The Role of Growth Factors (VEGF, TGF-β1) and Cyclic Guanosine Monophosphate in the Formation of Pulmonary Hypertension in Children with Bronchopulmonary Dysplasia

In 82 children with bronchopulmonary dysplasia (from 1 to 36 months of corrected age) we investigated the level of VEGF, TGF-β1 in blood and cyclic guanosine monophosphate (cGMP) in sputum. It was revealed that children with bronchopulmonary dysplasia had a significant increase in TGF-β1 (p < 0.05) and cGMP (p < 0.01–0.001), reduced VEGF (p < 0.05), indicating inhibition of angiogenesis, activation of fibrosis factors and endothelium-dependent vasodilation. Reliable direct dependence of activation of TGF-β1 in blood and cGMP in sputum, as well as inverse correlation between VEGF in blood and rLA had been proved, which gave reason to think of pulmonary hypertension as an adverse factor in fibrosis activation and angiogenesis inhibition in children with bronchopulmonary dysplasia. Reduced oxygen saturation and oxygen partial pressure moderately activated cGMP, but did not provide a sufficient reduction of pressure in the pulmonary artery

Cystatin C — an Early Marker of Renal Damage in Children with Diabetes Mellitus Type 1

Purpose: study of cystatin C as an early marker of renal damage in children with diabetes mellitus (DM) type 1. Methods. We examined 83 patients with diabetes mellitus type 1. Depending on the duration of the disease, patients were divided into 3 groups: 1st — with DM duration of 1–2 years, 2nd — 2–5 years, 3rd — more than 5 years after the onset of the disease. The control group consisted of 10 healthy children. Results. The maximum values of glomerular filtration rate, reflecting the phenomenon of intraglomerular hypertension, had been observed predominantly among patients of 2nd and 3rd groups. Stable and diagnostically significant (≥ 30 mg/day, III stage diabetic nephropathy) microalbuminuria has been detected in patients with diabetes duration more than 5 years. In patients of all groups in some cases significant microalbuminuria has been detected, but average indices were close to diagnostically significant. Increased excretion of glycosaminoglycans has been noted in 75 % of patients in the first group, 53.8 % — second group and in 52.1 % of patients in the third group of observations. There was a significant difference of cystatin C concentration in the urine of children with DM from the first group and the control group (p =0.03), between patients in second group and the control group (p = 0.003), between patients in third group and the control group (p = 0.003). Significant variability of this parameter was observed in children with DM duration of 1 to 2 years. The highest cystatin C median in urine was recorded in children from second group, which indicates a stable lesion of tubular apparatus of the kidney already in the second year of DM course. Moderate negative correlation was observed between Dopplerographic parameters of renal blood flow and cystatin C level, i.e. with an increase in cystatin C excretion, depletion of blood flow in main arteries is being detected. Conclusions. 1. Kidney damage in DM has been observed on the first year of the disease, with dominance of dysfunction of tubular apparatus, and cystatin C is a highly informative and stable early marker of renal dysfunction. 2. Early kidney damage in children with type 1 DM is diagnosed when cystatin C level is above 21.9 ± 1.4 ng/ml. 3. Additional symptoms for early kidney damage are increased excretion of glycosaminoglycans, hypoperfusion at renal main arteries, reduced glomerular filtration rate

