Suchasna pediatriia Ukrayina最新文献

{"title":"Optimization of the treatment of acute tonsillopharyngitis in childhood","authors":"O. Koloskova, A. Kosakovskyi, I. Horbatiuk, S. Tarnavska","doi":"10.15574/sp.2022.128.105","DOIUrl":"https://doi.org/10.15574/sp.2022.128.105","url":null,"abstract":"Acute tonsillopharyngitis (ATP) in children is an actual and not fully solved problem, which has interdisciplinary importance and requires optimization of diagnosis and treatment to improve the prognosis of the disease and the quality of life of children. Purpose - to optimize the tactics of treatment of children with ATP by supplementing the complex of therapy with drugs of anti-inflammatory and immunomodulatory action with the evaluation of clinical and immunological markers of the effectiveness of the proposed treatment. Materials and methods. We monitored 51 hospitalized children with a clinical diagnosis of ATP. All children underwent a complex clinical and paraclinical examination with the determination of C-reactive protein (CRP) in the blood serum upon admission to the hospital, and on the 7th day of treatment, the serum concentration of interleukin (IL) -4, -6, -8, tumor necrosis factor α (TNFα), and interferon-γ (γ-IFN) as markers of therapy effectiveness. The patients were randomly divided into 2 clinical groups: the Group 1 was formed by 28 patients (average age - 8.0±0.9 years, the share of boys - 53.5±6.1%) with ATP, who received standard treatment and standardized extract of Pelargonium sidoides EPs® 7630 (Umckalor) and the complex homeopathic drug Tonsilotren in age-related doses according to the instructions. The remaining 23 children formed the clinical Group 2 (average age - 8.7±1.0 years (p>0.05), the share of boys - 56.5±8.3% (p>0.05), and received the same standard treatment for ATP and served as a comparison group. The groups were matched for the main clinical characteristics. Results. We obtained significantly better results of treatment of children with ATP when using the combination of the drugs Umckalor and Tonsilotren in complex therapy, which are proven by the presence of statistically reliable chances of a milder clinical course of the disease on the 3rd day of treatment (assessment of the severity of ATP - <26 points): attribute risk - 59.8%, relative risk - 2.8 (95% CI: 1.1-7.2), odds ratio - 25.6 (9.0-72.6). The effectiveness of the proposed therapy was confirmed on the 7th day of treatment by the probably lower content of pro-inflammatory markers IL-8 (15.2±5.4 pg/ml vs 37.6±7.6 pg/ml) and γ-IFN (21.8±2.3 pg/ml vs. 30.0±1.2 pg/ml) compared to standard treatment, as well as twice lower TNF-α concentration (2.1±0.5 pg/ml vs. 4.5±2.5 pg/ml). The use of the combination of the drugs Umckalor and Tonsilotren was accompanied by a statistically significant reduction in the risk of maintaining a high serum concentration of pro-inflammatory cytokines (CRP - >10.0 mg/l, γ-IFN and IL-8>10.0 pg/ml) in relation to the standard treatment: absolute risk reduction - 20.8%, relative risk reduction - 32.3% with the minimum required number of patients to treat - 3.1. Conclusions. In the complex treatment of children with ATP, the use of a combination of the standardized extract of Pelargonium sidoides EPs® 7630 (Umckalor) and the co","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":"42706628","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 profile peculiarities and matrix Gla protein concentration in Ukrainian pediatric patients with heterozygous familial hypercholesterolemia","authors":"T. Marushko, T. Kurilina, Yeva-Emiliia Kulchytska","doi":"10.15574/sp.2022.128.12","DOIUrl":"https://doi.org/10.15574/sp.2022.128.12","url":null,"abstract":"Atherosclerotic changes in the vascular walls begin early in childhood, especially in association with familial hypercholesterolemia (FH). The process may be subclinical, which nevertheless requires therapeutic and preventive measures. Purpose - to evaluate baseline lipid profiles, the thickness of carotid intima-media complexes, blood pressure indices and the association with concentration changes of dephosphorylated-uncarboxylated matrix Gla protein (dp-uc MGP) as a marker of subclinical arterial lesions in different age groups of pediatric patients with FH. Materials and methods. Children with heterozygous FH (n=15), stratified by age and sex, were included in the study. The control group consisted of healthy peers (n=21). Blood samples were analyzed to determine levels of total (TC), low-density (LDL-C), very-low-density (VLDL-C), high-density (HDL-C), remnant (rC) and non-high-density (non-HDL-C) cholesterol, triglycerides (TG), apolipoproteins A1 (apoA1) and B (apoB), lipoprotein (a), and dp-uc MGP. The intima-media complex thickness of the common carotid artery and blood pressure were measured in all study subjects. The obtained data were processed using the accepted methods of medical statistics and SAS® OnDemand for Academics. Results. Lipid profile changes in pediatric patients with FH were characterized by high levels of LDL-C, non-HDL-C and lipoprotein (a) in the 5-9 years age group; in the 10-14 years age group - high levels of LDL-C, TG, rC, non-HDL-C and lipoprotein (a); in the 15-18 years age group - high levels of LDL-C, TG, non-HDL-C and lipoprotein (a). At the same time, the most marked dyslipidemia changes were evident in children aged 10-14 years in the FH group. apoA1 levels were significantly decreased in all FH children. Elevated levels of lipoprotein (a) (>30 mg/dL) in FH children were found in all age groups, suggesting that elevated lipoprotein (a) levels can be used as a factor for cardiovascular risk stratification. Dp-uc MGP levels were significantly elevated in all age groups of FH children compared to healthy peers. Conclusions. A lipid profile examination is necessary to diagnose FH in children, along with family health history and cascade screening. As atherosclerotic changes at 5-18 years of age remain subclinical, and the instrumental tests available in routine medical practice are not sensitive enough to detect them, therefore, preventive or therapeutic measures cannot be initiated promptly. The evaluation of circulating matrix Gla protein in pediatric patients with FH can be used as a marker of vascular wall calcification, which may allow early preventive measures against microcalcification to be developed. 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 t","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":"48914541","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":"Course of COVID-19 in immunocompromised patients","authors":"T. Hariyan, T.V. Tomashivska, O. Dyvonyak, G. Pavlyshyn, O. Boyarchuk","doi":"10.15574/sp.2022.128.98","DOIUrl":"https://doi.org/10.15574/sp.2022.128.98","url":null,"abstract":"Purpose - to analyze the currently described variants of the course of COVID-19 in immunocompromised patients in order to inform the medical community and focus on this problem. Two clinical cases of different course of COVID-19 in patients with primary immunodeficiencies, both mild, asymptomatic and severe, with a fatal outcome, are presented. In the first case, in a child with Nijmegen breakage syndrome, despite lymphopenia, the course of SARS-CoV-2 was asymptomatic, which may be due to the regular administration of immunoglobulin for replacement purposes. The peculiarity of the second case was a repeated episode of COVID-19 in an immunocompromised child with APECED. The first episode of COVID-19 in September 2020 had a mild course, but led to the manifestation of immunodeficiency symptoms. The present symptoms (retinopathy, hepatitis), except for mild mucosal candidiasis, are not part of the triad of classic APECED symptoms, although along with the reaction to the live vaccine, they made it possible to suspect immunodeficiency. Immunosuppressive therapy contributed to stabilization of hepatitis, but ocular symptoms were without positive dynamics. The second episode of COVID-19 was observed in January 2022. It proceeded with prolonged fever for 2 weeks, which was resistant to treatment, with progressive cytopenia, hypoproteinemia, hypoalbuminemia, signs of active hepatitis, hyperferritinemia, elevated triglycerides; coagulopathy with low fibrinogen levels. Subsequently, signs of pneumonia were added, confirmed by radiology. Another feature of this case was the presence of a mixed infection - COVID-19 and Epstein-Barr virus infection. The cause of death in this case was not only COVID-19 pneumonia, but also progressive macrophage activation syndrome. Conclusions. Thus, the sequence of COVID-19 in patients with inborn errors of immunity can be either asymptomatic and mild or fatal, depending on the type of immune disorders, the therapy received, and concomitant conditions. SARS-CoV-2 in immunocompromised individuals requires close attention for timely diagnosis of life-threatening conditions. 