Suchasna pediatriia Ukrayina最新文献

{"title":"Evaluation of the effectiveness of combined therapy of pre-pubertal children with Growth hormone deficiency with recombinant growth hormone and vitamin D drugs","authors":"D. Kvacheniuk, O. Bolshova","doi":"10.15574/sp.2023.131.31","DOIUrl":"https://doi.org/10.15574/sp.2023.131.31","url":null,"abstract":"The treatment of somatotropic insufficiency (SI) remains one of the most important problems in paediatric endocrinology. Since 1985, recombinant growth hormone (rGH) has been widely used to correct the growth of children with SI. Sufficient clinical experience has been gained in the use of rGH preparations, and the efficacy and safety of rGH therapy in children and adolescents with various forms of short stature has been proven. However, there are a number of factors that can have a significant impact on the achievement of final height in adulthood, including a wide range of sensitivity to exogenous growth hormone (GH), the degree of endogenous GH deficiency, patient compliance, and other uncertain factors. Patients with GH deficiency require long-term treatment, the effectiveness of which decreases significantly over time, prompting the search for optimal treatment options. Purpose - to evaluate the effectiveness of combined therapy of pre-pubertal children with SI with rGH and vitamin D drugs. Materials and methods. 23 pre-pubertal children with isolated SI were examined, who took monotherapy with rGH for 3 years. When the effectiveness of monotherapy decreases, vitamin D are added to the treatment complex. The level of 25(OH)D in blood serum is determined by the immunochemiluminescence method on microparticles (Abbott, USA). The levels of GH and insulin-like growth factor-1 were studied by solid-phase enzyme immunoassay using Immulite 2000 XPI kits. Results. At the end of the first year of rGH monotherapy, all patients showed a significant (p<0.05) increase in height. However, already after the second and third years of treatment, height velocity (HV) decreased in all patients. The increase in HV in the third year of treatment with rGH was significantly lower (p<0.05) than in the first year. Thanks to the addition of vitamin D, the further decrease in HV was stopped after the third year of monotherapy with rGH. The increase in HV during the first year of combined therapy was significantly (p<0.05) greater than during the third year of treatment with rGH monotherapy. The same trend was observed after the second year of combined therapy. Conclusions. In the presence of a decrease in the effectiveness of therapy with rGH after the first years of treatment, it is considered appropriate to use combined therapy of children with SI with rGH and vitamin D. 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":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46685407","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":"Comparative characterization the fortification of different types of nutrition for preterm and sick infants. What's the best? (Systematic review)","authors":"O. Kostiuk, D. Spatz, Ye.Ye. Shunko","doi":"10.15574/sp.2023.131.52","DOIUrl":"https://doi.org/10.15574/sp.2023.131.52","url":null,"abstract":"Human milk is the preferred feeding for all infants, including those of very low birth weight and vulnerable groups. However, mother’s milk is generally likely has insufficient protein to promote appropriate growth. That's why fortification of human milk is required to meet nutrient requirements for growth and development for these preterm infants who are at high risk for growth faltering during the hospital stay. There are multiple strategies and products that may be employed to support desired growth rates. Purpose - Conduct comparative analysis the current literature on the fortification own mothers’ milk and influence of this fortification on the outcomes for preterm and sick infant’s health. Materials and methods. Search Strategy: A systematic search of the literature was conducted using search strategy was based on MeSH terms/subject headings and separate keywords. The study designs included were randomized or quasi-randomized controlled trials in the English, Ukrainian and Russian languages. Study Selection: Published literature was searched from January 2010 up to July, 1, 2022 using five databases (PubMed, Ovid Medline, Web of Science, Ovid Embase, and the Cochrane Library). The search resulted in 75 articles, and an additional article was identified by an expert in the field; 20 were used for review. Data Extraction: Data from the full-text articles was extracted into a Table. The manuscripts were organised in the table as follows: first Cochrane reviews and systematic reviews, followed by individual research studies that were not cited in any of the systematic reviews. Results and conclusions. The primary outcomes of this review were influence of different types fortification of mother's milk and time of starting fortification in short term growth parameters (length, head growth, and weight gain), feeding intolerance (defined as clinical signs only and/or cessation of feeding), length of hospital stay (number of days that the baby remained in the neonatal unit), and post menstrual age (i.e., gestational age plus chronological age) at discharge. Secondary outcomes were narcotising enterocolitis and sepsis. The study results suggested that early human milk fortification appears to positively affect growth for infants whose human milk feedings are fortified with a fortifier without adverse effects. Implications for Practice: Adequate nutrition in the early weeks of life is rarely achieved in premature infants, resulting in extrauterine growth restriction. The use of fortified human milk produces adequate growth in premature infants and satisfies the specific nutritional requirements of these infants. The use of individualised fortification is recommended but with proper protocols. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47117153","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":"Determination of tolerance to physical exertion body reserves in school-age children with obesity and arterial hypertension","authors":"Y. Marushko, T. Hyshchak, N.G. Kostynska, O.A. Dmytryshyn","doi":"10.15574/sp.2023.131.37","DOIUrl":"https://doi.org/10.15574/sp.2023.131.37","url":null,"abstract":"Determining of tolerance to physical exertion (TPE) in children with various diseases is an important diagnostic aspect of modern medicine. This area helps to improve the prognostic capabilities of doctors and improve approaches to therapeutic interventions in patients with various pathologies. In pediatrics, there are limited data on the study of TPE in patients with hypertension and no data at all in children with a combination of hypertension and obesity. Purpose - to assess the level of TPE and body reserves in school-age children with obesity and arterial hypertension. Materials and methods. 112 patients aged 9-18 took part in the study. All patients were divided into four groups. The Group 1 (control) included children with normal blood pressure and normal body weight; the Group 2 included patients with arterial hypertension and normal body weight; the Group 3 - with normal arterial pressure and obesity; the Group 4 - with a combination of arterial hypertension and obesity. Results and conclusions. If patients have hypertension or obesity, a decrease in VO2max is noted, which is more pronounced when these pathologies are comorbid. Obese boys have a tendency to increase maximum systolic blood pressure during bicycle ergometry (158.2±8.4 mmHg) compared to healthy children (149.4±10.5 mmHg). The average values of maximum diastolic blood pressure during bicycle ergometry in all studied groups did not differ significantly from the average values of the control group. Obesity is accompanied by a more pronounced decrease in vascular reserves than arterial hypertension, the comorbidity of these diseases in patients is associated with the deterioration of these reserves in comparison with patients who have only one disease. The obtained results indicate a decrease in cardiac reserves when the patient has comorbidities of arterial hypertension and obesity. At the same time, the presence of only one of the named diseases in the patient is not accompanied by a significant decrease in indicators compared to the control group. In patients with arterial hypertension, a less effective use of myocardial reserves and an increased demand for myocardial oxygen during work compared to healthy children are noted. 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":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47104596","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":"Probiotics, gut microbiota, and diseases associated with the immaturity of the digestive tract in very preterm infants","authors":"D. Dobryk, D. Dobryanskyy","doi":"10.15574/sp.2023.131.22","DOIUrl":"https://doi.org/10.15574/sp.2023.131.22","url":null,"abstract":"Interruption of the formation of gut microbiota in preterm infants increases the probability of necrotizing enterocolitis (NEC) and late-onset neonatal sepsis (LOS). The use of probiotics can reduce the corresponding risk. Purpose - to evaluate the clinical effectiveness of enteral administration of Lactobacillus reuteri DSM 17938 in reducing the incidence of NEC, LOS, and overall mortality in infants with gestational age (GA) ≤32 weeks, as well as the effect of the probiotic on the formation of the gut microbiota. Materials and methods. 100 newborns with GA ≤32 weeks and birth weight ≤1500 g were enrolled in the open randomized study. 50 infants in the probiotic group until reaching postmenstrual age (PMA) of 36 weeks received Lactobacillus reuteri DSM 17938 at a dose of 108 CFU/day with enteral feeding (EF), and 50 infants in the comparison group received standard treatment. The primary effectiveness criteria were the incidence of NEC, LOS, and overall mortality. As the secondary criteria, the duration of the period to reach the full EF, the number of episodes of feeding intolerance, duration of antibacterial therapy, weight at PMA of 36 weeks, and length of hospital stay were used. Results. The administration of Lactobacillus reuteri DSM 17938 at a dose of 108 CFU/day neither reduced the incidence of NEC and LOS nor overall mortality. This intervention, however, significantly reduced the length of hospital stay in infants with GA ≥28 weeks (56.0 (46.0-71.0) days vs 65.0 (60.0-87.9) days; р=0.03), and was associated with the earlier achievement of full enteral volume (23.0 (16.0-37.0) days vs 30.0 (18.0-37.0) days; р=0.26) and fewer episodes of feeding intolerance in infants with GA <28 weeks (1.0 (1.0-3.0) vs 3.0 (3.0-4.0); р=0.19). No effect of the probiotic therapy on the gut colonization by Lactobacillus spp. and Bifidobacterium spp. was observed. Conclusions. Enteral administration of Lactobacillus reuteri DSM 17938 improves tolerance to EF and reduces the period to achieve full EF and the total length of hospital stay in preterm infants. The effect of this probiotic on the incidence of NEC and LOS, as well as the postnatal formation of the gut microbiota, requires further study. 