Якість життя дітей після оперативного лікування коарктації аорти

The questionnaire study outcomes of children after surgical correction of aortic coarctation are presented in the article. Factors influencing the patients' quality of life after surgical treatment of congenital heart disease are identified.Objective: to evaluate the quality of life in children after surgical treatment of aortic coarctation.Materials and methods. In total 36 children aged from 6 to 15 years after surgical treatment of aortic coarctation were interviewed. The English version of the Pediatric Quality of Life Inventory™ 3.0 Cardiac Module (PedsQL Cardiac Module) was used to assess the quality of life.Results. In 68.88% of cases children considered their life to be full, 27.77% (10 patients) incomplete, 8.33% (3 patients) found it difficult to answer. All patients noted the physical activity limitation by doctors and parents; 52.77% of respondents emphasized the communication problems and psychological difficulties; in 41.66% of cases, the children reported overprotection by their parents; in 33.33% of cases, there was an arterial hypertension; 27.77% of respondents reported about deterioration of the general sense of well-being, 25.00% of patients had learning difficulties due to congenital heart disease.Conclusions. Despite the satisfactory surgical treatment outcomes, the patients noted a decrease in their quality of life due to various factors. The most significant were as follows: disturbance in well-being, physical activity limitation, constant control by parents, the need for medical treatment and regular visits to doctors.В статье представлены результаты анкетирования детей после хирургической коррекции коарктации аорты. Определены факторы, влияющие на качество жизни пациентов после оперативного лечения врожденного порока сердца.Цель: оценить качество жизни пациентов после хирургической коррекции коарктации аорты.Материалы и методы. Проведено анкетирование 36 детей после оперативного лечения коарктации аорты. Для оценки качества жизни использовали вариант английской версии опросника Pediatric Quality of Life Inventory™ 3.0 Cardiac Module (PedsQL Cardiac Module).Результаты. 68,88% детей считали свою жизнь полноценной, 27,77% (10 чел.) — неполноценной, 8,33% (3 чел.) затруднялись ответить. Все пациенты отмечали ограничение физической активности врачами и родителями; 52,77% опрошенных подчеркивали наличие проблем коммуникабельности и психологические трудности; 41,66% констатировали гиперопеку со стороны родителей; в 33,33% случаев имела место артериальная гипертензия; у 27,77% респондентов отмечалось нарушение самочувствия, у 25,00% пациентов отмечались трудности в обучении, обусловленные наличием врожденного порока сердца.Выводы. Несмотря на удовлетворительные результаты проведенного оперативного лечения у пациентов отмечалось снижение качества жизни за счет различных факторов. Наиболее значимыми были: нарушение самочувствия, ограничение физической активности, постоянный контроль со стороны родителей, получение медикаментозного лечения и необходимость регулярного посещение врачей.У статті представлені результати анкетування дітей після хірургічної корекції коарктації аорти. Визначено фактори, що впливають на якість життя пацієнтів після оперативного лікування вродженої вади серця.Мета: оцінити якість життя пацієнтів після хірургічної корекції коарктації аорти.Матеріали і методи. Проведено анкетування 36 дітей після оперативного лікування коарктації аорти. Для оцінки якості життя використовували варіант англійської версії запитальника Pediatric Quality of Life Inventory™ 3.0 Cardiac Module (PedsQL Cardiac Module). Результати. 68,88% дітей вважали своє життя повноцінним, 27,77% (10 пацієнтів) — неповноцінним, 8,33% (3 пацієнта) не змогли відповісти. Усі пацієнти відзначали обмеження фізичної активності лікарями і батьками; 52,77% опитаних підкреслювали наявність проблем комунікабельності та психологічні труднощі; 41,66% констатували гиперопеку з боку батьків; у 33,33% випадків мала місце артеріальна гіпертензія; у 27,77% респондентів відмічали порушення самопочуття, у 25,00% пацієнтів були труднощі у навчанні, зумовлені наявністю вродженої вади серця.Висновки. Незважаючи на задовільні результати проведеного оперативного лікування, у пацієнтів констатовано зниження якості життя за рахунок різних факторів. Найбільш значущими були: порушення самопочуття, обмеження фізичної активності, постійний контроль з боку батьків, необхідність отримання медикаментозного лікування і регулярного відвідування лікарів

The Role of the ECG in the Prediction of the Formation of Chronic Pulmonary Heart Disease in Children with Bronchopulmonary Dysplasia

We observed 130 patients aged 1 to 36 months with a diagnosis of bronchopulmonary dysplasia (BPD). It is found that children with bronchopulmonary dysplasia have tachycardia (p 10 mm (F-2.8; lambda Wilks –0.827, p 6.5 mm (F-1.01; lambda Wilks –0.809, p < 0.05)

Topical Issues of Child Disability in Terms of Healthcare Reform

The article presents an analysis of disability in children from Kharkiv region for 5 years. In the structure of child disability, the dominant is congenital abnormality, second one — diseases of the nervous system, third one — endocrine pathology. We have identified problems and prospects for improving medical care providing for children with disabilities and ways to reduce the disability of the child population

Arteriohepatic Dysplasia (Alagille Syndrome) in a Child (Clinical Case)

The article presents a clinical case of a child with a rare nosology — Alagille syndrome. Among the causes of neonatal cholestasis, Alagille syndrome is ranked second, it occurs with an incidence of 1 per 70,000 of newborns. This syndrome is characterized by an insufficient number or by a small dia­meter of intrahepatic bile ducts, which carry bile from the liver. Alagille syndrome includes a combination of at least three of the five main symptoms: chronic cholestasis, cardiovascular defects, abnormalities of the spine, eye defects, typical craniofacial signs. The only definitive therapy with the formation of liver cirrhosis and without gross defects is liver transplantation