Биоинформатический анализ специфических антигенов T. pallidum

Using bioinformatics methods (PSI-BLAST, PSORTb, Cello, BOMP, TMBETADISC-PSSM, TMHMM, LipoP, UiB Lipo, SignalP servers), the authors analyzed sequences of fifteen T. pallidum proteins, which may be potential antigens for the diagnostics of the syphilitic infection. They revealed that Tp0259, Tp0453, Tp0608, Tp0326, Tp0249, Tp0136 and Tp0684 proteins may be promising for further studies.С помощью методов биоинформатики (серверов PSI-BLAST, PSORTb, Cello, BOMP, TMBETADISC-PSSM, TMHMM, LipoP, UiB Lipo, SignalP) проанализированы последовательности 15 белков T. pallidum, которые могут являться потенциальными антигенами для диагностики сифилитической инфекции. Установлено, что перспективными для дальнейшего изучения могут являться белки Tp0259, Tp0453, Tp0608, Tp0326, Tp0249, Tp0136 и Tp0684

СТРАТЕГИЯ ИНФУЗИОННО-ТРАНСФУЗИОННОЙ ТЕРАПИИ ПРИ ОПЕРАЦИЯХ С МАССИВНОЙ КРОВОПОТЕРЕЙ У ДЕТЕЙ С ОПУХОЛЯМИ ТОРАКОАБДОМИНАЛЬНОЙ ЛОКАЛИЗАЦИИ

Surgeries for thoracoabdominal tumors in children predispose to water and electrolyte imbalance, imbalance in the coagulation system, etc. In spite of abundance of recommendations for children, the volume of basic infusion therapy is uncertain.Study purpose. To estimate the clinical effectiveness of the conducted infusion therapy with isotonic balanced electrolyte solution in children who underwent thoracoabdominal surgeries accompanied with massive blood loss and a complex estimation of the conducted infusion and transfusion therapy.Materials and methods. The intraoperative and early postoperative (days 1–5) periods were analyzed in 22 patients (ASA II–III) who underwent an operation for thoracoabdominal malignant tumors with massive perioperative blood loss in 2016–2017. Group I included 11 patients who had infusion with balanced crystalloid solutions of 5 to 10 ml/kg/hour under combined anesthesia. Group II includes 11 patients who had infusion with balanced crystalloid solutions of 11 to 20 ml/kg/hour under combined anesthesia.Results. According to the conducted study, a higher hemodynamic stability was observed in patients from the group of basic infusion therapy with balanced crystalloid solutions of 11–20 ml/kg/hour. It was expressed as the decrease of the mean dose of the used vasopressors and volume of the infusion of colloidal solutions. The patients also had a less intense response to stress.Хирургические вмешательства по поводу опухолей торакоабдоминальной локализации у детей предрасполагают к нарушениям водно-электролитного баланса, свертывающей системы и т. д. Несмотря на то, что для педиатрических пациентов существует множество рекомендаций, объем базовой инфузионной терапии остается неопределенным.Цель исследования. Оценка клинической эффективности проводимой инфузионной терапии изотоническим сбалансированным раствором электролитов у детей при оперативных вмешательствах торакоабдоминальной локализации, сопровождающихся массивной кровопотерей, а также комплексная оценка проводимой инфузионно-трансфузионной терапии.Материалы и методы. Проведен анализ интраоперационного и раннего послеоперационного (1–5‑е сутки) периодов у 22 пациентов (ASA II–III), оперированных в 2016–2017 гг. по поводу злокачественных опухолей торакоабдоминальной локализации, сопровождающихся массивной периоперационной кровопотерей. В I группу вошли 11 пациентов, которым в рамках сочетанной анестезии проводили инфузию сбалансированными кристаллоидными растворами в дозе от 5 до 10 мл/кг/час. Во II группу включены 11 пациентов, которым в рамках сочетанной анестезии проводили инфузию сбалансированными кристаллоидными растворами в дозе от 11 до 20 мл/кг/час.Результаты. По данным проведенного исследования бóльшая гемодинамическая стабильность отмечалась у пациентов в группе с базовой инфузионной терапией сбалансированными кристаллоидными растворами в объеме 11–20 мл/кг/час, выражающаяся в снижении средней дозы применяемых вазопрессорных препаратов, объема инфузии коллоидных растворов. Также у пациентов в этой группе интенсивность стресс-ответа была менее выражена.

Functional abdominal pain in children

Abdominal pain is one of the most common children’s complaints in the practice of a pediatrician and a family doctor. In most cases, the cause of chronic abdominal pain is non-organic, functional abdominal pain syndrome (FAPS) without objective signs of an underlying organic disorder. At present, among various groups of antispasmodics, selective myotropic antispasmo­dics, namely myocyte cell membrane fast sodium channel blockers (mebeverine), are chosen for the treatment of functional gastrointestinal disorders. In clinical practice, mebeverine hydrochloride (SPARK®, JSC Farmak) is of interest for the treatment of patients with abdominal pain. SPARK® is available in capsules; one capsule contains 200 mg of mebeverine hydrochloride. The pathogenetically justified indication of mebeverine is a relief of chronic abdominal pain in adults and children over 10 years. The drug has no systemic effects. The efficacy of SPARK® (mebeverine) for FAPS in children was studied in the gastroenterological department of the Children’s Clinical Hospital No. 19 in Kharkiv. Forty-four children aged 10 to 18 years with FAPS were examined. The functional pathologies included: functional dyspepsia (FD) — 54.1 %, irritable bowel syndrome (IBS) — 20.8 %, functional biliary disorders (FBD) — 79.2 %; FD + FBD — 34.1 %, FD + IBS — 16 %, FBD + IBS — 8.3 %. The diagnosis was verified according to unified treatment protocols. The patients received a comprehensive pathogenetic therapy and a selective antispasmodic, SPARK®, 1 capsule twice daily for seven days. The pain syndrome was evaluated at admission and every day during the observation period [17]. A numerical pain rating scale was used to assess pain intensity. A tendency towards abdominal pain relief was observed in all patients from the study group; children with mild pain did not report abdominal pain from day 5 of therapy and patients with moderate pain — from day 6. The pain persisted longer, up to 7 days, in children with severe pain. Therefore, abdominal pain is one of the most common and complex problems in medical practice. It mostly occurs in functional gastrointestinal disorders. The use of selective myotropic antispasmodics (mebeverine) to relieve abdominal pain is pathogenetically justified. The results obtained showed the efficacy of SPARK® in the treatment of functional abdominal pain in children. Side effects and allergic reactions to the drug were not observed. Mebeverine (SPARK®) can be the drug of choice and is recommended for abdominal pain in adults and children over 10 years

