Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ最新文献

{"title":"Sepsis-associated injury of the nervous system in premature infants with very low body weight","authors":"O.S. Yablon, V.O. Vlasenko","doi":"10.15574/pp.2023.95.66","DOIUrl":"https://doi.org/10.15574/pp.2023.95.66","url":null,"abstract":"The immaturity of the organs and systems of preterm born children significantly complicates the differentiation between physiological and pathological changes in the brain. The etiology of brain damage in premature babies is complex and multifactorial, and even with the most favorable course of the neonatal period, they require additional respiratory support, a large number of invasive medical interventions and have a high risk of infectious complications. Sepsis-associated encephalopathy (SAE) is defined as diffuse or multifocal cerebral damage that is caused by a systemic response to infection even without clinical or laboratory evidence of direct brain infection. Purpose - to determine the clinical features of sepsis-associated brain damage in prematurely born children <32 weeks gestation with a birth weight <1500 g. Materials and methods. 38 prematurely born children, who were divided into two groups, were examined. The Group I (n=14) included children who were diagnosed with sepsis in the early neonatal period. The Group II (n=24) included prematurely born, in which no septic lesions were observed. Results. Children of both groups were born in a state of severe and moderate asphyxia. Analysis of associations between maternal, obstetric, and antenatal factors showed a significant prevalence of such factors as prelabor rupture of membranes, сervical weakness, rupture of the fetal bladder, and placement of an obstetric pessary in children with sepsis. All children with sepsis had pneumonia, acute kidney injury, and brain injury in the neonatal period. In the neurological status of children with very low birth weight who underwent SAE, the seizure syndrome, 3-4 grade intraventricular hemorrhages, periventricular leukomalacia, complications in the form of post-hemorrhagic ventriculomegaly were significantly more common. Conclusions. In children with very low birth weight who underwent SAE, convulsive syndrome, 3-4 grade intraventricular hemorrhages, and periventricular leukomalacia were significantly more common. 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":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135927066","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":"Problematic issues of pathogenesis, diagnosis, prevention and approaches to the treatment of arterial hypotension in children (literary data, own researches)","authors":"Yu.V. Marushko, T.V. Hyshchak, Yu.R. Izirinska","doi":"10.15574/pp.2023.95.86","DOIUrl":"https://doi.org/10.15574/pp.2023.95.86","url":null,"abstract":"Arterial hypotension (AHT) is an actual problem in pediatrics. It is a symptom complex characterized by a decrease in systemic blood pressure (BP) and accompanied by a number of clinical symptoms that reflect a decrease in blood flow and perfusion pressure in all organs and tissues. Purpose - to summarize data from the literature and own experience regarding diagnosis, pathogenetic and clinical features of the course and principles of treatment of AHT in children. Results. A review of modern literary data showed a wide range of etiopathogenetic mechanisms of AHT formation and a high specific weight of primary AHT in the pediatric population. A modern method of accurate diagnosis of AHT is daily blood pressure monitoring (DBPM). According to the results of DBPM conducted by us in 677 children aged 8-17 years with complaints of BP fluctuations, AHT was established in 107 (15.8%) examined. AHT in girls occurred almost twice as often compared to boys - 66.4% versus 33.6% (p<0.0001). In 64.5% of cases there was labile AHT, in 33% - stable AHT of the first stage, in 2.5% of children - stable AHT of the II stage. There were no gender differences in the frequency of different degrees of AHT. Conclusions. The issue of low BP is an urgent problem in pediatrics. According to the results of DBPM, AHT is detected in 15.8% of children aged 8-17 years and has a mostly labile course. AHT requires in-depth study in order to develop new preventive and therapeutic measures and to alleviate the consequences 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 participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135926632","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":"Functional state of the fetoplacental complex in pregnant women with HCV infection","authors":"Yu.M. Zapopadna","doi":"10.15574/pp.2023.95.35","DOIUrl":"https://doi.org/10.15574/pp.2023.95.35","url":null,"abstract":"Purpose - to study the functional state of the fetoplacental complex (FPC) during pregnancy in women with hepatitis C virus (HCV infection). Materials and methods. A prospective clinical and statistical analysis of the functional state of the FP during pregnancy in 40 women (main group, MG) with HCV infection was conducted on the basis of the Kyiv City Center of Reproductive and Perinatal Medicine for the period 2020-2021. The control group (CG) consisted of 50 healthy pregnant women. Statistical processing of research results was