Prognosis of cellular energy metabolism shifts in adolescents with community-acquired pneumonia

Pneumonia is one of the most severe respiratory pathology forms in children, which contributes significantly to infant mortality. The high risk of chronic bronchopulmonary process and child`s disability, in case of severe and complicated disease, requires careful pathophysiological change's analysis in community-acquired pneumonia (CAP) in children. In particular, for the prediction of these disorders in children with CAP are important the dysmetabolic phenomena study and the specific approaches development. The immediate aim of this work is to study the cellular energy metabolism (CEM) features and to develop approaches for the early bioenergetic disorders diagnostics in conditions of community-acquired pneumonia in adolescents.The aim of the study is to develop approaches for the early diagnosis of shifts in energy metabolism in children aged 14-18 years with CAP. An examination of 41 children aged 14-16 years with the definition of CEM indicators was conducted in order to develop an approach for predicting CEM disorders in community-acquired pneumonia using the method of logistic regression. A logistic regression method was used to develop a method for predicting CEM disorders in children with CAP. The characteristics of CEM in children with CAP were determined. A decrease in the succinate dehydrogenase activity and an increase in the lactate dehydrogenase / succinate dehydrogenase ratio in children with CAP relative to the reference parameters were observed, which indicated an inhibition of the anaerobic energy synthesis pathway. Two mathematical models for predicting CEM disorders in CAP based on logistic regression equations were proposed. The first mathematical model consisted of social and health characteristics and of pneumonia clinical course characteristics. In ROC analysis the area under the curve (AUC) was 0.82, diagnostic specificity – 71%, diagnostic sensitivity – 90%. The second model included only hematological parameters, AUC – 0.78, diagnostic specificity – 69%, diagnostic sensitivity – 81%. Thus, changes in CEM in children with CAP aged 14 – 18 years have been established. Two methods for predicting disorders of CEM in children with CAP have been developed, which can be applied to optimize the treatment of children with CAP aged 14-18 years

Prognosis of cellular energy metabolism shifts in adolescents with community-acquired pneumonia

Однією з найбільш тяжких форм респіраторної патології в дітей є пневмонія, що вносить істотну частку в дитячу смертність. Високий ризик хронізації бронхолегеневого процесу й інвалідизації дитини, у випадку тяжкого та ускладненого перебігу захворювання, вимагають ретельного аналізу патофізіологічних змін при позалікарняній пневмонії (ПП) у дітей. Зокрема, на часі є вивчення дизметаболічних явищ та розробка специфічних підходів щодо прогнозу розвитку таких розладів при ПП у дітей. Метою роботи є дослідження особливостей клітинно-енергетичного метаболізму (КЕМ) та розробка підходів до ранньої діагностики біоенергетичних порушень за умов позалікарняної пневмонії в дітей підліткового віку. Проведено обстеження 41 дитини віком 14-18 років із визначенням показників КЕМ, для розробки способу прогнозування розладів КЕМ при ПП було застосовано метод логістичної регресії. Визначено характеристики КЕМ у дітей, хворих на ПП. Констатовано зниження активності сукцинатдегідрогенази та збільшення значення співвідношення лактатдегідрогенази до сукцинатдегідрогенази при ПП відносно показників контрольної групи, що вказувало на пригнічення анаеробного шляху метаболізму. Запропоновано дві математичні моделі прогнозування розладів КЕМ при ПП на базі рівняння логістичної регресії. Перша математична модель складалась з анамнестичних даних, супутніх патологічних станів та характеристик клінічного перебігу ПП, при ROC-аналізі площа під кривою (AUC) становила 0.82, діагностична специфічність – 71%, діагностична чутливість – 90%. Друга модель включала в себе гематологічні показники, AUC – 0.78, діагностична специфічність – 69%, діагностична чутливість – 81%. Таким чином, установлено наявність зрушення КЕМ при ПП у дітей віком 14-18 років, розроблено два способи прогнозування розладів КЕМ при ПП у дітей, що може бути застосовано для вдосконалення медичної допомоги підліткам із урахуванням індивідуальних особливостей організму. Pneumonia is one of the most severe respiratory pathology forms in children, which contributes significantly to infant mortality. The high risk of chronic bronchopulmonary process and child`s disability, in case of severe and complicated disease, requires careful pathophysiological change's analysis in community-acquired pneumonia (CAP) in children. In particular, for the prediction of these disorders in children with CAP are important the dysmetabolic phenomena study and the specific approaches development. The immediate aim of this work is to study the cellular energy metabolism (CEM) features and to develop approaches for the early bioenergetic disorders diagnostics in conditions of community-acquired pneumonia in adolescents.The aim of the study is to develop approaches for the early diagnosis of shifts in energy metabolism in children aged 14-18 years with CAP. An examination of 41 children aged 14-16 years with the definition of CEM indicators was conducted in order to develop an approach for predicting CEM disorders in communityacquired pneumonia using the method of logistic regression. A logistic regression method was used to develop a method for predicting CEM disorders in children with CAP. The characteristics of CEM in children with CAP were determined. A decrease in the succinate dehydrogenase activity and an increase in the lactate dehydrogenase / succinate dehydrogenase ratio in children with CAP relative to the reference parameters were observed, which indicated an inhibition of the anaerobic energy synthesis pathway. Two mathematical models for predicting CEM disorders in CAP based on logistic regression equations were proposed. The first mathematical model consisted of social and health characteristics and of pneumonia clinical course characteristics. In ROC analysis the area under the curve (AUC) was 0.82, diagnostic specificity – 71%, diagnostic sensitivity – 90%. The second model included only hematological parameters, AUC – 0.78, diagnostic specificity – 69%, diagnostic sensitivity – 81%. Thus, changes in CEM in children with CAP aged 14 – 18 years have been established. Two methods for predicting disorders of CEM in children with CAP have been developed, which can be applied to optimize the treatment of children with CAP aged 14-18 years

