Neonatology, surgery and perinatal medicine最新文献

{"title":"ALGORITHM OF A DIFFERENTIATED APPROACH TO MANAGEMENT OF PERSISTENT PULMONARY HYPERTENSION IN PREMATURE INFANTS","authors":"T. Klymenko, M. Kononovych","doi":"10.24061/2413-4260.xiii.2.48.2023.5","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.5","url":null,"abstract":"Introduction. Oxidative stress (OS) is recognized as a contributing factor to the development of persistent pulmonary hypertension (PPH) in premature infants. In the modern scientific literature, there is a lack of unequivocal recommendations for the management of PPH, considering the levels of OS, what determines the need for the development of a differentiated approach for management to infants with pulmonary hypertension.The aim of the study. To increase the efficacy of management of premature infants with persistent pulmonary hypertension with asphyxia and respiratory distress syndrome based on the development of the algorithm of a differentiated approach for management of pulmonary hypertension considering the levels of oxidative stress as determined by the urinary 8-hydroxy-2-deoxyguanosine (8-OHdG).Material and methods. Were analyzed the observations of 96 infants born prematurely at gestational age of 26/1–34/6 weeks: group I consisted of 50 infants with respiratory distress syndrome (RDS), group II - 50 infants with RDS associated with perinatal asphyxia. PPH was determined by echocardiography on the 1st and on the 3rd-5th day of life, and quantitative determination of the urinary 8-OHdG (ng/ml) was performed on 44 neonates on the 1st and in dynamics on the 3rd-5th day of life using enzyme-linked immunosorbent assay (ELISA). For comprehensive radiographic assessment of PPH, all infants received chest X-Ray with determination of Moore's, Schwedel's, and cardiothoracic indexes (CTI).Statistical analysis was performed using Microsoft Excel 2019 software. Under the conditions of normal distribution of quantities, parametric statistical methods were used to calculate the arithmetic mean (M) and the representativeness error of the mean (m). Using Fisher`s exact test (φ) we analyzed the quantitative parameters. Using the heterogeneous sequential Wald procedure, development of diagnostic criteria was performed. The essence of the procedure is to determine both diagnostic (DC), prognostic coefficients (PC) and diagnostic informativeness (I) of the investigated indicators. The minimum informativeness of the feature required for addition to the developed algorithm was considered I ≥ 0.25.The algorithm was developed on the basis of diagnostic coefficients of clinical and anamnestic data of the examined groups of children, echocardiographic criteria for the presence and determination of the degree of PPH, the dynamics of OS levels and their comparison with the indicators of a comprehensive radiological assessment of pulmonary hypertension in prematurely born infants with RDS and perinatal asphyxia in association with RDS in gestational age of 26-34 weeks.Design of a study was discussed and approved at a session of the Ethical commission of the Kharkiv Medical Academy of Postgraduate Education (Prot. № 5 from 18.12.2020). All parents gave an informed consent for examination of their children.The study was carried out in accordance to the plan of the r","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129889360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANALYSIS OF THE RISK OF RECURRENT WHEEZING IN CHILDREN WITH BRONCHIOLITIS BASED ON THE WEIBULL MATHEMATICAL MODEL","authors":"N. Tokarchuk, O. Ocheredko, A. Overchuk","doi":"10.24061/2413-4260.xiii.2.48.2023.7","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.7","url":null,"abstract":"Given the frequency of recurrent wheezing (up to 50 % of cases) in young children during the first year after bronchiolitis, the assessment of the prognostic value of diagnostic biological markers of bronchiolitis requires special attention.According to modern concepts, mast cells, eosinophils, play a significant role in the pathogenesis of bronchiolitis, with degranulation of which the release of cationic proteins (eosinophilic cationic protein (ECP), eosinophil-derived neurotoxin (EDN)) and molecular mediators, namely vascular cell adhesion molecule-1 (VCAM-1), which is a regulator of leukocyte adhesion and transendothelial migration. That is why VCAM-1, ECP and EDN are discussed as important prognostic markers in assessing the risk of recurrent wheezing in children with bronchiolitis.The aim