Neonatology, surgery and perinatal medicine最新文献

{"title":"MODERN ASPECTS OF PHARMACOGENETICS: FROM THEORY TO PRACTICE IN PERINATOLOGY AND PEDIATRICS","authors":"O. Skavinska, Y. Cherniavska, L. Fishchuk, V. Pokhylko, O. Yevseienkova, Z. Rossokha","doi":"10.24061/2413-4260.xiii.4.50.2023.20","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.4.50.2023.20","url":null,"abstract":"Pharmacogenetic testing (PT) is a modern tool in the doctor’s practice, which allows to make the right clinical decision indiffi cult cases, when the expected result of medical measures is not achieved. It is clear that certain metabolic processes in the human body, as well as a number of diseases, are genetically programmed. Therefore, despite the large number of unexplained mechanisms of individual response to drugs, genetic testing occupies one of the leading positions among methods of selecting drug therapy in complex clinical cases. However, the successful implementation of this promising method must overcome a number of obstacles, including limited evidence of eff ectiveness, ethical, legal, and social factors. The purpose of this review is to highlight modern concepts and practical aspects of the use of PT. The article addresses the problem of expanding the indications for PT when it is not limited to preventive use only. PT allows to identify drugs associated with an increased risk of causing side eff ects, with a narrow therapeutic index, to reduce the number of drugs in treatment, to choose the dosage of the drug. A variety of PT platforms can be used in a physician’s offi ce, which can be broadly divided into two categories – genotyping- based tests and sequencing- based tests. Depending on the gene being tested, diff erent algorithms can be used to generate results. Some gene variants can be described in terms of metabolic activity or general function, while others can only be described as present or absent. Results for gene variants can also be reported as normal, intermediate or low function for the corresponding gene. Pharmacogenetic clinical decision support systems (CDSS) are computer- based systems that assist healthcare providers in prescribing medications at the point of care. These systems provide physicians and other healthcare providers with appropriately fi ltered pharmacogenetic information, such as drug-gene interaction alerts or patient- specifi c treatment recommendations. A pharmacogenetic CDSS can either be integrated into a local hospital information system or used as a stand- alone application such as a web service or mobile application. Pharmacogenetics can increase the quantity and quality of information available to pregnant women and their physicians about medication use during pregnancy. Implementation of PT recommendations intoroutine pediatric practice requires carefully coordinated strategies at the national, regional, and health system levels. To date, pharmacogenetics provides mosaic information on the association between response to drug therapy and genetic background. It is expected that the next step will be a study in a larger group of participants to investigate the contribution of epigenetic factors and to provide clinical recommendations for adjusting or selecting therapy based on the personal characteristics of the patient.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139313723","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":"TO THE ISSUE OF THE DEVELOPMENT AN ALGORITHM FOR A DIFFERENTIATED APPROACH TO THE MANAGEMENT OF PERSISTENT PULMONARY HYPERTENSION IN PREMATURE INFANTS","authors":"T. Klymenko, M. Kononovych","doi":"10.24061/2413-4260.xiii.4.50.2023.3","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.4.50.2023.3","url":null,"abstract":"The management of premature infants with persistent pulmonary hypertension (PPH) remains a major problem in modernneonatology. In recent years, scientifi c studies have identifi ed the role of oxidative stress (OS) in the development and course of PPH. The reserve for reducing mortality and optimizing the management of premature infants with respiratory distress syndrome (RDS) and asphyxia is the development of an algorithm for a diff erentiated approach to the management of PPH in premature infants, taking into account the severity and dynamics of OS, and its implementation into clinical practice. Aim of the study. To increase the eff ectiveness of management of premature infants with persistent pulmonary hypertension with asphyxia and respiratory distress syndrome based on the development of an algorithm for a diff erentiated approach to the management of pulmonary hypertension taking into account the levels of oxidative stress as determined by urinary 8-hydroxy-2-deoxyguanosine (8-OHdG).Material and methods. 