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":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43540005","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":"Case of acute recurrent myocardial infarction in a child","authors":"O. Synoverska, Yuliya Alekseyeva, T. Velychko, Z. Vovk, N. Fomenko","doi":"10.15574/sp.2023.131.104","DOIUrl":"https://doi.org/10.15574/sp.2023.131.104","url":null,"abstract":"Information on the essential aspects of prevalence, etiology and pathogenesis of coronary heart disease, which is the leading cause of death in the world, is given in this article. It is emphasized that the incidence of ischemic coronary events is the result of a complex sequence of pathogenetic links, which involves the formation of atherosclerotic lesions and destabilization as the primary provoking factor. Purpose - the attraction of the medical community attention to the problem of ischemic heart disease in children. A clinical case of recurrent myocardial infarction in a child who was examined and treated at the MNPE «Ivano-Frankivsk Regional Children’s Clinical Hospital of the Ivano-Frankivsk Regional Council», is described here. The key points of the patient’s complaints, anamnesis of life and this disease are described, the data of the objective condition at the hospitalization and during dynamic observation of the child, which showed the signs of left ventricular overload, coronary blood flow disorder, dilatation of the left heart ventricles, decreased left ventricular contractility. The data of the main indices of laboratory and instrumental methods of research, including X-ray diagnostic methods, performed not only on the basis of the department, but also in the Scientific-Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine (Kyiv). The treatment of this clinical case in the child is described in this article. The data of dynamic observation are given. The discussion and conclusions emphasize the problem of coronary insufficiency in pediatrics, which requires clinical understanding, the choice of the correct diagnostic algorithm and qualified medical care. The study was performed in accordance with the principles of the Declaration of Helsinki. Informed consent of the child’s parents was obtained for the research conduction. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47918039","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":"A case of mitochondrial episodic myopathy (variant without optic atrophy and reversible leukoencephalopathy) in the Carpathian region","authors":"N. Fomenko, M.I. Oleksyn, O. Synoverska, T. Berezna, Y.L. Kryshtafovych","doi":"10.15574/sp.2023.131.134","DOIUrl":"https://doi.org/10.15574/sp.2023.131.134","url":null,"abstract":"Mitochondrial episodic myopathy with/or without optic nerve atrophy and reversible leukoencephalopathy (MEOAL, OMIM 251900) belongs to rare primary mitochondrial myopathies, caused by nuclear genome DNA mutations with autosomal recessive inheritance. Purpose - to inform about the case of this current rare mitochondrial miopathy and encrease the knowledge of practical doctors in scope of diagnostics and treatment of the current orphan pathology Clinical case. In the clinical case being presented herein, the sick child had a severe course of the disease in the form of episodes of severe myopathy (during one of them there was a need for long-term mechanical lungventilation with the placement of a tracheostomy) in combination with severe metabolic crises. During crises, persistent keto- and lactic acidosis, a sharp increase in transaminases (alanine aminotransferase and aspartate aminotransferase) and creatine kinase in blood serum were observed. The patient did not have optic nerve atrophy or leukoencephalopathy. A similar course of the disease is described in the literature by different authors in only 3 cases. Molecular genetic analysis (Invitae laboratory, San Francisco) revealed 2 mutations of the FDX2 gene (the disease is associated with this gene) with uncertain pathogenic significance. Considering the presence of cardinal symptoms of MEOAL, this diagnosis was set to the patient, and therefore the detected mutations of the FDX2 gene should be considered as pathogenic. Conclusions. A thorough syndromic analysis of the phenotype together with a set of paraclinical examinations, including modern molecular genetic methods, made it possible to establish a clinical diagnosis of an extremely rare primary mitochondrial myopathy, which will contribute to further elucidation of relationships in the «genotype-phenotype» system and, possibly, reclassification of pathogenic genotypes in modern databases, as well as finding optimal approaches in treatment and rehabilitation of patients. 