ORIGINAL INVESTIGATIONS
Introduction. Postnatal growth retardation in premature infants with very low birth weight (VLBW) remains an unresolved problem. There are different approaches regarding the duration of use of breast milk fortifiers during breastfeeding and specialized formulas during formula feeding, as well as the timing of the appointment of complementary feeding.
Objective: to evaluate the physical development and component body composition in VLBW infants, depending on nutritional support over the first year of life.
Materials and methods. The study included ninety three VLBW premature infants of 2 to 11 months postnatal age (PNA). The main (1st) group included infants (n = 74) who received dietary correction depending on the nutritional status, while no such intervention was performed in the (2nd) comparison group (n = 19). Up to 64 weeks of postconceptional age (PCA), weight, body length, and head circumference were assessed using INTERGROWTH-21st international growth standards, then in the software “WHO Anthro (2009)”. Fat and fat-free (lean) mass were determined using the air plethysmography method (PEA POD, LMi, USA).
Results. The analysis of the nutritional status revealed a moderate deviation, not exceeding 1 sigma, decrease in indices (Z-scores) of anthropometric indices in infants of the 1st and 2nd groups by PNA of 2–3 months. Further in infants of the 1st group on the background of prolonged use of fortified nutrition (breast milk fortifier or specialized formulas for preterm infants) and timely introduction of complementary foods, nutritional deficiencies throughout the first year of life in general were not revealed. In the 2nd group of infants without additional correction of nutrition by 4–5 months of age, the development of mild nutritional deficiency was noted by 6–7 months of age. By 6–7 months of age, it turned into moderate nutritional deficiency, which persisted until 8–9 months of age and then turned into mild nutritional deficiency. Analysis of the component body composition showed that during the observation period, the fat-free body mass (FFM) gain in infants in the 1st group was 3.40 kg, in Group 2 infants — 2.2 kg. At the same time, % body fat mass (FM) in infants in groups 1 and 2 had no significant differences (%FM 1 = 19.3 [15.3–22.5], %FM 2 = 19.9 [16.7–24.6], p = 0.769) and did not exceed the values characteristic of preterm infants.
Conclusion. A comprehensive assessment of the nutritional status of VLBW infants during the first year of life allowed us to evaluate the positive impact of long-term use of fortified diets and timely introduction of certain complementary foods. Optimization of nutrition made it possible to prevent the development of nutritional deficiency, which can have a significant positive impact on their further growth, development, and health status.
Contribution:
Pinaeva-Slysh E.L., Skvortsova V.A., Borovik T.E., Basargina M.A. — research concept and design of the study;
Pinaeva-Slysh E.L., Illarionova M.S. — collection and processing of material;
Pinaeva-Slysh E.L. — statistical processing;
Pinaeva-Slysh E.L., Skvortsova V.A., Borovik T.E. — writing the text;
Zimina E.P., Petrova A.S., Malyutina L.V., Lukoyanova O.L. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Сonflict of interest. The authors declare no conflict of interest.
Received: August 21, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Genetically engineered biological preparations (GEBP) are successfully used in various immunosuppressive diseases. Despite the effectiveness of GEBP, some patients experience primary non-response, as well as loss of effect from therapy. There is a need to objectively assess the effect of the therapy for its timely correction. The aim of the work was to determine the survival rate of GIBP depending on the form of pathology, drug, age, and immune indices in children with Crohn’s disease (CD), ulcerative colitis (UC), psoriasis (PS), multiple sclerosis (MS).
Materials and methods. Three hundred eighty three children (1394 observations) were examined in dynamics: 117 children with BC (treated by infliximab (IFX)/adalimumab (ADA), 83 children with UC (IFX/ADA), 87 children with PS (ADA), 96 children with PC (IFNβ1α) during the maintenance course therapy. Lymphocytes were immunophenotyped by flow cytometry with the determination of Treg (CD4+CD25highCD127low), Th17 lymphocytes (CD4+CD161+CD3+), succinate dehydrogenase (SDH) activity in Treg. Data processing was carried out using Statistica 16.0 application. Kaplan–Mayer survival curves are constructed. The significance of the differences between the groups was assessed using the Gehan–Wilcoxon criterion (p < 0.05).