100 premature infants between 26/1-34/6 weeks of gestation were included in the study: groupI consisted of 50 infants with RDS, group II – 50 newborns with RDS associated with perinatal asphyxia. The presence and severity of PPH was determined in all infants on the fi rst and third to fi fth day of life by echocardiography (EchoCG), and quantitative determination of 8-OHdG level (ng/ml) – in 44 infants on the fi rst day, and in dynamics – on the third to fi fth day of life by enzyme- linked immunosorbent assay (ELISA). For radiographic evaluation of PPH, all infants underwent chest radiography with determination of Moore’s, Schwedel’s and cardiothoracic index (CTI). The research was conducted in compliance with bioethical requirements as part of the planned scientifi c work of the Department (state registration number 0122U000025).Results. It was found that the characteristics of pulmonary hypertension in premature infants with RDS were signifi cantly lower levels of mean pressure in the pulmonary artery (mPAP) on the fi rst and 3-5 days of life than in children with perinatal asphyxia. It was noted that the factors with high diagnostic signifi cance determining the occurrence of persistent pulmonary hypertension are: birth weight <1500 g; presence of perinatal asphyxia; low Apgar score on the 1st (1-3 points) and on the 5th minute of life (<7 points); gestational age <30 weeks; non-appropriateness for gestational age; male sex. Furthermore, it was found that urinary 8-OHdG levels as a biomarker of OS in preterm infants with RDS and perinatal asphyxia correlated with mPAP on the fi rst and third to fi fth days of life, and that urinary 8-OHdG levels had a high diagnostic value for determining the risk of developing severe PPH on the third to fi fth days of life. The diagnostic signifi cance of the data of the comprehensive radiological assessment of PPH – the radiological indices of Moore, Schwedel, CTI for the development of severe PPH w","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139313225","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 DEVELOPMENT OF THE HUMAN FACIAL REGION OF SKULL","authors":"O. Tsyhykalo, I. Popova, R. Dmytrenko, N. Kuzniak, V. Honcharenko","doi":"10.24061/2413-4260.xiii.2.48.2023.15","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.15","url":null,"abstract":"Introduction. Elucidation of the peculiarities of the morphogenesis of the structures of the human maxillofacial region does not lose its relevance among scientists-anatomists, embryologists, maxillofacial and pediatric surgeons, which is explained by a rather large congenital pathology of the structures of the human face, which rank third among all congenital malformations (CMF). Morphological studies of the sources of rudiments and the chronological sequence of the appearance of the bones of the facial part of the human head, clarifying the critical periods of their development will contribute development of new and improvement of existing methods of early diagnosis and effective surgical correction of CMF of the face.The aim of the study. The aim of this paper was to clarify the sources, to find out the chronological sequence of the appearance of rudiments and the peculiarities of the morphogenesis of the bones of the facial part of the human skull.Material and methods. Specimens of 20 embryos and 25 human pre-fetuses aged from 4 to 12 weeks of intrauterine development (IUD) (4.0-80.0 mm parietal-coccygeal length (PCL)) were studied. A complex of classical and modern methods of morphological research is applied: making and studying a series of consecutive histological sections, microscopy, morphometry, three-dimensional reconstruction.The investigations were performed keeping to the major regulations of the Resolution of the First National Congress on Bioethics «General Ethic Principles of Experiments on Animals» (2001), ICH GCP (1996), the European Union Convention on Human Rights and Biomedicine (04.04.1997), and the European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes (18.03.1986), the Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects (1964-2008), EU Directives №609 (24.11.1986), the Orders of the Ministry of Health of Ukraine № 690 dated 23.09.2009, №944 dated 14.12.2009, № 616 dated 03.08.2012.The work is carried out within the framework of the initiative research work of the Department of Histology, Cytology and Embryology of Institution of higher education “Bukovinian State Medical University\" \"Structural and functional peculiarities of tissues and organs in ontogenesis, regularities of