Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ最新文献

{"title":"Analgesia in childbirth - comparison and analysis of the classical technique of epidural analgesia and modified with puncture of the dura mater","authors":"Ye.M. Sulimenko","doi":"10.15574/pp.2023.95.12","DOIUrl":"https://doi.org/10.15574/pp.2023.95.12","url":null,"abstract":"Epidural analgesia (EA), most commonly used for labor analgesia, is an effective and relatively safe technique, but may be associated with slow onset, inadequate block. The use of Dural puncture epidural (DPE) is designed to find a balance between improving the quality of analgesia and reducing the frequency of side effects. Purpose - to compare two methods of labor analgesia. Materials and methods. All women (n=80) were divided into two groups: the Group I (n=40) used DPE, the Group II (n=40) used EA. In both groups, the same technique of epidural puncture and catheterization was used, in the Group I additionally puncture of the dura mater. Analgesia was evaluated using the visual analog pain rating scale (VAS). The quality and effectiveness of analgesia, the hemodynamics of the woman were evaluated. Complications and unwanted effects were recorded. Fetal condition: cardiotocography (CTG), umbilical cord blood lactate, pH. A statistical analysis of the obtained data was carried out. Results. The first contraction (VAS1) in the Group I were fixed on 11.43.3 min, and in the Group II on 21.57.2 min (p0.05). Monolateral block in the Group I - 4 (10%) versus 10 (25%) (p0.05). Contractions (VAS 1) after 30 min in the Group II - 7 (17.5%) versus the absence of such in the Group I. Stroke volume in the Group I decreased by 2.1% versus 1.5% in the Group II. The data for hypotension and occurrence of complications, CTG, cord blood lactate, and pH were not different by group. Conclusions. The use of the DPE technique against EA gives better results in terms of the quality and effectiveness of analgesia. The mother’s hemodynamics remained stable when using DPE. The DPE technique does not increase the frequency of complications compared to EA. There was no difference between the groups when assessing the state of the fetus according to CTG data, pH indicators and umbilical cord blood lactate. 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 author.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"53 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":"135926834","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 menstrual disorders associated with psychopathology","authors":"V.О. Dynnyk, H.О. Havenko","doi":"10.15574/pp.2023.95.55","DOIUrl":"https://doi.org/10.15574/pp.2023.95.55","url":null,"abstract":"The health of the younger generation is a public value. Today, the state of health of teenage girls is of particular concern due to its progressive deterioration. Purpose - to study the features of the clinical course of menstrual function disorders in adolescent girls with comorbid mental health disorders. Materials and methods. 154 girls aged 11-17 were examined with menstrual cycle disorders (77 with oligomenorrhea (OM) and 77 with abnormal uterine bleeding (AUB)). Assessment of physical and sexual development, age of menarche was carried out. Depending on the examination by a psychiatrist, all girls with OM and AUB were divided into groups: without deviations in mental status, with anxiety-phobic disorders and depressive states. Results. It was found that the average growth indicators were probably higher in girls with OM in relation to adolescents with AUB, especially in the presence of psychopathology. The use of BMI did not reveal a significant difference when comparing patients with OM and AUB. Abnormalities of sexual development were probably more often registered in patients with AUB, with its advance, this acquired a significant difference (p˂0.01) and depended on both body mass index (BMI) and psychopathology. If the percentage of patients with disorders of sexual development did not differ depending on psychopathology in girls with AUB, then in adolescents with OM, the specific weight of girls with abnormalities of sexual development increased with the appearance of psychopathology. The average age of menarche was significantly lower in patients with AUB compared to patients with OM (p˂0.003). Early menarche was more typical for AUB. Much more often in adolescents with AUB, it was registered with normative fluctuations of BMI and its excess, as well as with anxiety-phobic disorders both with AUB and OM. Conclusions. The analysis of the conducted studies indicates reliable differences regarding the clinical course of menstrual function disorders by the type of OM and AUB with comorbid psychopathology. It was established that there are significant differences in such indicators as growth, puberty, time of menarche, which depended on the type of menstrual disorders and comorbid psychopathology. 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":"6 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":"135927067","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":"Hysterectomy during the menopausal transition as a predictor of metabolic disorders","authors":"O.M. Proshchenko, D.O. Govsieiev","doi":"10.15574/pp.2023.95.43","DOIUrl":"https://doi.org/10.15574/pp.2023.95.43","url":null,"abstract":"Although data on the decrease in ovarian function after hysterectomy (GE) are found in literature sources, the nature of changes in the hormonal and metabolic profile, its chronological sequence, the issue of the relationship with the development of metabolic syndrome (MS), even in the case of preservation of ovarian tissue, remain controversial and fragmented, which served as an impetus for conducting this study. Purpose - to assess the risk of metabolic disorders after GE during the menopausal transition. Materials and methods. A comprehensive assessment of the long-term consequences of GE was carried out in 160 women of the menopausal transition age. Metabolic homeostasis parameters were evaluated before surgery and in dynamics after surgical intervention (after 