry of Health of the Russian Federation. RESULTS: The severe form of COVID-19 was diagnosed in 34 patients out of 791 (4.3%). Adverse outcomes were 1.4%. In 27 out of 34 children (79.4%), new coronavirus infection occurred against the background of severe comorbid pathology. Pneumonia was diagnosed in 91.2% of cases. 88.2% of patients needed oxygen therapy. CONCLUSIONS: Severe forms of COVID-19 in children are characterized by high fever with severe intoxication, respiratory tract damage with a significant volume of lung damage (CT-3 and CT-4) with the development of multiple organ failure. Predictors that require mandatory hospitalization in specialized hospitals for background pathology in severe forms of COVID-19 are: primary immunodeficiency conditions, oncohematological pathology with postcytostatic aplasia of hematopoiesis, severe organic lesions of the central nervous system, epilepsy, protein-energy deficiency of 3–4 degrees, bronchopulmonary dysplasia, atypical emolytic uremic syndrome with acute kidney damage. Comprehensive treatment of such patients should be carried out by a multidisciplinary team in a specialized department with extensive diagnostic and therapeutic capabilities.
{"title":"Features of severe forms of new coronavirus infection (COVID-19) in children","authors":"S. L. Bannova, D. Ivanov, Yuriy S. Alexandrovich, V. N. Timchenko, T. A. Kaplina, G. V. Kondratiev, Evgeniy Yu. Felker, Rustam N. Ibragimov, Marina V. Razgon, M. Revnova, M. Komissarova, V. P. Novikova","doi":"10.17816/ped625937","DOIUrl":"https://doi.org/10.17816/ped625937","url":null,"abstract":"BACKGROUND: The problem of the complicated course of COVID-19 and deaths in children with severe comorbid pathology is relevant. Severe forms of the disease are often the cause of critical conditions and deaths, including decompensated respiratory failure, acute respiratory distress syndrome, septic shock, cardiac, hepatic, renal insufficiency, coagulation disorders, damage to the central nervous system. \u0000AIM: The aim is to analyze the features of the course of COVID-19 in children who require mandatory hospitalization in specialized hospitals for background pathology, to identify predictors of the development of severe forms of COVID-19 in order to choose the optimal ways of treating this pathology. \u0000MATERIALS AND METHODS: Under the supervision of the St. Petersburg State Pediatric Medical University in the department for children with new coronavirus infection COVID-19 with intensive care and intensive care wards in the period 2020–2022 with a confirmed diagnosis of “new coronavirus infection” there were 791 patients aged 0 to 17 years. The diagnosis was made on the basis of clinical and epidemiological data, the results of a comprehensive laboratory and instrumental study. The severity of the disease was determined in accordance with the methodological recommendations of the Ministry of Health of the Russian Federation. \u0000RESULTS: The severe form of COVID-19 was diagnosed in 34 patients out of 791 (4.3%). Adverse outcomes were 1.4%. In 27 out of 34 children (79.4%), new coronavirus infection occurred against the background of severe comorbid pathology. Pneumonia was diagnosed in 91.2% of cases. 88.2% of patients needed oxygen therapy. \u0000CONCLUSIONS: Severe forms of COVID-19 in children are characterized by high fever with severe intoxication, respiratory tract damage with a significant volume of lung damage (CT-3 and CT-4) with the development of multiple organ failure. Predictors that require mandatory hospitalization in specialized hospitals for background pathology in severe forms of COVID-19 are: primary immunodeficiency conditions, oncohematological pathology with postcytostatic aplasia of hematopoiesis, severe organic lesions of the central nervous system, epilepsy, protein-energy deficiency of 3–4 degrees, bronchopulmonary dysplasia, atypical emolytic uremic syndrome with acute kidney damage. Comprehensive treatment of such patients should be carried out by a multidisciplinary team in a specialized department with extensive diagnostic and therapeutic capabilities.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"104 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439976","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. Shishkova, V. Bocharov, Yulia S. Chernaya, Alexander V. Shashkov, Ivan V. Porfirev, Alexandr G. Titov
