Modern Pediatrics. Ukraine

Medical prevention of respiratory-synchitic viral infection in the present and future

2025-03-05T23:54:31+02:00

Respiratory syncytial virus (RSV) is one of the most common respiratory viral agents and the main cause of lower respiratory tract infections in children and the elderly that have an unfavorable outcome. Unfortunately, current national recommendations for the treatment of patients with RSV infection (RSVI) are limited mainly to pathogenetic and symptomatic therapy. Instead, scientists are focusing on the development of new drugs that inhibit the activity of various viral proteins and surface receptor molecules of respiratory tract epithelial cells.

Aim - to provide an overview of the main current and future strategies for RSVI prevention.

The drug prophylaxis of RSVI, which is recommended in the form of passive and active immunization, is highly effective. Passive immunization is recommended for children, while vaccination is mainly indicated for pregnant women and the elderly. For passive immunization in children, medications containing recombinant monoclonal RSV-neutralizing antibodies, such as palivizumab and nircevimab, are used. Palivizumab is administered intramuscularly once a month throughout the RSV season. At the same time, nirsevimab requires only a single injection to achieve the preventive effect. The duration of the preventive effect of nirsevimab is due to the modification of the mAb molecule, which significantly increases the half-life of the mAb. For children in the first six months of life whose mothers were vaccinated during pregnancy, it is recommended to be vaccinated with Abrisvo vaccine during the period of increased incidence of RSVI. For the prevention of RSVI in the elderly, it is recommended to use Arexvie and Abrisvo vaccines, and for pregnant women - the bivalent subunit Abrisvo vaccine. It is believed that the introduction of new RSVI preventive strategies will significantly reduce both the incidence of the disease and the risk of adverse outcomes from this infection.

The authors declare no conflict of interest.

Raynaud's phenomenon: a modern view of the problem

2025-03-06T00:14:36+02:00

Raynaud's phenomenon (RP) is present in almost all patients with systemic connective tissue diseases and is often the first clinical manifestation of the disease, preceding skin and organ involvement several years later.

Aim - to study and analyze available data regarding the prevalence, risk factors for development, clinical features and diagnosis of RF based on an analysis of modern literature data.

Raynaud's phenomenon is quite common in the general population (about 5%), and is usually caused by cold exposure or significant changes in temperature (primary RF). There are primary and secondary RF. In both primary and secondary RF, the typical episode is characterized by the sudden appearance of cold fingers (or toes) coupled with sharply limited changes in skin color (white) due to restricted blood flow, followed by cyanotic skin color (blue), indicating on tissue hypoxia. During rewarming, the ischemic phase (white or blue attack) usually lasts 15-20 minutes. After recovery, the skin turns red, which leads to reperfusion erythema. To establish a diagnosis, blue-white changes are usually necessary. In patients with highly pigmented skin, skin changes may be more visible on the palmar surface of the fingers.

Conclusions. Despite the significant prevalence of RF, it is extremely difficult to establish its exact prevalence, especially in the pediatric population. If RF is suspected, the doctors should pay attention not only to changes in the color of the extremities, but also to swelling and telangiectasia in the patient during examination and medical history. Despite the absence of a “gold standard” for diagnosing RF, nail fold capillaroscopy is recognized as the main method for diagnosing RF today.

The authors declare that there is no conflict of interest.

Modern methods of treatment and rehabilitation of children with autism

2025-03-06T00:29:48+02:00

Autism (Autism Spectrum Disorder (ASD)) has many symptoms and can vary quite widely from complete asociality and atrophy of the speech apparatus to increased sensitivity, vulnerability, and inability to cope with problems, and this, accordingly, is a huge medical and social problem that requires significant efforts to solve. As we live in an era of various technologies that occupy the main place in the development of modernity, particularly in medicine, doctors are finding new methods of treating various diseases, even such as ASD. Therefore, the topic of the work is the use of stem cells and effective methods of rehabilitation for children with ASD, which proves to be quite relevant at present.

Aim - through a systematic literature review, to investigate the effect of stem cells on ASD treatment and determine effective correction methods.

The article presents data on the use of stem cells and their influence on brain areas that cause ASD. It contains data about children with ASD worldwide and in Ukraine. The concept of ASD is described, which human conditions are characteristic of ASD when it is better to use experimental methods in treatment, what are the advantages of stem cells, and the positive results that occur with the use of stem cells. Methods suitable for effective and efficient correction of ASD are also described.