Results. The survival rate of biological therapy in CD patients on IFX therapy is significantly higher than in children with UC — 161 weeks versus 135 weeks. There was no difference in CBT on ADA therapy between patients with CD and UC. The IBT index depends on the age of the patients: on IFX therapy (159 weeks) the best indices were in CD patients over 12 years. Combination therapy improves the survival of TNF blockers in patients with IBD (azathioprine) and PS (methotrexate). The survival of GIBP is influenced by the ratio of effector and regulatory cells (Th17|Treg) and the functional activity of Treg (SDH activity). A decrease in IBD was revealed in patients with IBD, PS, and MS with an increase in the Th17/Treg index above the age norm and a decrease in the activity of SDH in Treg below the norm.
Conclusion. The survival rate of biological therapy for immunosuppressive diseases in children depends on the form of pathology, the drug, the age of patients, previous therapy, combination therapy, as well as immune indices during the maintenance course. Monitoring of Th17/Treg and SDH activity in Treg may be an important laboratory criterion for the effectiveness of GIBP.
Contribution:
Radygina T.V., Petrichuk S.V. — research concept and design of the study;
Radygina T.V., Petrichuk S.V., Kuptsova D.G., Kurbatova O.V., Abdullaeva L.M., Freydlin E.V., Potapov A.S., Kuzenkova L.M. — collection and processing of material;
Radygina T.V. — writing the text;
Radygina T.V., Petrichuk S.V., Fisenko A.P., Kuptsova D.G., Kurbatova O.V., Potapov A.S., Murashkin N.N., Kuzenkova L.M., Semikina E.L. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 05, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Introduction. Necrotizing enterocolitis (NEC) is one of the common causes for abdominal surgery in newborns and infants over he first months of life with a high mortality rate (23.5%), increased in case of surgery to 67%.
Materials and methods. We compared premature (n = 25) and full-term (n = 22) newborns operated for NEC complications (laparotomy, resection of necrotized sections of the intestine, intestinal stoma). Also, we evaluated the results of treatment of infants with intestinal stoma after surgical NEC (n = 110, groups 1, 2 and 3).
Results. Full-term cases with congenital heart defects are at risk of surgical NEC (p < 0.05). Subtotal and total forms of NEC are associated with lethal outcomes up to 100% in both premature and full-term infants. It is necessary to preserve the ileocecal angle; length measuring of the remaining intestine along the mesenteric edge helps to predict further risks: 60 cm and less leads to 80–100% of post-resection short bowel syndrome.
Conclusion. NEC in full-term newborns is due to its hypoxic nature and impaired mesenteric perfusion (congenital heart defects). Surgical NEC can occur without typical symptoms (“covered perforation”), the discrepancy between the clinical and radiographic picture may indicate to subtotal or total intestinal necrosis with up to 100% of lethal outcomes.
Contribution:
Gurskaya A.S., Zorkin S.N., Dyakonova E.Yu. — research concept and design of the study;
Nakovkin O.N., Sulavko M.A., Karnuta I.V., Klepikova A.A., Piloyan F.S., Akhmedova D.M. — data collection and processing;
Bayazitov R.R. — statistical processing of the data;
Gurskaya A.S. — writing the text;
Ekimovskaya E.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 12, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Introduction. The correction potential of modern systems is limited by the natural mobility of scoliotic deformities, which sometimes require multiple discectomy and osteotomy. Choosing the optimal method of treatment for scoliosis in the thoracic and lumbar regions is difficult due to the variety of approaches and options available for osteotomies. There is no single algorithm for the treatment of idiopathic scoliosis, making it necessary to develop a differentiated approach and treatment strategies.
Purpose of the study. To optimize the choice of surgical treatment tactics for children with idiopathic scoliosis based on a comparative analysis of the use of one-stage and two-stage surgical treatment.
