Suchasna pediatriia Ukrayina最新文献

{"title":"Evaluation of the effectiveness of bedaquiline and delamanid treatment among children and adolescents with multi-drug-resistant pulmonary tuberculosis","authors":"M. Sakhelashvili, I. Platonova, O. Sakhelashvili-Bil, Z. Piskur","doi":"10.15574/sp.2023.130.17","DOIUrl":"https://doi.org/10.15574/sp.2023.130.17","url":null,"abstract":"Introduction. Against the backdrop of multiple and widespread drug resistance of Mycobacterium tuberculosis (MDR-TB), there has been a significant decline in the effectiveness of treatment of tuberculosis (TB) patients in Ukraine and globally. Therefore, in recent years, new antimycobacterial drugs, such as bedaquiline (Bdq), delamanid (Dlm) and pretomanid, have been introduced to improve treatment efficacy in adults, children and adolescents. The purpose - to study the effectiveness of complex treatment with bedaquiline (Bdq) and delamanid (Dlm) in children under 18 years old with multiple and extensively drug-resistant pulmonary TB (MDR/XDR-TB). Materials and methods. To study the clinical efficacy of chemotherapy with Bdq and Dlm, a retrospective cohort analysis of medical records was conducted. The main group consisted of 40 children with MDR/XDR-TB who received comprehensive antimycobacterial therapy with Bdq and Dlm; and the control group consisted of 27 patients who received treatment without Bdq and Dlm. Results. It was found that during the first three months of treatment, there was a decrease in bacilli in all patients treated with Bdq and Dlm and in the group of patients without these new drugs (control), but in the control group, the decrease was significantly slower, p<0.05. According to the immune system parameters, after the intensive phase was completed, the activity of a specific process was 1.7 times more frequent in patients of the control group than in the main group. After completion of the course of treatment, all patients in the main group showed resorption of infiltration, compaction of foci, and formation of fibrosis in the lungs according to the results of X-ray tomographic examination. However, in 14.8% of patients in the control group, treatment failure was noted with the resumption of bacterial release and destruction in the lung tissue, and in the main group, all patients had healing of the decay cavities. In the majority (77.5%) of patients in the main group, treatment resulted in the formation of small residual changes, but large residual changes were 2.3 times more common in the control group in the form of multiple dense foci, fibrosis and residual decay cavities. Conclusions. Studies have shown the high efficacy of complex treatment with Bdq and Dlm in children and adolescents. In particular, in MDR/XDR-TB patients treated with Bdq and Dlm, treatment results were 2 times more likely to be considered “cured” than in the control group, and 1.5 times less likely to be considered “complete”. The treatment success rate in the main group was 100.0%, and in the control group - 85.2%. 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":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43929233","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":"Spina bifida health issues of children in Ukraine","authors":"O. Boyarchuk, M. V. Koshmaniuk, K. Hlushko, M. Lovga, D. Savkiv","doi":"10.15574/sp.2023.130.40","DOIUrl":"https://doi.org/10.15574/sp.2023.130.40","url":null,"abstract":"Spina bifida is one of the most common congenital neural tube defects, which leads to dysfunction of many organs and systems and to disability. Purpose - to conduct a comprehensive analysis of the health status of children with spina bifida and hydrocephalus in Ukraine based on questionnaires of parents and their children, study of medical documentation and online counseling to improve the multidisciplinary support to children of this group. Materials and methods. A program of multidisciplinary online support for children with spina bifida in Ukraine was launched in June 2022 at the initiative of the patient organization «Association of parents of children with spina bifida and hydrocephalus «Lights of Spirit» and with the support of the international organization «Child Help». At the first stage, parents of children with spina bifida filled out a questionnaire to participate in the project, where demographic data and data on the child’s health were indicated. A total of 149 children with spina participated in the project. Girls predominated among the children (63.1%). The age of the patients ranged from 1 month to 24 years. At the next stages, online counseling was conducted with the participation of doctors of the multidisciplinary team and the head of the «Light of Spirit» NGO. Results. Impaired motor function was observed in 87.2% of children with spina bifida. Only 32.9% of children could walk independently, 14.1% needed outside help or aids, and 42.3% used a wheelchair or wheelchair to get around. Orthopaedic pathology was observed in 75.2% of patients, and hydrocephalus in 65.8% of children. A neurogenic bladder was noted in 79.9% of patients at the time of the questionnaire, and urinary tract infections (UTIs) in 77.9%. Clean intermittent catheterization was regularly performed in only 51.7% of patients. The study showed that early initiation of catheterisation was associated with a lower incidence of UTIs. Constipation was observed in 81.9% of children, faecal micturition and/or faecal incontinence in 58.4% of children. Bowel cleansing was performed in 49.7% of patients, and only 26.8% regularly. Skin damage (wounds and bedsores) was observed in 12.8% of children, and allergic manifestations in 21.8% of patients. Only 15% of children were immunized in accordance with the national vaccination schedule, and 70% of children were not vaccinated at all. Body weight disorders were observed in 43% of children, most often overweight/obesity (32.2%). Conclusions. A comprehensive analysis of the health status of children with spina bifida and hydrocephalus in Ukraine made it possible to outline a number of problems of children with this pathology, which affect quality of life and require a multidisciplinary approach to treatment and rehabilitation. 