BACKGROUND: Parents raising children with disabilities are often exposed to stress and emotional burnout associated not only with the parenting process itself, but also with the need to create special conditions for the development and maintenance of the physical and mental well-being of their children. It is important to reveal factors that determine the parents’ adaptation success in a child’s illness situation. Parents of disabled children often join communities via Internet in order to exchange experiences and competencies in the field of care and interaction with children. This is rapidly developing trend of modern society and requires close attention of psychologists and other specialists working with parents of children with disabilities. This knowledge will allow us to develop appropriate mechanisms for cooperation, treatment and prevention in relevant peer support networks. AIM: The aim of the study was to reveal the relationships of sociodemographic and clinical factors with the severity of burnout and engagement in child care in parents who joined online peer support networks for persons raising children with disabilities. MATERIALS AND METHODS: The study involved 125 parents (121 mothers and 4 fathers) caring for children with disabilities. Mean [±SD] age, 36,3 ± 6,7 years. The “Level of relatives’ emotional burnout / parent-child version” was used as an assessment tools. Also, semi-structured interview for assessing socio-demographic and clinical characteristics was applied. RESULTS: The results of the study showed that age of the mother and child, the education and the work activities of the mother, the child’s kindergarten attendance, the age of onset and duration of the child’s illness, the nature of the relationship with him and the degree of parent’s activity in the treatment and rehabilitation process are the factors associated with engagement and burnout in parents of children with disabilities who joined online peer support networks. In particular, the lesser the age of the mother and the disabled child, the more exhaustion, tendency to devaluate successes and achievements in the process of children’s treatment (inefficacy) and tendency to destructively defuse of stress tension in mothers. The process of exhaustion is most likely at the initial periods of adaptation of the mother to the disease of the child, then the adaptation to the existing situation occurs. Burnout acts as a pathological process that contradicts the general trend and develops in cases when, due to environmental or personal factors, difficulties in adapting the parent to the child’s disease arise. CONCLUSIONS: Understanding of parents’ burnout processes is important for moderators of Internet communities, since it allows to route work with information content.
{"title":"Interrelation of sociodemographic and clinical factors with burnout and engagement among mothers, who joined online peer support networks for persons raising children with disabilities","authors":"A. M. Shishkova, V. Bocharov, Yulia S. Chernaya, Alexander V. Shashkov, Ivan V. Porfirev, Alexandr G. Titov","doi":"10.17816/ped625946","DOIUrl":"https://doi.org/10.17816/ped625946","url":null,"abstract":"BACKGROUND: Parents raising children with disabilities are often exposed to stress and emotional burnout associated not only with the parenting process itself, but also with the need to create special conditions for the development and maintenance of the physical and mental well-being of their children. It is important to reveal factors that determine the parents’ adaptation success in a child’s illness situation. Parents of disabled children often join communities via Internet in order to exchange experiences and competencies in the field of care and interaction with children. This is rapidly developing trend of modern society and requires close attention of psychologists and other specialists working with parents of children with disabilities. This knowledge will allow us to develop appropriate mechanisms for cooperation, treatment and prevention in relevant peer support networks. \u0000AIM: The aim of the study was to reveal the relationships of sociodemographic and clinical factors with the severity of burnout and engagement in child care in parents who joined online peer support networks for persons raising children with disabilities. \u0000MATERIALS AND METHODS: The study involved 125 parents (121 mothers and 4 fathers) caring for children with disabilities. Mean [±SD] age, 36,3 ± 6,7 years. The “Level of relatives’ emotional burnout / parent-child version” was used as an assessment tools. Also, semi-structured interview for assessing socio-demographic and clinical characteristics was applied. \u0000RESULTS: The results of the study showed that age of the mother and child, the education and the work activities of the mother, the child’s kindergarten attendance, the age of onset and duration of the child’s illness, the nature of the relationship with him and the degree of parent’s activity in the treatment and rehabilitation process are the factors associated with engagement and burnout in parents of children with disabilities who joined online peer support networks. In particular, the lesser the age of the mother and the disabled child, the more exhaustion, tendency to devaluate successes and achievements in the process of children’s treatment (inefficacy) and tendency to destructively defuse of stress tension in mothers. The process of exhaustion is most likely at the initial periods of adaptation of the mother to the disease of the child, then the adaptation to the existing situation occurs. Burnout acts as a pathological process that contradicts the general trend and develops in cases when, due to environmental or personal factors, difficulties in adapting the parent to the child’s disease arise. \u0000CONCLUSIONS: Understanding of parents’ burnout processes is important for moderators of Internet communities, since it allows to route work with information content.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"36 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440336","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}