Conclusion. The use of any method for the correction or treatment of ASD must correspond to the individual development of the child. Since there is currently no therapeutic method capable of curing ASD, people with this condition have to follow a special diet, undergo medication treatment and various therapies, but they are not able to completely cure ASD. Correctional methods remain the only way to ease the life of people with ASD.

No conflict of interest was declared by the authors.

Analysis of medical support and health of children in Ukraine during the war

2025-03-04T23:21:37+02:00

In the context of the Russian Federation's aggressive war against Ukraine, children are the most vulnerable group for maintaining the viability of society, forming the foundations of development and defense capabilities of the state.

Aim - is to analyze and evaluate the main indicators of medical care and health of children during martial law.

Materials and methods. A retrospective analysis of the main indicators of medical care and health of children in Ukraine during martial law was conducted. The methods of systematic approach, bibliosemantic, comparative analysis, and statistical data processing were used.

Results. The analysis of medical care and children's health under martial law showed a reduction in resources for medical care for children - 3 regional and 7 city children's hospitals were liquidated, 2701 pediatric beds were reduced, 849 pediatricians (loss rate 8.1% and 10.9%), decreased access to medical care for children in terms of reduced number of visits to doctors (6.31 per child per year in 2021 and 5.25 in 2023, loss rate 16.85%), and coverage of children with preventive examinations (95.03 and 89.9%). A significant negative impact of racist aggression on certain determinants of children's health has been proven - an increase in the incidence of children in the first year of life (1,256.97‰ and 1,496.55‰, growth rate 16.43%), the incidence of all forms of active tuberculosis in children (7.9 per 100 thousand children and 11.1), primary disability of children (20.5 per 10 thousand children and 25.0). The study was conducted with a limited set of indicative indicators, which is due to the impossibility of obtaining general statistics for the period of martial law.

Conclusions. The study confirmed the hypothesis of destabilization of medical care for children and deterioration of their health during martial law.

The authors declare that there is no conflict of interest.

Assessment of National infection prevention and control program in 2018-2023 at the national level: analysis of trends and priority directions of improvement

2025-03-04T23:39:06+02:00

The Implementation of Key Components of an Infection Prevention and Control (IPC) Program at the national level is designed to support countries and health care institutions in developing and strengthening IPC programs and strategies to prevent healthcare-associated infections (HAI). In order to comprehensively assess the implementation of IPC programs at the national level, the World Health Organization developed the Infection Control Assessment Tool (IPCAT2). The objective of IPCAT2 is to provide technical assistance to countries to determine which core components of IPC are implemented, as well as to identify gaps or weaknesses in the key components of IPC

Aim - is to conduct a comparative assessment of the national IPC program at the national level in Ukraine.

Materials and methods. In order to assess the implementation of key components of the IPC program in Ukraine, IPCAT2 was used and the national program was assessed in 2018, 2021 and 2023 by analyzing existing regulatory and technical documents.

Results. The assessment of the national IPC program at the national level in Ukraine demonstrated the strengthening of the national program from 17.5% in 2018 to 59.8% implementation in 2023. According to the results of the assessment in 2023, the implementation of the IPC Program was 96% of the recommended indicator, the implementation of the IPC Guidelines - 56%, the IPC Education and Training component - 38%, Epidemiological surveillance for HAI - 73%, IPC Multimodal strategies - 63%, IPC Monitoring and feedback - 33%. The greatest progress is noted in the implementation of the national IPC program, IPC guidelines and the implementation of multimodal approaches. The least implemented aspects are education, training and monitoring of IPC.

Conclusions. The IPC program assessment with the IPCAT2 tool is a useful tool for optimizing and strengthening IPC at the national level. The assessment helped to form priority areas for the development of the IPC program in Ukraine.

The author declares no conflict of interest.

Characteristics of bronchial asthma in children during the war in Ukraine

2025-03-04T23:48:22+02:00

Aim - to study the features of the course of bronchial asthma (BA) in children during the war in Ukraine.