carried out using standard programs Microsoft Excel 5.0 and Statistica 8.0. Results. The hormonal status of FPK in MG of pregnant women, starting from the 18th week, was characterised by a significant decrease in the secretion of progesterone (PG) (159.314.6 nmol/l in MG versus 205.44.8 nmol/l in CG; p<0.05) and human chorionic gonadotropin (39.24.6 mIU/mL versus 52.85.3 mIU/mL, respectively). Estradiol (E2) levels in MG of pregnant women from the 18th week of pregnancy were significantly lower (26.32.7 nmol/l) than in CG of pregnant women (33.71.4 nmol/l, p<0.05). A synchronous decrease in the level of PG and E2 was observed in the case of threatened abortion against the background of bloody discharge, which indicated clinical manifestations of placental dysfunction (PD). In MG of pregnant women, the level of placental lactogen (PL) at week 18 was almost the same (80.913.2 nmol/l) compared to CG of pregnant women (79.57.1 nmol/l; p>0.05). From the 29th week, the level of E2 in MG of pregnant women is significantly different from CG (25.61.3 nmol/l in MG versus 51.20.7 nmol/l in CG; p<0.05). The most pronounced difference was the level of estriol (E3) and cortisol (Cr) in blood serum relative to CG in MG of pregnant women, which was manifested by a decrease in the level of E3 (up to 86.4±5.2 nmol/l in MG versus 98.42.6 nmol/l in CG; p<0.05) against the background of a simultaneous increase in Cr content (up to 751.118.6 nmol/l in MG versus 625.618.4 nmol/l in CG; p<0.05). Endocrinological disorders also changed before delivery (39-40 weeks): the E2 level decreased (to 45.41.9 nmol/l in MG versus 65.30.6 nmol/l in CG; p<0.05), E3 (up to 28.32.0 nmol/l versus 57.81.8 nmol/l, respectively; p<0.01), PG (up to 499.4±11.6 nmol/l versus 604,216.3 nmol/l, respectively; p<0.05) and PL (up to 201.4±12.4 nmol/l versus 63.418.8 nmol/l, respectively; p<0.05) and the Cr content increased (up to 812.4±16.7 nmol/l versus 651.614.6 nmol/l, respectively; p<0.01). Conclusions. The functional state of the FPC in pregnant women with HCV infection, on the eve of delivery, is characterized by a high level of premature maturation of the placenta, changes in the volume of amniotic fluid, due to which significant hemodynamic and endocrinological subcompensated disorders appear, but in some cases they are decompensated, which causes disorders from the functional state of the fetus and the high frequency of development of fetal","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135926836","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":"Immunoinflammatory changes in the severe course of COVID-19 in pregnant women","authors":"O.O. Karlova, A.V. Balan","doi":"10.15574/pp.2023.95.28","DOIUrl":"https://doi.org/10.15574/pp.2023.95.28","url":null,"abstract":"Pregnant women are the most sensitive contingent to the effects of the virus and this is due to adaptive physiological changes in the woman’s bronchopulmonary system and features of the immune system. “Physiological tolerance” is formed during pregnancy and this is accompanied by a decrease in the level of T-helpers and natural killers in pregnant women and leads to a decrease in the resistance of the woman’s body to the action of altering viral and bacterial agents. Purpose - to reveal the peculiarities and clarify the nature of clinical and instrumental changes in pregnant women with a severe course of COVID-19 under dynamic observation. Materials and methods. The study included 40 pregnant women with coronavirus disease with a gestational age of 22 to 41 weeks, who formed the main group. The control group consisted of 40 women whose pregnancies were not complicated by coronavirus disease. The course of the disease and the influence of the coronavirus infection on the course of pregnancy were evaluated according to the results of: general - clinical examination, laboratory examination (general blood test, biochemical blood test, coagulogram, C-reactive protein, D-dimer, procalcitonin and interleukin 6), instrumental examination (cardiotocographic research, pulse oximetry). Results. Peculiarities of changes in clinical and laboratory indicators in pregnant women were studied depending on the stage of development of the coronavirus disease. During the study, it was established: a significant increase in the level of indicators in accordance with the control group, namely an increase in leukocytes by 38.2% to 10.07±1.59×109/l (р<0.05), an increase in thrombocytes by 35% to 314.36±49.70 (р<0.05), an increase in monocytes by 22.5% to 7.08±1.12 and a decrease in lymphocytes to 13.46±2.13, which is 51.2% lower than the indicators of the control group. The level of C-reactive protein in pregnant women with COVID-19 is probably higher than in all groups of examined patients. The level of D-dimer exceeded the indicators of the control group in patients of all groups with the maximum values of indicators in patients at the time of admission to department of anaesthesiology and intense therapy (DAIT) and was 4867.42 ng FEU/ml, which was 6.3 times higher than the level of the control group (p<0.05). It should be noted that the amount of interleukin-6 in patients of all studied groups was statistically higher than that of the control group. Conclusions. Immune-inflammatory blood