Кафедра педіатрії № 1 та неонатології
Permanent URI for this communityhttps://repo.knmu.edu.ua/handle/123456789/175
Browse
50 results
Search Results
Item Research on the prevalence of congenital heart defect diagnosis(2024-11-11) Рибка, Олена Сергіївна; Апалькова, Дарʼя Миколаївна; Михайловина, Ольга Василівна; Шелест, Анастасія Романівна; Труш, Олексій СтаніславовичSince the 1970s, the incidence of congenital heart defects diagnosed in children has nearly doubled (from 4.547 cases per 1,000 live births in 1970-1974 to 9.410 per 1,000 live births in 2010-2017). These data provide a wide range of opportunities for interpretation.Item The Challenges of the Pediatrics Palliative Care in Kharkiv(2024-10-16) Riga, O.; Ріга, Олена Олександрівна; Marston, J.; Marabyan, R; Trofimov, I.; Penkov, A.; Konovalova, N.Item The level of reactive oxygen species as amarker of asthma severity in children(2023-01) Makieieva, Natalia; Andrushchenko, Vira; Malakhova, Valeriia; Tkachenko, Anton; Onishchenko, Anatolii; Polyakov, Valentin; Vygivska, LudmyaThe aim of the research was to assess the reactive oxygen species (ROS) levels in granulocytes of patients with asthma. Materials and methods: The study involved 35 children aged 5 to 17 years. 26 children with persistent asthma, partially controlled course in the period of exacerbation were divided into groups: 1 group - mild asthma (n = 12), group 2 - moderate asthma (n = 7) group 3 - severe asthma (n = 7) and control group included almost healthy children (n = 9). ROS levels in granulocytes were evaluated using BD FACSDiva™. The spirographic complex was used to assess the function of external respiration. Rresults: The level of ROS in granulocytes of patients with severe asthma was significantly reduced compared with children in the control group and patients with mild and moderate asthma (p₁-₃ = 0.0003, p₂-₃ = 0.0017, p c-₃ = 0.0150). The concentration of ROS in granulocytes ≤ 285 a.u. was prognostically significant with high specificity and sensitivity with severe asthma. Conclusions: The concentration of ROS levels in neutrophils in patients with severe asthma probably reflected the suppression of their products, which suggests the depletion of the reserve capacity of neutrophils. Decreased concentrations of reactive oxygen species in children with asthma can be considered as a possible marker of asthma severity.Item Aspects of the development of the program of palliative assistance for children of the kharkiv region throuth the challenges of the military conflict(2023) Riga, Olena; Marston, Joan; Khaustov, Maxym; Myasoyedov, Valeriy; Penkov, Andriy; Marabyan, RomanIn the context of armed conflict, palliative care, pain management, and care for the dying and bereaved require increased and urgent attention. The devastating humanitarian crisis in Ukraine makes these issues even more critical. In 2021, a project working group was created in the Kharkiv region to prepare the program for the implementation of palliative care for children in the Kharkiv region. The main reasons for the imperfect development of pediatric palliative care in Kharkiv region were some points such as: lack of a systematic vision of the organization of pediatric palliative care services; acute shortage of qualified medical personnel, lack of educational programs and opportunities to study best practices in this field; lack of relations between primary and secondary (tertiary) links of medical care and coordination; lack of formulations of children’s drugs for pain relief and fear of prescribing opioid analgesics; an imperfect system of informing medical workers about the rights of children as patients; lack of interdisciplinary cooperation in the field of providing pediatric palliative care (education, social services, clergy, lawyers, economists); lack of joint programs between health, social and education departments in the field of pediatric palliative care; lack of a state policy in the field of pediatric palliative care; lack of a system for financing pediatric palliative care measures and monitoring their effectiveness. Before the war, the approximate number of children in need of palliative care in the Kharkiv region was 9,000 - 10,000, plus an estimated 21,000 - 25,000 family members. As of January 1, 2022, there were 426,000 children under the supervision of health care institutions in the region. 