Наукові праці. Кафедра пропедевтики педіатрії
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Item Comorbidity and impact of bronchial asthma to gastroesophageal reflux disease in children(2024) Карпушенко, Юлія Валентинівна; Кarpushenko, Yuliia; Фролова, Тетяна Володимирівна; Frolova, Tetyana; Дробова, Надія Миколаївна; Drobova, Nadiia; Ащеулов, Олександр Михайлович; Ashcheulov, OleksandrGastroesophageal reflux disease (GERD) is a highly comorbid disease with bronchial asthma (BA). The relationship between GERD and BA is complicated and controversial. Aim: to analyze impact factors of BA and GERD in children with comorbid pathology for the further development of early diagnostic and preventive measures. Materials and methods. 81 children (aged 6 to 18 years) were involved in the study and divided into two groups: children with GERD and BA as a main group (n=27) and children with GERD and without allergy as a control group (n=54). The verification of diagnoses was carried out according to the unified clinical protocols of medical care. The results were processed using nonparametric statistical methods. Results. Esophageal motility disorders (EM) were detected in 100% of patients with BA, regardless of the severity. Inflammatory changes of the esophageal mucosa (EM) were equally frequently detected in patients with mild and moderate persistent BA, and were absent in patients with severe BA. GERD was diagnosed in 44.4% of patients with BA. 25.0% of patients had the erosive form of GERD, 25.0% — non-erosive GERD, 50.0% — endoscopically negative GERD, in the control group — 33.0%, 35.0%, 32.0% respectively. Conclusion. All patients with BA had esophageal motility disorders. GERD was diagnosed in 44.4%. Inflammatory changes of EM (erosive and non-erosive forms of GERD) were detected in 22.0% of patients with mild and moderate forms of BA, and in severe forms of BA — endoscopically negative GERD. The frequency of inflammatory changes reached 68.0% in the control group. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution indicated in the work. The informed consent of children's parents was obtained for conducting the studies. No conflict of interests was declared by the authors.Item Clinical report of Mediterranean fever in a child in Ukraine – Don’t miss it!(2024) Pashenko, К.Y.; Фролова, Тетяна Володимирівна; Frolova, Tetyana; Карпушенко Юлія Валентинівна; Кarpushenko, Yuliia; Muratov, G.R.; Savvo, О.М.; Khalturina, Т.О.; Ащеулов, Олександр Михайлович; Ashcheulov, OleksandrIntroduction. Familial Mediterranean fever (FMF) is a non-infectious genetic disease caused by a mutation in the MEFV gene. This disease is more common in people of Mediterranean or Middle Eastern descent, but can occur in any ethnic group, including those living European countries. FMF has typical clinical symptoms. Its long term without appropriate treatment the disease can lead to a violation of the child's physical development and result in the development of amyloidosis. The aim is to focus the attention of the medical community of Ukraine and inform European medical specialists on the FMF cases due to migration changes in Ukraine. This article presents a clinical case of FMF in a 4-year-old child who was admitted to our hospital with complaints of fever, abdominal pain, vomiting, and stool retention. Additional examination included: laboratory tests (complete blood count, urinalysis, biochemical blood test with determination of liver and kidney tests); instrumental methods: ultrasound examination of the abdominal organs and urinary system, X-ray examination of the abdominal organs with contrast. The results of additional tests revealed the signs of inflammatory process and impaired kidney function. When clarifying the family medical history, it was revealed that the older brother suffers from FMF (a mutation of the MEFV genotype was determined) and takes specific therapy (colchicine). The final diagnosis was determined: Acute strangulated intestinal obstruction Familial Mediterranean Fever (clinically). Peritonitis. Operative laparoscopic and conservative treatment was performed. The patient was discharged in a satisfactory condition with appropriate recommendations. Conclusions. The number of FMF cases in children have increased due to changes in the migration process in Ukraine. The relevance of this disease has increased. Taking into consideration a significant migration of population, the likelihood of an increase in the number of cases of FMF in European countries is increasing, which requires awareness among a wide range of doctors. In this report we have described a pediatric FMF case which was represented by recurrent episodes of fever, abdominal pain, impaired kidney function test results, and inflammatory markers. A determined mutation of the MEFV genotype in the brother of our patient makes the diagnosis of FMF unquestionable. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.Item Assessment of the prevalence of atopic dermatitis in children of Kharkiv city(2024) Karpushenko, Yuliia; Kozhyna, OlhaItem Досвід гібридного формату викладання освітнього компоненту «Догляд за хворими, практика» в сучасних умовах(2024) Фролова, Тетяна Володимирівна; Терещенкова, Ірина Іванівна; Дробова, Надія МиколаївнаItem The influence of atopy on cystic fibrosis course in children(2024) Drobova, Nadiia; Karpushenko, Yuliia; Servetnyk, AnzhelaThe course of cystic fibrosis (CF) depends on the influence of different modifying factors. One of these factors is atopy. The role of atopy in CF course is incompletely determined today and requires further study. The purpose of the study: to improve medical care for patients with CF by clarifying the pathogenetic role of atopy in the disease course. Materials and methods. Analysis of data from a clinical and paraclinical examination of 42 children with CF in the Kharkiv region. Patients were divided into two groups: with an elevated level of total immunoglobulin E (n=19) and with a normal level of this indicator (n=23) to determine the features of CF course depending on the atopy presence. Results and discussion. In the group with elevated and normal levels of total serum IgE, boys were predominant, as in the general population, and accounted for 73.6% and 60.8%, respectively. The first manifestations of CF were represented mainly by intestinal signs in both groups at 68.4% and 73.9% of cases, respectively. Data analysis of the clinical features of CF course in children with elevated level of IgE (severity of lung and liver lesions) revealed results without significant differences between groups. High level of sensitivity to ordinary domestic, food and pollen allergens was not detected in children of group with elevated level of IgE. Patients with CF and atopy were found to have a probable increase in the levels of CD3, IgM, spontaneous NBT; phagocytosis of latex; decreasing in the levels of CD4, IgA compared to the group with a normal level of total IgE. Conclusion. Features of the CF phenotype associated with the atopy were analyzed. The received data can be used when determining the treatment algorithm, taking into account the individual characteristics of the disease course.Item Tolerance and Safety of an Anti-Regurgitation Formula Containing Locust Bean Gum, Pre-, and Postbiotics: A Multi-Country Multi-Center Prospective Randomized Controlled Study in Infants with Regurgitation(2024) Klymenko, Viktoriia; Karpushenko, Yuliia; Salvatore, Silvia; Durczak-Hilleman, Maria; Loboda, Andrii; Petrashenko, Viktoriia; Olechowski, Wiesław; Lista, Gianluca; Meneghin, Fabio; Amodio, Sonia; Bongers, Anke; Ludwig, Thomas; Vandenplas, YvanThis multi-center prospective randomized controlled trial was a tolerance and safety study investigating the thickener locust bean gum (LBG) in infants with regurgitation, to support the re-evaluation of the safety of LBG in infant formula. The primary objective was to demonstrate that after an 8-week intervention, stool consistency was not inferior (i.e., was not looser or more watery) in infants fed an anti-regurgitation (AR) formula containing LBG vs. the stool consistency of infants fed with an unthickened control formula. A total of 103 full-term infants with regurgitation were randomized to the test or control formula. The test formula contained LBG (0.4 g/100 mL), short-chain galacto-oligosaccharides, and long-chain fructo-oligosaccharides (scGOS/lcFOS; 9:1; 0.4 g/100 mL) and postbiotics and the control formula contained scGOS/lcFOS (0.8 g/100 mL), the same amount of postbiotics, and did not contain LBG. The average stool consistency score at the 8th intervention week was the primary outcome parameter. Secondary outcome parameters were stool consistency at other timepoints, stool frequency, Infant Gastrointestinal Symptom Questionnaire (IGSQ) score, growth, (serious) adverse events ([S]AEs), regurgitation severity, and infant well-being. Overall, the infants were 36.9 ± 12.9 [mean ± SD] days old, 62.7% girls in the test, and 50.0% girls in the control group. The primary analysis showed that the test group did not have looser or more watery stools than the control group. IGSQ sum scores decreased comparably in both groups. The frequency of regurgitation was significantly lower in the test group compared to the control group (mixed model repeated measurement, p ≤ 0.028) and parent-reported well-being scores were favorable. Adequate growth was observed in both groups. Both products were well-tolerated and safe and the AR formula with LBG was efficacious in reducing regurgitation frequency. This study provides further evidence for the dietary management of regurgitation by LBG-containing formulae in infants who are not exclusively breastfed, and the reassurance it can bring to parents.