Materials and methods. A retrospective analysis of medical records was conducted for 145 children aged 5-17 years diagnosed with BA of varying severity from 2014 to May 2024. All children were divided into two groups: before the start of the war (Group I, n=72) and after the start of the war (Group II, n=73). The following parameters were analyzed: gender, age, BA phenotype, severity of BA, level of BA control, number of exacerbations per year, sensitization profile, basic therapy, and presence of comorbidities.

Results. Among the children in the Group II, there was a significantly higher frequency of severe BA cases (23% compared to 11%), with corresponding basic therapy using inhaled corticosteroids and long-acting beta-agonists (ICS/LABA) (30% compared to 14%), an increased number of patients with the mixed phenotype (60% compared to 44%) and comorbid BA (97% compared to 86%), as well as patients sensitized to more than 7 allergens (11% compared to 0%).

Conclusions. The study results demonstrated a worsening of the course of BA in children during the war in Ukraine, which may be associated with psycho-emotional stress, delayed access to medical care, and the negative impact of environmental pollution. This necessitates further scientific research to study the risk factors related to the war in Ukraine.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interest was declared by the authors.

Possibilities of logistic regression analysis in building a prognostic model of personal risk assessment of the development of osteopenic syndrome in children with juvenile idiopathic arthritis

2025-03-05T00:11:15+02:00

Osteopenic syndrome (OS) is one of the possible complications of the course of juvenile idiopathic arthritis (JIA) in children. The issue of development and clinical implementation of an individual methodology for the definition of prognostic criteria for objective quantitative assessment of the risk of developing osteopenia in children with JIA is relevant and requires further clarification. The logistic regression, which is used to predict and estimate the probability of an observation belonging to one or another gradation of a qualitative characteristic, can be useful for creating effective predictive models.

Aim - to evaluate the prognostic significance and informativeness of some clinical indicators with the selection of the most optimal potential factors within the framework of the development of a mathematical equation for calculating the personal probability of osteopenia in a patient with JIA and the construction of an adequate, convenient for use in practical medicine prognostic model.

Materials and methods. The results of clinical, anamnestic and laboratory-instrumental data of 50 children with JIA (average age - 13.0 (11.0; 16.0) years) were analyzed. Laboratory research methods, in addition to general clinical ones, included the determination of 25 hydroxyvitamin D level, parathyroid hormone, osteocalcin, bone alkaline phosphatase (ostease), the marker of bone resorption β-Cross Laps in blood serum. The bone mineral density was assessed using ultrasound densitometry.

Results. Two prognostic models of OS risk in patients with JIA were created based on logistic regression analysis taking into account the most informative predictors. The models have high-quality operational characteristics in terms of sensitivity, specificity, and diagnostic (prognostic) effectiveness.

Conclusions. The developed prognostic models can be used in clinical pediatrics for personal assessment of the degree of risk of developing osteopenic syndrome in children with JIA, selection of high-risk groups and prevention of possible complications.

No conflict of interest was declared by the authors.

Zinc levels in children with community-acquired pneumonia: a comparative study in the context of SARS-CoV-2 infection

2025-03-05T00:26:57+02:00

It has been proven that a deficiency of zinc, can significantly weaken the body's immune response to infection. Zinc plays a key role in many immunological processes, such as the proliferation and differentiation of lymphocytes, antibody synthesis, and phagocytosis.

Aim: to assess the dynamics of zinc levels in pediatric patients with community-acquired pneumonia, taking into account the presence or absence of SARS-CoV-2 co-infection in the acute phase of the disease and the recovery period.

Materials and methods. The study included 114 children aged 6 to 18 years. The Basic group consisted of 81 patients diagnosed with community-acquired pneumonia, divided into subgroups based on the presence or absence of SARS-CoV-2 co-infection. The Control group consisted of 33 healthy children matched by age and gender. Zinc levels in serum were determined for all children. The results of the study were processed using Microsoft Excel 2013.

Results. All children in the Basic group had decreased serum zinc levels in both the acute phase and convalescent periods. Children with severe community-acquired pneumonia, regardless of viral infection, showed only a slight increase in zinc levels with standard treatment. A significant decrease in serum zinc levels was found in all children with pneumonia compared to the Control group. Patients with SARS-CoV-2 demonstrated a more pronounced zinc deficiency compared to those with pneumonia of other etiologies. During treatment, a gradual increase in zinc levels was observed in all patient groups.