changes in pregnant women occur in the case of a severe course of COVID-19 and are accompanied by an increase in the level of interleukin-6 at all stages of the severe course of the disease. СRP is a marker of the severe course of the coronavirus disease in pregnant women. The identified changes are accompanied by coagulopathy and hypercoagulation with increased D-dimer content in patients with a severe course of the disease. The research was carried out in accordance with the princi","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135926634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peculiarities of the course of pregnancy in women with premature birth","authors":"N.Y. Lemish","doi":"10.15574/pp.2023.95.21","DOIUrl":"https://doi.org/10.15574/pp.2023.95.21","url":null,"abstract":"Purpose - to determine the peculiarities of the course of pregnancy and childbirth in women who had complications from the group of major obstetric syndromes, clinically manifested by premature birth (PB). Materials and methods. A retrospective clinical-statistical analysis of the course of pregnancy and childbirth of n=69 pregnant women with spontaneous PB at a gestation period of 24-36 weeks and 6 days was carried out. Depending on the period of pregnancy, they were divided into groups: the Group I - 9 pregnant women 24-26 weeks 6 days, the Group II - 28 women 28-31 weeks 6 days, the Group III - pregnant women 32-36 weeks 6 days. The Control group (CG) consisted of 56 practically healthy pregnant women with a healthy reproductive history and an uncomplicated course of this pregnancy. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. Were received significant differences between the Group I and the CG (p=0.007), in the presence of signs of the threat of termination of pregnancy during the second “wave” of cytotrophoblast invasion, so the chance of giving birth in the early term is 4.2 times higher than at term. In the presence of isthmic-cervical insufficiency (ICN), the reliability of differences between the Groups I and II (p=0.0021), Groups I and III (p=0.012) is observed between the Group I and CG (p=0.00083) and the risk of very early PB is 2.6 times higher than the risk of premature, late premature - 2.2 times. Disturbances in uteroplacental blood circulation have the presence of significant differences between Groups I and II (р=0.0051). There is a direct relationship between the level of blood pressure and blood circulation in the uterine arteries. Therefore, the observed difference is not accidental: in the Group II, preeclampsia was observed significantly more often. Violation of feto-placental hemodynamics when comparing groups demonstrated the existence of statistically significant differences between the Groups I and II (p=0.048), as well as between the Group I and CG (p=0.02). In the presence of clinical signs of fetal growth retardation syndrome (GRS), there is a significant difference between the Groups I and II (р=0.033). Conclusions.The features of the course of pregnancy with premature birth include the threat of termination during the second “wave” of cytotrophoblast invasion; isthmic-cervical insufficiency, which can lead to very early premature birth; vaginal infectious-inflammatory and dysbiotic diseases. Severe forms of placental insufficiency and preeclampsia are more often an indication for termination of pregnancy at 28-33 weeks 6 days. The research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research. No conflict of interests was declared by the author.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135927064","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":"Quality of life as a criterion for the effectiveness of surgical treatment of genital prolapses combined with uterine leiomyoma","authors":"O.P. Baryshnikova, K.V. Chaika, N.V. Tytarenko, A.V. Vozniuk, V.O. Rud","doi":"10.15574/pp.2023.95.49","DOIUrl":"https://doi.org/10.15574/pp.2023.95.49","url":null,"abstract":"Criteria for choosing the volume of surgical intervention in patients with genital prolapse combined with uterine leiomyoma have not been developed. Purpose - to evaluate quality of life after hysterectomy with and without correction of genital prolapse. Materials and methods. 120 patients were examined. In the Control (I) Group (n=40), hysterectomy was performed without correction of genital prolapse, in the other two groups - hysterectomy and correction of genital prolapse using a mesh implant by the method of pectopexy (the Group II, n=40) or lateral fixation (the Group III, n=40). The PFDI-20, PISQ and PD-QOL questionnaires were used to assess the quality of life after the operation. Statistical analysis was performed with SPSS Version 21.0. Results. Significant differences in the average number of points were registered in the Group II and Group III - 45.39±27.02 and 49.78±17.24 points respectively; p<0.001. The sexual function index also significantly increased: from 18.93±14.61 to 24.85±12.19 points in the Group II and from 17.55±10.64 to 24.30±13.92 points in the Group III (р=0.01). During the analysis 12 months post surgery, attention was drawn to reliable differences in the average estimates of the impact of manifestations of genital prolapse on the quality of life (the PD-QOL questionnaire), physical and social limitations, interpersonal relationships and emotional problems in the Group II/Group III compared to patients in the Group I (p<0.05). Conclusions. The data we obtained allow us to talk about the effectiveness of simultaneous correction of genital prolapse with hysterectomy using mesh implants. 