The use of hypoallergenic mixtures in children with signs of atopy

Introduction. Studies are indicative that about a quarter of infants in Ukraine have atopic manifestations. If the breastfeeding is impossible, hypoallergenic mixtures should be used. The arm of the research. To establish clinico-paraclinical efficacy of hypoallergenic mixtures TM “Humana Ha” in infants with clinical manifestations of atopic abnormality of constitution. Methods. 27 children aged from 2 to 12 months with the symptoms of atopic dermatitis and 25 infants who were fed on formula and had the usual signs of wheezing syndrome underwent complex examination. Results. In the Ist clinical group among patients with mild forms of eczema (11,1%) score on EASI scale decreased from 28,8 ± 2,1 to score 12,2 ± 1,8 score (P <0,05). The using mixture “Humana-HA” was led to a decrease in absolute risk register high concentration of IL-4 in serum by 20,9%, relative risk reduction – 23,5% (95% CI 15,5-33,1), and the minimum number of patients which should be treatment to get one positive result was 4,2 (95% CI 1,2-10,4). Conclusions. The using of partially hydrolyzed mixture “Humana-HA” in infants with signs of atopic dermatitis significantly improves the flow of mild and moderate forms. Application of partial protein hydrolyzate ”Humana-HA” in the diet of infants with atopic dermatitis reduces the content of immunoglobulin E and interleukin-4 in serum

Indicators of the bronchial lability and hyperreactivity in children with bronchial asthma and exercise induced bronchoconstriction

The results of the analysis of the bronchial hyperreactivity indicators in 60 children suffering from asthma with exercise induced bronchoconstriction and without exercise induced bronchospasm are presented in the article. It has been established that higher bronchial lability was typical for children with asthma and exercise induced bronchoconstriction. The bronchial hypersensitivity to inhaled histamine in a concentration less than 0,4 mg/ml with 77 % specificity, 71 % post-test probability and significant odds ratio indicate a phenotype of childhood asthma with exercise induced bronchoconstriction

Diagnostics of septic myocardial dysfunction in neonates

Neonatal sepsis (NS) continues to be the one of the major problems in neonatal practice. This is due to the variability of clinical manifestations and, in part, the lack of available diagnostic markers that are significantly associated with mortality as a result of neonatal sepsis. The purpose - to study the role of paraclinical markers of myocardial dysfunction in neonates with sepsis. Materials and methods. To achieve this goal, 87 newborns (the main group) with manifestations of a generalized infectious-inflammatory process were under our observation. The control group included 30 newborns, in which infectious and inflammatory diseases were refuted. Examination and treatment of patients with NS was carried out in accordance with modern international guidelines and recommendations. Results and discussion. Based on a comprehensive clinical and paraclinical examination of neonates of the main group, it was found that 25 (28.7%) newborns suffered from early sepsis, respectively, the remaining 62 (71.3%) patients had late NS. According to the severity of the condition, 76 (87.4%) children of the main group included in the study required intensive care, which was provided in the neonatal intensive care unit. The average value of procalcitonin in the main observation group was 2.53±0.33 ng/ml, respectively, in the control group - 0.24±0.04 ng/ml (p<0.05). The mean values of creatine phosphokinase, MB fraction and troponin I in the main observation group were 58.44±2.39 U/l and 0.33±0.05 ng/ml, respectively, in the control group - 41.74±2.45 U/l and 0.04±0.01 ng/ml (p<0.05). Conclusions. Generalized infectious-inflammatory process in neonates is accompanied by increased activity of cardiotropic biochemical markers. The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors

The modern possibilities of increasing the efficiency of basic anti-inflammation therapy of school-age children’s bronchial asthma

The effect of Nucleinat included in the basic therapy of bronchial asthma (BA) has been analyzed by means of double-blind, placebo-controlled method in 98 school age children. Two clinical groups were formed with the help of the table accidental numbers. The application of the Nucleinat in complex anti-inflammatory therapy of the BA was accompanied by decrease of bronchial hyperresponsiveness due to the possible reduction of the inflammatory process activity in the airways. The use of Nucleinat in the basic therapy of the school-age children significantly reduced the risk of moderate bronchial responsiveness: DAR – 28,5%, DRR – 54,8%, MNT – 1,8 (95% CІ 0,1-7,1)

Features of exercise induced bronchial asthma course in schoolchildren with poly morphisms in glutation-S-transferase genes

With respect to the principles of bioethics, on the base of allergy department of Chernivtsi Regional Children's Hospital it has been conducted a comprehensive clinical and paraclinical examination of 51 children with symptoms of exercise induced asthma phenotype depending upon the presence or the absence of genes polymorphism of the enzymes of glutation-S-transferase – GSTT1M1. The study showed that the course of the disease was more severe in the patients with deletions of the mentioned genes, though with more rapid effect of standard reliever treatments as compared to the patients with genotype GSTT1+M1+. The patients with exercise-induced asthma in the presence of deletion genes polymorphisms of GSTT1M1 (GSTT1delM1del, GSTT1+M1del or GSTT1delM1+) require a special attention to their environmental enhance¬ment and normalization of their life-style

Pharmacogenetic aspects of basic anti- inflammatory therapy of bronchial asthma in school-aged children under the deletion polymorphism of genes Gstt1 and Gstm1

Based on a comprehensive survey of 150 school-age children who suffer from bronchial asthma, there has been found that homozygosity for both alleles of the gene of glutathione transferase (GSTT1+ M1+) was associated with more frequent use both inhaled corticosteroids at 3 Step 3 of basic therapy and leukotriene modifiers as well as better asthma control level according to the ACT-test. Under the presence of such genotypes as GSTT1+ M1-, GSTT1-M1+ or GSTT1-M1-, the basic treatment was more likely within 2-nd and 4-th Steps by GINA recommendations, but the level of asthma control was worse in these children

Indices of exhaled breath condensate in children with eosinophilic phenotype of bronchial asthma

The indices of exhaled air condensate have been studied in 160 children with different phenotypes of bronchial asthma. It has been demonstrated that there occur changes in children with the noneosinophilic phenotype of bronchial asthma as compared with the patients with the eosinophilic phenotype of the disease that are indicative of a higher activity of inflammatory processes in the respiratory tracts. The proteolytic activity according to azocasein lysis more than 1,5 ml/h had the highest diagnostic value of detection of noneosinophilic phenotype: spesiphity 84,7 %, the predictable value of a positive result 79,1 %, the odds ratio 7,5, the posttesting probability of positive result 79,1 %

What is the role of nucleinat in a complex of control therapy of bronchial asthma in school-age children? Double-blind placebo controlled method

The effect of Nucleinat on bronchial hyperresponsiveness, the parameters of the phagocytic activity and phagocytic index of neutrophils their oxygendependent metabolism and the blood content of nitric oxide metabolites in 98 school age children with bronchial asthma has been studied by means of a double-blind placebocontrolled method. Two clinical groups were formed with the help of the table of accidental numbers. The first clinical group included 47 children who took Nucleinat in a dose of 0,25 g per diem during 21 days in a complex of base-line theraphy. The second clinical group was formed of 51 children who took placebo according to the same regimen. It has been shown that thanks to the use of Nucleinat a reduction of bronchial hypersensitivity and optimization of disease control have been achieved, which was indirectly evidenced by an increased risk of detecting moderate bronchial responsiveness to histamine (OR = 3,6; 95% CІ: 1,3-9,3) and a decrease of the phagocytic activity of neutrophils (OR=1,9 with 95% CI (0,9-4,4)).Кафедра педіатрії та дитячих інфекційних хворо