Conclusions. The study revealed a decrease in zinc concentration in children with community-acquired pneumonia, both during the acute phase and during the convalescent period of the disease. Patients with SARS-CoV-2 infection had significantly lower zinc levels compared to children without detected coronavirus.

The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Ethical Committee for all participants in the process. The informed consent was obtained from children and parents for participation.

No conflict of interests was declared by the authors.

Medical and psychological aspects of health formation in school-age children under the influence of social priorities

2025-03-05T00:53:20+02:00

The influence of social priorities on the health formation of school-aged children is increasing in wartime conditions, making its study of significant theoretical and practical importance for improving the functioning of the healthcare system.

Aim - to investigate the characteristics of health formation in school-aged children under the influence of issues caused by social priorities.

Materials and methods. A randomized controlled study was conducted on 1,100 patients aged 7-18 years from general education schools and gymnasiums. The study examined the dynamics of disease formation in children under the influence of established social priorities (children's attitudes toward education, work, family, and society) within the educational process. Data collection and processing were performed using the automated project system Universal Online, version 43.1.

Results. Data analysis from PubMed and Cochrane Library confirmed a strong relationship between schoolchildren’s health and social factors. A negative correlation between the number of healthy children and social problems (-0.72) indicates that improving health reduces social difficulties. A positive correlation between morbidity and social problems (0.91) confirms their interconnection. A strong correlation between the younger and middle age groups (0.97) suggests similar disease influences, while a moderate correlation between the older group (0.49-0.44) is associated with age-related changes. Linear regression analysis showed that for every increase of one healthy child, the average number of children with social problems decreases by 0.4276.

Conclusions. A strong connection between children's health and their social priorities has been established. Health improvement contributes to reducing social problems, enhancing adaptation, and academic success. The increase in morbidity and social challenges requires a comprehensive approach involving doctors, psychologists, teachers, parents, and public institutions. Considering age-specific factors is crucial for effectively supporting children’s health and social well-being.

No conflict of interest was declared by the authors.

Determination of activity impairment and participation of children with cerebral palsy in the formation of an individual rehabilitation program

2025-03-05T01:09:12+02:00

The main cause of children's disability is cerebral palsy (CP), which leads to varying degrees of impaired activity and functioning of children. The early intervention program (ER) for up to 4 years, that is, an individual rehabilitation program for up to 4 years, contributes to improving the functional capabilities of the child and reducing the risk of secondary complications in children with CP.

Aim - to conduct a comparative analysis of impaired activity and functioning of children with spastic forms of cerebral palsy, depending on the availability of RV services for children under 4 years of age.

Materials and methods. The study involved 105 children aged 4-14 years, divided into two groups: Group A (43 children who received EI) and Group B (62 children who did not). Assessment was conducted using standardized international classifications.

Results. Children of group A had significantly lower values and there was a statistically significant difference in the indicators of such concomitant conditions with CP, such as: nutritional disorders (p=0.018), orthopedic complications (p=0.001). Also, in the children of group A compared to group B, lower values were observed in such categories as: pain and discomfort (67.4% versus 80.6%), quick fatigue (65.1% versus 74.2%), violations language (69.8% versus 75.8%). In the categories: hearing impairment (p=0.744), visual impairment (p=0.984) and epileptic seizures (p=0.469) statistically significant differences between groups were not found.

Conclusions. An individual rehabilitation program within the framework of the EI service from birth to 4 years has a positive effect on the prevention of secondary complications in children with CP, contributing to the improvement of their functioning, performance of activities and participation of children with CP.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.

Personalized treatment and prophylactic strategies in pediatric patients from the Ukrainian familial hypercholesterolemia registry: a comprehensive study

2025-03-05T21:57:16+02:00

Familial hypercholesterolemia (FH) is a genetic disorder characterized by elevated low-density lipoprotein (LDL) levels, increasing the risk of premature cardiovascular disease. Personalized treatment strategies tailored to pediatric FH patients offer promising solutions for effective management.

This study aimed to develop and evaluate a personalized treatment and prophylactic program focused on managing lipid levels and reducing cardiovascular risks in children with FH.