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 institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135926833","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":"Long COVID in children: frequency and diagnostic challenges","authors":"L.A. Volianska, E.I. Burbela, V.O. Perestiuk, T.M. Kosovska, O.R. Boyarchuk","doi":"10.15574/pp.2023.95.101","DOIUrl":"https://doi.org/10.15574/pp.2023.95.101","url":null,"abstract":"Purpose - to analyze the prevalence of symptoms of long COVID-19 in the pediatric population and the methods of their diagnosis. Electronic search of scientific research using known databases from PubMed, SCOPUS, ResearchGate, Wiley Online Library and Google Scholar from 2019 to February 2023. The keywords for this review: long COVID, post COVID, COVID-19, pediatrics, children, adolescents, post-acute sequelae of SARS‐CoV‐2 infection (PASC). Exclusion criteria were: duplicated, dedicated exclusively to adults, analyzed only acute COVID-19. In the analysis were included research from the post-Covid period in children and adolescents, which contained the results of the assessment of their state of health and displayed certain clinical manifestations that remained after the end of the acute infection within 4-12 weeks. Optimistic forecasts regarding the course of SARS-CoV-2 infection in the child population at the beginning of the pandemic quite quickly passed into the stage of uncertainty in forecasts of the course of the post-Covid period and the consequences of the transferred disease. Most children infected with COVID-19 recover, but some of them have persistent symptoms after an infection. The true prevalence of “long-term COVID” is under investigation study. Reports on the range of its manifestations are very diverse and differ in conclusions about the intensity of their impact on the quality of children’s life. Hence, there is an obvious need for long-term clinical observations with a mandatory comparison with the data of control groups appropriate age. Because this category of convalescents will need of a multidisciplinary approach in monitoring them, and therefore they will bear a significant burden on the health care system. No conflict of interests was declared by the authors.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135926832","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":"Placental factors in pregnant women with isolated heart disease of the fetus","authors":"Y.V. Duderina","doi":"10.15574/pp.2023.95.6","DOIUrl":"https://doi.org/10.15574/pp.2023.95.6","url":null,"abstract":"The placenta, as a unique and transient organ in humans, ensures the development and protection of the fetus, the expression of angiogenic and antiangiogenic factors and their receptors. The integrity of the fetoplacental endothelial barrier is critical for the development of fetal organs, especially the cardiovascular system. Placental growth factor (PLGF) regulates the morphologic and functional development of the uteroplacental vasculature and can vary with gestational age and in various pathologic conditions of the pregnant woman. Since there is a differential expression of PLGF and soluble form of fms-like tyrosine kinase (sFlt-1) at different gestational ages and their competitive interaction, it is advisable to study their level in the blood of a pregnant woman as indicators of regulation of the placental vascular system in pathological conditions of the woman and fetus. Purpose - to determine the levels of placental factors, namely PLGF and sFlt-1, in the serum of pregnant women with isolated congenital heart disease (CHD) in the fetus to increase the effectiveness of diagnostics and the ability to predict heart diseases. Materials and methods. The work was based on a prospective clinical study of a hospital sample, using the case-control study method, with the evaluation of some clinical and laboratory data in 30 pregnant women with isolated fetal CHD (study group) and 60 pregnant women with a healthy fetus (control group). In order to minimize the influence of various risk factors for fetal heart disease, the criteria for selecting pregnant women with non-syndromic forms of CHD and the control group were defined. Clinical, laboratory and statistical methods were used in the study. The level of angiogenesis indicators in blood serum of pregnant women of both groups was determined by enzyme-linked immunosorbent assay in units of pg/ml in the third trimester of pregnancy. The statistical analysis was carried out using the R software package. ROC analysis and AUC (area under the ROC curve) were used for quantitative interpretation. Differences with p<0.05 were considered statistically significant. Results. According to the results of the study, the age of the women in the study group ranged from 17 to 39 years with a mean of 28.36±5.12, and the age of the women in the control group was 29.63±5.39 (p=0.239). The mean gestational age of women in the study group