CABINET OF A HEALTHY CHILD IN THE CONTEXT OF HEALTH CARE REFORM

One of the key tasks of the children’s polyclinic is the prevention of childhood diseases. This issue is devoted to many studies, which  unfortunately suggest a weakening of preventive positions in recent years. Increase level requirements for the provision of primary  health care for children’s population and priority prevention areas leads to the increase of the role of the room of a healthy child, and  necessitates changes in the organization of work and equipping of this unit.  Based on the existing laws and regulations and modern ideas about the key role of a room of healthy child in the preventive work  and maintenance of children’s health, we have developed and submitted proposals on optimization of work of this department  of the children’s clinic

THE PARATHYROID HORMONE LEVEL AND ITS CORRELATION WITH THE SUPPLY OF VITAMIN D IN EARLY CHILDHOOD

The literature data and the finding of our studies on the analysis of the correlation between the level of parathyroid hormone and supply of vitamin D of children (n=107) of early age are presented in the article.The serum level of vitamin D in the analyzed group of children was 24.8 [17.6–32.5] ng/ml, the median of the parathyroid hormone  was 21.0 [12.3–25.5] pg/ml. It has been established that children with optimal supply of vitamin D have significantly lower parathyroid hormone levels vs. the children with vitamin D insufficiency (25 (OH) D from 20 to 30 ng/ml) and deficiency (calcidiol values  below 20 ng/ml). The correlation between the level of vitamin D and parathyroid hormone was r=-0.18, p=0.035.The best supply of vitamin D was found in children of the first year of life – 25 (OH) D concentration was 29.95 [16.2–40.3] ng/ml.  The parathyroid hormone level (16.5 [10.7–23.8] pg/ml) in these children was reliably lower (p=0.05) vs. the children of the second  and third years of life. A positive correlation was established between the age of patients and the parathyroid hormone level (r=0.2,  p=0.05). Preventive doses of vitamin D were received by 42.1% of children. The blood serum concentration of 25 (OH) D in them  was higher (32.7 ng/ml), and the parathyroid hormone level was significantly lower (14.9 pg/ml) vs. the children who did not receive  cholecalciferol preparations (p<0.05).The obtained results demonstrate a strong correlation between vitamin D deficiency and the increased parathyroid hormone level that reflect  the importance of these hormones in the regulation of calcium-phosphorus metabolism and the opposite role in bone tissue calcification

EFFICIENCY OF PREVENTION AND MANAGEMENT OF VITAMIN D DEFICIENCY IN YOUNG CHILDREN IN RUSSIA DEPENDING ON THE REGION OF RESIDENCE (BASED ON THE RESULTS OF RODNICHOK-2 STUDY)

Medical examination of 360 children from four regions of Russia (Moscow, Astrakhan, Stavropol, Kazan) showed significant regional differences in the sufficiency and compensation of vitamin D deficiency at the baseline (Day 0) and established factors associated with vitamin D sufficiency on Day 0. The established interregional differences in vitamin D levels were not due to insolation, but primarily to adequate vitamin D supplementation received at the baseline. Vitamin D supplementation (an average of 894 ± 632.6 IU/day) significantly reduced the risk of vitamin D deficiency (RR 0.15, 95% CI 0.09–0.26, P = 5.7 x 10–14). The study included the analysis of factors associated with the increase in 25(OH)D levels during the administration of Aquadetrim, identification of predictors of patient’s response and the analysis of identified predictors. The most important factor determining the patient’s response was the dose of vitamin D taken by the patient: 25(OH)D levels increased by 1 ng/ml with an increase in the dose of vitamin D by 90 IU per day. As can be seen from the above, the study results indicate that the vitamin D deficiency requires a long-term preventive therapy (for at least several months) with adequate doses of vitamin D (1000–2000 IU/day)