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":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49100591","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":"Lymphadenopathy and worm infestation in children: the action algorithm","authors":"S. Nykytyuk, I. Tsymbalyuk, Kh.I. Dorozhovska, S. Levenets, T.O. Voroncova, M.V. Dollinna","doi":"10.15574/sp.2022.128.90","DOIUrl":"https://doi.org/10.15574/sp.2022.128.90","url":null,"abstract":"Fever is a common complaint in children with lymphadenopathy. Reactive lymphadenopathy is defined as the presence of one or more lymph nodes with a diameter of more than 1.5-2.0 cm. A thorough diagnosis of lymphadenitis accompanied by hyperthermic syndrome is necessary. Purpose - is to determine the diagnostic algorithm of actions based on the example of a clinical case of fever of unclear origin. Clinical case. The peculiarity of this case is a prolonged hyperthermic syndrome with lymphadenitis against the background of helminthic invasion (toxocarosis). During her stay in the hospital, the girl’s condition was serious due to hyperthermic syndrome and lymphadenopathy. The diagnostic algorithm for this condition in children is proposed. During the examination, a diagnosis of Reactive cervical lymphadenopathy of infectious-allergic genesis; concomitant - «Parasitic invasion is mixed (toxocariasis, ascariasis). Fever» was established. The child’s condition upon admission was severe, due to intoxication and hyperthermic syndrome. The treatment was effective, the patient’s condition improved during the hospitalization. But establishing a diagnosis required the cooperation of doctors of many specialties and a large number of additional examinations. Conclusions. Therefore, it is necessary to form the alertness of pediatricians to toxocarosis and increase the level of knowledge about the correct diagnostic algorithm in such cases. Informing health care professionals about such lymphadenopathy and helminthic infestation in children should help practitioners distinguish them from febrile reactions or other conditions and improve treatment outcomes. The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child’s parents was obtained for the research. 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":"43149766","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 neutropenia in children: short and long way to diagnosis","authors":"O. Boyarchuk, O. M. Shulhai, L. Dobrovolska","doi":"10.15574/sp.2022.128.80","DOIUrl":"https://doi.org/10.15574/sp.2022.128.80","url":null,"abstract":"The diagnosis of neutropenia is based, first of all, on the results of the assessment of the absolute number of neutrophils in the complete blood count and the clinical picture. Genetic confirmation of the diagnosis of congenital neutropenia can be long and not always successful. The purpose of work - to analyze the clinical course and laboratory features of congenital neutropenia in children on bases of two clinical cases in order to pay the doctors’ attention to the diagnosis of these diseases. We present clinical cases that confirm the variability of clinical and laboratory manifestations and the severity of the course of neutropenia. In the first case, congenital neutropenia was manifested by profound clinical signs with cyclicity, was accompanied by fever, aphthous stomatitis, and gingivitis. The absolute neutrophil count was consistent with severe neutropenia, but it took several years for genetic confirmation of the diagnosis. The second case of cytopenia, including neutropenia in a boy, was found in twins by chance, as the children had no clinical manifestations associated with neutropenia. Despite the obviousness of neutropenia in the general blood test with or without clinical manifestations, the path to a complete diagnosis is not always simple. Cytopenia in children, including neutropenia, requires a multidisciplinary approach to diagnosis, excluding both the causes of secondary neutropenia, hematological pathology, and immune disorders, primarily the phagocytic defects. Genetic testing can help verify an accurate diagnosis in patients with inborn errors of immunity, however, the genetic variants of a large number of congenital neutropenias remain unknown. Isolated neutropenia in children, as well as in combination with other cytopenias, require careful monitoring and the selection of optimal management tactics, as they can have serious complications. Following of patients will make it possible to expand knowledge about the disease course, the dynamics of symptoms, the occurrence of complications in order to prevent them. 