Suchasna pediatriia Ukrayina最新文献

{"title":"Transcription factor T-bet is a diagnostic marker for necrotizing enterocolitis development in premature newborns","authors":"O. Abaturov, A. Tovarnytska","doi":"10.15574/sp.2022.128.6","DOIUrl":"https://doi.org/10.15574/sp.2022.128.6","url":null,"abstract":"Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease that mainly affects preterm infants. The non-specificity of the clinical picture and the high percentage of complications determine the need for early diagnosis and prevention of the disease. Purpose - to establish a relationship between the T-bet expression level in the cells of the buccal mucosa, the development of HEC and the method of feeding in premature newborn infants. Materials and methods. We examined 74 newborns, who were treated in neonatal departments. We selected three groups for comparison: the Group 1 consisted of 32 newborns up to 37 weeks of gestation on breastfeeding (BF); the Group 2 - 30 preterm newborns on artificial feeding (AF); the control group - 12 full-term newborns on BF. We determined the expression level of T-bet transcription gene factor in the cells of the buccal mucosa scrapings of the newborns. Thereafter, we have calculated the T-bet normalized expression levels in the cells of the mucous membranes of infants of the Group 1 and the Group 2 in relation to the control group, where the expression level of the specified factors was taken as 1 c.u. Results. The gestational age median of the Group 1 children was 33 (31; 34) weeks; the Group 2 - 32.5 (32; 35) weeks; and it was comparatively higher versus in the Group 1 (p<0.001) - 40 (39; 41) weeks. NEC has significantly more often developed in premature children on AF than on BF (p<0.05) - 30.0±8.4% versus 9.4±5.2%. The T-bet expression in the cells of the buccal mucosa scrapings was higher in preterm children, and the highest level was in the Group 2 - 2.4 (1.98; 3.84) c.u. versus 1.48 (1.13; 2.22) c.u. in the Group 1. We have proved a direct relationship between AF and T-bet level (r=0.370; p<0.004). Pairwise comparison revealed a higher level of T-bet in children with NEC (p=0.002): 2.36 (1.94; 3.17) c.u versus 1.74 (1.01; 3.27) c.u. without signs of NEC. We found a direct correlation between the T-bet level and the development of HEC (r=0,271; p=0.021). Conclusions. The T-bet expression level in the cells of the buccal mucosa increases in newborns with the appearance of the clinical signs of NEC. The level of T-bet expression in the buccal mucosa cells can be a marker of the inflammatory process development in intestine of infants. The expression of T-bet in the buccal mucosa cells of newborns with clinical signs of NEC is higher than in full-term newborns that reflects the tendency to NEC development. We have demonstrated that the T-bet expression level is higher in preterm neonates on AF. Therefore, AF can be considered as a risk factor for the development of NEC in preterm infants. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47330202","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":"Linear IgA-bullous dermatosis in a child during martial law. Clinical case","authors":"S. Nedelska, T. Svyatenko, O.D. Kuznetsova, V.P. Pukhyr","doi":"10.15574/sp.2022.128.85","DOIUrl":"https://doi.org/10.15574/sp.2022.128.85","url":null,"abstract":"Linear IgA-bullous dermatosis (chronic childhood disease) - a rare autoimmune subepithelial vesiculobulular disease caused by the formation of IgA autoantibodies, directed against various hemidesmosomal antigens, which is more common in children of early preschool age. Purpose - is to describe our own clinical observation of a case of linear IgA-bullous dermatosis in a girl aged 2 years 9 months to increase the level of alertness of doctors regarding this pathology in children, especially at an early age. Clinical case. At the time of admission her condition was of moderate severity due to the presence of a confluent papular-vesicular rash located on the face, neck, limbs. The rash was accompanied by the development of erosions surrounded by a ring of vesicles and caused a feeling of discomfort, severe itching. During local treatment and systemic antifungal tablets, the child’s condition improved, however, complete remission was not achieved after 7 week of the therapy, new bullas appeared. Additional diagnostic investigation allowed to suppose the diagnosis linear IgA - bullous dermatosis. Adjustment of therapy was made (steroids per os administration) and the child's condition improved gradually in a month. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41454502","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":"Comorbid pathology issues in pediatric gynecology","authors":"V. Dynnik, N. Bagatska, O. Dynnik, O.G. Verchoshanova, H. Havenko","doi":"10.15574/sp.2022.128.32","DOIUrl":"https://doi.org/10.15574/sp.2022.128.32","url":null,"abstract":"The problems of diagnosis, therapeutic tactics and medical prognosis in comorbid, polymorbid pathology stand out among the most actual problems of modern health care. Purpose - to study the frequency and nature of comorbid conditions in patients with pubertal abnormal uterine bleeding (PAUB). Materials and methods. The study included 342 girls aged 11-17 suffering from PAUB. All patients were examined by a multidisciplinary team of doctors. Results. It has been shown that menstrual irregularities are combined with other somatic, mental and endocrine pathologies in the vast majority of patients. Only 9.6% of the patients examined had no concomitant pathologies. More than half of girls have a combination of more than three comorbidities. The first three ranks are occupied by endocrine, mental and digestive system disorders. More than a third of patients with endocrine disorders had deviations in terms of body weight - overweight and obesity, which is much more often accompanied by changes in carbohydrate and lipid metabolism. In patients with mental disorders astheno-neurotic syndrome and vegetative-vascular dystonia syndrome prevailed. Functional disorders of the biliary tract were mainly recorded among the disorders of the digestive system, about 18% of girls suffered from gastritis, cholecystitis. The presence of comorbid pathology reduced the effectiveness of non-hormonal therapy by 1.5 times and increased the number of relapses by 3.5-4 times. The effectiveness of non-hormonal therapy was 81.8% on the absence of concomitant pathology; relapses were recorded only in 16.7%. Conclusions. Comorbid pathologies in patients with PAUB aggravate the severity of the girl’s condition, reduces adaptive capabilities, adversely affects the effectiveness of non-hormonal therapy, contributes to the recurrence of the disease and is a risk factor for the development of serious metabolic, endocrine and cardiovascular diseases in the future. The category of patients with concomitant pathology requires a special examination algorithm and the appointment of an adequate therapeutic intervention, taking into account all the identified nosological forms and drug compatibility. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46201203","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":"Prediction of recurrent course of respiratory infections in premature infants","authors":"E.B. Kozakevіch, V. Kozakevіch, L. Ziuzina, M.E. Fesenko, E. Melashchenko","doi":"10.15574/sp.2022.127.53","DOIUrl":"https://doi.org/10.15574/sp.2022.127.53","url":null,"abstract":"The problem of prevention of frequent respiratory diseases for children remains relevant. Among premature infants, the most vulnerable group are children with very low and extremely low birth weight. Therefore, the development of a clinical prognostic model for the development of respiratory recurrent infections in premature infants may be the basis for creating a preventive program of early intervention. Purpose - to determine the clinical and genetic determinants of the development of recurrent respiratory infections for children born with a body weight less than 1500 g and to develop an algorithm for early prediction of adverse effects. Materials and methods. A cohort prospective study was conducted, which involved 155 children with very low and extremely low body weight. Prediction of the development of recurrent respiratory diseases was performed using simple and step-by-step multiple logistic regression analysis. Genetic methods included polymorphism studies of the GSTP1, GSTT1, GSTM1, ACE, AGT2R1 and eNOS genes. Results. Important predictors of increased morbidity of the examined children in a simple logistic regression analysis were: body weight at 12 months <10 percentile, rickets in the first year of life and artificial feeding at discharge from the neonatal hospital. The study showed no effect of genes polymorphism of the glutathione-S-transferase family and genes of the renin-angiotensin system on the development of recurrent respiratory infections in children with born weight less than 1500 g. Conclusions. The developed model for predicting the recurrent course of respiratory infections for children born with a body weight less than 1500 g has a high specificity (95.35%) and moderate sensitivity (76.90%), which indicates the possibility of its use for a personalized approach to prevention adverse effects. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47136627","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":"Morphofunctional features of the heart in adolescents with juvenile idiopathic arthritis during long-term treatment","authors":"T. Holovko, N. Shevchenko, L. Bogmat, V. Nikonova, K.V. Shtrach, T. Yevdokymova","doi":"10.15574/sp.2022.127.6","DOIUrl":"https://doi.org/10.15574/sp.2022.127.6","url":null,"abstract":"Juvenile idiopathic arthritis (JIA) is the term used for descriptions of a group of inflammatory diseases beginning before the age of 16 years. In the last 25-30 years many studies are devoted to the study of cardiovascular risk in adult patients with rheumatoid arthritis, since with the lengthening of the life expectancy of these patients, change in the structure of their mortality. Purpose - to establish the features of morphofunctional characteristics of the heart in adolescents with juvenile idiopathic arthritis on the background of a long (more one year) basic treatment. Materials and methods. Were examined 91 adolescents with polyarticular