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 ","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44059480","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":"Assessment of life quality indicators in school-age children with hypertension and obesity","authors":"Y. Marushko, N.G. Kostynska, T. Hyshchak","doi":"10.15574/sp.2023.130.50","DOIUrl":"https://doi.org/10.15574/sp.2023.130.50","url":null,"abstract":"The steady increase in the prevalence of obesity, arterial hypertension (Н) and their comorbidity among children and adults requires additional scientific research to identify the features of the combined course of these diseases and possible ways to improve treatment and preventive measures in patients of different age groups. Purpose - to analyze indicators of the quality of life (QL) in school-aged children with H and obesity. Materials and methods. 95 children aged 9-18 were examined. The examinees were divided into 4 groups: the Group 1 - children with normal blood pressure and normal body weight (BW); the Group 2 - patients with H and normal BW; the Group 3 - with normal blood pressure and obesity; the Group 4 - children with Hand obesity. QL was determined for all children using the Ukrainian version of the Pediatric Quality of Life Inventory 4.0 questionnaire. The frequency of certain complaints and some peculiarities of children’s lives in the study groups were also determined using a questionnaire developed by us. Statistical processing of the obtained results was carried out using MedStat v 5.2 (Y.E. Lyakh, V.G. Guryanov) and EZR v 1.35 (Saitama Medical Centre, Jichi Medical University, Saitama Japan 2017) programs. Results and conclusions. QL indicators in patients with obesity and H are lower (p<0.05) than in the group of healthy children. The lowest indicators of the QL are observed in the Group 4, which were significantly lower (p<0.005) compared to the same indicators in the Groups 2 and 3. Patients with H had significantly more frequent (p<0.05) complaints of headache and dizziness compared with the Group 1. Patients with obesity had more (p<0.05) complaints of heart palpitations during minor physical exertion compared to healthy children. In patients of the Group 4, complaints of headache, dizziness, palpitations during minor physical exertion were more common compared to the Group 1 (p<0.05), and dizziness was more common than in the Group 3 (p<0.05). According to survey data, 44.7% of obese children estimated their body weight as normal and did not consider it appropriate to change their lifestyle. 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":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46189620","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":"Microsocial risk and protective factors for development of irritable bowel syndrome in children","authors":"M. Semen, O. Lychkovska","doi":"10.15574/sp.2023.130.32","DOIUrl":"https://doi.org/10.15574/sp.2023.130.32","url":null,"abstract":"Irritable bowel syndrome (IBS) is a stress-sensitive gastrointestinal disorder, which occurs as a result of the complex interaction of individual physiological, psychological and psychosocial factors. A tendency of IBS to cluster in families is caused not only by genetic predisposition but also by epigenetic mechanisms of psychosocial transmission of somatic symptoms from parents to children. Purpose - to determine the role of certain microsocial risk factors in the development of IBS in children. Materials and methods. The study involved 54 patients aged 6 to 12 years old with a diagnosis of IBS established in accordance with the Rome IV criteria, as well as 50 practically healthy children from the control group. For a detailed study of perinatal and microsocial risk factors and prevention of IBS, the developmental histories of children were analyzed and the «family history» method was used (descriptive and phenomenological collection of life history from the patient’s parents). Data were processed using Microsoft Excel 2016 and analyzed with GraphPad (Prism 5.0). Results. Perinatal risk factors that can lead to the development of IBS in children are birth from the first in order of delivery, caesarean section, breastfeeding for less than 3 months. There is also a correlation between an increased risk of IBS in children and the presence of psychosomatic disorders in infants and young children, a tendency to somatization in the mother; the frequency of visits to doctors by the child and mother more than 6 times a year; authoritarian parenting style by the mother and hyperprotective parenting style by the father; frequent overeating and food intolerances. On the contrary, birth from a multigravid woman, absence of psychosomatic disorders of infants and toddlers, parental emotional warmth and democratic parenting may be protective of the development of IBS in children. Conclusions. A number of microsocial factors have been identified that are associated with an increased risk of IBS. Awareness of those factors and consequently their correction may be important for the prevention of IBS in children. 