of the study. To analyze the risk factors for recurrent wheezing in children with bronchiolitis, considering allergic history, the influence of external factors (passive smoking, place of residence), levels of VCAM-1, ECP, EDN in the blood serum.Material and Methods. This article is a part of the research work of the Department of Paediatrics No. 1 of Vinnytsia National Medical University named after M.I. Pyrohov on the topic \"Optimization of diagnosis and treatment of somatic pathology in children\", state registration No. 0115U007075.A clinical examination of 67 infants was carried out. The main group consisted of 34 children with bronchiolitis without a complicated allergic history. The comparison group consisted of 33 children with bronchiolitis who had a burdened allergic history. The average age of the children in the main group was 8.4±1.6 months, and 6.2±1.4 months in the comparison group. The analytical component of the study was based on parametric survival models (Weibull and generalized Gamma models). The analysis of Weibull models was performed in the statistical packages of analytical system R for Mac OS X FAQ, Version 3.1.0 2014-04-10, R. app 1.64 based on the Mac OS X 10.9 platform, 64-bit Intel Core i7 architecture.The study was approved by the Commission on Biomedical Ethics for compliance with the moral and legal rules for conducting medical research at Vinnytsia National Medical University named after M.I. Pyrohov. It was established that the research does not contradict the basic bioethical norms and meets the principles of compliance with the basic provisions of the GCP (1996), the Council of Europe Convention on Human Rights and Biomedicine (04.04.1997), WMA Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects (1964-2008) and Order of the Ministry of Health of Ukraine No. 690 of 23.09.2009 (as amended by Order of the Ministry of Health of Ukraine No. 523 of 12.07.2012). All patients were informed about the purpose and possible consequences of the research procedures. All patients signed an informed written consent to participate in the study prior to the procedure.Results of the study. The risks ","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117079083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEWER KNOTS IN CIRCUMCISION ARE ASSOCIATED WITH LESS POSTOPERATIVE PAIN: A RETROSPECTIVE COMPARATIVE STUDY","authors":"Süleyman Sağır, M. Azizoğlu, Müslüm Ergün","doi":"10.24061/2413-4260.xiii.1.47.2023.4","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.4","url":null,"abstract":"Male circumcision is the most frequently performed surgical procedure among Muslim and Jewish communities, mainly for medical, religious, and traditional reasons (1-4). In the USA, circumcision is frequently performed for cosmetic purposes. Although it is seen as a simple procedure, it is quite prone to complications like other surgical procedures. The early and long-term complications of circumcision are well known and the overall complication rate has been reported between 0.2% and 3.9%. Common complications associated with circumcision are acute bleeding, pain, edema, wound infection, and unnecessary foreskin. Rare complications include meatal stenosis, urethral fistula, partial and total glandular amputations, glandular necrosis, penile curvature, and penile rotation. In addition, keloid formation and scar hypertrophy are some rare complications that cause poor cosmetic appearance.The aim of paper: Our aim in this study was to investigate the effect of the number of sutures placed during circumcision on postoperative pain, infection, bleeding amount, and analgesic need in children.Materials and methods: A total of 715 patients who applied to our hospital for circumcision requests between November 2019 and January 2022 were retrospectively analyzed. The patients were randomly divided into three groups according to the number of knots used during the surgical procedure: Group 1 (8 sutures), group 2 (6 sutures), and group 3 (4 sutures). The patients were evaluated in terms of whether they needed analgesics in the postoperative period (1-hour), bleeding status, and whether this bleeding needed re-intervention.Results: The average age of the participants in the study was 4.06±2.51 years, and the average weight was 18.66±7.07 kg. The operation was completed using 8 sutures (group 1) in 47.5%, 6 sutures (group 2) in 27.7%, and 4 sutures (group 3) in 24.9% of the patients. Postoperative infection developed in 2.8% of the participants, and bleeding was observed