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":"43845504","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":"Polymorphism of clinical manifestations, experience of diagnosis and treatment of multisystem inflammatory syndrome associated with COVID-19 in children","authors":"L. Pypa, I. V. Odarchuk, Yu. M. Lysytsia, V. Ruda, K. Krenov","doi":"10.15574/sp.2022.128.37","DOIUrl":"https://doi.org/10.15574/sp.2022.128.37","url":null,"abstract":"Purpose - to analyze the literature data on possible variants of the course of pediatric multisystem inflammatory syndrome (PIMS-TS) in children; to describe our own experience in the diagnosis and treatment of some cases of PIMS-TS in children of different age groups; to present possible variants of clinical manifestations of the above disease; to draw attention to the need for early diagnosis and team care and treatment of such children. This novel clinical syndrome later identified as PIMS-TS temporally associated with SARS-CoV-2. In contrast with KD, PIMS-TS appears to occur in children at an older age with a predominance of gastrointestinal symptoms, hemodynamic instability, and myocardial dysfunction. However, the exact pathomechanism remains to be understood. Nevertheless, the post-viral immunological reaction is postulated to be the underlying mechanistic underpinnings. The paper describes the clinical course of the disease in a 5-year-old boy who complained of abdominal pain and hyperthermia, and the disease was masked by surgical pathology. The phenomena of intoxication syndrome, polyserositis, skin manifestations in the form of a polymorphic rash, hyperemia of the conjunctiva, swelling of the feet and hands increased in dynamics. The course of the disease in a 10-year-old girl who had symptoms of a viral infection is also described. However, upon going to the hospital, both children were diagnosed with a serious condition, they were hospitalized and given appropriate treatment. Therefore, the multifaceted nature of the PIMS-TS’ course underlines the need for early recognition and multispecialty care and management. 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":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46364976","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":"Neurodegenerative disease with accumulation of iron in the brain in a child with hemophilia A complicated by inhibitory antibodies","authors":"O. Dorosh, Kh. Bodak, Yaryna Kozak, L. Dubey, O.W. Dworniak, I. Tsymbalyuk-Voloshyn, M. Dushar","doi":"10.15574/sp.2022.128.68","DOIUrl":"https://doi.org/10.15574/sp.2022.128.68","url":null,"abstract":"Hemophilia A is an X-linked recessive disorder caused by a deficiency of plasma coagulation FVIII, which may be inherited or arise from a spontaneous mutation. FVIII deficiency leads to a decrease in normal hemostasis and is manifested by spontaneous or induced bleeding. As a result of hemorrhages in the central nervous system, neurological complications are possible. In such cases, doctors should be on the alert so as not to miss another accompanying pathology. Neurodegenerative disease with iron accumulation in the brain is a genetically and clinically heterogeneous group of hereditary progressive disorders of the central nervous system with pronounced iron accumulation in the basal ganglia, which have a specific picture on magnetic resonance imaging of the brain in combination with characteristic clinical signs. Purpose - is to describe a clinical case of a combination of two complex hereditary diseases in a 10-year-old boy, hemophilia A of moderate severity, complicated by an inhibitor, and a progressive neurodegenerative disease with accumulation of iron in the brain, with associated neurodegeneration associated with the protein of the mitochondrial membrane. The publication reports for the first time a clinical case of a combination of two complex hereditary diseases in a 10-year-old boy, confirmed by molecular genetic studies: hemophilia A of moderate severity, complicated by an inhibitor with the detection of a large deletion of exons 23-26 in the gene, and progressive neurodegeneration with brain iron accumulation, with the presence of a pathogenic mutation of the C19orf12 gene, variant c.204_214del (p.Gly69Argfs*10) in a homozygous state, autosomal recessive type of inheritance, Mitochondrial-membrane Protein-Associated Neurodegeneration. Coagulopathy is controlled by prophylactic administration of emicizumab subcutaneously. Neurodegeneration with brain iron accumulation in the child was manifested