Кафедра пропедевтики педіатрії № 2
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Item Congenital immunodeficiency disorders in the pediatric practice(2022) Lupaltsova, Olga; Drobova, Nadiia; Servetnyk, AnzhelaIntroduction. Congenital immunodeficiency disorders are genetic pathology that affect the immune system function and is important problem of modern medicine.Material and methods. This dates are performed the clinical case of the child with congenital complement deficiency. Results. Patient was diagnosed with allergic skin symptoms (atopic dermatitis, eczema), persistent bacterial infections of the upper and lower respiratory tract, late teething, diarrhea, chronic diseases of the gastrointestinal tract. That signs were manifestations of immunodeficiency states. During clinical and paraclinical examination the following data was detected in immunological blood test: decreased levels of CD3+-lymphocytes, CD3+CD8+-cytotoxic lymphocytes, CD19 +-lymphocytes. Gene panel of boy identifies one pathogenic variant in С8B (c. 1282C>T (p.Arg428*)), heterozygous, one pathogenic variant in C3 (c.2402C>T (p.Thr801Met)), heterozygous, which is associated with autosomal recessive and dominant. Uncertain significance variants were detected. Genetic signs in family members were also detected. Conclusion. Genetic testing for identifying of congenital defects is very important in primary immunodeficiency diagnostic process.Item Patients examination and semiotics of children disease : workbook for the third-year students of the medical university(2021) Karpushenko, YuliiaНавчальний посібник (робочий зошит) може бути використано студентами для самостійної підготовки домашніх завдань і для роботи на практичних заняттях з дисципліни "Пропедевтика педіатрії". Робочий зошит містить скорочену інформацію за темами занять, таблиці, малюнки, схеми, які треба заповнити інформацією, необхідною для об’єктивного обстеження пацієнта і діагностики симптомів захворювань. Зміст відповідає вимогам навчальної програми з підготовки спеціаліста за спеціальністю 7.120101" Лікувальна справа "Item Allergic rhinitis symptoms prevalence In children of Kharkiv(2021) Klymenko, Viktoriia; Karpushenko, Juliia; Drobova, Nadiia; Kozhyna, OlgaThe purpose of the study was to identify the prevalence of allergic rhinitis (AR) symptoms in children of Kharkiv and to establish the dynamics of symptoms since 1998. The study conducted in 2015–2017 is phase IV of the international ISAAC program. 5735 children were interviewed, including 3238 children aged 6–7 years and 2197 children aged 13– 14 years. The incidence of non-cold-related sneezing was found in 14.7 % and 16.1 %, respectively; during the past 12 months similar problems with nose breathing were noted in 9.1 % and 9.9 %; accompanied by conjunctivitis – in 3.4 % and 4.8 % of children of 6–7 and 13–14 years, respectively. Most patients had seasonal exacerbations and mild/moderate rhinitis. AR diagnosis was verified in 12.2 % and 11.3 % of children, respectively. Decreasing of AR symptoms prevalence was found in children of all ages. The dynamics of AR symptoms prevalence, "eye" symptoms over the past 20 years show a probable decrease in all indicators, which can be explained by the widespread introduction in medical practice of screening methods for the disease diagnosing, activation of primary and secondary prevention.Item Methods for constructing estimated two-factor linear regression models for diagnosing the severity of bronchial asthma in children(2021) Pihnastyi, Oleh; Kozhyna, OlgaObjectives: Prognostication of bronchial asthma severity in children by means of two-parameter regression models building. Methods: A clinical study of 70 children with bronchial asthma diagnosis of 6 to 18 years old was done.142 factors were analyzed and a degree of relationship among them was revealed. Single-factor regression models were used during preliminary experimental data processing. Results: The correlation connection between the value observed and the factors under research was revealed. The method of two-parameter linear models with a fair accuracy was developed. Conclusion: The suggested method of approximate two-parameter linear regression models can be used for preliminary analysis of medical research data where the value observed depends on a big number of loosely connected factors.Item Causes of uncontrolled bronchial asthma among children in Kharkiv region(2021) Klymenko, Viktoriia; Piontkovska, Oksana; Kulik, TetianaBronchial asthma (BA) is one of the most common chronic diseases, according to WHO statistics in 2018, there were about 334 million patients worldwide, and 14% of them were children. BA among children reduces the quality of life, is one of the main reasons for skipping school days, can be a cause of disability and sometimes death. The aim of the work was to improve the uality of life of children with asthma by improving disease control. 50 children with asthma were examined. The study included a study of complaints of the patient and his parents, medical history, the results of clinical and laboratory and instrumental examinations. The main reason for the lack of control among children with asthma is the violation of the algorithms of basic therapy.Item Prevalence of Bronchial Asthma Symptomatic Manifestation among Children of Kharkiv(2019) Klymenko, Viktoriia; Kozhyna, Olga; Zemlianskyi, KonstantinThe aim of the work was to improve the diagnosis of bronchial asthma (BA) in the pediatric population by revealing the current prevalence of symptoms using an epidemiological method and identifying trends in the prevalence of symptoms since 1998. The study was performed in 2017 in Kharkiv. The standardized method of the International Study of Asthma and Allergy in Childhood (ISAAC) was used. The volume of the sample was calculated according to the formula for sample population determining and ensures the representativeness of the data obtained (Lisitsin Y.P., 1987), which amounted to 5434 children. 