in 25.1%. The number of participants who needed analgesia for the first hour after the operation was 66.8%. The median value of the postoperative pain scale was 5 (range: 1-9), and those with a pain scale of 5-9 were 65.5%. There was no significant difference between the groups in terms of age, weight, development of infection, and bleeding (p>0.05). Analgesia was needed in 88.7% of those in group 1, 69.9% of those in group 2, and 21.6% of those in group 3 (p<0.001). A score (MPOS) of 5 or higher was found in 86.8% of those in group 1, 71% of those in group 2, and 18.6% of those in group 3 (p<0.001).Conclusions: our study showed that group 3 (4 sutures) achieved lower pain scores, less analgesic consumption, and lower agitation scores after circumcision compared to other groups.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127120722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PECULIARITIES OF CHRONIC PAIN AND PAIN-RELATED STRESS MARKERS IN PRETERM INFANTS","authors":"H. Pavlyshyn, I. Sarapuk, K. Kozak, T. Zaitseva","doi":"10.24061/2413-4260.xiii.1.47.2023.1","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.1","url":null,"abstract":"Preterm infants are a special cohort of newborns that require long-term treatment in the neonatal intensive care unit (NICU). NICU stay, accompanied by numerous excessive stimuli, painful procedures, and separation from parents leads to a high risk of chronic pain and stress.The aim of research was to study the level of chronic pain and pain-related stress markers in preterm infants with a gestational age of less than 34 weeks, and their associations with various factors.Materials and methods. The study involved 104 preterm infants with gestational age (GA) less than 34 weeks who were treated in the NICU. The level of chronic pain and pain-related stress markers (dopamine, β-endorphin, serotonin) in urine samples was determined by an enzyme-linked immunosorbent assay using kits for the quantitative determination of dopamine (Dopamine Elisa kit, Elabscience, Wuhan, China), β-endorphin (β-endorphin Elisa kit, Elabscience, Wuhan, China), serotonin (Serotonin Elisa kit, Elabscience, Wuhan, China). Samples were analyzed in duplicate, and assays were performed using provided controls according to the manufacturer’s instructions.Ethics approval was obtained from the appropriate local ethics committee and research was conducted under the World Medical Association’s Helsinki Declaration. Informed consent was obtained from all the participants who took part in the study.All computations were performed using StatSoft STATISTICA Version 13 (Tulsa, OK). Quantitative data are presented as the median and interquartile range (IQR; 25th to 75th percentiles). For qualitative parameters, absolute and relative frequencies are presented. The Mann-Whitney U-test (for two independent groups) and Kruskal-Wallis test (for three groups) were used to compare numerical data. Significance was assumed at p<0.05. Correlations were analyzed using Spearman’s rank correlation coefficient.The study is a part of the scientific research: Implementation of the neuro-developmental care elements for preterm infants and their follow-up observation (0120U104281, 01.01.2020-12.31.2022).Research results and their discussion. Dopamine level in the urine of preterm infants was 132.20 [104.80; 183.70] pg/ml. It was significantly higher in children who underwent mechanical ventilation compared to non-ventilated neonates (164.60 [110.00; 253.70] pg/mL vs. 123.20 [98.65; 158.70] pg /ml), p=0.030, and was associated with the severity of respiratory disorders (H=5.84; p=0.049). Dopamine level was significantly lower in twins compared to singleton infants (113.70 [78.75; 164.70] vs. 145.10 [111.80; 208.50], p=0.017.β-endorphin level in the urine of preterm newborns was 29.87 [20.61; 46.94] pg/ml. It was significantly higher in twins compared to singletons (38.30 21.97; 59.61] vs. 27.80 [19.66; 39.16], p=0.046). β-endorphin level was significantly lower in children with neonatal seizures (p=0.039).Serotonin level in the urine of preterm infants was 23.49 [16.13; 32.19] pg/ml. It was significantly hi","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132499926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UPDATED CLINICAL PROTOCOLS OF INHERITED FATTY ACID OXIDATION DISORDERS IN NEWBORNS: CONSOLIDATED DATA FROM THE INTERNATIONAL CLINICAL