variant, constitutional, sex-, age-related and comparative human morphology\". State registration number: 0121U110121. Terms of execution: 01.2021-12.2025.Results. Sources of facial structures – mesenchyme of five facial evaginations (frontal process, paired mandibular and hyoid branchial arches) are determined on specimens of 4-week aged human embryos. At the end of the 4th week of IUD, two processes of the mandibular branchial arch are visible – maxillary and mandibular, and the brain is surrounded by an ectomeningeal capsule, the source of which is mesenchyme of neuroectodermal origin. Its outer layer (ectomeninx) forms the splanchnocranium – the rudim","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"10 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":"124821071","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":"ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH","authors":"T. Klymenko, T. Znamenska, O. Karapetyan, O. Melnіchuk","doi":"10.24061/2413-4260.xiii.2.48.2023.3","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.3","url":null,"abstract":"Introduction. Hearing impairment (HI) occupies an important place among perinatal pathology. According to theWHO, the frequency of severe hearing impairment is observed in 1–2 per 1000 newborns and in 15% of newborns whorequired intensive therapy after birth. Mild and moderate HI occurs in 1–2% of children with perinatal pathology.The aim of the work is to study the predictors of hearing impairment and the factors that determine the severityof deafness in children aged 2–3 months who suffered oxidative stress at birth.Material and methods. 131 cases of observation of newborns of 27–36 weeks of gestation with HI in Communalnonprofit enterprise «City perinatal center» Kharkiv city council were analyzed. Children whose families had casesof HI were excluded from the study. During the observation, the audiological examination was carried out in thenewborn period (primary examination) and at 2–3 months of age. To meet the aim of the work, alternative groupswere formed: Group I (n=51) with unilateral and Group II (n=80) with bilateral hearing impairment.To determine the predictors of the severity of PS in the comparison groups, the factors determining deafnesswere studied, and their prognostic informativeness was established. The t-Student and φ-Fisher criteria weredetermined, the Wald-Henkin heterogeneous sequential procedure algorithm was used, predictive coefficients (PC)and informativeness (I) were determined.By decision of the Bioethics Commission № 3 dated March 21, 2023, the study materials comply with the TokyoDeclaration of the World Medical Association, the International Recommendations of the Helsinki Declaration onHuman Rights, the Council of Europe Convention on Human Rights and Biomedicine, the Laws of Ukraine, and therequirements of the Code of Ethics of a Doctor of Ukraine.The study was carried out within the framework of the scientific research work of the Department of Pediatrics№ 3 and Neonatology of KhNMU «Study of peculiarities of the course of oxidant stress diseases in newborns» 2022–2024 (state registration № А22U000025).Results. Factors of obstetric and somatic anamnesis of the mother did not influence the nature of HI in the child.Among the complications of pregnancy and childbirth in the anamnesis of children with bilateral HI, dysfunction ofplacenta was more often observed 33.8 and 13.7 % (р<0.001), threat of abortion 30.0 and 17.6 % (<0.05), anemiapregnant women 31.2 and 13.7 % (p<0.001), fetal distress 56.2 and 37.3 % (p<0.01), cesarean delivery 68.8 and 47.1% (p <0.001), especially regarding fetal distress – 67.3 and 29.2 % (р<0.001).The frequency of bilateral HI in children is inversely proportional to gestational age and birth weight and isassociated with a low Apgar score. Sexual dimorphism was revealed: girls predominated in the group with bilateralhearing loss, 56.2 and 35.3 % (р<0.001). Children with bilateral HI more often required surfactant therapy 78.8 and33.3 % (p<0.001), as well as longer respiratory support an","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"23 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":"125028478","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":"CASUISTIC CASE OF RETROPHARYNGEAL ABSCESS WITH AN ATYPICAL CLINICAL PICTURE IN A CHILD","authors":"O. Plaksivy, O. Mazur, M. Tsurkan, T. Chyfurko, K. Yakovets","doi":"10.24061/2413-4260.xiii.2.48.2023.21","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.21","url":null,"abstract":"Retropharyngeal abscess is an acute purulent inflammation of the lymph nodes and loose tissue of the pharyngeal space. The pharyngeal space spans