3374 parents of children 6–7 years old and 2552 children 13–14 years old were surveyed; in total 5926 students, which accounted for 97% of the total number of uestionnaires distributed. The standardized ISAAC questionnaire contains 8 questions about the symptomatic manifestations of BA. The percentage of positive responses in children 6-7 years old was analyzed; the results are presented for 2017, 2002 and 1998, respectively. 1. The presence of ever wheezing (wheezing) in the past (the first question of the ISAAC questionnaire) was found in 13.8%; 19.4% and 24.1% of children, respectively. 2. "Wheezing" was observed in the last 12 months in 6.6%; 12.5%; 12.2%. 3. More than three episodes of "wheezing" in the past 12 months were found in 0.9%; 2.5% and 2.3%. 4. Sleep disturbance from "wheezing" one or more nights a week during the last 12 months occurred in 1.9%; 1.3% and 1.4%. 5. Speech was limited to wheezing during the last 12 months in 0.5%; 1.7% and 1.5%. 6. The presence of asthma in the history was noted in 1.5%; 6.8% and 5.5%. 7. "Wheezing" in chest during or after exercise during the last 12 months was at 2.0%; 10.4% and 4.6%. 8. Dry cough at night (not associated with a cold or inflammatory diseases) over the past 12 months was noted at 6.9%; 13.7% and 11.9% of children. The percentage of positive answers to 8 questions of the ISAAC questionnaire in children 13-14 years was analyzed. The results are presented on issues for 2017, 2002 and 1998 respectively: 1. - 9.9%; 29.6%; and 25.3%. 2. - 3.4%; 20.9% and 12.9%. 3. - 0.4%; 2.5% and 1.2%. 4. - 0.6%; 1.1% and 0.8%. 5. - 0.5%; 2.3% and 1.9%. 6. - 1.6%; 5.5% and 6.1%. 7. - 2.8%; 20.6% and 13.2%. 8. - 4.6%; 19.3% and 12.1%. The obtained results and the dynamics of prevalence are analyzed in comparison with both average and individual data for different regions and countries of the world. The current prevalence of respiratory symptoms in children of Kharkiv was revealed in 15.9% (10.1% in the younger school age, 5.8% in the adolescent age). The trends to reduce both the prevalence and severity of BA manifestations in the region over the past 20 years have been identified. Attention is focused on the low level of diagnosis of BA.Item Fractalkine as a Severity Marker of Atopic Dermatitis in Infants and Toddlers(2018) Klymenko, Viktoriia; Oleksandr, Mykhailovych; Vуsotska, Olena; Pecherskaya, GannaIntroduction: Atopic dermatitis (AD) is a common chronic inflammatory skin disease. The aim of the studywere the relationship determining between level of serum fractalkine and clinical signs of AD; and establishing correlation between the level of serum fractalkine and paraclinical signs of AD (total Ig E level, immunogram value). Material and methods:60 children with clinical manifestations of AD in the exacerbation period of the disease (main group) and 16 healthy children without chronic diseases (control group) took part in the clinical study. Results: The study showed that the serum fractalkine level is elevated in all forms of AD severity: mild – 8.55 (6.11–10.79) ng/ml, moderate – 10.97 (5.61–14.01) ng/ml, severe – 12.53 (9.01–16.68) ng/ml. It was also estab-lished that serum fractalkine levels correlate with the overall assessment of the AD severity on the SCORAD scale, total intensity of all lesions, erythema, excoriations, itching and sleep disturbances (p< 0.05). Direct cor-relation of fractalkine level count with neutrophil count (27 [24–71] p< 0.05), and vice versa – with the number of lymphocytes (61.5 [26–70] p< 0.05) was uncovered when analyzing serum fractalkine levels and paraclinical criteria. The study found a connection between the serum fractalkine levels and immune indicators as well: inter alia the probable reduction of CD3, CD16, Ig G and the probable increase of CD4, CD22, CD25 and Ig E. Conclusion: Fractalkine can be used as an objective severity marker for acute phase of AD.Item Features of Cystic Fibrosis Course in Children Depending on Interleukin-4 Gene Mutation(2018) Drobova, NadiiaCystic fibrosis (CF) course features depend not only on the difference in CF transmembrane conductance regulator gene mutations, but also onother gene modifiers. Interleukin-4 (IL-4) gene is a one of gene modifiers. The aim of the present study was to improve medical care for patients with CF by clarifying the pathogenic role of IL-4 gene polymorphism in the course of the disease. The study involved examination of 42 children with CF and 54 practically healthy children as control group. Patient examination was carried out by the standard methods in the remission period. Determination of C589T polymorphism of IL-4 gene was carried out using polymerase chain reaction inreal time. DNA was isolated from buccal epithelium cells. Patients with IL-4 gene mutation (C589T) were characterized by more frequent primary manifestation of the respiratory signs, Staphylococcus aureus predominance within respiratory pathological microorganisms, the incidences of bronchiectasis and lung fibrosis, more severe liver lesions, elevated total serum immunoglobulin E level, elevated levels of the CD25 lymphocytes, circulating immune complex and reduced immunoglobulin A levels. The data demonstrate features of CF phenotype associated with IL-4 gene polymorphism.