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":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47298269","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":"Assessment of acoustic signal characteristics in children with community-acquired pneumonia according to the prevalence and nature of lung tissue damage using the new device «Trembita-Corona»","authors":"Y. Marushko, O. Khomych","doi":"10.15574/sp.2023.130.79","DOIUrl":"https://doi.org/10.15574/sp.2023.130.79","url":null,"abstract":"Relevance. According to the new orders and guidelines of 2022, radiography is not performed for all children. Therefore, the creation of a fully automated system of control and assessment of breathing sounds, without exposing patients to radiation, is currently an urgent task. Purpose - to determine the features of the acoustic signal in segmental and focal pneumonia in children with a new acoustic diagnostic device “Trembita-Corona”. Materials and methods. 76 children aged from 1 month to 18 years were examined. The children were divided into two groups: the Group 1 - 47 patients with segmental pneumonia; the Group 2 - 29 patients with focal pneumonia. All children were also examined using the “Trembita-Corona” acoustic monitoring device. Results. The acoustic signal was investigated in 12 octaves. The first 9 octaves were the most promising. Each octave was divided into third octaves. We found reliable differences in the average signal power in 0, 1, 4, 6, 7, 15, 20, 23-26 third octaves. When studying the average signal power between children with segmental and focal pneumonia, the main differences were found precisely in the frequency of peaks in 0-3,10,11,14-16, 18,20,22 third octaves. Conclusions. The use of the acoustic monitoring device “Trembita-Corona” in making a diagnosis is very promising method. The average signal power between children with segmental and focal pneumonia, the main differences were found precisely in the frequency of peaks in 0, 1, 2, 3, 10, 11, 14, 15, 16, 18, 20, 22 third octaves. 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":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48213677","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 effect of applying peach oil with vitamins A, E, D externally on the skin at atopic dermatitis in children","authors":"O. Mochulska, I. Chornomydz, K. Hlushko, I.O. Krycky, P. Hoshchynskyi, V. Dzhyvak","doi":"10.15574/sp.2023.130.96","DOIUrl":"https://doi.org/10.15574/sp.2023.130.96","url":null,"abstract":"Vitamins A, E, D play an extremely important role in ensuring the normal functioning of the skin and mucous membranes, an adequate immune response, and maintaining resistance to various adverse external factors. The impact of vitamins A, E, D, and the relationship between their availability and the susceptibility to skin allergies continues to be studied. Peach oil is widely used in medicinal ointments and creams for dermatitis, and vitamins are successfully used in the systemic treatment of atopic dermatitis in children. The possibility of combined external application of peach oil and vitamins A, E, D to the skin in atopic dermatitis in children is of scientific interest. Purpose - to study, evaluate and analyze the clinical effect of combined external application of peach oil and vitamins A, E, D on the skin in atopic dermatitis in children. Materials and methods. During the research, 64 children with atopic dermatitis and 32 children of the control group aged from 1 to 17 years were examined. Сomparative assessment of the clinical effect of traditional and improved complex therapy of 64 children with atopic dermatitis. Improved complex therapy included the external application on the skin of peach oil with vitamins A, E, D twice a day during four weeks. General clinical, immunological, questionnaires and statistical research methods were used. Results. The research of different variants for the treatment of atopic dermatitis in children showed better clinical effect of improved complex therapy with the external application on the skin of peach oil with vitamins A, E, D, which was accompanied by a decrease in the prevalence and intensity of skin manifestations, itching, normalization of sleep and it was confirmed by a decrease in the SCORAD index, a decrease markers of allergic inflammation - concentrations of leukocytes, eosinophils and histamine in the blood. The significant improvement in the course of the disease was noted under the influence of improved complex treatment compared to traditional therapy. Conclusions. The combined external application on the skin of peach oil and vitamins A, E, D with atopic dermatitis in children contributes to a significantly faster reduction of the skin signs such as dryness / flaking, xerosis/hyperkeratosis, lichenization/lichenification, erythema/hyperemia, edema/papules, excoriations/scratches, microvesiculation, exudation/wetting, hemorrhagic and serous crusts, hyperpigmentation, compared to traditional therapy of atopic dermatitis in children. 