Vol 10, No 3 (2019)

Objective. To estimate adaptation of an organism of the babies born with different types of light severity of a delay of pre-natal growth and development.

Material and methods. 609 children are examined. Since the birth under observation 141 children, from them are born in the result of the complicated pregnancy and childbirth, including with asymmetric type of light severity of a growth inhibition and development of a fruit – 57 (Group 1a) and with symmetric – 15 (Group 1b) and without that – 69 (Group 2) from mothers with the burdened somatic and obstetric and gynecologic anamnesis. Children are full-term, mature, looked round in 1 (131), 3 (118), 6 (109), 12 (110 children) months. Outcome recording methods were a comprehensive case history analysis, physical examination, assessment of cardiointervalography and body adaptation to the environment. Distribution-free statistical analysis methods.

Results. At children in Groups 1a and 1b satisfactory adaptation of an organism to conditions of the environment took place at the birth of 28. 07 and 26. 67%, in 1 month of 32. 69 and 35. 71%, in 3 months of 31. 11 and 25%, in 6 months of 51. 16 and 46. 15%, in 12 months of 48. 78 and 36. 36%. Tension and an overstrain of adaptation is recorded at 22. 81 and 40%, 36. 54 and 28. 57%, 33. 33 and 41. 67%, 30. 23 and 23. 04%, 19. 51 and 18. 18%. Unsatisfactory adaptation is defined at 42. 11 and 13. 33%, 21. 15 and 21. 43%, 24. 44 and 16. 67%, 11. 63 and 23. 04%, 21. 95 and 18. 18%. Failure of adaptation is revealed at 7. 02 and 20%, 9. 62 and 14. 29%, 11. 11 and 16. 67%, 6. 98 and 7. 69%, 9. 76 and 9. 09% of children respectively.

Conclusion. Study of characteristics of body adaptation to the environment in the scientific community is a perspective area, and any practical application (starting with perinatal centres) of assessment of body adaptation to the environment with follow-up groups identification and further determination during critical periods of growth and development (outpatient monitoring) justify patient-specific approach to outpatient follow-up of infants born with different types of mild intrauterine growth and development retardation.

The relevance of studying the provision of vitamin D in children with inflammatory diseases of the central nervous system (CNS) is due to a high prevalence of vitamin D deficiency conditions in children population, which, according to current literature data, leads to the imbalance of the immune system and a predisposition to a severe disease course, chronization of the process, development of autoimmune pathology. The study of the concentration of neurospecific proteins (NSP) in blood serum and cerebrospinal fluid (CSF) has been recently used to analyze the degree and nature of nervous tissue damage in case of various CNS diseases. The study included investigation of blood serum and CSF samples obtained from 107 children (34 – with encephalitis, 28 – with disseminated encephalomyelitis (DEM), 20 – with multiple sclerosis (MS), 25 – control group). Determination of vitamin D levels (25(OH)D) was performed by the method of electrochemiluminescence immunoassay, concentrations of myelin basic protein, neuron-specific enolase, S100 protein and glial fibrillary acidic protein – by ELISA method. A decrease in the concentration of vitamin D under 30 ng/ml was found in 95% of children with inflammatory diseases of the central nervous system, while the severity of the deficiency of 25(OH)D was associated with the severity of the disease course. In the early stages of the disease in all groups, a significant increase in the level of the main myelin protein was found, while an increase in the concentration of other NSP was observed less frequently and was associated with a severe and complicated course of the disease. Correlations of different intensity and direction between NSP and 25(OH)D were found, which indicates their importance in the pathogenesis of inflammatory diseases of CNS.

The high frequency of severe and complicated forms of infectious diseases in young children, with the possibility of death, confirms the importance of timely specific protection of this age group. In order to identify the causes of violation of the terms of vaccination of young children, 469 histories of children from 0 to 12 months of life were studied. The analysis showed that only 77% of the observed children in the first year of life were vaccinated according to the immunization schedule, whereas in 23% of cases, violations of the vaccination status were found. In 45% of children, the time of immunization was violated already at the stage of the maternity hospital: only every fifth child was not vaccinated because of health reasons, while 79% of children did not receive prophylactic vaccinations due to the mother’s refusal. Medical abductions prevailed in the structure of violations of vaccination terms in the сhildren’s оutpatient: 39% of children were vaccinated with deviations from the schedule due to temporary contraindications, 22% were vaccinated later than terms due to unreasonable medical leads. In 39% of cases of violation of vaccine status is associated with a misunderstanding of the parents of the risk of infectious diseases and the effectiveness of the child’s protection through immunization. Of these, 22% of children were denied, 10% of children were vaccinated with a significant delay, 7% of children did not reach the сhildren’s оutpatient during the year without an explanation of the reasons. Thus, the analysis showed that the majority of the observed children (57%) did not receive timely protection against infectious diseases due to attitudes towards vaccinations of parents, 43% of children were not vaccinated due to medical abductions.

Transpedicular screw fixation is the most established means to stabilize the spine. Present study evaluates personalized navigation templates application for vertebral pedicle passage. Navigation templates were used for inserting 35 transpedicular screws in 5 patients with spinal deformity (age 2–16). Each patient underwent computed tomography preoperatively. Acquired data was processed into a virtual 3d-model of target zone. Life size virtual pedicular probes were placed onto transpedicular trajectories determined on multiplanar cross-sections of the model. Navigation template was created by modification and union of geometric primitives. Target zone model and navigation template were made with PLA by 3D-printer. In surgery the template was placed on skeletonized posterior surface of appropriate vertebrae. After confirmation of template stability trajectories were passed to a depth of 20 mm through guiding tubes by pedicular probe. Resulting channels were controlled with ball tip feeler, and the full depth trajectories were made by free hand technique. Postoperatively screws placement accuracy was assessed by plain X-rays in each patient. Two patients (16 screws) also underwent computed tomography. In these patients screw placement accuracy was assessed by system based on 2 mm breach increments. 15 screws (93. 7%) were fully contained within the pedicle (grade 0), 1 screw breached external cortex of the pedicle by 0. 8 mm (grade 1). Efficacy and safety of navigation template for transpedicular screws insertion was demonstrated.

