Медицина. Лечение. Здоровье. МедЭксперт
«О медицине – профессионально»
The results of the state policy about health care and social protection of orphans and children deprived of parental care, for the period 1999–2011yy. are analyzed. The directions and further development of the chain of orphanages of the Ministry of Health Care System of Ukraine are shown.
Key words: orphans, children deprived of parental care, health care, social protection, orphanage.
This article contains critical review of modern literature devoted to rare disease in neuroichthyosis group — Sjogren— Larsson syndrome. Based on analysis of various literature sources, modern views on etiology, pathogenesis, clinical-diagnostically characteristic and therapeutic approaches to Sjogren—Larsson syndrome were generalized and systematically examined. The article presents the description of clinical case in clinics of SI «Institute of pediatrics, obstetrics and gynecology NMSA of Ukraine».
Key words: rare diseases, Sjogren—Larsson syndrome, neuroichthyosis, organic lesion of CNS.
In the article the questions about classification, assessment of severity and the way of therapeutic tactics during the bronchial asthma in pediatric patients are opened.
Key words: bronchial asthma, classification, monitoring criteria.
The onset of SLE in children poses a diagnostic challenge for different health professionals, particularly because the onset of the disease shows no clear clinical symptoms and characteristically disguised under a variety of onset masks and highly aggressive course. Analysis of the disease onset allows identifying groups of the most frequent SLE onset masks in children. The SLE onset in children characterises in 21% cases with atypical or incomplete progress, in which case the disease progresses under the mask of other ailments giving grounds for erroneous diagnoses.
Keywords: systemic lupus erythematosus, children, onset mask, clinical and instrumental characteristic.
The work presents the first ever experience in, and results of observing and treating children with various combined immune deficiency (CID) forms in Ukraine. The observation involved 121 children with various CID forms. High mortality in children with CID and possibilities of their survival with well-timed application of adequate therapy is shown. The work also presents revised approaches towards substitution therapy with immunoglobulins, antibiotic therapy and prevention measures at various CID forms as well as indications for stem cell transplantation.
Keywords: primary combined immunodeficiencies, complex combined immunodeficiencies, Nijmegen breakage syndrome, Wiskott-Aldrich syndrome, Louis Barr syndrome, DiGeorge syndrome, stem cell transplantation, intravenous immunoglobulins.
In vivo animal models have been used for experiments to confirm Derinat (sodium deoxyribonucleate) protective activity against A(H1N1) pdm 2009 virus. Placebo-controlled randomised clinical laboratory tests carried out in accordance with GCP Regulations have confirmed therapeutic efficacy and safety of Derinat at its inclusion into comprehensive treatment regimen for children >0 years with flu and ARI of other aetiology, which manifested itself in the form of statistically significant reduction of duration of the main disease symptoms, restoration of the initial shifts in lab ranges back to normal and faster elimination of causative agents from nasal passages of the patients.
Keywords: children, treatment, sodium deoxyribonucleate, immunity, antioxidant activity, flu and ARI.
Summary. The article presents the results of a clinical and anamnestic observation of 55 TB/HIV-infected children, determines the role of key risk factors in TB infection development and confirms diagnostic value of tuberculin-based diagnostics of HIV-infected children.
Keywords: tuberculosis, children, HIV-infection.
The objective of the study: to research the status of renin-angiotensin-aldosterone system in children with myocardial pathology at various levels of right ventricular function. 109 patients with myocardial pathology (recurrent cardiomyopathy, dysplastic cardiomyopathy, arrhythmias) were studied. Clinical studies with analyses of complaints, disease history, life history and objective research data were carried out. The study into the RAAS system included studies of plasma renin activity, angiotensin II and aldosterone levels in peripheral venous blood through radioimmunological analysis carried out with NarkoTest gamma meter. The morphofunctional status of the right ventricle was assessed based on results of ultrasound Doppler examination of the heart in M and B modes. It was established that in children with MP systolic dysfunction of the RV and it deconditional remodelling form and progress on the background of neurohumoral regulation systems and in particular, the RAAS activation.
Key words: renin-angiotensin-aldosterone system, right ventricle of heart, children, myocardial pathology.
The use of biologic drugs in clinical rheumatology has ushered in a considerable shift in the therapeutic paradigm of juvenile rheumatoid arthritis. This work analyses international experience of biologic drugs administration to patients with JRA and demonstrates first own results of the use of Adalimumab for treatment of patients with refractory JRA.
Key words: juvenile rheumatoid arthritis, biologic drugs, Adalimumab.
We described innovative organizational strategy for neonates who have prenatal diagnose of critical congenital heart disease (CCHD) with focus on earliest surgical repair, using autologous umbilical cord blood. Since September of 2009 to August of 2012, 390 neonates with CCHD were operated at our institution. For that period 50 neonates underwent the new strategy. The neonates were admitted to the cardiac department during an hour after birth. No patients required ICU admission, interventional procedures, mechanical ventilation or medications before surgery that result in significant positive economic effect compared with conventional approach. Mean age at operation was 3.9±1.1 hours (2–6). Mean volume of harvested cord blood was 85±24 ml (50–140). Forty (80%) neonates underwent open cardiac surgery without homologous blood transfusion.