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":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42806149","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":"Congenital vascular rings as a cause of respiratory and esophageal problems in children","authors":"O. Zborovska, A. Malska, R. Tammo, O.V. Teterin, H. Morkovkina","doi":"10.15574/sp.2023.130.104","DOIUrl":"https://doi.org/10.15574/sp.2023.130.104","url":null,"abstract":"Congenital anomalies of the aortic arch include a wide range of anatomic pathologies, which may be completely asymptomatic or accompanied by severe respiratory and/or esophageal symptoms, especially in the case of complete vascular rings (VR). Purpose - to draw the attention of pediatricians and family phisicians to possible clinical presentations of aortic arch anomalies, namely VR, to increase their awareness of this pathology, that will contribute to differential diagnosis. VR, are anomalies of the aortic arch that result from abnormal development of the embryonic aortic arches. The prevalence of VR is approximately 1%, of which 55% are double aortic arch. This congenital heart defect can be either isolated or combined with other congenital heart defects. Associated cardiac pathology occurs in 12.6%, and includes ventricular septal defect and Tetralogy of Fallot. Sometimes this defect is associated with DiGeorge’s and Turner’s syndrome. The timing of appearance of clinical symptoms varies from the early neonatal period to adulthood. However, most patients develop clinical symptoms in the first months after birth, and they indicate the need of cardiac surgery during the first year of life. Given the serious consequences of this anomaly, VR should be included in the list of differential diagnoses of wheezing, stridor, difficulty swallowing and bronchial obstruction syndrome in children, especially when these symptoms appear since birth, are persistent and respond poorly to standard therapeutical approaches. Therefore, it is important for pediatricians to be alert for a congenital heart defect such as VR as one of the possible causes of congenital stridor, wheezing, and swallowing disorders in infants. Contrast-enhanced computed tomography and magnetic resonance imaging of the heart are the diagnostic modalities of choice for VR diagnosis. These diagnostic methods provide accurate location, nature of branching and dominance of the aortic arch as well as the degree of compression of the airway and esophagus. Three-dimensional reconstruction helps to plan future surgical intervention. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45512225","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":"Signs of physical violence against a child: recognition and organizational measures","authors":"S. Mokia-Serbina, T. Lytvynova, N.I. Zabolotnia","doi":"10.15574/sp.2023.130.109","DOIUrl":"https://doi.org/10.15574/sp.2023.130.109","url":null,"abstract":"The severity and urgency of the problem necessitates timely detection of cases of physical violence against children due to the frequency and high risk of negative consequences. Purpose - to provide an organizational framework for improving the quality of diagnosis of physical violence against children in accordance with international standards based on available evidence. Materials and methods. Practical guidelines for reviewing and establishing suspicion of child abuse are provided in accordance with the clinical guidelines of the National Institute for Health and Care Excellence (NICE, 2019), the American Professional Society on the Abuse of Children (APSAC, 2019), and information from the Up to Date and PubMed databases. The recommendations are based on the data of the World Health Organization and the current legal and regulatory framework in Ukraine. Results. Clinical guidelines and scientific literature related to the study of physical abuse, in particular, early signs of its detection, are reviewed and analyzed. The main stages of the examination of children with suspected physical abuse are presented, the levels of concern are described with recommendations for consideration or suspicion. The issue of early detection of signs and factors that indicate the likelihood of risks to the child's health and development that require immediate response from healthcare professionals is highlighted. Special attention is paid to the problem of medical care in Ukraine for children who have already suffered from physical violence. Conclusions. A well-founded approach to defining the nature, types and signs of physical violence is an extremely important issue, as it allows for timely recognition of the situation, proposals for effective elimination of the identified problems and prevention of negative consequences. No conflict of interests was declared by the authors.","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47413730","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":"Health-related quality of life and physical activity in Ukrainian pediatric patients with heterozygous familial hypercholesterolemia","authors":"Yeva-Emiliia Kulchytska, T. Marushko, T. Kurilina","doi":"10.15574/sp.2023.130.24","DOIUrl":"https://doi.org/10.15574/sp.2023.130.24","url":null,"abstract":"Introduction. Familial hypercholesterolemia (FH) is a genetically determined disease characterized by elevated low-density lipoprotein levels since birth and predisposes a person to develop atherosclerosis-induced cardiovascular disease. Healthcare providers should monitor the health status and physical activity level in pediatric patients with FH, as a high-risk group for cardiovascular disease. Purpose - to investigate the self-reported health-related quality of life (HRQoL) and physical activity energy expenditure based on the questionnaire data (PAEEq) in children with heterozygous FH