Dynamics of the incidence rate of pneumonia in children in Ukraine over the past 20 years

Pneumonia ranks third in the structure of hospital mortality in infants after perinatal pathology and congenital malformations in Ukraine. Over the past 20 years in Ukraine, there has been a 33,7% increase in the incidence of pneumonia in children (p˂0.01), with the predominant detection of this pathology in children from regions of the country who have problematic issues in the proper provision of pediatric services. The highest incidence of pneumonia in all age groups was observed in children of Ivano-Frankivsk, Rivne, Kyiv and Vinnitsa regions. Thanks to the progressive development of domestic pediatrics and the introduction of modern medical and diagnostic technologies, in particular, vaccine prophylaxis, over the past 20 years, the death rate of children from acute infections of the upper respiratory tract, pneumonia and influenza has decreased by almost 5 times. Changes in recent years in the incidence of pneumonia in children correspond to the dynamics of the spread of influenza and acute respiratory viral infection, especially during the epidemics 2009-2010 and 2015-2016. Assessing the dynamics of this indicator in subsequent periods is extremely important in the context of the COVID-19 pandemic, which continues

Features of atopic dermatitis in children with oxalic acid dysmetabolism

The article presents the features of atopic dermatitis in children with concomitant metabolic disturbances of oxalic acid. The influence of metabolic shifts was evaluated by clinical presentation, morphofunctional parameters of the skin and the features of oxalic acid metabolites excretion. In this study, a high incidence of dysmetabolic changes was identified, their significance was determined by the involvement of different systems for oxalic acid products excretion. The increased concentration of oxalate in the urine and in the exhaled air condensate had irritant effect and is associated with the hereditary metabolic disorders, early manifestation of atopy symptoms and the intensity of skin itching, with moderate increase of immunoglobulin E level

Correction of metabolic disorders in secondary acetonemic syndrome on the background of acute respiratory infection in children

Acetonemic syndrome (AS) is one of the most frequent metabolic disorders in children. Despite the large number of works on the pathogenesis of hyperketonemia, the role of the processes of cellular energy metabolism in the development of this condition has not been finally clarified. The study of the metabolism energy balance makes it possible to identify important pathogenetic links, prognostic criteria for the occurrence and course of AS, and also to determine approaches to its correction. A comparative controlled study was conducted among 64 children with secondary AS on the background of inflammatory diseases of the respiratory tract: acute rhinopharyngitis, acute simple bronchitis, acute laryngotracheitis, community-acquired pneumonia, acute tracheitis, acute obstructive bronchitis. The work identified significant predictors for the occurrence of the AS. Statistically significant relationship was revealed between the level of acetonuria and the severity of the patient’s condition. In order to correct the AS, the combination balanced preparation Ionica was used in 36 children of the main group. The use of the glucose-containing drug Ionica allowed improving the activity of energy metabolism enzymes (succinate dehydrogenase, lactate dehydrogenase, glycerophosphate dehydrogenase, glutamate dehydrogenase), reduce the duration of AS manifestations in the main group, as well as the need for infusion therapy

Peculiarities of indices of exhaled air condensate in children depending on the type of neurocirculatory dystonia

У дітей, що страждають на нейроциркуляторну дистонію, вивчали біохімічні показники конденсату видихуваного повітря для визначення їх діагностичної цінності у виявленні типу вегетативного тонусу. Показано зростання вмісту метаболітів оксиду азоту та протеолітичної активності за лізисом азоальбуміну в конденсаті видихуваного повітря при ваготонічному типі захворювання. Відмічено, що найвищою діагностичною цінністю виявлення ваготонічного типу вегетативного тонусу відносно симпатикотонічного володіла протеолітична активність за лізисом азоальбуміну, більша за 1,24 мл/год.Изучали биохимические маркеры конденсата выдыхаемого воздуха у детей, страдающих нейроциркуляторной дистонией, для определения их диагностической ценности выявления типа вегетативного тонуса. Показано при ваготоническом типе заболевания повышение содержания метаболитов оксида азота и протеолитической активности по лизису азоальбумина в конденсате выдыхаемого воздуха. Отмечено, что наиболее высокой диагностической ценностью выявления ваготонического типа вегетативного тонуса относительно симпатикотонического владеет протеолитическая активность по лизису азоальбумина больше 1,24 мл/час.The biochemical indices of exhaled air condensate were studied in children, suffering from neurocirculatory dystonia to determine their diagnostic value, while detecting the type of the vegetative tonus. An increase of the content of nitrogen oxide metabolites and proteolytic activity after azoalbumin lysis in the exhaled air condensate in case of the vagotonic type of the disease was shown. It was marked that the proteolytic activity after azoalbumin lysis possessed the highest diagnostic value of the vegetative tonus in relation to sympathicotonic one, more than 1,24 ml/hrs