T. A. Kaplina, D. Ivanov, V. N. Timchenko, S. L. Bannova, G. V. Kondratyev, V. Sukhovetskaya, M. Subbotina, E. B. Pavlova, A. Nazarova, A. V. Fedorova, O. V. Bulina
The problem of non-smooth course of COVID-19 in people with severe comorbidities is topical. The greatest number of deaths from a new coronavirus infection was noted in the presence of such diseases as: obesity, chronic bronchopulmonary, cardiovascular diseases, HIV infection, diabetes mellitus, oncohematology, etc. Due to the focus of the healthcare system on the COVID-19 pandemic, less attention is paid to the fight against the immunodeficiency virus, despite the fact that the epidemiological situation with HIV infection in the Russian Federation continues to be tense. Individuals with HIV infection may be at increased risk of complications and death associated with COVID-19. The stage of HIV infection, indicators of the immune status, viremia, and taking antiretroviral therapy correlate with the severity of the course of COVID-19/HIV and have prognostic value. A clinical observation of the course of a new coronavirus infection in a 15-year-old teenager born to an HIV infected mother (who hid her HIV status at the time of hospitalization of a child) who was not at a dispensary observation at the AIDS Center was presented. The child was hospitalized with a new coronavirus infection (COVID-19), complicated: acute community-acquired (interstitial) bilateral pneumonia. The low index body mass of the child, the presence of concomitant pathology, the non-smooth course of the disease made it possible to suspect the patient of an immunodeficiency condition and identify concomitant HIV infection in the secondary disease stage (4B), the progression phase with the absence of antiretroviral therapy. Conclusion: the non-smooth course and severity of the disease were mainly due to secondary infections pathology. Severe immunosuppression detected in a child due to HIV infection contributed to the long-term persistence of the SARS-CoV-2 virus. In this case, it was not established that HIV infection in the patient was a factor predisposing to the severe course of COVID-19 and contributing to a prognostically unfavorable outcome. Complex therapy including antiretroviral therapy prevented further progression of immunosuppression and led to recovery from new coronavirus infection and management of comorbidity. The increase in the number of HIV-infected persons in the late stages of infection, often detected by chance, only during hospitalization, presents difficulties for therapy due to late diagnosis, the presence of a combined secondary pathology and the severity of its course against the background of low immune status parameters.
{"title":"Clinical case of COVID-19 in an HIV-infected teenager","authors":"T. A. Kaplina, D. Ivanov, V. N. Timchenko, S. L. Bannova, G. V. Kondratyev, V. Sukhovetskaya, M. Subbotina, E. B. Pavlova, A. Nazarova, A. V. Fedorova, O. V. Bulina","doi":"10.17816/ped625945","DOIUrl":"https://doi.org/10.17816/ped625945","url":null,"abstract":"The problem of non-smooth course of COVID-19 in people with severe comorbidities is topical. The greatest number of deaths from a new coronavirus infection was noted in the presence of such diseases as: obesity, chronic bronchopulmonary, cardiovascular diseases, HIV infection, diabetes mellitus, oncohematology, etc. Due to the focus of the healthcare system on the COVID-19 pandemic, less attention is paid to the fight against the immunodeficiency virus, despite the fact that the epidemiological situation with HIV infection in the Russian Federation continues to be tense. Individuals with HIV infection may be at increased risk of complications and death associated with COVID-19. The stage of HIV infection, indicators of the immune status, viremia, and taking antiretroviral therapy correlate with the severity of the course of COVID-19/HIV and have prognostic value. A clinical observation of the course of a new coronavirus infection in a 15-year-old teenager born to an HIV infected mother (who hid her HIV status at the time of hospitalization of a child) who was not at a dispensary observation at the AIDS Center was presented. The