Assessment of the functional state of the microvasculature in children with diabetes mellitus type 1

Objective: to assess the functional state of the microvasculature in children with diabetes mellitus type 1 (DM type 1).Materials and methods: 63 children with a verifi ed diagnosis of diabetes mellitus type 1 were examined. Th e control group consisted of 30 practically healthy children. Methods: clinical, paraclinical (determination of glycated hemoglobin level, study of microcirculation indicators using laser Doppler fl owmetry (LDF), statistical.Results: microcirculatory disorders accompanying the course of diabetes mellitus type 1 depending on the length of illness were identifi ed. In children with diabetes mellitus type 1 with standing less than 3 years an increase in the average modulation of blood fl ow mainly due to passive regulation mechanisms and the predominance of hypera adaptation in assessing the functional states of microcirculation of varying severity with an increase in the energy of oscillatory processes were observed. Signs of non-nutritive hyperemia in the zone rich in arteriovenous anastamoses and a decrease in perfusion due to an increase in perfusion fl uctuations and coeffi cient of variation in the distal extremities, as well as a decrease in amplitudes in the active tone-forming range, a gradual decrease in the energy of oscillations and randomness criteria were diagnosed with standing in the duration of the disease.Conclusions: disorders in children with diabetes mellitus type 1 microcirculatory detected using LDF are staged. Th e contribution of non-nutritive blood fl ow to microcirculation increases as the disease progresses, which leads to tissue hypoxia. Evaluation of the combination of energy, information and non-linear parameters of the oscillatory component of the blood flow allows you to identify the type of functional state in the microcirculation system

Факторы риска, определяющие тяжесть бронхообструктивного синдрома при острых респираторных вирусных инфекциях у детей

The article deals the possibilities of using early clinical and anamnestic data for the diagnosis of severe bronchial obstruction in children.The aim of the study was to search for informative indicators that affect the severity of bronchial obstruction against the background of acute respiratory viral infections, and to develop a mathematical predictive model for use at the stages of hospitalization.Materials and methods. The study was based on the examination and observation of 386 children aged 1 month to 5 years who were treated in the respiratory department and the intensive care unit with a diagnosis of bronchial obstruction syndrome. To search for informative indicators, 34 anamnestic signs were studied, including those in mother-child pairs. Comparison of indicators was carried out according to Student's t-test for independent samples and у 2 test to assess categorical differences. To assess the effect of each independent variable on the outcomes of interest, variables reaching P ≤ 0.25 in bivariate analysis were included in a multivariate logistic regression model.Results. Mathematical processing showed that only 1 9 factors were identified as significantly influencing the severity of the disease (p < 0.001), while others were not potential determinants of severity. For the main ones, diagnostic values were calculated and a mathematical forecasting model was built with a high level of reliability — 95%.Рассмотрены возможности раннего прогнозирования тяжелого течения бронхообструктивного синдрома у детей.Цель исследования — поиск информативных показателей, влияющих на степень тяжести бронхообструкции на фоне острых респираторных вирусных инфекций, и разработка математической прогностической модели для использования на этапах госпитализации.Материалы и методы. Наблюдались 386 детей в возрасте от 1 месяца до 5 лет жизни, проходивших лечение в респираторном отделении и отделении интенсивной терапии с диагнозом «Бронхообструктивный синдром». Для поиска информативных показателей было изучено 34 анамнестических признака, в том числе в парах «мать-дитя». Сравнение показателей проводили по t-критерию Стьюдента для независимых выборок и критерия %2 для оценки категориальных различий. Для оценки влияния каждой независимой переменной на интересующие результаты, переменные, достигающие в двумерном анализе значения P ≤ 0,25, были включены в многофакторную модель логистической регрессии.Результаты. Математическая обработка показала, что только 19 факторов были определены как существенно влияющие на тяжесть течения заболевания (р < 0,001), тогда как другие не являлись потенциальными детерминантами тяжести. Для главных из них были рассчитаны диагностические значения и построена математическая модель прогнозирования, имеющая высокий уровень достоверности — 95%

Features of the course of neuroblastoma in children

The aim of the study -to conduct retrospective analysis of the initial clinical symptoms of NB, to assign children to risk groups and to analyze the survival rate of patients.Цель исследования - провести ретроспективный анализ начальных клинических симптомов НБ, распределить детей по группам риска и проанализировать выживаемость пациентов