КЕСАРСЬКИЙ РОЗТИН ЯК ФАКТОР РИЗИКУ РОЗВИТКУ СОМАТИЧНОЇ ПАТОЛОГІЇ У ДІТЕЙ

At present time the caesarean section operation is one of reserves of improvement of perinatal morbidity and mortality indices. Today it is established stable growth trend in the number of operative delivery in the developed countries of the world, above the WHO recommended 15%. Operative way of delivery is a pathological stress-factor which can cause different disorders of different systems of the body, dysbiotic changes that can have longterm consequences on the child’s health. The analysis of the literature data indicates that children born by C-section are at risk of developing a variety of somatic diseases, allergic and autoimmune pathology and require close physicians’ attention. Since the pathogenic mechanisms of identified changes are not fully understood but a group of such children is growing each year and further research in this direction is urgent.В настоящее время операция кесарева сечения является одним из резервов улучшения показателей перинатальной заболеваемости и смертности. Сегодня в развитых странах мира установилась устойчивая тенденция к росту числа оперативных родов, выше рекомендованных ВОЗ 15%. Оперативные роды являются патологическим стрессовым фактором, при котором у новорожденного развиваются нарушения со стороны разных систем организма, дисбиотические изменения, которые могут иметь отдаленные последствия на здоровье ребенка. Проведенный анализ данных литературы указывает на то, что дети, рожденные путем кесарева сечения, являются группой риска развития различных соматических заболеваний, аллергической и аутоиммунной патологии, и требуют пристального внимания врачей. Поскольку патогенетические механизмы выявленных изменений не вполне понятны, а группа таких детей растет ежегодно, дальнейшие исследования в данном направлении являются весьма актуальными.На теперішній час операція кесарського розтину (КР) є одним з резервів поліпшення показників перинатальної захворюваності і смертності. На сьогодні у розвинених країнах світу встановилася стійка тенденція до зростання кількості оперативних пологів, вище рекомендованих ВООЗ 15%. Оперативні пологи є патологічним стресовим фактором, при якому в новонародженого розвиваються дисбіотичні зміни, порушення з боку різних органів та систем організму, що може мати віддалені наслідки та негативно впливати на здоров’я дитини. Проведений аналіз даних літератури вказує на те, що діти, народжені шляхом КР, є групою ризику щодо розвитку різних соматичних захворювань, алергічної та аутоімунної патології, і потребують пильної уваги лікарів. Оскільки патогенетичні механізми виявлених змін не є цілком зрозумілими, а група таких дітей зростає щороку, подальші дослідження в даному напрямку є досить актуальними

Validation of the dermatology-specific proxy instrument the Infants and Toddlers Dermatology Quality of Life

Background: The first dermatology-specific proxy health-related quality of life (HRQoL) instrument for children 0–4 years old with skin diseases, the Infants and Toddlers Dermatology Quality of Life (InToDermQoL), was recently developed. In order to avoid the problem of cross-cultural inequivalence focus groups work and pilot tests were organized simultaneously in all national centres of the project. The InToDermQoL showed good comprehensibility, clarity and acceptance. Objective: To validate the InToDermQoL questionnaire during international field tests. Methods: Internal consistency, test–retest reliability, convergent and discriminant validity of the InToDermQoL questionnaire were checked during international field tests. Results: Parents of 473 children with skin diseases filled in the national language versions of the InToDermQoL questionnaire. All three age-specific versions of the InToDermQoL questionnaire with 10, 12 and 15 items, respectively, showed high internal consistency (Cronbach's α 0.90–0.93), good test–retest reliability (correlation coefficients > 0.9), significant correlations with the most widely used atopic dermatitis-specific proxy instrument, the Infants Dermatitis Quality of Life Index (correlation coefficients 0.68–0.79). The InToDermQoL versions for children <3 years old well correlated with the atopic dermatis severity measure Scoring of Atopic Dermatitis (correlation coefficients 0.66 and 0.86 for 10 and 12 items versions, respectively). The InToDermQoL questionnaire discriminated well among different diagnoses and disease severity levels. Conclusion: Our field tests confirmed internal consistency, test–retest reliability, convergent and discriminant validity of the InToDermQoL questionnaire. Development and validation of the InToDermQoL questionnaire make it possible to assess dermatology-specific aspects of HRQoL in youngest children with skin diseases. There are many reasons to assess HRQoL in dermatologic clinical practice, and we hope that our new instrument will be used internationally in paediatric dermatology for research and practical needs. © 2019 European Academy of Dermatology and Venereolog

Which Health-Related Quality of Life Items Most Affect Acne Patients?

BACKGROUND: Health-related quality of life (HRQoL) assessment in patients with acne is recommended by several national guidelines. There are several acne-specific HRQoL instruments. OBJECTIVES: Participants of the European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on QoL and Patient Oriented Outcomes (PO) and Acne, Rosacea, and Hidradenitis Suppurativa (ARHS) agreed to scrutinize aspects of existing acne-specific HRQoL instruments for their relevance in international study. METHODS: Consensus agreement on items related to QoL was reached after an independent assessment by seven experts from the EADV TFs on QoL and PO, and a list of 97 items was prepared and proposed to a group of acne patients. In order to have data from patients to check if any important topics were overseen, another group of acne patients from participating countries was asked to list how acne influenced different aspects of their lives. RESULTS: Based on results obtained from 601 acne patients from nine countries, most of the items and topics showed low relevance for acne patients especially during the previous month or shorter time periods. Based on percentage of relevance and factor analysis, short (6 items) and long (45 items) lists of the most relevant topics were formed. CONCLUSION: Most of the items and topics from the initial list showed low relevance for acne patients. None of the identified acne-specific HRQoL instruments contain all the items that were deemed most relevant to acne patients. For this reason, participating members of the EADV TFs on QoL and PO, and ARHs are in the process of developing a new acne-specific HRQoL instrument