variant of JIA, of which - 70 girls and 21 boys aged 10 to 18 years old and the duration of the disease is about 80 months. All patients received methotrexate for more than 12 months, the dosing regimen was from 6.51 mg/m2 to 22.72 mg/m2 per week. The control group consisted 45 healthy peers, of which 29 girls and 16 boys. An ultrasound examination of the heart with determination of structural and functional parameters of the left (LV) and right ventricles (RV) of the heart was done for all patients. Results. In patients with a polyarticular JIA, LV functional parameters of the heart were within normal values, but compared with similar indicators of adolescents in the control group showed a decrease in of the end-diastolic size (EDS) and of the end-diastolic volume (EDV) of the LV, a decrease in emission fraction (EF) and stroke volume (SV) of the LV, but normal values of the minute blood volume (MVC) of the LV due to an increase in the heart rate. In patients with JIA, a significant increase in both systolic (the end-systolic size and the end-systolic volume) and diastolic (EDS, EDV) parameters of the RV, thickening of it’s myocardium (TM), increase in SV and the MVC, but decrease in EF. Conclusions. Development morphofunctional disorders of the left and especially the right ventricles of the heart in patients with JIA occurs with long periods of illness and the use of basic therapy, as well as with their delayed appointment and low doses of use. The study was carried out in accordance with the principles of the Declaration of Helsinki. Study Protocol adopted by the local ethics committee of the institution specified in the work. For holding studies obtained the informed consent of parents and children. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43739338","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":"Emotional component of quality of life in patients with juvenile idiopathic arthritis","authors":"L. Bogmat, A.O. Fadieieva","doi":"10.15574/sp.2022.127.21","DOIUrl":"https://doi.org/10.15574/sp.2022.127.21","url":null,"abstract":"For children with juvenile idiopathic arthritis (JIA), the quality of life (QoL) emotional component is influenced by numerous factors: the arthritis subtype, disease duration, and activity, patient’s treatment, patient’s physical condition, and pain level, also his age, and sex. However, it’s important to determine the emotional component in the structure of QoL in children with different JIA subtypes (polyarthritis, oligoarthritis, and uveitis-associated arthritis) and features of psychological adaptation in modern conditions. Purpose - to determine both the emotional component of QoL in patients with JIA and their emotional condition considering the disease subtype, its duration, and the therapy complex. Materials and methods. The study was carried out at the SI «Institute for Children and Adolescents Health Care of the NAMS of Ukraine», Kharkiv, from November 2020 to November 2021. The assessment was provided by JADAS27, functional state by CHAQ, QoL according to PedsQLTM 4.0 Generic Core Scales, and emotional state according to the Montgomery-Asberg scale (MADRS) for depression assessment and clinical indicators. Statistical processing of the material was carried out using parametric and non-parametric methods, the critical level of significance for statistical testing hypotheses comparing groups was set at 0.05. Results. The 118 patients with JIA were examined, of them 47 patients with polyarticular, 43 patients with oligoarticular, and 28 patients with JIA-u subtypes. The study involved 77 girls and 41 boys aged 2 to 18 years (133.3±4.6 months). The majority (112 patients) received methotrexate therapy, 30 of them - methotrexate in combination with immunobiological therapy, 6 - sulfasalazine. The overall QoL in the group of children with JIA was at the level of 70.9±1.4 points for the last month and 72.6±1.4 points for the last week without significant difference, and the emotional component in the group as a whole was significantly higher for the last month - 73.1±1.6 points, while during the hospital stay it decreased to 66.3±1.7 points (p≤0.05). According to the results of the assessment of emotional state by the MADRS questionnaire, children aged 8 years and older did not have a depressive episode - 6.02±0.72 points. No significant differences were observed for HRQoL and emotional component in groups with different variants of arthritis and depending on age. However, certain results with a decrease in QoL and emotional state were observed in children with polyarthritis and uveitis-associated variant of JIA. The duration of the disease and treatment affected the QoL and emotional state, especially in the first year (QoL = 62.5±3.8 points for the last month). Correlations between MADRS and emotional state according to PedsQL were indirect and strong both for the last week and for the last month (r=-0.821; r=-0.784; p≤0.05). MADRS and total PedsQL scores also had indirect, medium strength correlations for the study periods (r=-0.558; r=-0","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41841419","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":"Neonatal mortality