Materials and methods. The study subjects were ninety four patients with idiopathic scoliosis (Lenke type 1–4), operated on between 2017 and 2023. They were divided into three groups: group I (control) — 30 patients underwent one-stage dorsal correction with G1 osteotomy, group II — 31 patients who received two-stage treatment, and group III — 33 patients who underwent a one-stage correction with apical G2 osteotomy. Depending on the initial thoracic kyphotic angle, subgroups were defined as A (hypokyphosis), B (normokyphosis) and C (hyperkyphosis). The minimum follow-up period was 12 months.
Results. The frontal balance in all examined patients was in a state of relative compensation, both before surgical treatment and in the postoperative period. When comparing the results in patients from the second and third groups, we found no significant differences (p > 0.05). The second group showed a higher degree of correction of the main arch of spinal deformity (p < 0.05) in the frontal plane compared to the control and third group patients. When analyzing the results of thoracic kyphosis formation, we obtained reliable results in formation more significant indices in patients after surgery in Group II (subgroups A and B), for whom a two-stage applied surgical method was supplemented with anterior release and halo pelvic traction. In Group III (subgroup C), we obtained significant results in thoracic kyphosis indices when using single-stage surgery performed from the dorsal approach supplemented with G2 osteotomy.
Conclusion. The condition of the sagittal profile, including the severity of thoracic kyphosis, is an important criterion for choosing the tactics of surgical treatment of scoliotic deformities of the thoracic and lumbar spine. Two-stage treatment, including ventral release and halo-pelvic traction, is recommended for rigid deformities of the thoracic or thoracolumbar spine, under conditions of initial normal kyphosis or hypokyphosis. Severe deformities with initial hyperkyphosis should be corrected preferably in a single stage using posterior surgery, supplemented by G2-osteotomy. The use of G2-osteotomies in patients with initial normal- or hypokyphoses is impractical due to the risk of neurological complications, development of pseudoarthroses, and increase in volume of perioperative bleeding.
Contribution:
Samokhin K.A., Chelpachenko O.B. — concept and design of the study;
Pimbursky I.P., Butenko A.S., Davydov D.M., Davletgaleev G.T. — collection and processing of the material;
Sumenko V.V. — statistical processing of the material;
Samokhin K.A., Chelpachenko O.B. — writing the text;
Samokhin K.A., Chelpachenko O.B., Yatsyk S.P. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 14, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Introduction. Diffusion tensor imaging (DTI) is a technique that allows evaluating diffusion of water molecules along the myelin sheath of nerve fibers and obtaining information about the integrity of brain and spinal cord pathways. Obtaining reproducible values of diffusion parameters is an urgent and feasible task. The aim of this study was to establish the values of DTI parameters along the entire length of the spinal cord in healthy children for further use in the assessment of acute injury, its consequences and other spinal cord diseases.
Materials and methods. The study included fifteen healthy patients of 13 to 18 years, including 6 girls and 8 boys, average age was 15.2 ± 1.2 years. The study was performed on a Philips Achieva dStream 3T MRI scanner (Netherlands). As part of this study, a spine MRI protocol was developed to cover the entire volume of spinal cord with separate visualization of cervical and thoracic spine (duration: 9 min 48 sec). The IRIS ZOOM sequence (Philips) was used to obtain DTI images. Spinal Cord Toolbox software package was used to process the data. Statistical analysis was performed using GraphPad Prism software, and significance was determined at p < 0.05.
Results. Mapping and calculation of the following diffusion parameters: fractional anisotropy (FA), medial (MD), longitudinal or axial (AD) and transverse (RD) diffusion showed the average values of the parameters FA, AD, MD, RD of the spinal cord of children to be: FA, AD, MD, RD of spinal cord were: FA = 0.63 ± 0.06, AD = 2.1 ± 0.3 × 10−3 mm2/s, MD = 1.15 ± 0.16 × 10−3 mm2/s, RD = 0.68 ± 0.12 × 10−3 mm2/s. An increase in FA was detected at the Th2–Th9 level compared to the values at the C6–Th1 and Th10–Th12 levels. The AD coefficient at the Th2–Th9 level is increased relative to the C2–C5 and C6–Th1 levels. MD values in spinal cord areas at the Th2–Th9 and Th10–Th12 levels are statistically higher relative to higher levels of the spinal cord. RD values in the zone at the Th10–Th12 level are increased relative to all other areas.