from the base of the skull to the lower edge of the pharynx. It is bounded anteriorly by the posterior pharyngeal wall and posteriorly by the prevertebral fascia. Laterally, it is bounded by the parapharyngeal spaces and the neurovasc ular bundles of the neck, and it extends into the posterior mediastinum inferiorly., which facilitates the spread of abscess into the mediastinum, causing mediastinitis. The lymph nodes of the pharyngeal space are regional to the nasopharynx, oropharynx, posterior nasal cavity, auditory tube, and tympanic cavity. Therefore, the causative factors of retropharyngeal abscess are inflammatory diseases of the upper respiratory tract and middle ear. Retropharyngeal abscess is an extremely serious pathology of early childhood and is observed in children of the first 4 years of life. In children over the age of 4, it practically does not occur due to regression and obliteration of the lymph nodes and regression of the pharyngeal space.We have described a clinical case of the retropharyngeal abscess in a child aged 4 years and 10 months, the symptoms and course of which are radically different from the classic symptoms of this pathological condition in children of early childhood. In the differential diagnosis of the retropharyngealt abscess it is necessary to distinguish it from a number of diseases, namely ARVI, acute nasopharyngitis, tonsillitis, including lingual and pharyngeal tonsils, stomatitis, paratonsillitis, paratonsillar abscess, Ludwig's angina, parapharyngeal phlegmon, phlegmon of the neck, mononucleosis, acute stenosing laryngotracheitis, acute subglottic laryngitis (pseudocroup), pneumonia,cervical lordosis, aneurysm of ascending aorta or cervical artery, tumors of the nasopharynx, foreign bodies of pharynx, larynx, and cervical esophagus.Complications make this disease extremely dangerous. The most common complications are observed in the second week of the disease in cases of undiagnosed process, namely laryngeal oedema with development of acute stenosis, pneumonia, sepsis, meningoencephalitis, spread of inflammation to the interfascial space of the neck and posterior mediastinum with development of purulent mediastinitis and varrious septic complications.The most unexpected and dangerous complication is death by asphyxia, which occurs when the abscess opens spontaneously due to aspiration of pus.Thus, retropharyngeal abscess occurs mainly in early childhood due to the peculiarities of the anatomical structure of the pharyngeal space, loose tissue and lymph nodes. These anatomical features of the pharynx and pharyngeal space in childhood and the causative factors should be taken into account by the doctor in case of any deterioration of the child's general condition accompanied by hyperthermia, impaired breathing and swallowing difficulties. However, the less freq","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"7 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":"128444435","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":"DIFFICULTIES IN THE DIAGNOSIS OF COARCTATION OF THE AORTA IN THE NEWBORN IN THE EARLY NEONATAL PERIOD: ANALYSIS OF CLINICAL CASES","authors":"M. Gonchar, A. Boichenko, I. Kondratova, B. Ponomar","doi":"10.24061/2413-4260.xiii.2.48.2023.20","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.20","url":null,"abstract":"Introduction. The problem of diagnosing coarctation of the aorta in the early neonatal period is still relevant and presents certain difficulties due to the peculiarities of hemodynamic adaptation to extrauterine life.The aim of the study is to evaluate own clinical observations with emphasis on the difficulty in diagnosing coarctation of the aorta in neonates in the early neonatal period and to perform differential diagnosis with coarctation (pseudocoarctation) of the aorta.The study was carried out according to the ethical norms and principles for conducting medical researches involving human subjects.The research was conducted within the framework of the National Development Program of the Department \"Quality of life and course of somatic diseases in children under conditions of social stress\", implementation period 2023-2025, state registration number: 0123U101768.Results. The article presents two clinical observations: the first case is a newborn with coarctation of the aorta in a non-emergent state during the first days of life in the presence of evictive morphological changes of the descending aorta; the second case is a newborn with clinical signs of hemodynamic disorders with diagnosed hemodynamic pseudocoarctation (kinking) at the stage of hemodynamic adaptation to extrauterine life. Adequate medical support