in Ukraine against COVID-19 pandemic: do not lose vigilance","authors":"N. Rynhach, R.O. Moiseienko, N.G. Gojdа","doi":"10.15574/sp.2022.127.86","DOIUrl":"https://doi.org/10.15574/sp.2022.127.86","url":null,"abstract":"Purpose - to highlight the peculiarities of mortality of children in the first year of life (absolute number and level by individual causes and gender) in Ukraine in 2019-2020; to find out whether there have been changes during the year of the COVID-19 pandemic in the country that could hinder the achievement of the SDGs in the area of reducing child mortality. Materials and methods. The information base of the study was the official data from the State Statistics Service of Ukraine regarding the distribution of deceased children by sex, age groups, place of residence and causes of death in 2019-2020. For comparative analysis were used a data from the Statistics Poland and World Population Review (USA) databases. In the course of the analysis were used the following methods: systematic approach, bibliosemantic, epidemiological, statistical, graphical representation. Results. It has been shown that approximately 80% in the structure of mortality under the age of 1 year in Ukraine are accounted for by two main causes: certain conditions that occur in the perinatal period - 58.5% (in 2019 - 54%) and congenital malformations - 22.3% (in 2019 - 25%). The focus is on preventable causes (first of all, external causes and infectious diseases). In 2020 were reported six deaths under the age of 1 year due to COVID-19 firstly. Despite the decline in infant mortality in 2019-2020 from 7.0 to 6.7 per 1000 live births, indicates the likelihood of a negative impact of the COVID-19 pandemic on infant mortality in Ukraine, primarily as a result of the influence of indirect factors, and the need for actions to eliminate or minimize such influence. Conclusions. An analysis of the spectrum and weight of the contribution of the causes of death is a tool for determining the lines and scope of intervention to prevent them on the way to Ukraine achieving by 2030 the declared indicator of infant mortality in children aged 0-4 years old of 6.7 per 1000 live births. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46231518","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":"Comprehensive analysis of serum concentration of matrix metalloproteinase 1 and tissue inhibitor of metalloproteinase 1 in preschool children suffering from recurrent respiratory infections","authors":"O. Voloshin, Y. Marushko","doi":"10.15574/sp.2022.127.29","DOIUrl":"https://doi.org/10.15574/sp.2022.127.29","url":null,"abstract":"Purpose - to systematically examine the state of interrelatedness between the serum concentration of matrix metalloproteinase 1 and the tissue inhibitor of metalloproteinase 1, the frequency of acute respiratory infections (ARIs), and a heterogeneous set of other clinical and laboratory parameters in preschool children. Materials and methods. Forty children (21 boy and 33 girls) aged 1 to 6 years old, undergoing inpatient treatment on acute respiratory infection, were involved in the clinical study. They were studied serum concentrations of MMP-1 and TIMP-1, C-reactive protein, certain blood leukocyte fractions, erythrocyte sedimentation rate, the content of several macro- and microbiological elements in their hair as well as a number of clinical signs. Also, two integral indicators of ARIs recurrence were calculated, namely, the infectious index (InI) and resistance index, as well as integral indices of inflammation and dolichostenomelia. The statistical processing of the primary digital material obtained was performed by IBM SPSS Statistics 27 licensed program. Results. The younger children had higher serum MMP-1 concentrations (p=0.007) and MMP-1/TIMP-1 ratio (p=0.008) compared to the older children. The girls showed higher values of MMP-1 (p=0.008) and MMP-1/TIMP-1 ratio (p=0.012) than the boys. The strong positive correlation between MMP-1 and InI in the children (ρ=0.514; p=0.001; 95% CI [0.232; 0.716]) was demonstrated. Using ordinal logistic regression method, a significant and simultaneously multidirectional dependence of InI categorical index on MMP-1 (B=1.078; p=0.013; 95% CI [0.223; 1.933]) and the age category of the examined children (B=-1.942; 95% CI [-3.757; -0.126]) was established. Conclusions. It is assumed that more frequent ARIs in children are accompanied by higher levels of serum MMP-1. It is not unlikely that there is differential «tuning» of MMP-1 activity in response to varying frequency of ARIs during the previous year. The degree of influence of the predictor, namely MMP-1, in ordinal regression models is determined by both the significance of this predictor and the variant of its combination with other studied covariates. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46094130","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":"Lipid markers for predicting non-alcoholic fatty liver disease in adolescent boys with hypoandrogenism","authors":"L. Strashok, S. Turchina, G. Kosovtsova, O. Buznytska, E. Zavelya, M. Isakova, A. Yeshchenko, M. Khomenko","doi":"10.15574/sp.2022.127.46","DOIUrl":"https://doi.org/10.15574/sp.2022.127.46","url":null,"abstract":"Metabolic syndrome (MS) and the conditions associated with it are pressing problems for humanity. The gastroenterological component of MS is considered to be non-alcoholic fatty liver disease (NAFLD). There are no scientific studies on the influence of hypoandrogenism (HA) on metabolic control and the formation of NAFLD in adolescent boys. Purpose - to determine the prognostic value of changes in the lipid profile for the formation of NAFLD in adolescent boys with HA. Materials and methods. In 2019-2021 was carried out a comprehensive examination of 107 adolescent boys aged 13-18 with HA: the clinical examination, blood tests to determine the level of γ-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, lipidogram, testosterone, immunoreactive insulin. The morpho-functional state of the hepatobiliary system was studied by ultrasound, according to the results of which adolescent boys with HA were divided into observation groups (the Group 1 - with normal liver parameters, the Group 2 - with signs of steatosis). Prognostic assessment of the formation of liver steatosis in HA was carried out using ROC analysis with AUC calculation. Results. According to the ultrasound signs of NAFLD was detected in a third of adolescent boys with HA. The state of insulin resistance was established in 22% of adolescent boys, significantly more often in patients with NAFLD. Analysis of blood lipid spectrum indicators in young men with HA showed the presence of proatherogenic changes more pronounced in the group with NAFLD. ROC analysis for quantitative biochemical indicators demonstrated that while using the distribution point for β-lipoproteins >5.8 g/l for the detection of liver enlargement as a sign of NAFLD in adolescent boys with HA the sensitivity was 72.0%, the specificity - 55.3%. The value of the area under the ROC curve was 0.624 [0.514; 0.725] with the level of statistical significance p=0.045. Conclusions. A third part of adolescent boys with HA according to ultrasound examination had signs of NAFLD at the stage of steatosis. Atherogenic dyslipidemia was found in all adolescents with HA, which was more pronounced in patients with NAFLD. The predictive value of determining the level of β-lipoproteins for the detection of NAFLD in adolescent boys with HA was revealed. The determination of β-lipoproteins may be economically feasible in relation to the diagnostic examination of adolescent boys with HA. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44779824","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 evaluation of the use of inhalation of 6% N-acetylcysteine in 3% NaCL solution (Flu-Acyl Broncho) in the treatment of children with acute bronchitis","authors":"Y. Marushko, T. Hyshchak, T. Iovitsa, S. Yesipova, O. Khomych","doi":"10.15574/sp.2022.127.126","DOIUrl":"https://doi.org/10.15574/sp.2022.127.126","url":null,"abstract":"Purpose - to propose an optimization of treatment of acute bronchitis in children by introducing inhalation of FLU-ACIL broncho before therapy. Materials and methods. An open, prospective, multicenter, non-interventional, comparative (with active control) study with two therapeutic groups was conducted. The experience of therapy of 45 children with moderate acute bronchitis aged 2-12 years old was summarized. The main group included 30 children who received inhalation of Flu-Acyl Broncho in the complex treatment: 5 ml 2 times a day 3-4 hours before bedtime for 7-10 days; the comparison group included 15 children who received oral acetylcysteine/ambroxol for 7-12 days. If it is necessary, antipyretic therapy with ibuprofen or paracetamol was used. The period from the onset of the disease to participation in the study was about 2-4 days. The study did not include children with concomitant acute middle ear diseases, acute sinusitis, acute allergic diseases and children with symptoms of obstruction. The results of examination and treatment of patients were analyzed using the software package «Statistica 6.0 for Windows». Results and conclusions. Comprehensive treatment of acute bronchitis in children with the administration of the inhalation Flu-Acyl Broncho, sterile solution for nebulizer and instillation, has a positive clinical effect, leads to faster relief (p<0.01) and disappearance (p<0.05) of cough compared to oral mucolytics. The additional anti-inflammatory and mucolytic effect of the inhalation route of administration of Flu-Acyl Broncho on the nasopharyngeal mucosa improves the results of treatment of children with concomitant acute respiratory pathology of the upper respiratory tract. This is manifested in faster, compared to oral mucolytics, elimination of rhinitis (p<0.001) and sore throat (p<0.05). All studies were performed in accordance with the ethical principles adopted by the Declaration of Helsinki and Good Clinical Practice (GCP) for medical research conducted on human subjects. Approval was obtained from the ethics committee of the Children’s Clinical Hospital No. 5 of Sviatoshynskyi district of Kyiv. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41667804","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}