Materials and methods. The study included 15 children aged 5-18 years diagnosed with FH. A comprehensive evaluation was conducted, assessing anthropometric data, dietary profiles, and compliance, quality of life, and physical activity energy expenditure (PAEE). An extended lipid profile analysis included ApoA1, ApoB, lipoprotein(a), and dp-ucMGP levels. Cardiovascular risks were evaluated using instrumental assessments. Patients were divided into age groups, and personalized interventions were implemented - medical nutrition therapy, pharmacotherapy (statins, Omega-3 fatty acids, ezetimibe), and lifestyle modifications. Statistical analysis was performed using SAS® OnDemand for Academics.

Results. A stepwise diagnostic and therapeutic algorithm for managing children with pediatric dyslipidemia was developed. Logistic regression analysis revealed statistical significance in personalized interventions, with a positive β coefficient of 1.34. The odds ratio for statins was 3.82, indicating that their inclusion increased the likelihood of achieving target LDL-C levels by nearly fourfold. PAEE showed a trend toward influencing LDL-C achievement.

Conclusions. Personalized treatment strategies, combining dietary correction and targeted pharmacotherapy, effectively improved lipid profiles and reduced cardiovascular risks in children with FH. Significant external factors impacting LDL-C targets were identified. This study highlights the importance of individualized approaches in pediatric FH care and underscores the need for further research.

This research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethical Committee. The informed consent was obtained from all participants.

No conflict of interest was declared by the authors.

Dynamics of the incidence and prevalence of autism spectrum disorders in childhood in Ukraine

2025-03-05T22:18:51+02:00

Аim - is to analyze the dynamics of the incidence and prevalence of autism spectrum disorders (ASD) per 100,000 children in Ukraine in the period 2008-2020 and to forecast these indicators until 2025.

Materials and methods. A retrospective analysis of the reporting data of the Public Health Center of the Ministry of Health of Ukraine in the period 2008-2017 and of the Institute of Forensic Psychiatry of the Ministry of Health of Ukraine in the period 2018-2020 was carried out. Incidence and prevalence rates per 100,000 child population (0-17 years) were calculated, and the availability of medical geneticists in Ukraine per 1 million population was determined. Calculations of prognostic indicators in 2025 have been carried out. Calculations were performed in the MedCalc® Statistical Software package (v.22.009).

Results. In Ukraine, in the period 2008-2020, a reliable trend towards an increase in the prevalence of ASD almost 10 times from 13.82 per 100,000 to 146.03 per 100,000 and the incidence rate from 2.28 to 22.15 per 100,000 of the child population was revealed. A reliable increase in these indicators is predicted by 2025. The number of cases of ASD among urban residents is significantly higher than among urban residents (75.36% versus 24.64%). However, a significant increase in the proportion of ASD cases among rural residents is predicted in 2025. Regional features of the prevalence and morbidity indicators in Ukraine were revealed. The highest incidence rate was found in Kyiv (26.27 per 100,000) and the lowest - in Luhansk region (23.50 per 100,000). The existence of a negative reliable relationship between prevalence and morbidity indicators with the supply of genetic doctors per 1 million population, with the number of visits to them, with the share of primary patients examined and with the share of families registered for the first time was established.

Conclusions. In Ukraine, a significant increase in the prevalence and incidence of ASD among the children's population is predicted until 2025, one of the reasons for this increase may be a decrease in access to medical and genetic counseling due to a decrease in the supply of genetic doctors.

No conflict of interests was declared by the authors.

Frequency of development of emotional disturbances in school-aged children with various somatoform disorders

2025-03-05T22:57:59+02:00

In recent years, the problem of diagnosis and treatment of somatized autonomic dysfunction in children has become extremely important due to its high prevalence and propensity for a cyclical, long-term course.

Aim - to investigate the frequency of the development of affective states in children with various somatoform disorders depending on the age, gender of the children, and their place of study.

Materials and methods. 380 school-age children were examined, of which 11.8% were of primary school age (6-9 years), 54.7% of early adolescence (10-14 years) and late (15-18 years) adolescence age - 33.5%. Personal anxiety was studied using the Spielberg-Khanin method, and the spectrum of depressive disorders using the M. Kovacs (1992) childhood depression questionnaire. The probability of differences was assessed using the Student’s two-sample t-test. Values were considered probable p<0.05.

Results. Personal anxiety was found in all children (100%) with cardio-respiratory and pain and non-specific somatoform disorders, somewhat less often in children with somatoform disorders from urinary system (82.8%) and functional gastrointestinal disorders disorders (81.1%). Depression was most often diagnosed in children with pain and non-specific somatoform disorders (55.2%) and in children with respiratory somatoform disorders (53.6%). It is much less common from the side of the cardiovascular system (27.7%).