Relevance of the study. Eating disorders in children in early childhood are among the leading causes of obesity and the metabolic syndrome. The aim of the study. For the prevention of noncommunicable diseases (obesity, metabolic syndrome) in the future, to carry out the analysis of actual nutrition of children of early age and to identify unfavorable factors influencing the formation of eating behavior.

Materials and methods. A survey of 297 parents with children aged 1 to 3 years. The survey is based on the Google Form on-line platform. The platform for the survey was the social network VKontakte, in particular, thematic groups for mothers with children from 1 to 3 years old. The questions were developed taking into account the recommendations set out in the modern normative documents on children’s nutrition.

Results. According to the data, only 28% of children had 5 organized meals per day, 51% had 4 feedings per day, 21% had 3 feedings. More than half of the children (52%) had 2 snacks per day. The most common snacks were flour products (30%), as well as vegetables and fruits (27%). Most parents (78%) did not pay attention to the design of dishes, 16% did not provide adequate replacement of dishes that the child refused. It should be noted that 12% of children do not like vegetables. A joint meal was not organized in 7% of families. During the meal, 40% of parents and 23% of children used a TV/tablet/smartphone. There are a large number of families (37%) who visit fast food restaurants (fast food) with young children, while 26% of them offered menu items to children.

Conclusion. Identified adverse factors in the formation of eating behavior require changes in the approaches to monitoring a young child on nutritional issues both by a pediatrician and by the implementation of a number of recommendations by parents.

Breast cancer is a serious medical and social problem for most developed countries of the world. The search for new prognostic factors and targets for targeted therapy currently continues to be a pressing issue, as there are forms of breast cancer with uncertain targets for any type of therapy. The purpose of this work is to conduct an immunohistochemical study to detect and evaluate the expression of the antigen of the cow leukemia virus in the tissue of various types of breast cancer.

Method. 100 cases of breast cancer were investigated, divided into subgroups, the studied parameters: steroid hormone receptors, HER2 / neu, VEGF, BLV expression, molecular genetic research on BRCA1/BRCA2 mutations.

Results. In the group of triple negative breast cancer, 4 cases were detected expressing a cow leukosis virus antigen. Expression was represented by grains and clumps in the cytoplasm and on the surface of the tumor cell membrane, the wall of microvessels. Also in these cases, increased expression of VEGF was detected.

Conclusion. The results indicate that expression of the BLV antigen was observed only in cases of poorly differentiated triple negative breast cancer. It is also noteworthy that the same type of BRCA1 gene mutation (5382insC) and increased expression of vascular endothelial growth factor were detected in these tumors. The authors first used the immunohistochemical method for detecting the antigen of the BLV virus, which made it possible to reliably confirm its presence in breast tumors with similar molecular genetic and immunohistochemical profiles.

Searching the optimal options for reoperations in overweight patients has the same lengthy and difficult history as all bariatric surgery. The key issues of this aspect of obesity surgery are inefficiency (inadequate weight reduction or it regain) and the unavoidable complications of conservative methods and the negative effects of primary surgery. Weight regain after bariatric surgery is a multicomponent problem. The main reason for the unsatisfactory results of surgical (and conservative) treatment of obesity in some patients is the nature of obesity – the lifelong chronic recurrent disease. A certain role in the return of excess weight is played by the imperfection of the currently existing surgical procedures for the correction of overweight, as well as the wrong choice of options for surgical interventions and technical errors in their implementation. Increase the number of worldwide operations for obesity and its associated diseases translates the problem of revision bariatric surgery from the category of narrow questions in this field of medicine into a serious problem. The article describes modern approaches to the surgical treatment of re-gaining weight after bariatric operations. It considered options for audit procedures, depending on the previously performed surgery. Original techniques of repeated operations for effective correction of the relapse of overweight are described in article.

Vasily Pavlovich Zhukovsky (1861–1938) belongs to Russian pediatricians who pioneered the field of pediatrics in 19^th – beginning of 20^th centuries and established it as an independent branch of medicine, however, his representation in modern history of medicine literature is lamentably scarce. He contributed a lot in institutionalization of pediatrics, worked out new actual problems of pediatrics. His doctoral dissertation subject was problem of rickets, a vaguely known disease in those days. V.P. Zhukovsky was one of the first to study special features in physiology and pathology in newborns, he wrote one of the first Russian manuals in neonatology “Diseases of newborn children” published in 1897. He is also the author of a special monograph “Congenital heart defects in children at birth” (St. Petersburg, 1913). He paid a lot of attention to the problems of infant mortality, especially newborn mortality; clearly raised the question of necessity of antenatal care of the fetus and of the obstetricians and pediatricians’ team working. He contributed a lot in organization of teaching of pediatrics, to amelioration of work of the children ambulatories and the department for the newborns at St. Petersburg obstetrical institution (nowadays Maternity clinic number 6 named after Professor V.F. Snegiryov), where he worked from 1897 to 1910 as one of the first Russian neonatologists. He can be by right considered one of the pioneers of Russian neonatology as he stand at the origins of new branches of Russian pediatrics such as neonatology, pediatric neurology and cardiology.