child was hospitalized with a new coronavirus infection (COVID-19), complicated: acute community-acquired (interstitial) bilateral pneumonia. The low index body mass of the child, the presence of concomitant pathology, the non-smooth course of the disease made it possible to suspect the patient of an immunodeficiency condition and identify concomitant HIV infection in the secondary disease stage (4B), the progression phase with the absence of antiretroviral therapy. Conclusion: the non-smooth course and severity of the disease were mainly due to secondary infections pathology. Severe immunosuppression detected in a child due to HIV infection contributed to the long-term persistence of the SARS-CoV-2 virus. In this case, it was not established that HIV infection in the patient was a factor predisposing to the severe course of COVID-19 and contributing to a prognostically unfavorable outcome. Complex therapy including antiretroviral therapy prevented further progression of immunosuppression and led to recovery from new coronavirus infection and management of comorbidity. The increase in the number of HIV-infected persons in the late stages of infection, often detected by chance, only during hospitalization, presents difficulties for therapy due to late diagnosis, the presence of a combined secondary pathology and the severity of its course against the background of low immune status parameters.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"18 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440819","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}
Victoria N. Abramova, A. N. Taits, Marina A. Pugacheva, Valery I. Matukhin, Elena E. Kuts
BACKGROUND: Intrauterine synechiae (Ascherman syndrome) is one of the fairly common causes of infertility. Despite a large number of clinical studies, there are still no effective methods of both prevention and treatment, which is one of the main causes of reproductive failures. The article discusses the experience of combined preimplantation preparation of patients with uterine factor infertility caused by intrauterine synechia. An assessment of the effectiveness of preparation for the in vitro fertilization procedure, with subendometrial use of platelet-rich autoplasma against the background of surgical, antibacterial and hormone therapy, is given. AIM: Evaluation of the effectiveness of complex preimplantation preparation of patients with uterine factor infertility caused by intrauterine synechia. MATERIALS AND METHODS: Study of the results of preparation for in vitro fertilization with thawed embryos of 30 women with infertility against the background of Asherman’s syndrome. Treatment: surgical (hysteroscopic adhesiolysis), antibiotic therapy (semisynthetic penicillin’s with clavulanic acid), hormonal support (conjugated estradiol valerate and micronized progesterone) and subendometrial administration of platelet-rich autoplasma. The main criterion for the effectiveness of treatment is the onset of biochemical and clinical pregnancy. RESULTS: The method of combined preimplantation preparation of infertile patients with intrauterine synechia showed high efficiency of the in vitro fertilization procedure: the onset of clinical pregnancy in 46.7% of women, live birth in 36.7%. CONCLUSIONS: A comprehensive method of preparation for in vitro fertilization of patients with intrauterine synechiae significantly increases the chances of successful embryo implantation during this procedure.
{"title":"Complex method of preparation for in vitro fertilization of patients with intrauterine synechia","authors":"Victoria N. Abramova, A. N. Taits, Marina A. Pugacheva, Valery I. Matukhin, Elena E. Kuts","doi":"10.17816/ped625939","DOIUrl":"https://doi.org/10.17816/ped625939","url":null,"abstract":"BACKGROUND: Intrauterine synechiae (Ascherman syndrome) is one of the fairly common causes of infertility. Despite a large number of clinical studies, there are still no effective methods of both prevention and treatment, which is one of the main causes of reproductive failures. The article discusses the experience of combined preimplantation preparation of patients with uterine factor infertility caused by intrauterine synechia. An assessment of the effectiveness of preparation for the in vitro fertilization procedure, with subendometrial use of platelet-rich autoplasma against the background of surgical, antibacterial and hormone therapy, is given. \u0000AIM: Evaluation of the effectiveness of complex preimplantation preparation of patients with uterine factor infertility caused by intrauterine synechia. \u0000MATERIALS AND METHODS: Study of the results of preparation for in vitro fertilization with thawed embryos of 30 women with infertility against the background of Asherman’s syndrome. Treatment: surgical (hysteroscopic adhesiolysis), antibiotic therapy (semisynthetic penicillin’s with clavulanic acid), hormonal support (conjugated estradiol valerate and micronized progesterone) and subendometrial administration of platelet-rich autoplasma. The main criterion for the effectiveness of treatment is the onset of biochemical and clinical pregnancy. \u0000RESULTS: The method of combined preimplantation preparation of infertile patients with intrauterine synechia showed high efficiency of the in vitro fertilization procedure: the onset of clinical pregnancy in 46.7% of women, live birth in 36.7%. \u0000CONCLUSIONS: A comprehensive method of preparation for in vitro fertilization of patients with intrauterine synechiae significantly increases the chances of successful embryo implantation during this procedure.