Conclusions. Functional gastrointestinal disorders (37.6%) and cardio-respiratory disorders (31.8%) are the most common in school-age children; somewhat less frequently, somatoform disorders from the urinary system (15.3%) and painful and non-specific disorders were found among the examined children. somatoform disorders (15.3%). In the vast majority of children, somatoform disorders were associated with affective states. Anxiety of varying degrees of severity occurred with the same frequency in individuals of different sexes, while depressive disorders were significantly more common in girls and in children of younger adolescence (10-14 years).

The research was conducted in accordance with the principles of the Declaration of the Helsinki. The research protocol was approved by the ethics committee for all participants. Parents’ informed consent was obtained for the research.

The authors declare no conflict of interest.

Features of the course of perinatal period in children with bronchial asthma. Analysis of comorbid pathology

2025-03-05T23:21:53+02:00

The formation and course of bronchial asthma are associated with risk factors of the perinatal period. When analyzing the morbidity of the examined patients, it was noted that almost all children had concomitant pathology represented by acute respiratory viral infections (ARVİ), diseases of ENT organs, iron-deficiency anemia, diseases of the endocrine, kidney and urinary systems, infectious and parasitic diseases, as well as concomitant allergopathology.

The aim of the study is to study the peculiarities of the course of perinatal period in children with bronchial asthma and to analyze the comorbid pathology in these children.

Material and methods. To solve the set tasks, 983 children with several episodes of bronchial obstruction in the anamnesis, who were subsequently diagnosed with bronchial asthma of varying severity, were included in the study. There were also 116 children under observation with a diagnosis of acute bronchitis with bronchial obstructive syndrome. These children formed the comparison group. The analysis of variance F-Fisher and nonparametric Wilcoxon U-criterion and Kruskel-Wallis criterion were used for comparison and probabilistic evaluation of differences between the values of the compared groups.

Results. We took into account the following criteria: the course of pregnancy in mothers of the examined children, the obstetric and gynecological history of mothers. When analyzing concomitant pathology, it was found that infectious and helminthic-parasitic diseases were most frequently observed in children with bronchial asthma - in 516 (52.5±1.6%) cases.

Conclusion. The results of the study showed that various perinatal pathologies are more often diagnosed in mothers of children with both moderate bronchial asthma and concomitant allergic rhinitis, in children with severe asthma and do not occur in the group of children with mild persistent disease. In general, concomitant diseases were significantly more common in children with severe bronchial asthma compared to mild and moderate (p<0.05).

Analysis of pathogens of hospital-acquired infections in the pediatric department of intensive care

2025-03-05T23:36:45+02:00

The problem of nosocomial infections and antibiotic resistance has acquired particular relevance and has medical, socio-economic importance.

Aim - to investigate the microorganism spectrum and prevalence of nosocomial infections (NI) pathogens in the pediatric intensive care unit (PICU) and to determine the association between NI and mortality in PICUs patients.

Materials and methods. A retrospective analysis of 101 case histories of children aged (1 month - 18 years) of the PICU of hospital N from 2019 to 2021. Strains from various loci were studied (sputum, swabs from the throat and nose, blood, urine, feces, cerebrospinal fluid (CSF), pleural fluid, central venous catheter (CVC), culture from a wound, navel, ear, secretions of scrotum) were studied. Microorganisms were identified by traditional methods on the basis of their morphologic, cultural, and biochemical properties. According to international diagnostic standards, 49 patients among 101 hospitalized ones were diagnosed with NI. The research results were statistically analyzed using the Microsoft Excel 2010 spreadsheet program and IBM SPSS Statistic version 22.

Results. Ps. aeruginosa was identified significantly more often than Kl. pneumonia - 39.9% (n=153) of patients compared with 27.7% (n=106). Patients with NI are 1.6 times more likely to be infected with Ps. aeruginosa than Kl. pneumonia. Kl. pneumonia infection was significantly more frequent in patients than Candida alb. - 27.7% (n=106) compared with 13.6% (n=52). However, infection with Candida alb. was significantly more common than Methicillin-resistant Staphylococcus aureus (MRSA) - 13.6% (n=52) compared with 6.5% (n=25). Patients with NI are twice as likely to be infected with Candida alb. than MRSA. Fatal cases were found significantly more often in 18.4% (n=9) of patients with NI.

