Experience of Bacillus subtilis Application under Antibacterial Therapy In Children

The antibiotic-associated diarrhea remains an actual problem in medicine. In our research the antibiotic-associated diarrhea was observed in 10 % of patients. Antibiotics (cephalosporins of the 3rd generation) cause dysbiotic disturbances mainly due to the growth of conditional opportunistic flora (Candida) and E.сoli with hemolitic properties. Use of an alimentary functional product of Subalin not only reduced negative influence of antibiotics on an intestine normal flora, but also contributed to the elimination of existing dysbiotic disorders. To our opinion, complete recovery of quantitative and qualitative composition of intestinal microflora requires using probiotic medication longer than antibiotic therapy for 7–10 days, but this requires further investigation

Echocardiography and ultrasound dopplerography assessment of central and peripheral hemodynamics in children with septic shock

Background. The severe course of sepsis is usually associated with the development of septic shock and multiple organ failure. For effective treatment, it is recommended to perform instrumental monitoring of preload, contractile capacity of the heart and tissue perfusion. We aimed to evaluate changes in central and peripheral hemodynamics by echocardiography and Doppler ultrasound in children with septic shock. Materials and methods. A retrospective study of cases of septic shock in children aged 0 to 18 years who underwent treatment in the intensive care unit was conducted. Patients were monitored for central and peripheral hemodynamics by echocardiography and Doppler ultrasound. The initial study of hemodynamic parameters was carried out over the first 3 hours after hospitalization. The second study was carried out in 24–36 hours after the hospitalization. The third study was conducted in the period of convalescence within 24–48 hours after the withdrawal of sympathomimetic drugs. Results. Thirty-four cases of sepsis associated with septic shock were investigated. In 24 (70.6 %) patients, the etiological factor was meningococcus, in 1 (2.9 %) staphylococcus, and in 9 (26.5 %) no aetiology was established. In 6 children from the study group fatal outcome occurred. Values of mean blood pressure, ejection fraction, peripheral resistance were relatively lower in the acute shock period, and increased after stabilization of hemodynamics. Evaluation of peripheral blood circulation at admission showed decreased diastolic velocity in abdominal aorta and upper mesenteric artery and systolic velocity in posterior tibial artery. The results of initial investigation demonstrated that 44.1 % patients had increased cardiac output along with decreased systemic vascular resistance (‘warm shock’), and just 8.8 % had features of ‘cold shock’ (decreased cardiac output and increased vascular resistance). The fatal course of the disease was associated with higher heart rate, lower systolic velocity (V max) values in the truncus coeliacus and femoral artery, diastolic velocity (V min), and peripheral resistance index in the renal artery at the initial examination. Conclusions. Comprehensive study of central and regional hemodynamics parameters in children through echocardiography and Doppler ultrasound allows non-invasive diagnostic of early violations associated with septic shock and control of the effectiveness of therapeutic measures

METHODOLOGY FOR ASSESSMENT OF THE QUALITY OF LIFE OF CHILDREN WITH CORONA VIRUS INFECTION AND THE POST-VIDAL SYNDROME

Background. The urgency of the problem is due to the rapid spread of the coronavirus infection in the world, as well as the frequent occurrence of a wide range of post-coronavirus complications in children, which significantly affect the quality of life. These changes also remain in the post-Covid period. Assessment of the quality of life in children with post-covid syndrome in Ukraine is at the stage of formation, therefore, methodologically, the creation and validation of children's questionnaires with subsequent assessment of the quality of life remains an urgent problem. Aim: to summarize data from the literature regarding the study of health-related quality of life in children with SARS-CoV-2 infection and post-covid syndrome. Materials and methods. An assessment of literature data on the frequency and course of coronavirus infection, its manifestations, damage to the respiratory system and other organs and systems in children, and asthenic manifestations was carried out. Results. Based on the analysis of the scientific literature, the possibilities of using the quality of life assessment method in pediatric practice, in particular in children with COVID-19 and the consequences of the infection, were considered. One of the most frequently used questionnaires for assessing the quality of life in children is the PedsQL 4.0 questionnaire, which, due to good psychometric qualities, the availability of parallel forms for children and parents, a wide age range, simplicity and ease of filling out, can be recommended for determining the health-related quality of life in children. It is shown how the study of the quality of life related to health allows to study the impact of the disease and treatment on the components of the child's health. Conclusions. Research on quality of life allows monitoring the condition of a child with post-covid syndrome during treatment and rehabilitation, as well as evaluating the effectiveness of these measures

Status of child population health — the future of the country (part 1)

The article of the team of scientists of pediatricians and organizers of pediatric health care of Ukraine is devoted to the study of the main trends in the health status of children over last 22 years. The results of the analysis of the incidence and prevalence of diseases among Ukrainian child population, infant mortality rates over the past two decades demonstrates that they remain significantly higher than the average European indicators against the background of a progressive decrease in the number of child population at 3,16 million people. The prevalence of childhood diseases in Ukraine over past 22 years has grown by 41 %, the incidence of childhood diseases arose by 36 %. The article considers the ways of solving a number of new social and medico-ecological problems that negatively affect child health