216,900 children lived in the city of Kharkiv, 209,700 in the rural areas. In the pre-war period there were 9,372 children with disabilities in the Kharkiv region. The structure of the causes of disability was as follows: congenital malformations - 25.5% (2389 children), diseases of the endocrine system - 16.4% (1537 children), diseases of the nervous system - 16.0% (1497 children), mental and behavioral disorders 13.8% (1295 children), ear diseases - 9.2% (862 children). The authors’ vision is: to start policy development and creation of an effective system of pediatric palliative care in accordance with the needs and international standards; creation of an effective system of training of medical and social workers in pediatric palliative care protocols and standards; development of coordinated pediatric palliative care at the place of residence/stay of the child; mobile teams; hospital beds and hospital teams; wide public awareness and involvement of public organizations in the provision of pediatric palliative care; attraction of budgetary and extra-budgetary funds for financing pediatric palliative care. Authors also speculate that other important steps need to be implemented to regional program of pediatric palliative care and integrated with international recommendations and organizations.Item Vitamin D status in children with paralitic syndroms(2023-09) Riga, Olena; Khaustov, Maxym; Mikhaylova, Aleksandra; Orlova, NataliaThe aim: Determination of serum 25(OH)D in the children with paralytic syndromes and its distribution depending on age, sex, taking anticonvulsant drugs, nutritional status for a period of one year (autumn-spring) of one center. Materials and methods: There were recruited of 77 children with paralytic syndromes and 73 health children for the same period aged from 1 till 18 years. The study included a scrutiny of medical history and analysis of medical documents, assessment of motor dysfunction by GMFCS, and nutritional status. Results: Among children with paralytic syndromes there were spastic tetraparesis 59.7%, malnutrition 92%, IV-V level of gross motor disfunction 80.5%, antiseizure medications 59.7% and cognitive impairment 77.9%. The variation of serum 25(OH)D is from 6.1 to 76.7 ng/mL with median 18.3 ng/mL in healthy children. The variation of serum 25(OH)D is from 2.2 to 83.0 ng/mL with median 14.8 ng/mL in children with paralytic syndromes (p=0.0103). Vitamin status among them is the following: insufficiency (21–29 ng/mL)–28.7% vs 16.8%; deficiency (<20 ng/mL)–56.1 vs 72.2% (p=0.0300). The 25.9% children with paralytic syndromes and those who have deficiency demonstrate severe deficiency (<10 ng/mL) compare 10.9% in healthy children (p=0.00189). There is a tendency to decrease of serum 25(OH)D in children with paralytic syndrome older 7 years. Conclusions: We failed to record a significant difference in the 25(ОН)D between males and females, between different level of GMFCS, and anticonvulsants using. Deficiency of vitamin D in 2.25 times higher in children with paralytic syndromes and severe malnutrition. Additional researches with specific items are need in perspective.Item Association of Myocardial Changes and Gene Expression of the NFATC1 and NFATC4—Calcineurin Signaling Pathway in Children with Bicuspid Aortic Valve /(2023) Kamenshchyk, Andrii; Gonchar, Margaryta; Oksenych, Valentyn; Kamyshnyi, AleksandrBackground: The role of NFATC gene expression in bicuspid aortic valve (BAV) progression is not fully understood. The aim of this study is to determine the significance of NFATC1 and NFATC4 gene expression for myocardial changes in children with BAV. Methods: In 47 children with BAV, the standard Doppler echocardiographic characteristics were detected, and the expression of the NFATC1 and NFATC4 genes was studied. Results: Posterior wall thickness in diastole (PWTd) and aortic valve peak pressure gradient (AoPPG) in BAV patients were significantly higher compared to healthy controls (PWTd median (min–max), 9 (7–10) mm vs. 7 (6–8) mm; and AoPPG median (min–max), 7.79 (2.98–15.09) mm Hg vs. 2.94 (2.42–3.72) mm Hg). The expression of the NFATC1 gene in BAV children was significantly higher compared to NFATC4 (NFATC1 median (min–max); 70.88 (8.79–106.51) e.u. vs. 7.72 (1.74–22.67) e.u., respectively p < 0.05). A significant correlation of NFATC1 expression with Ao found (R = +0.53, p < 0.05). In BAV patients with PWTd > 8 mm and Ao > 21 mm the NFATC1 expression was significantly higher compared to those with PWTd ≤ 8 mm and Ao ≤ 21 mm (NFATC1 median (min–max); 45.49 (5.01–101.52) e.u. vs. 15.53 (2.36–44.40) e.u., p < 0.05 and 81.11 (20.27–101.10) e.u. mm vs. 12.16 (2.40–45.49) e.u., p < 0.05, respectively). Conclusion: In children with BAV the high expression of the NFATC1 calcineurin signaling pathway gene is associated with elevated PWTd and Ao.Item Clinical variant of ossifying myositis in pediatric practice(2023-07) Сенаторова, Г.