Conclusion. The study established the diffusion indices of FA, MD, AD, RD of spinal cord in children aged 12 to 18 years and showed small differences between the spinal cord regions. The data obtained can be used as reference values for assessing spinal cord condition in various pathological processes (trauma, demyelinating and tumor diseases) in children for the corresponding age group.
Contribution:
Akhadov T.A., Bozhko O.V., Ublinskiy M.V. — research concept and design;
Bozhko O.V., Ublinskiy M.V., Kobzeva A.A., Melnikov I.A. — conducting research;
Bozhko O.V., Ublinskiy M.V., Voronkova E.V. — collection and analysis of data;
Ublinskiy M.V., Voronkova E.V. — statistical analysis;
Bozhko O.V. — writing the text;
Akhadov T.A., Ublinskiy M.V. — editing the text;
Akhadov T.A., Bozhko O.V., Ublinzkiy M.V. — approval of the final version of the article.
All co-authors — responsibility for the integrity of all parts of the article.
Acknowledgment. The study was supported by grant from the Moscow Department of Health No. 2112-9/22.
Conflict of interest. The authors declare no conflict of interest.
Received: September 27, 2024
Accepted: October 08, 2024
Published: November 12, 2024
PUBLIC HEALTH, MANAGEMENT AND SOCIOLOGY OF HEALTH CARE, MEDICAL AND SOCIAL EXAMINATION
Introduction. Determining the trajectory of a future career and understanding one’s occupational mission imposes responsibility on the life in the individual and society as a whole. Among many vocations, one of the most difficult, not only in terms of mastering, the need for constant updating of special knowledge, but also because of many moral and ethical aspects, is the occupation of a doctor.
The purpose of the work is to identify the leading factors of motivation for professional self-determination of pediatricians.
Materials and methods. One hundred six pediatricians practicing in Moscow, graduated from 35 medical universities of the country took part in the work. An online questionnaire was used for sociological analysis. The respondents were selected using the “snowball” method.
Results. Leading factors encouraging the choice of pediatrics as a an vocation were found to be the interest of the person himself in the profession (67%) and the opportunity to help people (19.8%). This indicates the psychological motives of a person in choosing a profession to dominate over social motives. The prestige of the profession and the influence of parents are not considered the main motives for choosing (4.7% and 2.8%, respectively). Most of the pediatricians surveyed (63.2%) are completely satisfied with their chosen profession, which indicates a conscious decision at the time of admission and a desire to develop further within the chosen vocation. Due to their own choice, 95.3% of respondents plan to work in pediatrics in the future. 64.2% of respondents see the main benefit for other people and society in improving children’s health.
Conclusion. The dominant motives of professional self-determination of pediatricians, determining the choice of a future specialty, are personal conscious goal-setting in choosing a medical vocation and the opportunity to help children. Working as a pediatrician guarantees a high degree of satisfaction from the chosen path and daily activities.
Contribution:
Antonova A.I., Shuraeva L.Yu., Komarova O.V. — concept and design of the study;
Antonova A.I. — data acquisition and analysis, statistical processing;
Antonova A.I., Shuraeva L.Yu. — writing the text;
Shuraeva L.Yu., Komarova O.V., Iontseva M.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 27, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Introduction. There is a risk of an exponential increase in the incidence of polio in the world, if there is a deviation from the current plan of measures to localize endemic areas of polio and until global eradication of the virus achieved. Routine immunization against polio and widespread vaccination is the main goal of the polio control strategy. There is currently no need to strengthen planned vaccination work in Russia to consolidate the results of the polio control program, as evidenced by the data of dynamic serological monitoring. Aim: Evaluate the level of seroconversion after administration of poliovaccine and the duration of protective antibody titer maintenance in children.