compared with healthy peers to assess the health status. Materials and methods. The HRQoL scores were assessed using the KINDLR questionnaire in 15 patients with FH and 21 healthy peers. The physical activity level was evaluated using the C(Y)PAQ questionnaire. The KINDLR data together with other variables such as age, weight, height, sex, BMI and the PAEEq scores were analyzed in SAS® OnDemand for Academics. Results. HRQoL scores in FH children were similar to those of the control group (p>0.05). There was no association between PAEEq and the HRQoL scores in the FH (r=0.37, p=0.29) and the control group (r=0.43, p=0.20). The KINDLR Physical well-being score in the 5-9 years age group was significantly higher for FH children than for controls (p<0.01), while the total HRQoL score was not significantly different between FH children and controls. The group of FH children aged 5-9 with an intermediate level of PAEEq was the most physically active among the surveyed children. The controls aged 15-18 with low levels of PAEEq was the least active. All other age groups were characterized by a low intermediate level of PAEEq. Conclusions. Children with FH have HRQoL scores that are comparable to those of healthy peers. The FH and control groups were relatively satisfied with their quality of life. Thus, FH children consider themselves to be healthy, and from this underestimation of their cardiovascular risk they may have low adherence. Most FH children were found to have the low intermediate levels of PAEEq, which may indicate a lack of exercise and poor quality of life later on. Children with FH may have significant health problems in adulthood if they are not treated early and appropriately. In a similar manner, low PAEEq levels were demonstrated by the controls, so they should be also informed about the significance of regular physical activity and properly motivated. 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 patients 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":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48567111","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":"Monitoring of the health of children with aortic coarctation in the postoperative period","authors":"A. Senatorova, D. Khapchenkova, O. V. Buchnieva","doi":"10.15574/sp.2023.130.60","DOIUrl":"https://doi.org/10.15574/sp.2023.130.60","url":null,"abstract":"Purpose - to improve the observation of children after surgical treatment of the aortic coarctation. Materials and methods. A retrospective analysis of 87 case histories of patients with aortic coarctation in the preoperative period was performed; 44 patients underwent daily blood pressure monitoring, nitric oxide levels in 61 children were determined in the postoperative period; histological examination of 15 coarctated aortic sites was performed; quality of life was assessed in 56 patients with aortic coarctation after surgical treatment. Results. According to daily blood pressure monitoring, an inadequate increase in blood pressure during physical and mental activity was obtained; a violation of the circadian rhythm of blood pressure with insufficient decrease in systolic and diastolic or excessive decrease in diastolic pressure was detected. The results of the assessment of blood pressure variability revealed a significant difference in the standard deviation of the mean daily diastolic blood pressure (62.5 (55; 75)), daily diastolic blood pressure (72.5 (57; 78.5)), and an increase in the circadian systolic blood pressure index (16 (11.5; 17)). The level of nitric oxide in the blood of a group of patients with arterial hypertension was 4.18±0.86 μmol/l (M±SD - mean ± standard deviation). in the control group - 5.51±0.69 μmol/l. Thus, a significant decrease in nitric oxide in the group with arterial hypertension was established (t=-5.45; p<0.001). It was also diagnosed that in the group of patients with stable arterial hypertension, the level of nitric oxide was 3.74±0.79 μmol/l, and in the subgroup of patients with labile hypertension - 4.44±0.80 μmol/l, the subgroups in the content of nitric oxide significantly differed from each other (t=2.91; p<0.01), as well as from the values of the control group: with stable arterial hypertension (t=-6.72; p<0.001) and labile arterial hypertension (t=-4.41; p<0.001). The dependence of the level of nitric oxide in serum on the time of the postoperative period and the type of arterial hypertension was established. The histological features of area of narrowing in the form of foci of necrosis of cells and fibers, areas of hypo- and anelastosis, the presence of newly formed vessels of capillary type were identified and studied. The main factors in reducing the quality of life of patients with coarctation of the aorta in the postoperative period are the presence of arterial hypertension, restriction of physical activity, parents’ оverprotection. Conclusions. Based on the data obtained, an individual observation card of a patient with aortic coarctation was created. A set of clinical, instrumental and laboratory signs that may be a leading role in the occurrence and course of arterial hypertension in children (concomitant cardiovascular and somatic pathologies, initial level of systolic and diastolic blood pressure, level of the final product of nitric oxide in serum, structural features of the aortic wall) ","PeriodicalId":34724,"journal":{"name":"Suchasna pediatriia Ukrayina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46063057","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}