GUIDELINES","authors":"T. Znamenska, O. Vorobiova, I. Kuznietsov, I. Lastivka, T. Holota, A. Kremezna, V. Kryvosheieva, M. Obod, I. Samoilenko, V. Davydiuk, Y. Marushko, V. Pokhylko, L. Kirillova, L. Nikulina, V. Shveykina, O. Miroshnikov, O. Yuzva, E. Zbrozhik, K. Holiuk","doi":"10.24061/2413-4260.xiii.1.47.2023.9","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.9","url":null,"abstract":"Fatty acid oxidation disorders (FAODs) are a group of inherited metabolic diseases (IMDs) caused by impairments in mitochondrial β-oxidation of fatty acids (FA) due to defects in genes encoding enzymes, transporters, membrane channels, and receptors that mediate this process. A common characteristic of this group of IMDs is an energy deficit associated with suppression of energy metabolism in mitochondria due to a decrease in the production of ketone bodies and the substrate of the tricarboxylic acid cycle – acetyl-coenzyme A. Since energy deficiency is a common pathogenetic factor of the entire group of FAODs, the manifestation of these inherited diseases is similar, and only certain nosologies have specific differences in the clinical picture, accordingly, these disorders require similar treatment. Initial manifestations of FAODs in neonatal and early childhood most often include cardiomyopathy, liver dysfunction, and hypoketotic hypoglycemia. For newborns with FAOD, the main danger is rapidly progressing crisis states of metabolic decompensation with severe, often fatal consequences. In adolescence, in addition to the above severe symptoms, episodes of rhabdomyolysis may also occur.Since long intervals between meals are one of the main factors provoking episodes of metabolic decompensation in patients with FAODs, the key tool for their prevention is the avoidance of prolonged fasting. In cases of the development of metabolic crisis states, symptomatic treatment is used with the introduction of carnitine according to indications. The special role of carnitine is its involvement in the transport of long-chain fatty acids through the mitochondrial membrane. Treatment of FAODs caused by a deficiency of enzymes whose substrates are long-chain fatty acids involves the use of a low-fat diet and the addition of medium-chain triglycerides and docosahexaenoic acid to the diet. Success in treating IMDs as such and FAODs, particularly, is directly related to early detection of the disease and treatment beginning since the destructive effect of toxic metabolites on internal organs and the brain increases according to the duration of exposure, leading to their progressive damage and delay in physical and mental development.An effective tool for the early detection of newborns with IMDs is the extended neonatal screening program, the implementation of which, according to the WHO, has become the greatest achievement of the health care systems of the developed countries of the world in reducing the levels of child mortality and disability in the first 10 years of the 21st century. In 2019, the program of extended newborn screening of IMDs was started in Ukraine at the initiative of the State Institution “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova of the National Academy of Medical Sciences of Ukraine”, “Association of Neonatologists of Ukraine” and “CDC Pharmbiotest” (Baby Screen, https://baby-screen.com.ua).One o","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130949035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE ROLE OF MELATONIN IN COMPLICATED PREGNANCY","authors":"A. Pushkashu, A. Semeniak","doi":"10.24061/2413-4260.xiii.2.48.2023.13","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.13","url":null,"abstract":"Introduction. In recent years, there have been significant changes in the understanding of the hormone melatonin (MT). It has been confirmed that the processes of conception, pregnancy, and childbirth directly depend on the rhythm and level of MT secretion, but there is no general concept that could describe in detail the mechanisms of influence on ontogenesis.The aim of the study. To assess MT in the blood of pregnant with retrochorial hematoma (RCH) up to 12 weeks of pregnancy.Material and methods. Two groups were formed: 1st comprized 40 pregnant women with RCH, 2nd, control consisted of 44 healthy pregnant. Obstetric research, enzyme immunoassay to determine MT, and ultrasound were performed.The approval of the scientific work was obtained from the Bioethical Commission of the Bukovinian State Medical University (Ukraine).Statistical analysis was performed according to generally accepted methods of variational statistics.The work is a fragment of the research work “Prevention, diagnosis and treatment of disorders of the perinatal period and the reproductive system of women and adolescent girls” (No. 201110Н, state registration number 0111U006499).Results. A significant decrease of MT in the 1st group and the dependence of its level on the size of the RCH was revealed: in the case of hematomas up to 1 cm MT (59.31±10.32 pg/ml) (р ˂ 0.001), which is not observed in hematomas more than 1 cm, which are dangerous for pregnancy (93.98±14.52 pg/ml), which may indicate a compensatory increase in MT; and the term of pregnancy (in 10-12 weeks 79.03±9.61 pg/ml (р ˂ 0.05), in 5-6 weeks 93.78±17.44 pg/ml).Conclusions. In cases of RCH up to 1 cm the content of MT decreases with the development of pregnancy, which can be used as a prognostic marker for the diagnosis of pregnancy complications. The increase in the level of MT with RCH more than 1 cm can be considered as a compensatory increase for the preservation of pregnancy and a regulatory influence on the further course of pregnancy.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133729016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECTIVENESS OF POSTURAL THERAPY IN INFANTS WITH FREQUENT INTESTINAL COLIC","authors":"T. Sorokman, V. Ostapchuk","doi":"10.24061/2413-4260.xiii.1.47.2023.2","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.2","url":null,"abstract":"Infantile colic is a general term used to describe excessive crying, abdominal pain, and discomfort in the first months of life, and it causes stress for parents and concern for clinicians. Colic in babies is common all over the world. The Rome criteria offer diagnostic criteria for functional gastrointestinal symptoms but do not discuss their treatment. Manipulative treatments are considered effective interventions to reduce the severity of symptoms.The aim of the study. To evaluate the effectiveness of postural therapy in infants with intestinal colic.Methods. The current prospective cohort study used data from a mother-child cohort. 37 \"mother-child\" pairs (age of babies from 2 weeks to 4 months) were under observation. Two observation groups were created by the method of simple randomization: Group I - 17 infants who received traditional therapy (preparations based on simethicone, prokinetics, enzymes, antispasmodics, in case of significant flatulence, a gas removal tube or microenema was used), Group II - 20 infants who received postural therapy.To reveal the statistical difference between indicators in groups distributed normally, the Student's t-criterion of reliability was used, the degree of significance - r. The probability of the difference between relative values was determined by the Fisher's angular transformation method (Рφ).The research design and all the methods used in this study were reviewed and approved by the bioethics commission of the Bukovinian State Medical University (protocol No. 8, dated 02/17/2023).The study was carried out as part of the research work «Early diagnosis, treatment and prevention of combined pathology of the gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022).Results of the study. In 81.1% of babies, colic started after the 2nd week of life, in 18.9% - after the 1st month of life. The average age of onset of symptoms was 1.1 ± 0.1 months. Initially, colic occurred less often (1-2 times a week) and lasted up to 15 minutes, with age, their frequency and duration increased. We identified the main risk factors for the development of colic in babies: younger age of parents (F = 0.529, p = 0.001), mother's smoking (F = 0.498, p = 0.01), hypodynamia of the mother during pregnancy (F = 0.511, p = 0 .02), positive history of the father regarding functional diseases of the gastrointestinal tract (F = 0.788, p= 0.004), positive history of the mother regarding functional diseases of the gastrointestinal tract (F = 0.489, p= 0.01), food allergy in the mother (Ф = 0.476, p = 0.02), food allergy in the father (F = 0.329, p = 0.05), early (up to 3 months) transfer of the child to mixed or artificial feeding (F = 0.324, p = 0.05), hypoxic-ischemic CNS damage (F = 0.467, p = 0.05), body weight at birth <2900 g (F = 0.531, p = 0.01). The dynamics of symptoms in children of both observation groups was almost the same, with the exception of su","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116157092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACUTE DESTRUCTIVE PANCREATITIS IN