Materials and methods. A single-stage, single-center determination of the titer of antibodies to poliovirus types 1 and 3 was carried out using the neutralization method. There were studied 162 samples collected as part of the assignment from the Center of Hygiene and Epidemiology of the Republic of Buryatia (1.44% of the pediatric population of the children’s polyclinic): three groups of 1–2 years, 3–4 years and 15–17 years children. The average age in the group 1 was 1.64 ± 0.48 years, group 2 — 3.48 ± 0.54 years, and group 3 — 15.38 ± 0.67 years. Medical documentation was analyzed and compared: completed preventive vaccination cards (form 063/u) and preventive vaccination sheet in the child development card (form 112/u) for a complete collection children’s vaccination history.
Results. Deviations of vaccination dates from the current national calendar of preventive vaccinations noted in all age groups with a high frequency. In our analysis, 100% of children demonstrate the presence of protective antibodies to poliomyelitis types 1 and 3. The duration of preservation of neutralizing antibodies is 13.05 ± 0.94 years, with an average of 9–15 years.
Conclusion. The analyzed serological monitoring of postvaccinal immunity to poliomyelitis testifies to the high efficiency of the preventive work.
Contribution:
Balzhieva V.V., Khlebnikova L.A. — concept and design of the study;
Khlebnikova L.A. — data collection and processing;
Balzhieva V.V. — statistical processing of the data;
Balzhieva V.V., Khlebnikova L.A. — writing the text; editing the text, approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: August 14, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Introduction. Understanding children’s eating behaviour is crucial for promoting healthy nutrition. Objective. To assess the food preferences in schoolchildren.
Materials and methods. A mixed-mode survey was conducted in one hundred twelve 6 to 17 years schoolchildren, including 72 (70.5%) boys and 81 (72.3%) girl from Moscow. The average age was 12.23 ± 3.69 years (median = 13.0 years), with no significant age differences between genders (p = 0.855) or between Moscow and other regions (p = 0.690). The survey (α Cronbach = 0.891) included demographic and eating behaviour questions. Data were analyzed with SPSS using Spearman’s rank correlation, Mann–Whitney U test, Kruskal–Wallis test, and χ2 test, given the non-normal distribution of variables (p ≤ 0.001).
Results. Daily, 11 (9.8%) of the respondents eat vegetables, 14 (12.5%) eat fruits or berries, 18 (16.1%) have breakfast, and 87 (77.7%) consume sweets. Additionally, 62 (55.4%) often skip main meals due to sweets; 81 (72.3%) always have sweets at home; and 51 (45.5%) favour of fast food. Children in families where sweets are always available are more likely to skip main meals and breakfast, consume sweets, and prefer fast food, but eat vegetables, fruits, and healthy breakfasts less frequently (p ≤ 0.001). Daily sweet consumption is linked to lower fruit intake (p ≤ 0.001). Demographic characteristics did not impact food preferences (0.068 ≤ p ≤ 0.946). The highest index of correct eating habits, equal to 0.86, was in 2 (1.8%) children. There is no relationship between the number of correct eating habits and age (p = 0.379) and gender (p = 0.172). The criterion of “correct eating habits” is (p = 0.046) higher in Moscow schoolchildren than in children from the regions.
Conclusion. Unhealthy food preferences in children reflect parents’ non-compliance with healthy eating recommendations, which underscores the need for family initiatives in the field of healthy nutrition.
Contribution:
Miropolskaya K.Yu. — collection and processing of material, data analysis, writing the text;
Kochubey A.V. — concept and design of the study, data analysis, editing the text;
Vershinina M.G. — analysis of data obtained, editing the text;
Chernyakhovsky O.B. — data analysis, writing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 24, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Introduction. Conducting targeted epidemiological studies allows objectively characterizing the health status of the population.