С.; Фролова, Т.В.; Сенаторова, А.В.; Кіхтенко, О.В.; Осман, Н.С.; Senatorova, H.; Frolova, T.; Senatorova, A.; Kikhtenko, E.; Osman, N.Introduction. Ossifying myositis is a pathological process in muscles characterized by the formation of ossification in soft tissues. At present, the etiological factors of the disease remain not fully elucidated. The triggering factors of the disease are considered to be traumatic injuries, invasive medical manipulations against the background of genetic predisposition. Aim. Invite attention of general practitioners and pediatricians to a rare disease, namely progressive ossifying fibrodysplasia in children and the peculiarities of its diagnosis. Results. The article presents a clinical case of progressive ossifying fibrodysplasia (Munchmeyer's disease) in a 4-year-old girl. At birth, the child was diagnosed with a foot deformity characteristic of this pathology (shortening of the first metatarsal finger, flexion-rotation contracture of both feet). The clinic of the disease manifested itself at the age of 3 years, when, after falling on the back, a dense formation was noticed in the area of the left shoulder blade. Half a year after the fall, swelling and pain appeared in the sacro-coccygeal region of the spine. The girl was consulted by an orthopedist, dermatologist, and oncologist. During the examination of the child, characteristic clinical features of progressive ossifying fibrodysplasia were revealed, namely, deformation and fixed position of the chest, tense neck muscles, sharp limitation of movements in all parts of the spine, limitation of bending in the left elbow joint, clinodactyly, valgus deformity of the big toes. During the ultrasound examination, the following changes were diagnosed: swelling of muscle tissue in the neck area, subscapular area on the left and sacrococcygeal joint; multiple hypoechoic formations of irregular shape, heterogeneous echo structure with hyperechoic inclusions with an acoustic shadow; a focal change in the muscle structure in the form of a loss of the characteristic pinnate structure of the perimysium. The diagnosis was confirmed histologically. No characteristic changes were found in clinical and biochemical studies. The girl is under supervision. No worsening of the child's condition has been recorded over the past four years.Item Trajectories of serum 25(oh)d in children with paralytic syndromes when using vitamin d from different manufacturers and in different doses(2023-07) Ріга, Олена Олександрівна; Михайлова, О.В.; Michaylova, Olexandra; Riga, OlenaThe prevalence of vitamin D deficiency and insufficiency varies significantly in different subpopulations of children depending on age and diseases, and recommendations for their correction in children with paralytic syndromes are limited. Aim. Empirical determination of blood 25(OH)D trajectory in children with paralytic syndromes when using vitamin D from different manufacturers and in different doses. Material and methods. The 25(OH)D (ng/ml) of blood serum was analyzed by immune-enzymatic method "Labline-90" (Austria) with the test system "Monobind Inc." (ELISA, USA) in 77 children with paralytic syndromes aged 1-18 years, a repeat study after vitamin D3 supplementation was conducted in 36 children. The rate of increase in 25(OH)D concentration per month was calculated. Methods of descriptive statistics, non-parametric correlation analysis and Kaplan-Meier survival analysis were used with MedCalc Statistical Software (Belgium). This study was approved by the Ethics Committee (protocol No. 5, October 2021), which was conducted with the involvement of minor patients and did not contain measures that could harm their health. The research was carried out within the framework of the Department of Pediatrics of Kharkiv National Medical University "Medical and social aspects of adaptation of children with somatic pathology in modern conditions" (state registration number 0120U102471, 2020). Results. Vitamin D insufficiency was diagnosed in 17% of children with paralytic syndromes, and vitamin D deficiency in 