helps to avoid the development of a serious, potentially dynamic hemodynamic situation.Conclusions. Diagnosis of critical coarctation of the aorta in newborns has certain difficulties associated with the peculiarities of hemodynamics in the early neonatal period and the functioning of fetal communication. In order to avoid mistakes in the diagnosis of the emergency of the defect and to perform timely surgical intervention, dynamic monitoring of blood pressure and saturation indicators of the upper and lower extremities, central hemodynamic parameters is necessary. Differential diagnosis of coarctation of the aorta with kinking (pseudocoarctation) of the aorta should be based on the results of dynamic monitoring of pressure gradient in the descending part of the aorta with control of blood pressure and saturation in the four limbs during the neonatal period.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"49 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":"114759843","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":"CHALLENGES IN DIFFERENTIAL DIAGNOSIS OF COELIAC DISEASE AND GLUTEN INTOLERANCE IN CHILDREN","authors":"G. Senatorova, O. Omelchenko, T. Teslenko, G. Muratov, N. Orlova, K. Chatykian","doi":"10.24061/2413-4260.xiii.2.48.2023.9","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.9","url":null,"abstract":"Introduction. The group of gluten-dependent diseases currently comprises 3 pathological conditions: celiac disease, non-celiac gluten intolerance and wheat allergy. Celiac disease is a chronic, immune-inflammatory disease that occurs in genetically predisposed individuals in response to exposure to the main cereal protein - gluten. It is characterised by damage to the small intestinal mucosa, leading to its atrophy with corresponding intestinal and extraintestinal clinical manifestations. The treatment is a lifelong gluten-free diet. Gluten intolerance is a condition characterised by the onset of irritable bowel syndrome-like symptoms within hours or days of eating gluten-containing foods. These symptoms disappear quickly when the consumption of gluten-containing products is stopped. The causes of gluten intolerance are amylase inhibitors, trypsin and fructans (FODMAPS), which are present in wheat and other gluten-containing and gluten-free foods. New recommendations from the European Society of Paediatrics, Gastroenterology, Hepatology and Nutrition (ESPGHAN) for the diagnosis of celiac disease in children were published in 2020. The diagnosis of gluten intolerance requires the exclusion of celiac disease and wheat allergy.The aim of the study was to determine the characteristics of the clinical course of celiac disease and gluten intolerance (analysis of intestinal and extraintestinal symptoms), serological and morphological features for differential diagnosis and management.Material and methods. Thirty children aged 9 months to 11 years were included in the study for the period 2016-2023. Distribution by gender: 13 (43.3%) boys and 17 (56.6%) girls, p=0.1391. Patients were divided into two groups according to the diagnosis of celiac disease and gluten intolerance. The study included a detailed medical history, assessment of the child's examination and physical development. Determination of titer of IgA antibodies, IgA to tissue transglutaminase (tTG-IgA), endomysial IgA (EMA-IgA), gliadin IgG, wheat IgE antibodies, endoscopy and morphological examination of duodenal mucosal biopsies. Descriptive analysis and comparison of two proportions were used. Non-parametric methods were used to test hypotheses. Logistic regression analysis using the relative risk index (RR) and its 95% confidence interval (CI). Differences in parameters were considered statistically significant when p<0.05.The study was approved by the Commission on Biomedical Ethics for Compliance with Moral and Legal Rules of Medical-Scientific Research of the Kharkiv National Medical University. It was confirmed that the research does not contradict the basic bioethical norms and complies with the main provisions of the Good Clinical Practice (1996), the Convention of the Council of Europe on Human Rights and Biomedicine (04.04.1997), the Declaration of Helsinki of the World Medical Association on the ethical principles of research involving human subjects (1964-2008), and the Order o","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"160 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":"114607723","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":"CLINICAL VARIANT OF OSSIFYING MYOSITIS IN PEDIATRIC