Purpose of the work is to characterize current trends in the epidemiology of digestive diseases in children in the Udmurt Republic based on a special study.
Materials and methods. Survey of 2516 children of age 6–17 years: 6–14 years — 1,482, 15–17 years adolescents — 1,034. The study was continuous, all students of two secondary schools in Izhevsk. Stages: survey of schoolchildren (n = 2,516) and parents; clinical examination (n = 2,516); laboratory and instrumental examination in children suspected of having pathology of the digestive organs based on the results of stages I and II; IV — summing up and forming a group of children with proven pathology of the digestive organs (n = 1,141). Assessment of the reliability of differences in indicators based on Student’s t-test.
Results. The prevalence of gastroenterological diseases among all children does not have a gender component (p = 0.1). In the younger age group, girls and boys get sick with the same incidence. In adolescents, the prevalence of gastroenterological pathology in girls is higher than in boys (p < 0.001). The prevalence among boys of different ages does not have a statistical difference, and among girls of different ages, older schoolgirls are more often affected (p < 0.001). In the structure of pathology of the digestive organs in 6-17 years children dominated due to diseases of the stomach and duodenum. The prevalence of diseases of the hepato-pancreatic-biliary system and intestines was the same. The prevalence of digestive diseases is 453.5 ± 9.9 per 1000 subjects. The proportion of functional diseases is 9.9–96.7%, depending on age and the affected area of the gastrointestinal tract.
Conclusion. The true prevalence of digestive diseases exceeds official statistics. The structure is dominated by diseases of the gastroduodenal zone. Epidemiological features include an increase in the prevalence of pathology in girls of puberty. In children aged 6–14 years, functional diseases predominate; in children aged 15–17 years, the proportion of organic diseases increases.
Contribution:
Vikhareva E.G., Kovalenko T.V. — concept and design of the study;
Vikhareva E.G. — data collection and processing, statistical processing of the data, writing the text;
Kovalenko T.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: August 06, 2024
Accepted: October 08, 2024
Published: November 12, 2024
Aim. To study the association between family predisposition to gastrointestinal diseases with gastroesophageal reflux disease (GERD) in schoolchildren in ethnic populations of Tuva.
Material and methods. A total of one thousand seventy nine children (761 Mongoloid-Tuvinian and 318 Caucasian) aged of 7–17 years in the Republic of Tyva were examined. Anamnestic data and information on gastrointestinal complaints in schoolchildren were obtained. The diagnostic criterion for GERD was complaints of weekly heartburn. Statistical analysis was performed using the Pearson chi-square test.
Results. GERD children more often had anamnestic data on gastritis (p = 0.025), gastric ulcer (p = 0.039) and oncological diseases of the gastrointestinal tract (p = 0.052) in parents. At the same time, schoolchildren of the indigenous population with GERD manifestations had greater unfavourable conditions for a number of diseases in parents: gastritis (p = 0.01), gastric ulcer (p = 0.012). Whereas in Caucasians, a similar association was not established. The association between GERD in schoolchildren and gastrointestinal pathology in grandparents (2nd degree of kinship) also concerned only Tuvans in the presence of gastritis (p = 0.023). Summary data on family history of gastrointestinal diseases (1st and 2nd generation relatives) in GERD children, as expected, prevailed in Tuvans (gastritis (p = 0.004), peptic ulcer (p = 0.033) and specifically gastric ulcer (p = 0.02)). A more negative association between GERD in Tuvan children and a family predisposition to gastrointestinal diseases, in contrast to Caucasians, may be due to a higher prevalence of a number of gastrointestinal diseases in adults and is related with the functional features of the system, formed under the influence of the features of traditional life and nutrition.
Conclusion. In the Republic of Tyva, GERD in native schoolchildren is associated with a wide range of gastrointestinal diseases in relatives.