Conclusions. Gram-negative microorganisms prevailed 26 times in the examined patients with HIV from different locales - 70.5% (n=270) of samples to gram-positive - 13.3% (n=53). The prevalence of Ps. aeruginosa, Kl. pneumonia and Candida alb. was significantly higher than in European countries

The authors declare no conflict of interest.

Rare cases of Peutz-Jeghers syndrome in children

2025-03-06T00:51:05+02:00

Peutz-Jeghers syndrome is a genetic disease in which hamartomatous polyps of the gastrointestinal tract are detected, which leads to an elevated risk of developing colon cancer and other organs.

Aim: to determine the possibility of early diagnosis of Peutz-Jeghers syndrome in children.

The authors of the article present their clinical observations of patients with Peutz-Jeghers syndrome who were treated at Odesa Regional Children’s Clinical Hospital. Retrospectively, over the past 20 years, according to the data of the Odesa Regional Children’s Clinical Hospital, 2 patients with Peutz-Jeghers syndrome who were admitted to the hospital with acute abdominal syndrome were observed. The first case was a 5-year-old boy, who operated for the first time on ileoileal intussusception, resection of the small intestine with an end-to-end anastomosis. The second case was a 15-year-old girl, who operated on ileoileal intussusception, intestinal necrosis, peritonitis, and omentitis. Peitz-Jeghers syndrome was diagnosed after the first interventions.

Conclusions. Multiple polyps of the digestive tract are one of the causes of iron-deficiency anemia resistant to treatment with iron preparations, which requires the exclusion of Peutz-Jeghers syndrome. Abdominal pain syndrome in children requires a thorough family history, determination of phenotypic signs, and the appointment of a full clinical and instrumental examination. The suspicion of primary care physicians to the detection of phenotypic visual sign is a way to early diagnosis of possible Peutz-Jeghers syndrome; when detecting polyps of the digestive tract in a child during an endoscopic examination with histological examination of the removed polyp and the presence of phenotypic extraintestinal signs of Peutz-Jeghers syndrome.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the author.

Modern approach to the treatment of cystic fibrosis in children

2025-03-06T01:12:27+02:00

Cystic fibrosis is the most common monogenic pathology with an autosomal recessive type of inheritance. The frequency of carriers of the cystic fibrosis gene is 3-4%. The disease leads to damage to the respiratory system, pancreas, intestines, gallbladder, and liver, and can lead to electrolyte loss and the development of diabetes mellitus. In Ukraine, 250-300 children with cystic fibrosis are born every year. Their average life expectancy is 13-14 years. As of 2024, there are 16 children with cystic fibrosis in the Ternopil region.

Aim - to analyze and present clinical cases of cystic fibrosis in children, to investigate the features of the course and treatment of cystic fibrosis in children using the example of two clinical cases and to evaluate the effect of the three-component drug Tricaft (ivacaftor + tezacaftor + elexacaftor) on the course of the disease.

Literature search of scientific publications and study of inpatient charts of two patients who were inpatients in the gastroenterology department were conducted.

Clinical cases. The charts of inpatients and genetic confirmation of two patients diagnosed with cystic fibrosis were studied. In the first case, a boy, 12 years old, is treated annually on an outpatient and inpatient basis. It is known that the first patient was treated with the three-component drug Tricaft with the active ingredient elexacaftor, tezacaftor and ivacaftor. The second case is a boy, 16 years old, who did not receive the three-component drug in his treatment. In both cases, a comparative analysis of clinical manifestations was carried out and the course of the disease was assessed.

Conclusions. In children with cystic fibrosis with pancreatic insufficiency, in parallel with the intestinal tract damage, damage to the bronchopulmonary system is noted with varying degrees of severity of functional and clinical manifestations.

Clinical manifestations and complications from the side of the systems of lesions in cystic fibrosis worsen with age.

Taking drugs that moderate the CFTR receptor reduce the severity of clinical symptoms from the side of the bronchopulmonary system in children with cystic fibrosis, which is manifested in violations of the lowest degree of severity of the functions of the cardiovascular and bronchopulmonary systems.

The study was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the children's parents was obtained for the research.

No conflict of interests was declared by the authors.