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":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45007518","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":"Kounis syndrome: terra incognita","authors":"T.G. Berezna, O.B. Synoverska, N.M. Fomenko, Z.V. Vovk, T.V. Shatynska","doi":"10.15574/sp.2023.131.87","DOIUrl":"https://doi.org/10.15574/sp.2023.131.87","url":null,"abstract":"The most common cause of death in the world is acute disorders of coronary blood circulation, and allergic diseases, which are progressively increasing, are recognized as a «disease of civilization». Kounis syndrome is a pathology characterized by coronary disorders against the background of hypersensitivity caused by various conditions (medications, environmental influences, food, coronary stents, etc.). Vasospastic allergic angina, allergic myocardial infarction, and stent thrombosis with occlusive thrombus infiltrated with eosinophils and/or mast cells are three variants of this syndrome. In Ukraine, clinical cases of Kounis syndrome have not been described, which is explained by low awareness and, accordingly, insufficient alertness of the medical community. Purpose - to acquaint the medical community with the etiology, pathogenetic mechanisms, features of clinical manifestations and modern diagnostic methods of Kounis syndrome. The article presents a review of modern literature sources that describe the prevalence, most common causes, mechanisms of development, clinical manifestations, and management of various variants of Kounis syndrome. Conclusions. Kounis syndrome is a common pathology characterized by the development of coronary blood circulation disorders against the background of allergic diseases. In the presence of any allergic pathology (especially during an exacerbation), a search for signs of coronary circulation disorders (еlectrocardiography, determination of the level of troponins and other cardiac enzymes) should be conducted for the purpose of timely diagnosis and treatment of Kounis syndrome. To predict the risk of development and recurrence of Kounis syndrome, it is recommended to study the allergic profile of the patient and cardiological risk factors already in childhood (conducting the multicomponent Alex test, determining the lipid profile, еlectrocardiography after allergic provocation), studying the genome. To prevent the occurrence and recurrence of Kounis syndrome, patients with allergic pathology should follow basic therapy to achieve control over inflammation. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136080689","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":"Modern ideas about the importance of providing zinc in infectious diseases in children","authors":"V. V. Pechugina, O. Usachova","doi":"10.15574/sp.2023.131.97","DOIUrl":"https://doi.org/10.15574/sp.2023.131.97","url":null,"abstract":"Zinc (Zn) is an essential trace element that is critical for growth, development and maintenance of immune function. Zn is an indispensable trace element for humans, which is part of more than 20 metalloenzymes, including DNA and RNA polymerase, phosphatase, carbonic anhydrase and some others. The cycle of cell development requires this trace element. The permeability of cell membranes is also related to Zn. It has antioxidant properties and delays the apoptosis of peripheral cells. The formation of immunity depends on the body’s supply of Zn, and its deficiency causes atrophy of the thymic-lymphatic system. Zn is part of insulin, accelerates the regeneration of the mucous layer of the intestines, increases the activity of enzymes of the brush border of enterocytes, increases the level of secretory antibodies and the intensity of cellular immunity. The provision of this element cannot but affect the course of various infectious pathologies. Purpose - by analyzing modern literature data, to find out the importance of Zn provision in infectious pathologies in children. It is analyzed a review of the literature on the pathogenetic role of Zn in the diagnosis, pathogenesis and treatment of infectious diseases, based on a search for articles in the Science, Medline and PubMed databases published from January 2017 to June 2021. An analysis of current literature has shown that Zn is an important micronutrient involved in the regulation of innate and adaptive immune responses. Zn is necessary to ensure the barrier function of membranes. It is involved in the modulation of the pro-inflammatory response. Zn homeostasis is essential for many aspects of the immune system, including hematopoiesis, cell maturation and differentiation, cell cycle progression, and proper immune cell function. Consequently, Zn deficiency leads to cell-mediated immune dysfunctions. Such dysfunctions lead to deterioration of the body's response to bacterial infection. Zn is known to modulate antiviral immunity. Due to zinc, the production of interferon-α is activated and its antiviral activity is increased. Studies show that during the infectious process there is a decrease in the concentration of zinc in the blood plasma. Such changes, on the one hand, provide the needs of immune protection factors, and on the other hand, reduce the availability of the trace element for pathogens. Conclusions. Zn is one of the important trace elements that plays a leading role in maintaining homeostasis and is an integral component of the pathogenesis of various pathological conditions of infectious origin. The most studied is Zn deficiency in infectious diarrhea in children, but studies have been conducted in developing countries with limited resources. No works studying the prevalence of Zn deficiency in Ukraine were found. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42418459","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":"А bootstrap analysis of immune status in preschool children suffering from recurrent respiratory infections","authors":"O. Voloshin, Y. Marushko, I. Savchenko","doi":"10.15574/sp.2023.131.13","DOIUrl":"https://doi.org/10.15574/sp.2023.131.13","url":null,"abstract":"Purpose - to carry out a systematic analysis of humoral and blood cellular immunity parameters in preschool children with a different frequency of acute respiratory infection (ARI) during the previous year using bootstrap analysis. Materials and methods. Twenty-six children (11 boys and 15 girls) aged 1 to 4 years old, undergoing inpatient treatment on ARI, were involved in the clinical study. Serum concentrations of immunoglobulins (Ig) of classes A, M, G, E and a number of blood cellular immunity parameters were studied. Also, two indicators of ARI recurrence were calculated, namely, the infectious index and the resistance index. The statistical processing of the primary digital material obtained was performed by IBM SPSS Statistics 28 licensed program. Results. A direct moderate bootstrap correlation between the resistance index and serum IgA concentration in the preschool children with the different frequency of ARI according to their anamnesis (Bρ=0.407; p<0.001 [0.397-0.418]) was established. A rank correlation analysis, a multiple linear and an ordinal logistic regression combined with bootstrapping showed no significant relationship between particular serum Ig, on the one hand, and particular blood cellular immunity parameters, on the other hand. A partial bootstrap correlation analysis revealed the significant influence of many covariates studied on the strength of relationship between the indicators in the selected pair combinations. Conclusions. Provided the initial quantitative limitation of the observation group of the preschool children suffering from recurrent respiratory infections, the bootstrapping procedure applied significantly expands the interpretive possibilities of the clinical and immunological study results. Besides the standard estimation of the asymptotic significance of partial correlation coefficients, the bootstrap definition of their 95% confidence interval is an additional and highly informative way to check the results’ statistical validity. The study was conducted in accordance with the principles of the Helsinki Declaration. 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":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49517323","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":"Manifestation peculiarities of the neurological symptoms of acute polyneuropathies and their differential diagnostics in children during the period of coronavirus disease (COVID-19)","authors":"V. Svystilnyk, K. Savinova, V. Y. Krylova, L.M. Grychyna","doi":"10.15574/sp.2023.131.6","DOIUrl":"https://doi.org/10.15574/sp.2023.131.6","url":null,"abstract":"The relevance of the problem of diagnosis and treatment of polyneuropathy in children is due to the diverse clinical manifestations of this pathology, which are often acute and can lead to severe, life-threatening complications. Guillain-Barré syndrome (GBS) refers to acute or subacute, often post-infectious, immune-mediated polyneuropathies accompanied by axonal damage to nerve trunks and peripheral nerves. The present study is devoted to the assessment of neurological symptoms in the acute course of GBS, including its differential diagnosis with musculoskeletal lesions in coronavirus disease (COVID-19) in childhood. Purpose - to determine the features of the debut and characterize the neurological symptoms of acute polyneuropathies in children, including GBS in COVID-19. Materials and methods. We examined 10 children with confirmed GBS. Clinical-anamnestic, general clinical, clinical-neurological, clinical-instrumental and clinical-laboratory methods of examination were used. Results. In 1 of the examined patients aged 6 years, GBS developed in the acute period of COVID-19 and manifested as acute flaccid paresis in the distal, and after 4 days - severe weakness of the thigh muscles in combination with leg pain. In 8 of the examined patients, the debut of GBS occurred within 7-21 days after an acute respiratory viral infection. Of these, 6 children had the acute phase of COVID-19 14-21 days before the onset of GBS, which was confirmed by the results of an oropharyngeal PCR-test. The acute phase of COVID-19 in these patients was manifested by fever up to 38.0º, ague, hyposmia, lasting from 3 to 5 days. Severe pain in the legs was noted in all patients with GBS. The absence of elevated levels of creatine phosphokinase, alanine aminotransferase, aspartate aminotransferase according to biochemical blood tests in patients and the absence of myoglobin in the urine excluded rhabdomyolysis of skeletal muscles. Electroneuromyography (ENMG) confirmed the neural type of lesion in the legs. Conclusions. In most patients, the debut of GBS occurred 3 weeks after the acute phase of COVID-19. Pain syndrome and symmetrical flaccid paresis were the leading symptoms of the course of GBS in children. Reduced excitation conduction velocity along the motor fibres of the tibial and peroneal nerves, according to the results of ENMG, allowed confirming the diagnosis of GBS. Differential diagnosis of GBS with musculoskeletal lesions, in particular, the exclusion of the diagnosis of rhabdomyolysis in COVID-19 in children, allowed for timely prescription of adequate therapy. 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 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":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47348236","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}