12 months). Risk factors were identified during a general clinical examination, based on anamnestic data. Indicators of carbohydrate and lipid metabolism were evaluated in the examined women. Inclusion criteria: the age of the menopausal transition, GE due to benign uterine pathology, the patient's consent to participate in the research. Results. Analysis of carbohydrate metabolism indicators showed an increase in the HOMA-IR index and postprandial glucose level, changes in the lipid profile. When comparing clinical symptoms and laboratory research methods, in 34.37% of cases, the formation of MS was noted one year after GE. Based on multivariate analysis using binary logistic regression, the following risk factors for metabolic disorders were found to be statistically significant: high body mass index, waist circumference above 80 cm, age older than 45, climacteric syndrome, GE. Conclusions. A high body mass index, a waist circumference greater than 80 cm, the presence of signs of the climacteric syndrome, GE and age older than 45 years show the association with the development of metabolic disorders in the distant postoperative period, and their combined effect increases the risk of their development. These factors at the preoperative stage can serve as prognostic markers of metabolic disorders in the distant postoperative period. 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":"16 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":"135926835","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":"Тhe impact of bullying on children’s health and overcoming its consequences in the conditions of marital state (literature review)","authors":"I.S. Nedostup, B.M. Pavlykivska, V.B. Motriyk, T.V. Lotovska, B.N. Tkach, L.L. Fedyshyn, N.B. Osadets","doi":"10.15574/pp.2023.95.117","DOIUrl":"https://doi.org/10.15574/pp.2023.95.117","url":null,"abstract":"Purpose - to analyze data from the literature on the characteristics of bullying, its impact on the mental and physical health of children, and ways to overcome and prevent the consequences of this condition during the military invasion of Ukraine. For this, a search in scientometric databases was carried out, and a review of modern domestic and foreign medical literature, periodical publications, and official electronic resources was made. A review of the literature was conducted, which showed that the problems of school bullying and the consequences associated with it worsen not only mental and physical health but also have a negative impact on the quality of education of the younger generation. Bullying statistics regarding the number of completed administrative protocols in Ukrainian schools from 2019 to 2023 are given and analyzed. At the same time, human rights organizations noted that bullying was modified and became latent under martial law. It is emphasized that cases of bullying have a causal relationship with mental and physical health in adulthood. It is noted that starting in 2020, our country and the whole world will be celebrating the International Day of Combating Violence and Bullying at School. Forms of bulling, types of aggression and styles of behavior are described. It was noted that one of the important reasons for the spread of bullying is, unfortunately, its ignoring by adults. It is emphasized that children who differ in some way from others suffer most often from bullying.It is noted that under martial law, school bullying occurs more often in relation to temporarily displaced persons. It is emphasized that solving the problem of school bullying is possible through compliance with the principle of comprehensiveness between the administration of the institution, its employees, and parents. The main actors in the field of violence prevention and countermeasures who provide assistance outside educational institutions are listed. It is noted that the help and prevention of bullying consists of teaching the child to resist victimization. The role of the school nurse in the multidisciplinary medical team in overcoming the problems of school bullying and its consequences is noted. Recommendations for searching for information on organizations dealing with bullying issues on the website of the Ministry of Education and Culture of Ukraine are highlighted. It is emphasized that the most effective actions that contribute to reducing the number of cases of violence in the educational environment are systematic educational activities on non-violent behavior, implementation of high-quality preventive programs, and the promotion of anti-bullying policies. No conflict of interests was declared by the authors.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"22 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":"135927065","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":"Analysis of critical chemotherapy complications in children with acute leukemia and ways of their corrections","authors":"N.І. Мakieieva, S.O. Gubar, V.A. Koval, T.S. Zharkova","doi":"10.15574/pp.2023.95.93","DOIUrl":"https://doi.org/10.15574/pp.2023.95.93","url":null,"abstract":"Providing intensive care for critical conditions in pediatric hematological malignancies has its features and remains one of the most urgent tasks of pediatrics. Purpose - to assess the features of critical conditions in children with acute leukemia (AL) and to review the literature for their correction. Materials and methods. An analysis of the results of clinical, laboratory, and instrumental examination of 70 children treated in the Intensive Care Unit with AL aged from 1 month to 18 years has been carried out. Statistical analyses of data were conducted by STATISTICA 8. Results. Among the complications of cytostatic therapy, the following ones have been recorded: neutropenia (in 62 cases), agranulocytosis (16), hyperleukocytosis (1); critical thrombocytopenia (15) with the development of severe hemorrhagic syndrome (10) and hemorrhagic shock (2), disseminated intravascular coagulation syndrome (1); anemia of II-III degree (12), involvement of gastrointestinal tract in the form of stomatitis/esophagitis/gastroenterocolitis (16), hepatitis (21), pancreatitis (2), cardiopathy (2), cardiovascular failure (1), interstitional pneumonia (1), respiratory failure (6), acute renal failure (2), focal neurologic signs/seizures (2). Infectious complications included pneumonia (22), including one with acute lung destruction (5), pneumonia complicated by pleurisy (2) or pneumothorax (3), pyelonephritis (3), otitis media (3), contact peritonitis (2), meningitis (2), central vein phlebitis (4) with superior vena cava syndrome (2). The combination of pneumonia with other infectious foci was determined in 17 patients. Sepsis was diagnosed in 6 cases. Conclusions. In the examined patients there was a significant proportion of complications on the background of chemotherapy treatment of AL. The timely diagnosis and adequate correction of the complications can potentially reduce the mortality of AL. 