Contribution:
Polivanova T.V. — concept and design of the study, writing the text;
Polivanova T.V., Vshivkov V.A., Ahmetshin T.N. — data collection and processing;
Vshivkov V.A., Ahmetshin T.N. — statistical processing of the data;
Polivanova T.V., Vshivkov V.A. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 11, 2024
Accepted: October 08, 2024
Published: November 12, 2024
REVIEWS
Introduction. A review of the current literature on the features of the diagnosis of myocarditis in children is presented. Myocarditis is an acute or chronic inflammatory myocardial disease characterized by a variety of clinical manifestations, nonspecific symptoms and physical data. With insufficient number of informative diagnostic tests, there is a challenge for practitioners at all stages of medical care. Aim of the review is to comprehensively present the features of the clinical diagnosis of myocarditis in children. The presence of myocarditis should be assumed in situations where children, regardless of the age, first developed symptoms of heart failure (HF), as well as in the presence of a clinic of viral infections accompanied by respiratory or abdominal symptoms, combined with the development of tachycardia, hypotension or cardiac arrhythmias, even in the absence of cardiomegaly. Myocarditis should be clinically suspected at the stage when the necessary decisions should be made about the patient’s routing, the formation of a complex of diagnostic examinations and the start of therapy. Magnetic resonance imaging (MRI) of the heart is today the non-invasive gold standard for the diagnosis of myocarditis that allows detecting myocarditis within 2–3 weeks after the first symptoms appear. Endomyocardial biopsy can be used for accurate morphological diagnosis of myocarditis in children. Molecular biological and genetic studies that determine the severity and outcome of the disease are important for the diagnosis of myocarditis in children.
Conclusion. Based on the literature data and own experience in diagnosing myocarditis, the authors have developed an original diagnostic algorithm to make the right medical decision in case of suspected acute myocarditis in children.
Contribution:
Vasichkina E.S. — concept and design of the study;
Vasichkina E.S., Balykova L.A., Basargina E.N., Bregel L.V., Degtyareva E.A., Kovalev I.A., Kotlukova N.P., Leontyeva I.V., Yakovleva L.V., Groznova O.S. — collection and processing of material;
Vasichkina E.S., Kovalev I.A., Kotlukova N.P., Leontyeva I.V. — writing the text;
Balykova L.A., Basargina E.N., Bregel L.V., Degtyareva E.A., Yakovleva L.V., Groznova O.S. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 12, 2024
Accepted: October 08, 2024
Published: November 12, 2024
CLINICAL CASE
Introduction. Doubling of the urinary tract is a common developmental anomaly (0.8–1.0%). With complete doubling, vesicoureteral reflux (VUR) is detected in 66-72%, mainly in the lower segment. The aim of the work is to optimize the surgical treatment of VUR with doubling of the urinary tract by endoluminal plasty of the ureteral mouths and reimplantation of the ureter.
Materials and methods. In a 13-year child, a laparoscopic longitudinal intravesical ureterocystoneoimplantation technique was used in conditions of ureteral length deficiency and a proximal intervertebral anastomosis was applied.
Results. With the doubling of the urinary tract, a number of patients experience a recurrence of VUR, which determines the need for repeated reconstructive surgery. We present a clinical case of successful surgical treatment of recurrent VUR in both segments of a doubled kidney in a 13-year child. In the treatment, the technique of laparoscopic longitudinal intravesical ureterocystoneoimplantation was successfully applied in conditions of ureteral length deficiency and a proximal intervertebral anastomosis was applied.
Conclusion. The performed surgical intervention meets the requirements of efficiency and safety and can be used in conditions of ureteral length deficiency in patients with recurrent VUR after previously performed reconstructive operations.
Contribution:
Sharkov S.M., Shmyrov O.S. — concept and design of the study;
Margieva D.A. — collection and processing of the material;
Margieva D.A., Sharkov S.M. — writing the text; Margieva D.A., Sharkov S.M., Shmyrov O.S., Kulaev A.V., Surov R.V., Lazishvili M.N., Kozyrev G.V., Morozov K.D., Kovachich A.S., Lobach A.Yu. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 20, 2024
Accepted: October 08, 2024
Published: November 12, 2024
ANNIVERSARY
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