CHILDREN","authors":"S. Veselyy, M. Veselyy, E. Galinskij","doi":"10.24061/2413-4260.xiii.1.47.2023.5","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.5","url":null,"abstract":"Unlike adults, acute pancreatitis in children is a rare disease. The absence of unified standards for the diagnosis, treatment and rehabilitation of children with acute destructive pancreatitis, as well as high rates of complications and mortality, determined the relevance of our study.Materials and methods. Materials and methods. The results of treatment of 11 children with acute destructive pancreatitis were studied. The age of the patients ranged from 2 to 16 years. Laboratory examination in all patients included general and biochemical analyzes of blood, urine, peritoneal and thoracic exudate. All children underwent an ultrasound examination of the abdomen, chest cavity and mediastinum, and plain radiography of the chest and abdominal cavity. Computed tomography was performed in 6 patients (54.5%). Fibrogastroduodenoscopy (FGDS) was performed in 3 patients (27.3%). All patients underwent surgery. In 8 cases (72.7%), a median laparotomy was performed initially. In 3 observations (27.3%), surgical treatment began with video surgical revision of the abdominal organs, and then switched to conversion. Three patients (27.3%) subsequently underwent cystopancreatic jejunostomy. In one child, transcutaneous drainage of a false pancreatic cyst was performed under video surgical control. Synthetic somatostatin analogs and proteinase inhibitors were used as targeted therapy. All patients received long-term antibacterial therapy. Various methods of extracorporeal detoxification were used in 6 patients (54.5%).Statistical processing of the research results was carried out using standard methods with the calculation of relative values (absolute number of observations, % ratio).The approval of the scientific work was received from the Bioethical Commission of the Donetsk National Medical University (Ukraine).The work is a fragment of proactive research work of the Department of General and Children's Surgery of the Donetsk National Medical University (Ukraine). Results. Complications in the early postoperative period were noted in 8 children (72.7%). The group of the most severe complications included progressive enzymatic bacterial peritonitis, early adhesive intestinal obstruction, failure of cystopancreatic ileal anastomosis, profuse arrosive hemorrhage from the pancreas, cystopancreaticodigestive fistula and eventation. In the early postoperative period, 1 child aged 14 years (9.1%) died, and the rest of the patients were discharged in satisfactory condition. The average hospital stay for children was 23.1 days. In 7 patients (63.6%), complaints characterized by \"enteric\" discomfort occurred later.Conclusions. The principles of surgical and therapeutic tactics in children with acute destructive pancreatitis are based on a differentiated approach depending on the form of pancreatic necrosis and the development of purulent and destructive complications. Further study requires determination of situational surgical tactics, assessment of the effectiveness of","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125341544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHANGES IN THE INDICATORS OF ABDOMINAL ARTERIAL CIRCULATION WHEN APPLYING VARIOUS ANESTHETIC TECHNIQUES IN CHILDREN","authors":"Y. Semkovych","doi":"10.24061/2413-4260.xiii.1.47.2023.3","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.3","url":null,"abstract":"Intra-abdominal hypertension and abdominal compartment syndrome result from increased intra-abdominal pressure. In addition, intra-abdominal hypertension has been reported to be an independent risk factor for pediatric intensive care unit mortality.The study aimed to compare the efficacy and the effect of various anesthetic techniques using regional anesthesia on the indicators of abdominal arterial circulation in anterior abdominal wall surgery in children.Materials and Methods. The study included 90 children at the age of 7-18 years. All children underwent anterior abdominal wall surgery under general anesthesia and were divided into 3 groups: Group I included 30 children who underwent anterior abdominal wall surgery under general anesthesia using morphine; Group II comprised 30 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block combined with the quadratus lumborum block 4 via a single injection; Group III included 30 children who underwent anterior abdominal wall surgery under general anesthesia using the TFPB.The manuscript was approved by the Ethics