73%, so daily doses of 2000-4000 IU of vitamin D3 from different manufacturers were recommended at the discretion of the parents for 6 months. In reality, children received doses from 500 to 5000 IU randomly, from 2 to 7 months. Doses were stratified as greater than 2000 IU and less than 2000 IU. If the child received a dose of 2000 IU or more, the rate of increase of 25(OH)D in the blood in children was 3.6 ng/ml per month, if the dose was less than 2000 IU - 1.6 ng/ml per month. Conclusions. Children with paralytic syndromes should be screened and monitored for serum 25(OH)D levels. With a serum 25(OH)D level of less than 20 ng/ml, daily administration of vitamin D3 in a dose of at least 2000 IU for at least 6 months allows reaching a 25(OH)D level of 30 ng/ml in most of them. Further large-scale studies are needed to supplement current recommendations for vitamin D3 supplementation in children with paralytic syndromes.Item Chronic Pain and Physical Therapy in Children with Paralytic Syndromes: are there any changes during lockdown?(ALUNA Publishing House, 2022-09) Orlova, Natalia; Riga, Olena; Ishchenko, Tatiana; Onikiienko, Оlexander; Omelchenko, Olena; Alenina, Inna; Urivaeva, MarinaThe aim: To evaluate an influence of physical therapy on chronic pain in children with paralytic’s syndrome and to maternal emotional status on lockdown time during the COVID-19 pandemic. Materials and methods: Data from 96 children and their mothers (96 persons) were included in the study. On-site services of physical therapists before the pandemic (2018- 2019) were received by 64 children and by 32 children during quarantine measures due to COVID-19 pandemic (2020). The age of the children ranged from 1 to 6 years, the median age was 3 years and 3 months. Results: We note that there were more boys with paralytic syndromes. Among the leading paralytic syndromes, the most common was spastic tetraparesis. The frequency of children with level III–V motor disorders prevailed. Conclusions: The authors consider that physical rehabilitation in children with paralytic syndromes reduces the incidence of moderate chronic pain and improves the emotional state of parents. But, these changes do not occur during the pandemic.Item Severe and critical COVID-19 in children: a simple singlecenter, cross-sectional study(2021) Riga, Olena; Korsunov, Vladimyr; Penkov, Andriy; Michaylova, Olexandra; Urivaeva, Marina; Ischchenko, Tetyana; Georgiyants, MarineThe aim of the study: Description of the severe and critical clinical course of COVID-19 in children. Material and methods: There is descriptive, single-centered, cross sectional study with recruited of 16 children of severe and critical COVID-19 aged from 1 month till 17 years with hypoxic respiratory failure (8) and multisystem inflammatory syndrome in children (8). The study included of detailed information in period from the manifestation of the disease and hospitalization, the main clinical manifestations at admission to PICU, length of stay, comorbidity and outcomes. Results: Severe course and complications of SARS-CoV-2 infection among 16 children for the one year cross period were reported. Comorbid conditions were noted in 62.5% children. The two deceased children had only anemia, which was not diagnosed before admission. The underlying conditions were: mental retardation,epilepsy, severe obesity, congenital brain malformations, cerebral palsy, congenital heart diseases, anemic, bronchopulmonary dysplasia, adrenoleukodystrophy, Down syndrome and subinfections such as acute herpetic encephalitis, salmonellosis, chronic hepatitis B. Four children have died due to acute respiratory failure (3) and pulmonary thrombosis (1). Indicators of activity of inflammation and coagulopathy did not differ in them from children who survived. Conclusions: Different comorbid states are associated with severe COVID-19 in children, but the data on specific conditions is limited. Knowledge of comorbid conditions in children that increase the risk of severe or critical course of COVID-19 allows to define the optimum measures of epidemiological control in such children and to modulate the therapy from the onset of the infectious disease. Children without underlying medical conditions may develop severe and critical COVID-19 and require additional supervision or medical attention. More clinical research should be done on pediatric population with critical and severe SARS-CoV-2 infection in other countries.