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"66 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439424","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}
BACKGROUND: Empathy is considered a key element in doctor-patient relationship that may positively influence communication and outcomes. However, the correlation of empathy with perfectionism, which prevalence and rates among students are increasing, remains understudied. AIM: The aim is to study the associations between perfectionism and empathy in psychiatry and neurology residents. MATERIALS AND METHODS: Psychiatry and neurology residents (n = 100) aged 22–29 filled out the following validated instruments: “Three-Factor Perfectionism Inventory” (N.G. Garanyan, et al.) and “The Interpersonal Reactivity Index (IRI)” (M. Davis). The sample was divided into three groups with high (n = 37), medium (n = 33) and low (n = 30) levels of perfectionism. RESULTS: Residents with high level of perfectionism have higher level of personal distress (p 0.01). In this group were also observed significant positive associations between general level of perfectionism and empathic concern (p 0.05); socially prescribed perfectionism and personal distress (p 0.05), fantasy (p 0.05), empathic concern (p 0.05); perfectionistic cognitive style and personal distress (p 0.01). In residents with medium level of perfectionism a positive correlation exists between self-oriented perfectionism and perspective taking (p 0.05). In residents with low level of perfectionism perspective taking negatively correlated with general level of perfectionism (p 0.01) and self-oriented perfectionism (p 0.05); a positive correlation exists between socially prescribed perfectionism and personal distress (p 0.01). CONCLUSIONS: These findings allow to identify socially prescribed perfectionism and perfectionistic cognitive style, that associated with personal distress, as targets of psychological correction.
{"title":"Associations between perfectionism and empathy in psychiatry and neurology residents","authors":"Mariya V. Biletskaya","doi":"10.17816/ped626013","DOIUrl":"https://doi.org/10.17816/ped626013","url":null,"abstract":"BACKGROUND: Empathy is considered a key element in doctor-patient relationship that may positively influence communication and outcomes. However, the correlation of empathy with perfectionism, which prevalence and rates among students are increasing, remains understudied. \u0000AIM: The aim is to study the associations between perfectionism and empathy in psychiatry and neurology residents. \u0000MATERIALS AND METHODS: Psychiatry and neurology residents (n = 100) aged 22–29 filled out the following validated instruments: “Three-Factor Perfectionism Inventory” (N.G. Garanyan, et al.) and “The Interpersonal Reactivity Index (IRI)” (M. Davis). The sample was divided into three groups with high (n = 37), medium (n = 33) and low (n = 30) levels of perfectionism. \u0000RESULTS: Residents with high level of perfectionism have higher level of personal distress (p 0.01). In this group were also observed significant positive associations between general level of perfectionism and empathic concern (p 0.05); socially prescribed perfectionism and personal distress (p 0.05), fantasy (p 0.05), empathic concern (p 0.05); perfectionistic cognitive style and personal distress (p 0.01). In residents with medium level of perfectionism a positive correlation exists between self-oriented perfectionism and perspective taking (p 0.05). In residents with low level of perfectionism perspective taking negatively correlated with general level of perfectionism (p 0.01) and self-oriented perfectionism (p 0.05); a positive correlation exists between socially prescribed perfectionism and personal distress (p 0.01). \u0000CONCLUSIONS: These findings allow to identify socially prescribed perfectionism and perfectionistic cognitive style, that associated with personal distress, as targets of psychological correction.","PeriodicalId":506195,"journal":{"name":"Pediatrician (St. Petersburg)","volume":"101 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140438151","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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