Committee of the Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”, as evidenced by an Excerpt from the Minute of the Committee Meeting No. 2 dated February 24, 2022.The results obtained were statistically processed using statistical measures of variation, correlation analysis, Student’s t-test. Differences were considered statistically significant at p<0.05. The proportions were statistically compared by using a z-test.The study is a fragment of the research project of the Department of Children Diseases of Postgraduate Medical Education Faculty, Ivano-Frankivsk National Medical University “Health Status and Adaption of Children from the Precarpathian Region with Somatic Diseases, Their Prevention” 2021-2026, state registration number 0121U111129; the author is a co-researcher.Results and Discussion. The analysis of acute pain on the selected scales found significantly higher indicators of acute pain on the FLACC scale in the group of conventional anesthesia (Group I, p<0.001) as compared to Group II, where the TFPB in combination with the QLB-4 was used. The analysis of the Likert scale responses found that, over the course of treatment, there was a significant reduction in pain indicators among patients of Group II as compared to those in Group I and Group III (p<0.001). High pain intensity in children who received conventional anesthesia led to a prolonged length of hospital stay and increased IAP (FLACC scale (rx,y=0.38±0.16, р=0.02).Conclusions. A combination of regional anesthesia techniques and conventional anesthesia leads to a reduction in IAP, and increase in APP, a decrease in the resistance index in the superior mesenteric artery and shortens the length of hospital stay as compared to conventional anesthesia management.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115127305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MORPHOLOGICAL EVOLUTION AND DIAGNOSIS OF BRONCHOPULMONARY DYSPLASIA IN VERY PRETERM INFANTS","authors":"A. Menshykova, D. Dobryanskyy, O. Kovalyk","doi":"10.24061/2413-4260.xiii.1.47.2023.6","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.6","url":null,"abstract":"Bronchopulmonary dysplasia (BPD) remains one of the most common and severe diseases in very preterm infants, which can cause death. Since the first description of BPD in 1967, not only understanding of the disease’s nature, its definition, classification, epidemiology, features of the clinical course, diagnosis, prevention, treatment, and prognosis but the specific autopsy histopathological features have changed. The primarily reason for these is considered a change in the population of sick and dead infants as a result of improving clinical practice, increasing the survival rates of the most immature neonates, and reducing the incidence of severe BPD forms and the associated mortality.The BPD form that has been described initially is now called \"old\" BPD and is characterized by significant lung injury. In the smallest neonates, who were treated with exogenous surfactant, the histopathological signs of the disease changed, determining the need to modify the theoretical concept of BPD. The leading feature of the new BPD form was the disorder of lung development and formation, not their injury. Morphologically, this was manifested by a reduced number and simplified structure of acini, changes in the capillary structure with less obvious fibrosis of the lungs. Such morphometric methods as the radial alveolar count and the count of mean number of alveoli intercepts can be used for the histopathological diagnosis of a simplified lung structure. The use of these techniques helps to objectively assess lung growth retardation. Although the number of cases of \"new\" BPD currently prevails, some autopsies are still characterized by histopathological changes typical for the \"old\" form of the disease. A combination of classic and new features is also possible. When establishing a pathological diagnosis of BPD, it is essential to consider all specific histopathological changes that may indicate the presence and severity of the disease, as well as its role in thanatogenesis. This is important not only for the correct postmortem diagnosis of BPD, but also for the studying of various disease phenotypes.The article describes the main histopathological characteristic of various BPD forms, as well as methods of evaluating the simplified lung structure.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116682948","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}