Репозиторий Университета

© 2018, Pediatria Ltd.. All rights reserved. In 2011, a cohort for prospective follow-up was chose from the general population of newborns in Moscow. In 3 years of life, information on atopic dermatitis (AtD) symptoms was collected. Skin tests with allergens were performed in mothers and in children aged 1 year. Objective of the research – to correlate the sensitization of a child at the age of 1 year and sensitization of his mother with subsequent possible development of AtD in his early childhood. Study materials and methods: mother's sensitization and sensitization of a child at 1 year of age were examined separately for the possible appearance of AtD diagnostic signs at the age of 1, 2, 3 years of a child and in general in early childhood. The results of each study are presented by several methods of statistical processing: 1) analysis of conjugation tables, incl. hierarchical log-linear; 2) logistic regression models in which: a) the sensitization degree was considered, b) the sensitization was analyzed as a qualitative sign, in the presence of a papule. Results and discussion: рrospective monitoring of the cohort shows the dynamics of AtD frequency in early childhood, the number of sensitized mothers and their children. Mother's sensitization was not significant for AtD signs appearance in a child in early childhood. The sensitization of a child at the age of 1 year showed the importance of chicken egg allergen in relation to AtD signs appearance in early childhood. Study result: conclusions about the possible relationship of sensitization with AtD development in a child in early childhood.

© 2018 Hubail et al. Purpose: The aim of this study was to evaluate the progression of a case of a patient with epidermolysis bullosa (EB) since early age who survived to adulthood, presenting with recurrent skin blisters and disfiguring scars and disabling musculoskeletal deformities. Background: EB is a rare group of inherited diseases that affect the skin fragility causing it to blister in response to even minor trauma. Established novel treatments are limited in the literature due to its rarity, and more research is needed to set a global management approach. Clinical manifestations range widely from localized to generalized blistering. Methods: A rare case of EB surviving to adulthood despite the complications, which has been evaluated, treated during a relapse, and followed up. Conclusion: The described case is of considerable clinical interest due to its rarity and severity. Optimal management requires a multidisciplinary approach and revolves around the protection of the skin against slightest injury, use of careful wound care dressings, aggressive nutritional support, and early medical or surgical interventions if needed to manage any complications. Prognosis varies considerably depending on each case.

© 2018, Dynasty Publishing House. All rights reserved. The objective. Assessment of the practice of breastfeeding support in a department of neonatal and premature infant pathology of the Tambov Regional Children’s Clinical Hospital (TRCCH) after 3–4 years of becoming a WHO/UNICEF Baby Friendly Hospital. Patients and methods. Mothers were questioned using specially designed questionnaires at their admission to the department and at discharge from hospital. Overall, 356 mothers were questioned at admission and 327 at discharge. The results were processed on the SPSS.19 statistical programme. Frequency distribution, mean values (± standard deviation) and Student’s t-coefficient were determined. Results. The practice of supporting breastfeeding in the department consisted in observance of the 10 steps of successful breastfeeding: mother and infant remaining together (98.2%), breastfeeding on an infant’s demand (91.3%), breastfeeding at night (98.6%), breast milk extraction for infant feeding and lactation stimulation (88.6%), informing mothers about the benefits and technique of breastfeeding (90.5%). The percentage of breastfed infants significantly increased by the time of discharge from the department – to 89.4% (at admission – 71.9%; p < 0.0001), among them exclusively breastfed infants – to 66.5% (at admission – 45.3%; p < 0.0001). Conclusion. The practice of breastfeeding based on current international recommendations is successfully supported in the neonatal department of TRCCH. Nevertheless, breastfeeding parameters might be considerably improved due to attainment of continuity in the work of maternity clinics and TRCCH and optimization of the practices of breast milk extraction, storage and use in the department.

© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. Post-mortem MRI characteristics of the distribution and severity of nonimmune fetal hydrops (NFH). Materials and methods. The analysis of autopsy material of 2 stillborn and 22 newborns, divided into three groups was carried out. Group I consisted of the bodies of the dead due to NFH, group II - the bodies of newborns who died with the presence of general edema syndrome in the absence of NFH, group III (control) - the bodies of deceased newborns in the absence of NFH and general edema syndrome. Before autopsy, MRI was performed. On T1- and T2-weighted images was determined by the thickness and signal intensity of the skin with subcuta-neous tissue and the subsequent calculation of the tissue hydration index. The volume of fluid in the pericardial cavity, pleural and abdominal cavities determined when using three-dimensional processing of the obtained tomograms and calculated their specific volume in the corresponding cavities. Results. The values of the specific volume of free fluid in the pleural cavities and abdominal cavity less than 8% should be considered a natural postmortem sign, rather than the life-time accumulation of transudate, when examining the bodies of deceased newborns on the first day after death. The mean values of absolute and specific volumes of pleural fluid had the maxi-mum values in the NFH observations, exceeding the values of the control group by 6.3 and 5.1 times, respectively. The highest values of the absolute amount of ascites were observed in the group with general edema syndrome. In the NFH group, all cases had hydrothorax, 85.7% of cases had ascites, and 42.9% had hydropericardium. In the group of newborns with general ede-ma syndrome, hydrothorax was detected in 57.1%, ascites - in 85.7%, and hydropericardium - in 42.9% of cases. The thickness of the skin with subcutaneous tissue depended on the localization and group of research. The most pronounced deviations from the control level were recorded for the average values of the skin thickness of the anterior chest wall in group I and the scalp of the fronto-parietal region in group II. The mean values of the tissue hydration index were higher in the group with NFH, and the lowest in the control group. Conclusion. Postmortem MRI performing, allows an objective assessment of the nature and severity of anasarca and pathological fluid accumulations in the serous cavities of dead fe-tuses and newborns. In this regard, postmortem MRI is recommended as a mandatory component of the autopsy of the bodies of fetuses and newborns that died as a result of nonimmune fetal hydrops.

© The authors team, 2018.All Rights Reserved. This is the first report of a clinical case of subcutaneous adiponecrosis of a newborn with acute early neonatal period from a mother with risk factors in the form of diabetes, hypoglycemia during pregnancy, chronic infections, emergency surgical delivery due to acute fetal hypoxia. The article contains algorithm of the differential diagnostics of diabetic embryo-fetopathy and metabolic disorders in a newborn from a mother with diabetes.

© 2018, Pediatria Ltd.. All rights reserved.  Objective of the research – to reveal the correlation between neurochemical criteria in the neonatal period and the consequences of severe hypoxic hemorrhagic CNS lesions in children according to catamnesis data. Materials and methods: researchers analyzed 54 cases of newborns of different gestational age (GA) that were in the ICU after birth due to severe condition; all newborns had combined hypoxic hemorrhagic brain lesion detected by neurosonography – periventricular leukomalacia (PVL) and intraventricular hemorrhage (IVH) of various severity. Catamnesis follow-up was performed up to 2–2,5 years of age. The control group consisted of 20 newborns, comparable in GA, body weight at birth, with an Apgar score of at least 6 points in the 1st minute of life and without changes in neurosonography. In the neonatal period, serum concentrations of S100, BDNF, VEGF, ALCAM, DR5 were studied in dynamics using the quantitative ELISA (Enzyme Linked Immuno Sorbent Assay) according to a standard protocol. Results: the concentration of factors contributing to destructive changes in tissues (S100, DR5, ALCAM) in the serum, was in inverse correlation with the level of VEGF and BDNF. The latter had a direct correlation relationship. VEGF directly correlated with CNTF by the end of the 2 nd week of life. Results of catamnesis follow-up: 43 children diagnosed with cerebral palsy, 25 with spastic diplegia, 18 with spastic tetraparesis, and 11 without evident motor disorders. In 28 children I–III level of motor disorders was determined according to GMFS, in 26 children – IV–V level. At the age of 2 years, all children underwent MRI of the brain and gliio-atrophic changes were detected. Significant differences in the implementation of neurological consequences were found between the number of children with grade I and II IVH and PVL and III–IV degree IVH and PVL. Conclusion: children with PVL and IVH III–IV degree have a high risk of severe neurological outcomes – spastic tetraparesis, impaired motor activity by GMFS IV–V level, mental retardation and symptomatic epilepsy.