Approaches to the surgical treatment of congenital clubfoot in children

Background. The clubfoot is a severe deformity of the foot. The birth rate of children with congenital clubfoot is 0.1–0.4 %. Since the end of the 1980s, when the technique of I. Ponseti gained worldwide recognition, early conservative treatment using staged plaster casts has been the main feature. The effectiveness of this technique reaches 93 % and can significantly reduce the number of surgical interventions. However, delayed treatment, the absence or non-compliance with the mode of wearing braces, concomitant neurological pathology lead to a decrease in the effectiveness of conservative treatment and the use of surgery. The objective of the study is a retrospective analysis of the results of applying our surgical method for congenital clubfoot in children. Materials and methods. From 2009 to 2017, 87 children (57 boys (78 feet) and 30 girls (37 feet)) with congenital clubfoot were treated surgically in the orthopaedics and trauma unit of National Children Specialized Hospital “OHMATDYT”. During the study, we have taken into account the age, sex, type of deformity, volume of surgical intervention, immediate results of surgical treatment (up to 1 year), frequency of relapses. Sixty seven patients (83 feet) were operated for the first time, and in 20 children (32 feet), surgical treatment was repeated. The average age of patients was 4.5 years. Results. The immediate results of treatment (1 year after the operation) were good in 65 patients (74.7 %), satisfactory — in 14 (16 %) and unsatisfactory — in 8 (9.3 %). Two (2.3 %) patients had elements of excessive correction of deformity, which was manifested by pronation with valgus deformity of the heel. Relapses manifested by the appearance of one of deformity elements were detected in 8 (9.2 %) cases. The main their causes were non-compliance with the recommendations at the stages of rehabilitation (6 patients) and postoperative complications (2 patients). Conclusions. Immediate results of treatment (1 year after surgery) indicate the correctness of our approach for surgical reconstruction of the foot in patients with clubfoot

Cu6- And Cu8-Cage Sil- And Germsesquioxanes: Synthetic and Structural Features, Oxidative Rearrangements, and Catalytic Activity

This study reports intriguing features in the self-assembly of cage copper(II) silsesquioxanes in the presence of air. Despite the wide variation of solvates used, a series of prismatic hexanuclear Cu6 cages (1-5) were assembled under mild conditions. In turn, syntheses at higher temperatures are accompanied by side reactions, leading to the oxidation of solvates (methanol, 1-butanol, and tetrahydrofuran). The oxidized solvent derivatives then specifically participate in the formation of copper silsesquioxane cages, allowing the isolation of several unusual Cu8-based (6 and 7) and Cu6-based (8) complexes. When 1,4-dioxane was applied as a reaction medium, deep rearrangements occurred (with a total elimination of silsesquioxane ligands), causing the formation of mononuclear copper(II) compounds bearing oxidized dioxane fragments (9 and 11) or a formate-driven 1D coordination polymer (10). Finally, a "directed"self-assembly of sil- and germsesquioxanes from copper acetate (or formate) resulted in the corresponding acetate (or formate) containing Cu6 cages (12 and 13) that were isolated in high yields. The structures of all of the products 1-13 were established by single-crystal X-ray diffraction, mainly based on the use of synchrotron radiation. Moreover, the catalytic activity of compounds 12 and 13 was evaluated toward the mild homogeneous oxidation of C5-C8 cycloalkanes with hydrogen peroxide to form a mixture of the corresponding cyclic alcohols and ketones.

Cu₆- And Cu₈-Cage Sil- And Germsesquioxanes: Synthetic and Structural Features, Oxidative Rearrangements, and Catalytic Activity

This study reports intriguing features in the self-assembly of cage copper(II) silsesquioxanes in the presence of air. Despite the wide variation of solvates used, a series of prismatic hexanuclear Cu6 cages (1-5) were assembled under mild conditions. In turn, syntheses at higher temperatures are accompanied by side reactions, leading to the oxidation of solvates (methanol, 1-butanol, and tetrahydrofuran). The oxidized solvent derivatives then specifically participate in the formation of copper silsesquioxane cages, allowing the isolation of several unusual Cu8-based (6 and 7) and Cu6-based (8) complexes. When 1,4-dioxane was applied as a reaction medium, deep rearrangements occurred (with a total elimination of silsesquioxane ligands), causing the formation of mononuclear copper(II) compounds bearing oxidized dioxane fragments (9 and 11) or a formate-driven 1D coordination polymer (10). Finally, a "directed"self-assembly of sil- and germsesquioxanes from copper acetate (or formate) resulted in the corresponding acetate (or formate) containing Cu6 cages (12 and 13) that were isolated in high yields. The structures of all of the products 1-13 were established by single-crystal X-ray diffraction, mainly based on the use of synchrotron radiation. Moreover, the catalytic activity of compounds 12 and 13 was evaluated toward the mild homogeneous oxidation of C5-C8 cycloalkanes with hydrogen peroxide to form a mixture of the corresponding cyclic alcohols and ketones

CHRONIC APPENDICITIS AS AN UNDERLYING CAUSE OF CHRONIC RECURRENT ABDOMINAL PAIN IN CHILDREN

3120 patients with recurrent paroxysmal abdominal pain were registered in the clinic in the past 3 years. 138 patients aged 7–15 didn't reveal any pathologic changes in the abdominal and pelvic cavities. Clinically, all patients demonstrated paroxysmal attacks of local abdominal pain lasting for a time between 6 months and 4 years. Clinical examination and ultrasound scans gave evidence to link the abdominal pain (syndrome) with changes in appendix as the only cause of it. All 138 patients underwent laparoscopy with total abdominal and pelvic cavities revision. No other pathology but significant macroscopic changes of appendix has been found in all cases, so it has been appraised as a macroscopic sign of chronic inflammation. Morphologic studies of excised appendices has demonstrated the signs of chronic inflammation in all cases.Key words: chronic appendicitis, recurrent paroxysmal abdominal pain, ultrasound scan, laparoscopy, chronic inflammation

Status of child population health — the future of the country (part 1)

The article of the team of scientists of pediatricians and organizers of pediatric health care of Ukraine is devoted to the study of the main trends in the health status of children over last 22 years. The results of the analysis of the incidence and prevalence of diseases among Ukrainian child population, infant mortality rates over the past two decades demonstrates that they remain significantly higher than the average European indicators against the background of a progressive decrease in the number of child population at 3,16 million people. The prevalence of childhood diseases in Ukraine over past 22 years has grown by 41 %, the incidence of childhood diseases arose by 36 %. The article considers the ways of solving a number of new social and medico-ecological problems that negatively affect child health