at enrollment was 28.26±8.45 weeks. The mean PLGF level was 93.73±77.32 pg/mL in the study group and 198.63±168.27 pg/mL in the control group (p=0.002). The average level of sFlt-1 in the blood serum of the women in the study group was 9779.44±5407.53 pg/ml, while in the pregnant women in the control group it was 3124.6±1624.53 (p<0.001). The sFlt/PlGF ratio was 180.9±151.1 in the study group and 15.76±14.7 in the control group (p<0.001). Conclusions. The obtained results in the form of a decrease of the placental growth factor in the blood of pregnant women with congenital heart defec","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135927061","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":"Innovative cytogenomic diagnostics of neurodevelopmental disorders in children","authors":"L.H. Kirilova, O.O. Miroshnikov, O.V. Beregela, V.M. Badiuk, M.V. Filozop, O.O. Dolenko, Y.M. Bondarenko","doi":"10.15574/pp.2023.95.71","DOIUrl":"https://doi.org/10.15574/pp.2023.95.71","url":null,"abstract":"Today, genetic diagnosis methods are a powerful tool for a practicing doctor, which allows not only to establish the etiology of neurodevelopmental disorders in children, but also influences the further tactics of patient management, the choice of further diagnostic and therapeutic interventions, helps in predicting subsequent pregnancies for the family. Purpose - to analyze the information of modern specialized literature regarding the features of the use of modern cytogenetic methods of diagnosis, in particular, chromosomal micrometric analysis (СMA); give a clinical example of a child with a neurodevelopmental disorder and established chromosomal etiology. A review of the scientific literature regarding the advantages and features of using innovative methods of cytogenetic diagnostics (karyotyping, СMA), clinical manifestations of 2q13 microdeletion syndrome is given. A description of the clinical case of diagnosis of a child with 2q13 microdeletion syndrome is presented. A chromosomal micrometric analysis was performed, which revealed a heterozygous microdeletion on 2q13 with a size of 122 kilobases, which led to the loss of the NPHP1 and MALL genes. The obtained result of the CMA made it possible to optimize the tactics of monitoring the child, taking into account the increased risk of the development of kidney pathology and leukoencephalopathy, the recommended annual determination of the level of creatinine and urea in the blood, conducting an ultrasound of the kidneys and an MRI of the brain. Conclusions. The given clinical observation confirms the complexity of the diagnostic search for neurodevelopmental disorders in children. In children with autism spectrum disorder, developmental delay, intellectual disability, in the absence of epileptic seizures, regardless of the presence of dysmorphic facial features, it is recommended to begin the examination with CMA, and in children with epileptic encephalopathies, it is optimal to begin the examination with the next generation sequencing method (NGS), namely whole exome sequencing. The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135927063","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":"Reproductive health of refugees: barriers to accessing healthcare systems in host countries","authors":"Vl.V. Podolsky, V.V. Podolsky, N.V. Medvedovska","doi":"10.15574/pp.2023.95.107","DOIUrl":"https://doi.org/10.15574/pp.2023.95.107","url":null,"abstract":"Refugees around the world face numerous challenges when it comes to accessing healthcare services, particularly in the area of reproductive health. This narrative review aims to explore the barriers that refugees encounter when trying to access healthcare systems in their host countries. These barriers include language and cultural differences, lack of knowledge about the healthcare system, limited access to transportation, financial constraints, and stigma. Comprehensive healthcare services, including healthcare access, nutrition, and mental health support, are crucial to prevent and manage chronic diseases and improve health outcomes for refugees, particularly those with diabetes who may face restricted availability of medications and monitoring devices. It is essential to ensure refugees diagnosed with diabetes have sufficient access to insulin supplies and equipment to administer it securely. We also highlight the impact of these barriers on the reproductive health of refugees, including inadequate prenatal care, lack of access to contraception and family planning services, and increased risk of sexually transmitted infections. The findings of this review underscore the urgent need for policymakers and healthcare providers to address the unique challenges that refugees face when accessing reproductive healthcare. Efforts must be made to improve access to information, increase cultural competency among healthcare providers, and address financial and transportation barriers. By addressing these challenges, we can ensure that refugees have the necessary support and resources to maintain their reproductive health and well-being. No conflict of interests was declared by the authors.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135927062","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}