PRACTICE","authors":"H. Senatorova, T. Frolova, A. Senatorova, O. Kikhtenko, N. Osman","doi":"10.24061/2413-4260.xiii.2.48.2023.19","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.19","url":null,"abstract":"Introduction. Ossifying myositis is a pathological process in muscles characterized by the formation of ossification in soft tissues. At present, the etiological factors of the disease remain not fully elucidated. The triggering factors of the disease are considered to be traumatic injuries, invasive medical manipulations against the background of genetic predisposition.Aim. Invite attention of general practitioners and pediatricians to a rare disease, namely progressive ossifying fibrodysplasia in children and the peculiarities of its diagnosis.Results. The article presents a clinical case of progressive ossifying fibrodysplasia (Munchmeyer's disease) in a 4-year-old girl. At birth, the child was diagnosed with a foot deformity characteristic of this pathology (shortening of the first metatarsal finger, flexion-rotation contracture of both feet). The clinic of the disease manifested itself at the age of 3 years, when, after falling on the back, a dense formation was noticed in the area of the left shoulder blade. Half a year after the fall, swelling and pain appeared in the sacro-coccygeal region of the spine. The girl was consulted by an orthopedist, dermatologist, and oncologist. During the examination of the child, characteristic clinical features of progressive ossifying fibrodysplasia were revealed, namely, deformation and fixed position of the chest, tense neck muscles, sharp limitation of movements in all parts of the spine, limitation of bending in the left elbow joint, clinodactyly, valgus deformity of the big toes. During the ultrasound examination, the following changes were diagnosed: swelling of muscle tissue in the neck area, subscapular area on the left and sacrococcygeal joint; multiple hypoechoic formations of irregular shape, heterogeneous echo structure with hyperechoic inclusions with an acoustic shadow; a focal change in the muscle structure in the form of a loss of the characteristic pinnate structure of the perimysium. The diagnosis was confirmed histologically. No characteristic changes were found in clinical and biochemical studies. The girl is under supervision. No worsening of the child's condition has been recorded over the past four years.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"22 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":"125480801","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":"FETAL AND NEONATAL STATUS IN WOMEN WITH CEREBRO-VASCULAR DISORDERS AND RISK FACTORS FOR THEIR DEVELOPMENT","authors":"N. Abdullaieva, V. Lazurenko","doi":"10.24061/2413-4260.xiii.2.48.2023.12","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.12","url":null,"abstract":"Introduction. Cerebrovascular diseases in pregnant women are one of the most important problems of modern obstetrics and perinatology due to the steady increase in maternal and neonatal morbidity. Diabetes mellitus and hypertensive disorders are two of the most common complications of pregnancy, which negatively affect both short-term and long-term outcomes for the mother, fetus and newborn.The aim of the study was to determine the state of the fetus and the newborn in pregnant women with cerebral disorders, taking into account risk factors (hypertension, diabetes mellitus).Material and methods. 92 pregnant women were examined, of which the main group (77 pregnant women) consisted of women with extragenital pathology, in particular, cerebrovascular disease - 20 (21.7%), hypertension - 23 (29.8%), diabetes mellitus - 34 (44.1%), the control group consisted of 15 pregnant women (16.3%) with physiological pregnancy and their newborns.Scientific research passed the bioethics commission, no violations were found (Protocol No. 7 of 05.04.2023).Statistical processing of the data obtained during the study was carried out using Microsoft Office Excel 2016 (Microsoft, USA) and Statistica 10.0 (StatSoft, USA). The significance of differences in the characteristics of dependent groups with signs of normal distribution was assessed by the paired Student's t-test (t-test of dependent samples).This work is a fragment of the complex research work of the Department of Obstetrics and Gynaecology №2 of Kharkiv National Medical University \"Optimisation of diagnostics, treatment of diseases of the reproductive system and pregnancy complications in women with extragenital pathology\", state registration number 0121U11923).Results. Cerebrovascular disease was represented by the consequences of traumatic brain injury in 8 (40%) cases, acute cerebrovascular accident (ischaemic, haemorrhagic) - in 5 (25%), epilepsy - in 5 (25%), encephalopathy in cerebral palsy - in 3 (15%), arteriovenous transformation, angiomatous cavity - in 2 (10%) cases. Among women of the hypertension group, pre-eclampsia was found in 11 (47.8%), gestational hypertension - in 8 (34.7%), and chronic hypertension - in 4 (17.4%) cases. Pre-gestational diabetes was detected in 8 (23.5%) pregnant women in the diabetic group, and gestational diabetes in 26 (76.5%).Doppler flowmetry examination of blood flow in the middle cerebral artery (MCA) revealed a significant decrease (p<0.05) in the pulsatile index in pregnant patients of the main group (1.24±0.09) compared with women with a physiological course of the gestational process (1.82±0.11). There was a difference in the systolic-diastolic ratio in the SMA between women of the main and control groups (2.4±0.2 and 3.5±0.3, respectively) (p<0.05).When analysing the acid-base status of newborns, it was noted that the pH values in the groups with extragenital pathology had a shift to the acidic side. These shifts were most pronounced in the group with placenta","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"27 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":"116765266","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 INTENSITY OF UTERINE CIRCULATION IN PREGNANT WOMEN WITH A HISTORY OF CHRONIC ENDOMETRITIS","authors":"V. Likhachov, O. Taranovska","doi":"10.24061/2413-4260.xiii.2.48.2023.11","DOIUrl":"https://doi.org/10.24061/2413-4260.xiii.2.48.2023.11","url":null,"abstract":"Introduction. An essential prerequisite for the normal course of pregnancy is a complete gestational remodeling of the blood circulation, when the spiral arteries are transformed into uteroplacental vessels with reduced resistance and constant blood flow. Chronic endometritis is characterized by morphofunctional changes in the mucous membrane and microcirculatory disorders in the pool of spiral arteries. If pregnancy develops with the above disease, it may lead to disruption of gestational remodeling of the spiral arteries and contribute to increased resistance to fetoplacental blood flow.Aim. To study the peculiarities of blood flow in the uterine spiral arteries and uterine arteries during pregnancy in women with a history of chronic endometritis and to evaluate the role of preconception care in the prevention of pregnancy complications.Material and Methods.303 women with chronic endometritis were followed during pregnancy. Of these, 135 received antepartum treatment (Group I), which included broad-spectrum antibiotics, hormone replacement therapy for 3 months, and L-arginine during the antepartum period and the first 17-18 weeks of pregnancy. The other 168 women received no treatment during the preconception period (Group II). A control group of 20 healthy patients without chronic pre-pregnancy endometritis was also included.Doppler ultrasound of the spiral and uterine arteries was performed at 5-6 weeks of gestation and 17-18 weeks of gestation. The systolic-to-diastolic ratio (SDR) was calculated as the ratio of the maximum systolic blood flow velocity to the end-diastolic velocity, the pulsatility index (PI) was calculated as the ratio of the difference between the maximum systolic and minimum diastolic velocities to the mean blood flow velocity, and the resistance index (RI) was calculated as the ratio of the difference between the maximum systolic and minimum diastolic velocities to the maximum systolic blood flow velocity.The obtained data were processed using the methods of mathematical statistics, calculating the mean sample values (M), variance (σ), standard error of the mean (m), applying the Student’s t-test and calculating the odds ratio using the statistical software \"STATISTICA\" (StatSoft Inc., USA).During the research, the principles of patient-centered care were followed in accordance with the requirements of the Tokyo Declaration of the World Medical Association, the International Recommendations of the Helsinki Declaration on Human Rights, the Convention on Human Rights and Biomedicine of the Council of Europe, the Laws of Ukraine, the Orders of the Ministry of Health of Ukraine, and the requirements of the Ethical Code of the Ukrainian physician.The paper is an excerpt from the initiative scientific research project of the Department of Obstetrics and Gynecology No. 2 at Poltava State Medical University, entitled “Optimization of approaches to the management of pregnancy in women at high risk of obstetric and perinatal patho","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"75 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":"131832873","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}