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. An informed consent was collected in order to carry out the research. No conflict of interests was declared by the authors.","PeriodicalId":481772,"journal":{"name":"Ukraïnsʹkij žurnal Perinatologìâ ì pedìatrìâ","volume":"42 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":"135926633","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":"Anxiety level in overweight and obese children","authors":"M.L. Aryayev, D.S. Selimkhanova, I.M. Shevchenko","doi":"10.15574/pp.2023.95.61","DOIUrl":"https://doi.org/10.15574/pp.2023.95.61","url":null,"abstract":"Purpose - to evaluate personal and situational anxiety levels in overweight and obese children. Materials and methods. 153 children (72 girls and 81 boys) aged 12-17 were involved in the study at the Odesa Regional Children’s Clinical Hospital. Anthropometric indicators (weight, height, body mass index (BMI)) were assessed taking into account the sex and age of children. Based on BMI values, 3 groups were selected: 1 - children with a body weight corresponding to age and gender - 47 persons (Control); 2 - children with excessive body weight - 50 persons (Overweight); 3 - children with obesity - 56 persons (Obesity). The state of personal and situational anxiety was determined using the Spielberger-Khanin questionnaire. Statistical data analysis was carried out using packages STATISTICA 12.0, MedCalc 20.0, Microsoft EXCEL 2003. Results. In children with obesity, the most common comorbidities were biliary dyskinesia (14.28%), arterial hypertension (10.52%), skin infections 4% and obstructive sleep apnea syndrome 2%. In the studied groups of children, the level of anxiety increased in proportion to the degree of increase in body weight. Personal anxiety in children with obesity compared to control was noted at a higher level - 50.1±1.04 and 30.27±0.98, respectively (χ2=49.9, p=0.0001). Situational anxiety also increased in children with obesity, but the differences were expressed to a lesser extent - 38.94±0.74 and 33.91±0.93 (χ2=5.49, p=0.019). Conclusions. The obtained results indicate the feasibility of further study and monitoring of the psycho-emotional state and quality of life of overweight and obese children and adolescents for individual psychological support and correction of psycho-emotional disorders. 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":"135926831","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":"Tourniquet syndrome in children (literature review and own observation)","authors":"V.S. Konoplitskyi, S.V. Chornyi, Yu.Ye. Korobko, B.L. Pavlenko, S.M. Sytnyk, N.S. Nesterov, V.M. Kravchuk","doi":"10.15574/pp.2023.95.79","DOIUrl":"https://doi.org/10.15574/pp.2023.95.79","url":null,"abstract":"Tourniquet syndrome is a complex of pathological changes that occur in response to strangulation circular compression of part/parts of the body or organ, characterized by neurovascular disorders that can lead to the development of necrosis and gangrene. Strangulation of soft tissues can occur with various fibrous materials - wool, cotton, various cords, jewelry, Christmas tree decorations. In children, the most common cause of strangulation is hair and threads, in adults - jewelry. Purpose - to draw the attention of the medical community to a rare pathology, the tourniquet syndrome in children, which, despite its rather characteristic picture, is not always immediately recognized, which can lead to serious consequences. The leading etiological factor in the development of tourniquet syndrome can be postpartum telogen outflow in mothers, which is manifested by a large amount of hair prone to loss. The authors recognize the toes as the most frequent localization of the strangulation hair bundle in tourniquet syndrome, the II and III toes of the feet and hands are more often caught in the loop. Also, it is not uncommon for several fingers to be entwined. With tourniquet syndrome, a complication in the form of necrosis of the fingers, which requires their amputation, is about 7% of all cases of finger and foot pathology. Quick recognition and removal of the tourniquet for genitaltourniquet syndromeprevents devascularization of the clitoris and penis and their possible self-amputation. Conclusions. Hair bundle syndrome, or tourniquet syndrome, most often occurs in young children and can have serious consequences. To prevent this phenomenon, children’s clothes should be checked for the presence of threads and loops on the inside, the presence of piles of hair and threads in the “blind” parts of the clothes, turn the clothes inside out before washing, which helps prevent the accumulation of future bundles. It is also recommended that mother and child sleep separately. In case of injuries of the upper limbs, it is recommended to know jewelry from the fingers. Alertness about tourniquet syndrome will help avoid serious complications in children. It should also be remembered about the intentional cruel treatment of children with the imposition of potential bounties. No conflict of interests 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":"135927230","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}