Modern problems of treatment of Helicobacter-associated diseases in children: opportunities of adjuvant therapy

Background. The relevance of research is related to a significant spread of the pathology of the upper digestive tract in children, which in most cases is caused by the pathogenic effect of Helicobacter pylori (Hp). Modern eradication strategies require adjuvant therapy. The aim of the study was to evaluate the clinical effectiveness of the Lactiale symbiotic as an adjuvant therapy for eradication schemes in children of different ages with the pathology of the upper digestive canal. Materials and methods. Seventy children with Hp-associated pathology of the upper digestive tract aged 5 to 18 years were under observation. Patients were divided into 2 groups depending on the use of the symbiotic. The diagnosis was verified using fibrogastroscopy, endoscopic pH-metry, determination of Hp-infection, morphological examination. The results were statistically processed. Results. The results of using Lactiale symbiotic in patients of group 1 as an adjuvant therapy for standard pediatric Hp eradication schemes suggest the expediency and high effectiveness of such treatment. The dynamics of complaints, absence of side effects and good tolerabi-lity of drugs against the background of reception of a symbiotic were positive. The increase in eradication efficiency by 10 % compared with standard schemes corresponds to the results of other studies. The positive influence of the symbiotic on the processes of qualitative healing of ulcers and a significant increase in anti-inflammatory effect in patients of the main subgroup with peptic ulcer of the duodenum was determined. The low result of eradication, obtained in patients with functional disorders, can be considered predictable. This is evidenced by the latest conciliatory conclusions of experts: the effectiveness of eradication in patients with functional dyspepsia does not exceed 15–30 %. Conclusions. The use of the Lactiale symbio-tic as an adjuvant therapy for eradication schemes in children of different ages with Hp-associated pathology of the upper digestive tract is advisable, significantly increases the effectiveness of eradication, improves the tolerability of drugs, adhe-rence of patients to the treatment

Risk factors and possibilities of preventing gastroesophageal reflux disease in school-age children

Background. The article presents the main problems of early diagnosis of gastroesophageal reflux disease (GERD) in school-age children, which leads to late detection and initiation of treatment. The purpose of the study was to identify the main risk factors that may predispose the development of this disease, as well as triggers that provoke GERD in school-age children. Knowledge of risk factors can help prevent the formation of GERD in children, and, with timely diagnosis of therapy, reduce the severity of the disease and improve quality of life. Materials and methods. Open comparative study included 98 school-age children (31 girls, 67 boys) aged 6 to 18 years (mean age 14.2 years). Diagnosis of gastroesophageal reflux disease was conducted in accordance with the Order of the Ministry of Health of Ukraine dated January 29, 2013, No. 59 “On Approval of Unified Clinical Protocols for Medical Care of Children with Digestive Disorders”. During the comprehensive examination, the identification of possible risk factors was made, for which a detailed history collection was performed: the nature of the child’s nutrition and the regularity of the meal were evaluated, as well as the mode of the day, the presence and intensity of physical activity, the presence of chronic stress (psycho-traumatic situations), sleep duration, bad habits, false eating habits. Past medical history also revealed the duration of breastfeeding and the time of supplementary food introduction. Physical examination was also aimed at the detection of so-called symptoms of anxiety — “red flags” that may indicate the presence of complications or organic pathology. Results. In both age groups, boys were dominant; besides, there were significantly more children aged 13–17 years in the group with GERD. Early administration of supplements was revealed in both groups, as well as early artificial/mixed feeding. More than 85 % of children had signs of autonomic dysregulation and concomitant pathology of the upper digestive tract. Interestingly, body mass index met norms in most patients, so this risk factor was not significant. Conclusions. The study has revealed the main risk factors that contribute to the formation of GERD in children of two age groups: 6–12 and 13–17 years, and the relationship between individual risk factors with different forms of GERD was analyzed. Optimization of the primary screening diagnosis of GERD can be achieved by using adapted pediatric GERD questionnaire at the outpatient stage of medical care. It includes not only questions about typical esophageal clinical symptoms, but also extravascular and atypical GERD symptoms. Most of the risk factors and trigger factors are modified, so at the stage of primary care, the control of children’s status who are at risk of GERD, timely diagnosis and correction of risk factors, or reflux disorders which occur in the presence of these factors will prevent the development of disease or its severe course that will improve the quality of life of the patient

Petrology, Bulk-Rock Geochistry, Indicator Mineral Composition and Zircon U-Pb Geochronology of the End-Cretaceous Diamondiferous Mainpur Orangeites, Bastar Craton, Central India

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