Key words: Prenatal diagnosis, neonatal cardiac surgery, autologous umbilical cord blood.
CRPhs is well recognized marker of vascular damage. He causes in vascular wall numbers of proatherogenic effects. Endothelial dysfunction is a first stage of atherosclerosis. detection for signs of endothelial activation and injury is important because cardiovascular pathology is the leading cause of death in patients with rheumatoid arthritis (RA). In children with juvenile rheumatoid arthritis (JRA) possible presence of endothelial dysfunction in connection with the presence of systemic inflammatory process. Early prevention will reduce the risk of atherosclerosis and prolong life in patients with RA. Determining the level CRPhs performed in 22 children with JRA and 19 control healthy children. CRPhs in healthy children was 0.0084±0.0072 mg/L vs 0.07725±0.05 mg/L in children with JRA (р=0.01). In children with I degree of disease activity CRPhs was around average 0,08±0,035 mg/L, II and III 0,089±0,076 mg/L and 0,144±0,00063 mg/L respectively. In patients with absence of activity of the process level CRPhs responsible
0.0095±0.007 mg/L. CRPhs level is 0.140±0.055 mg/l in children with polyarthritis vs 0.067±0.045 mg/l (р=0.01) in petients with oligoarthritis and 0.12±0.005 mg/l in systemic form vs 0.086±0.04 mg/l in non-systemic disease (р=0.01). Disease duration, age, gender don`tinfluence on CRPhs level.Endothelial dysfunction (endothelium dependent dilation of the brachial artery) was associated with CRPhs (r=-0.92) in children with JRA.
Key words: CRPhs, juvenile rheumatoid arthritis, endotheium, inflammation.
The range of state and trait anxiety in children with rheumatoid arthritis (RA), their structure peculiarities and personality type are underinvestigation. 100% of investigated children showed the increasing level of trait anxiety, and 42.7% — the state anxiety according to the Spielberg—Hanin test. 75% of those under investigation demonstrated the score rise according the psychiatric state scale and the results of personality dimension after Eysenck.
Key words: Juvenile rheumatoid arthritis, psychosomatics, trait and state anxiety, Spielberg—Hanin's scale, personality structure, personality typology.
Nail bed capillaroscopy — informative method for examination children with systemic inflammatory diseases of connective tissue and juvenile rheumatoid arthritis. According to our data, children with systemic lupus erythematosus and juvenile rheumatoid arthritis has lesions of microcirculatory bed, more expressive in children with lupus.
Key words: Nail bed capillaroscopy, children, systemic lupus erythematosus, juvenile rheumatoid arthritis.
Results of a comparative trial into the efficacy of Symbiter Multi Probiotic on ARVI frequency and duration during autumn and winter seasons in healthy children living in children's houses.
Keywords: acute respiratory viral infections, non-specific ARVI prevention, probiotics, Symbiter.
The article presents results of a study on the effect of domestic multi probiotic Symbiter onto acute respiratory morbidity index and psychomotor and physical development indicators of children orphans from the children's home. 79 children aged between three months and three years and eight months participated in the study. The inclusion of Symbiter multi probiotic into the ARD prevention programme contributes to a twofold decrease of ARD morbidity and reduces both the incidence of complications and frequency of antibiotics administration for their therapy. The preventive effect of Symbiter multi probiotic continues for six months after intake discontinuation. Administration of Symbiter multi probiotic enhances children's physical development and body mass increase and has positive effect on their psychomotor development.
Key words: children, probiotics, Symbiter, acute respiratory infections, quotient, morbidity, psychomotor development, physical development.
The objective. To study the dynamics of the cortisol level during the neonatal period in infants with violation kidney function after asphyxia.
Materials and methods. 100 full-term infants with a gestational age 38–41 weeks and signs of kidney damage were examined: 50 children who had severe asphyxia and 50 children with moderate asphyxia. The comparison group consisted of 20 children without birth asphyxia. The cortisol level in serum was determined on 1–2, 7–8 and 25–30 days of life by ELISA.
Results. Newborns with signs of kidney damage due to moderate asphyxia are characterized by significant increase in serum cortisol concentration at 1–2 days of life (p<0.001). Reduction to physiological levels observed only in the late neonatal period. Children with renal damage after severe asphyxia have the highest content of serum cortisol in the first two days of life — 505.28±36.96 nmol/l. At the end of the neonatal period we observed suppression of cortisol production. The cortisol level in children with impaired renal function negatively correlated with low blood pH and base deficiency (BE). The high content of sodium in the serum in infants with impaired renal function caused by asphyxia in the first two days of life is an adaptive response due to elevated cortisol level.
Conclusion. Investigation found that disturbance renal function after neonatal asphyxia accompanied with increase synthesis of cortisol in the early neonatal period. Depletion synthesis of cortisol in case of severe asphyxia at the end of the neonatal period may contribute disadaptation infants, predispose to metabolic disorders.
Key words: newborn, asphyxia, cortisol, kidney, sodium.