by: Friedreich's foot, equinus feet, positive Babinski symptom, high tendon reflexes, optic nerve atrophy; partial dysplasia of both eyes; with myopia of both eyes, impaired accommodation, progressively increasing paresthesias in both legs, impaired gait, ataxic gait, coordination difficulties, muscle atrophy of both legs, visual impairment, rapid fatigue with preserved intelligence and mental development. Magnetic resonance imaging of the brain showed a moderate bilateral symmetrical lesion of the globus pallidus. Our report confirms that the use of molecular genetic studies plays an important decisive role in the verification of the disease, often determining its type and possible complications. 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":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43195336","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":"Study of age-related morphological changes in the vaginal process of the peritoneum in children","authors":"A. Havryliuk, V. Konoplitskyi","doi":"10.15574/sp.2022.128.21","DOIUrl":"https://doi.org/10.15574/sp.2022.128.21","url":null,"abstract":"Statistics state that nosologies resulting from an impaired obliteration of the processus vaginalis of the peritoneum (inguinal hernia, testicular hydrocele, cyst of spermatic cord elements) maintain a high level in the statistics of children's diseases. According to the literature, the above-mentioned diseases and complications in their treatment can cause male infertility which, in turn, will lead to a decrease in the reproductive health of the nation. Purpose - to study changes in morphological structures in the specimen of the vaginal process of the peritoneum based on the age of the child. Materials and methods. Children under the age of 8 years old, of both sexes, with an impaired obliteration of the vaginal process of the peritoneum (inguinal hernias, hydroceles, cysts of the elements of the spermatic cord) were subjected to the study. During the surgical procedure, surgical specimen of the wall of the processus vaginalis of the peritoneum was collected for the purpose of further morphological examination. Results. Muscular, fibrous and fatty elements in different proportions were found in histological specimens. The presence of degenerative pathohistological changes that contribute to the development of hernial defects of the inguinal canal was established. Thus, there is an age-related development of the muscle fibers atrophy of the processes with vacant replacement mainly by adipose tissue. Conclusions. Therefore, by analyzing the histological observations of the vaginal process of the peritoneum in children with an impaired obliteration of the vaginal process of the peritoneum, it is possible to draw a conclusion that the amount of fatty elements in the tissue of the vaginal process directly depends on the age of the child and the muscle elements in the tissue of the vaginal process inversely depend on the age of the child. 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":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48373866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To the issue of diagnosis of neuropsychological development of newborns and young children","authors":"V.B. Shveikinа, V. Martyniuk","doi":"10.15574/sp.2022.128.45","DOIUrl":"https://doi.org/10.15574/sp.2022.128.45","url":null,"abstract":"The current problem of neonatology and child neurology is highlighted - the features of early diagnosis of neuropsychological development of newborns and young children. The scientific literature on the morphofunctional features of brain development was analyzed, while the main attention was paid to the first two years of a child’s life. It is emphasized that the peak activity of brain development falls on the second half of pregnancy and the first three months of postnatal life. New data on the development of the brain are described, namely the presence of a transitional structure - the cortical subplate. It is shown that the development of the motor and behavioral sphere of a newborn and an infant is largely mediated by the coexistence of two separate but interconnected brain structures - the transitional structure, namely the subplate and the formation of the cortical plate during this period. It is emphasized that two age periods are important for the diagnosis of neurodevelopmental disorders: the first is about three months after birth, when the cortical subplate in the primary motor, somatosensory, and visual cortex is eliminated, and the second is the end of the first year, when the cortical subplate is eliminated in the prefrontal and parietal temporal regions. It was determined that the clinical manifestations associated with the disappearance of the subplate in the primary sensory and motor areas three months after childbirth coincide with a major transition in motor behavior, namely, spontaneously generated general movements are replaced by purposeful movements, adaptive behavior is formed in response to changes in environmental factors. Some clinical and diagnostic features in the detection of early disorders of neuropsychological development are highlighted, taking into account the stages of brain maturation (myelination, synaptogenesis). Some of the most common diagnostic scales and tests are considered. The most significant motor scales in the infant period, which are used to predict the outcome, are shown. Some standardized neurological assessments are highlighted. The concept of an early intervention program for infants with a high risk of developing cerebral palsy and cognitive impairment is defined. 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":"48402668","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 features of bronchial asthma persistence in children with alternative content of respiratory tract remodeling markers","authors":"O. Koloskova, H.A. Biluk, U. Marusyk, S. Tarnavska","doi":"10.15574/sp.2022.128.25","DOIUrl":"https://doi.org/10.15574/sp.2022.128.25","url":null,"abstract":"The research of bronchial remodeling and the role of angiogenesis processes in it are currently relevant for the study of the phenotypic features of the course of bronchial asthma in children and require further study in order to develop preventive and therapeutic measures. Purpose - to optimize treatment and prevention measures for persistent bronchial asthma (pBA) in children, to determine the clinical and anamnestic features of its phenotype, taking into account the accumulation of mediators of neoangiogenesis (фактора росту ендотелію судин - VEGF, матрична металопротеїназа-9 - MMP-9) in the respiratory tract as markers of bronchial remodeling. Materials and methods. A comprehensive examination of 116 children with pBA aged from 6 to 17 years (average age 11.6±0.29 years) and disease duration of 4.9±0.38 years was conducted. Three clinical groups were formed: the Group 1 was formed by 37 children with pBA with VEGF >80.0 ng/ml and MMP-9 >5.2 ng/ml in the sputum supernatant; the Group 2 included 41 children with an excess of one of these markers; and the control group consisted of 38 patients with values of these biomarkers below the median (VEGF<80.0 ng/ml and MMP-9 <5.2 ng/ml). The main clinical characteristics of the observation groups were comparable. Results. The article shows that uncontrolled pBA (sum of points >20) during the 4-year follow-up occurred most often in children of еру Group 1 and the Group 2, and indications of insufficient control of asthma indicated a probable risk of developing structural changes in the bronchi: OR - 2.23 (95% CI: 1.2-4.1), RR - 1.5 (95% CI: 1.0-2.2) and RR - 22%. The severe course of pBA was also associated with the risk of bronchial remodeling with the accumulation of angiogenesis mediators in their lumen as follows: OR - 2.2 (95% CI: 1.1-4.52), RR - 1.42 (95% CI: 1.0-2.5) and AR - 19%. Accumulation of remodeling markers in airways in patients with asthma in the Group 1 and the Group 2 is associated with a predominantly eosinophilic phenotype of the disease. At the same time, patients with a low content of markers of bronchial remodeling in sputum (control group) have better chances of achieving complete control over the symptoms of pBA compared to children with a high content (total absolute risk - 19.0%, total relative risk - 45.1%, the minimum number of patients who need to be treated to obtain a positive result - 2.2) and average (total absolute risk - 10.2%, total relative risk - 30.6%, the minimum number of patients who need to be treated to obtain a positive result - 3.2) content of angiogenesis factors in sputum. Conclusions. In patients with pBA, the accumulation of markers of bronchial remodeling in the lumen of the airways was associated with a severe uncontrolled course of asthma and worse chances of achieving disease control. 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 parti","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":"45524480","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}