COVID-19 and new-onset type 1 diabetes mellitus: case in an adolescent patient

During the COVID-19 pandemic was found a significant increase in diabetic ketoacidosis and severe ketoacidosis at diabetes diagnosis in children and adolescents. Underlying causes may be multifactorial and reflect reduced medical services, fear of approaching the health care system, and more complex psychosocial factors (Kamrath C., Mönkemöller K., Biester T., 2020). During the COVID pandemic, a surge in pediatric type 1 diabetes mellitus cases appears to be occurring, potentially due to the presence of autoantibody-induced immune dysregulation triggered by COVID-19 (Nielsen-Saines Karin, et all., 2021)

Signs of inflammation in the airways in children with exercise induced bronchial asthma

The study basing on examination of 102 children with bronchial asthma defines indices of inflammatory activity in the airways and sets the diagnostic value of these indices as tests for verification exercise-induced bronchial asthma. The children with no signs of exercise-induced asthma compared to patients having them, were shown to experience some changes in the exhaled breath condensate, indicating a higher activity of inflammation in the airways. The content of nitrogen monoxide metabolites less than 50 mcmol/L or markers of proteolytic activity by azocol lysis less than 0.2 ml/hour in pulmonary expiration products increase the chances of having exercise-induced bronchial asthma phenotype with these tests sensitivity within 66.7-75.7%

Severe bronchial asthma in children with exercise-induced bronchospasm

Based on a complex examination 46 of schoolchildren suffering from severe asthma, we established that greater proportion of schoolchildren with exercise-induced asthma was with symptoms of mucospin hypereosinophilia (average content of eosinophilic granulocytes over 8 %) than children suffering from severe type of the disease, with no signs of exercise-induced bronchoconstriction. The bronchi of the schoolchildren with severe exercise-induced bronchial asthma are hyperresponsive to histamine, significantly greater proportion of patients with severe airway hypersensitivity to histamine (PC20H<0,5 mg/ml) among the children exercise-induced asthma than those without phenomena of exercise-induced constriction

Relieving treatment of bronchial asthma attack in schoolchildren suffer from severe disease phenotype

У дослідженні показано, що триденний курс системних глюкокортикостероїдів порівняно з коротшим терміном їх призначення характеризувався вірогідним ризиком регресу бальної оцінки тяжкості нападу на 7-й день стаціонарного лікування. Також продемонстровано, що довенне введення еуфіліну на тлі застосування інгаляційних β2-агоністів короткої дії та системних глюкокортикостероїдів асоціювало з ризиком зменшення тяжкості нападу на 3-й та 7-й день стаціонарного лікуванн

Immunoprophylaxis of infectious diseases in children during the COVID-19 pandemic

Summary. Restrictive rules during the COVID-19 pandemic and the desire to minimize children’s contact have reduced the coverage of routine vaccinations in all age groups. Interruptions in routine immunization can lead to outbreaks of vaccine-control infectious diseases, which will be an additional burden on the public health care system overloaded by the COVID-19 pandemic. In this situation, the role of medical staff as a source of objective information with the involvement of all motivational potential is exacerbated. The aim of the study – to analyze the parents’ adherence to immunization with the definition of the role and place of various information sources of immunoprophylaxis, including health care professionals. Materials and Methods. To achieve this goal, we conducted an anonymous survey of 87 parents whose children were hospitalized at the Chernivtsi Regional Children's Clinical Hospital or sought outpatient care at the Chernivtsi City Children's Polyclinic using a developed questionnaire containing 14 questions with answer options. Results. The bigger part of parents (82 %) expressed a positive attitude to vaccination during the survey, the part of parents who have an ambiguous attitude to vaccination, so far refuse and those who have a negative attitude to some vaccines, reaches 16 %. The study also shows a certain imbalance between the personal vaccination history of parents and the history of vaccination of their own children. According to the parents’ view (79 %), the most important sources of information on immunization should be health workers, while the survey shows that the part of parents who receive the necessary information about the benefits of vaccination in medical institutions were 14 % lower and amounted to 65 %. Conclusions. The paper shows positive parents’ adherence to vaccination and a high level of their trust in health care professionals as a source of relevant information. Health care professionals do not make full use of their own "vaccination potential" and in some cases are sources of negative information about vaccination. There is an urgent necessity in educational work of health care professionals to increase the population's adherence to immunization, especially in the context of the COVID-19 pandemi

Characteristics of respiratory manifestations of COVID-19 against the background of an accompanying oncological pathology in pediatric practice (case from practice)

Резюме. Під час пандемії, спричиненої поширенням нового коронавірусу SARS-CoV-2, у хворих на COVID-19 респіраторні симптомами виявилися найчастішими та були вирішальними у формуванні тяжкості захворювання, а в окремих випадках мали прямий причинно-наслідковий зв’язок із летальністю. Хоч, на відміну від дорослих, діти мали легший перебіг коронавірусної хвороби, однак при наявності супутньої патології (цукровий діабет, імунодефіцит, ожиріння тощо), для них також притаманний підвищений ризик ушпиталення із проведенням протезування функцій респіраторного тракту. У статті наведено клінічний випадок коронавірусної інфекції у дитини на тлі онкологічного захворювання, зокрема тяжкого перебігу COVID-19 із проявами позагоспітальної лівобічної полісегментарної вірусно- бактеріальної пневмонії, ускладненої ексудативним плевритом, дихальною недостатністю та ексудативним перикардитом на тлі вперше діагностованої безсимптомної неходжкінської Т-клітинної лімфоми. Проведення комплексного лікування (оксигенотерапія, інфузійна терапія, комбінована антибіотикотерапія, стероїди, діуретини, дренування плевральної порожнини) характеризувалося позитивною динамікою з продовженням таргетного лікування онкологічної патології. Отже, тяжкість COVID-19 у цього пацієнта визначалася респіраторними симптомами з реалізацією тяжкого перебігу за рахунок серцево-легеневих ускладнень та формуванням каскаду запальної реакції на тлі неходжкінської Т-клітинної лімфоми

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries