Pediatrician (St. Petersburg)

Congenital chlamydia infection develops as a result of the intranatal transmission of the pathogen Chlamydia trachomatis from mother to fetus, more often occurs in the form of conjunctivitis, symptoms of which appear in the second to third weeks of a child’s life, or atypical pneumonia developing at 2–3 months of an infant’s life. The clinical picture of the pneumonia is characterized by an obsessive paroxysmal whooping pertussis-like cough with a moderately pronounced symptom of intoxication. Rare manifestations and complications of chlamydial infection in the form of encephalitis, myocarditis, recurrent otitis media in children under 6 months of age are described. Congenital ureaplasma and mycoplasma infection caused by pathogenic or opportunistic types of urogenital mycoplasmas and ureaplasmas more often occurs in the form of atypical pneumonia, which develops in 2–3 weeks of a child’s life. It is characterized by a gradual onset with catarrhal syndrome with the addition of a dry, intense paroxysmal cough with a moderately pronounced intoxication syndrome. In premature infants, the course of the disease is more severe, cases of meningitis, sepsis, and myocarditis have been described. Ureaplasma infection is one of the independent risk factors for the development of bronchopulmonary dysplasia and retinopathy in premature infants. The main criterion for the diagnosis of congenital ureaplasma, mycoplasma or chlamydia infection is the isolation of the deoxyribonucleic acid of the pathogen in biological media by polymerase chain reaction in the presence of clinical and/or laboratory data For the treatment of chlamydia, ureaplasma and mycoplasma infections in newborns and young children, antibacterial drugs from the macrolide group are used in most cases The duration of the course of therapy and the method of administration depends on the severity of the clinical manifestations of infection in the child, the results of laboratory and instrumental studies.

BACKGROUND: To date, the literature contains a sufficient number of recommendations for medical care for early anemia of prematurity. But the timing of the beginning of prevention of this disease varies. Therefore, the search of laboratory criteria for the start of drag prevention of anemia of prematurity is very relevant.

AIM: Identify the possibilities of using reticulocyte indices for prescribing drug prevention of early anemia of prematurity.

MATERIALS AND METHODS: A retrospective cohort study included 35 preterm infants. They were divided into two groups. The group 1 consisted of premature infants with early anemia of prematurity which developed before the 30^th day of life (n = 16). The group 2 was children with a later manifestation of this disease (n = 19). We were analyzed the parameters of the general blood test with reticulocyte indices and the level of ferritin, transferrin, lactoferrin, erythropoietin in the blood serum at the time of diagnosis of early anemia of prematurity.

RESULTS: Determination of the absolute number of reticulocytes below 110×10⁹/L and the relative number of reticulocytes less than 2.6% on days 8–14 of premature baby’s life determine the drug prevention of early anemia of prematurity in this time period.

CONCLUSIONS: Prescribing drug prophylaxis based on the obtained laboratory parameters will prevent the early onset (before the 30^th day of life) of early anemia in premature infants, as well as reduce the frequency and volume of blood sampling.

BACKGROUND: Postoperative pain syndrome has a negative impact on all vital systems of the body, slowing down the wound healing period and creating a risk of adverse hemodynamic events, thromboembolic complications and the development of chronic pain syndrome. Tyrosyl-D-arginyl-phenylalanyl-glycine amide (TAPGA) is an innovative tetrapeptide drug for subcutaneous administration.

AIM: The aim of the study was to evaluate the efficacy and safety of TAPGA in the early postoperative period in oncological patients of gynecological and urological profile.

MATERIALS AND METHODS: The study was conducted at the Ostroverkhov Kursk Oncology Scientific and Clinical Center. A retro- and prospective analysis of 50 patients from the departments of gynecological oncology (women after hysterectomy) and urological oncology (men after prostatectomy) was performed. Two groups were formed. Patients in the first group were prescribed a combination of “TAFGAA+ketorolac” in the early postoperative period, patients in the second group received pain therapy consisting of a combination of “rimeperidine+ketorolac”. Statistical analysis of the data was performed in Excel, differences between quantitative characteristics in the study groups were assessed using the paired Student’s t-test. Statistically significant results were considered to be values of p < 0.05.

RESULTS: The pain intensity in women of the 1st group was less than in women of the group 2, there was a significantly lower visual analogue scale (VAS) score in women of the group 1 compared to the group 2. In men, there were no significant differences in the intensity of pain syndrome between the prescriptions of these drug combinations — the VAS was no more than 4 points for the entire observation period. Postoperative nausea and vomiting of varying degrees were noted in 100% of women in the group 2 and only in 33% of women in the group 1. In men, this adverse event was noted in 70% of patients in the group 2 and in 50% of the group 1. Patients were activated faster in the group 1. Hemodynamic parameters did not differ significantly in the compared groups of gynecological and urological profiles, however, 13% of female patients had arterial hypertension, which could be caused by both insufficient pain relief and the presence of concomitant hypertension. Recorded the following adverse events were reported in group 1: asthenia — 2 cases, 2 cases of headache in women and 1 case in men.

CONCLUSONS: TAFGAA in the early postoperative period provided reliable and effective analgesia with a favorable safety profile within the framework of multimodal pain relief.

Traumatic brain injury represents one of the most complex biomedical challenges, affecting millions of people worldwide each year. Various experimental and theoretical models are used to understand the pathophysiology of traumatic brain injury and to develop effective therapeutic strategies. This review focuses on three main groups of models: theoretical (in silico), cellular (in vitro), and animal (in vivo). Theoretical models of traumatic brain injury are based on mathematical approaches and computer simulations to analyze mechanical brain injuries, edema processes, ischemia, and neuroinflammation. In silico approaches provide high precision and reproducibility but require proper validation with biological data. Cellular models include the cultivation of neurons, astrocytes, microglia, and brain organoids, which are subjected to mechanical or chemical factors that mimic traumatic brain injury. These systems allow researchers to study cellular and molecular mechanisms such as apoptosis, neuroinflammation, and regeneration. However, in vitro models are limited by the absence of a systemic response characteristic of an entire organism. Animal models are considered the “gold standard” for studying traumatic brain injury. These involve direct mechanical impacts on the brains of animals (e.g., mice, rats, pigs), enabling the reproduction of clinical aspects of trauma, including behavioral and pathophysiological changes. Despite their high physiological relevance, in vivo models face ethical limitations and challenges in extrapolating results to humans. This article provides an overview of modern approaches to traumatic brain injury modeling, including their classification, characteristics, advantages, and limitations. The data presented may serve as a foundation for developing more effective treatment and rehabilitation strategies for traumatic brain injury patients.

One of the important tasks of modern dentistry is to find indicators that would allow predicting the development of complications of dental implantation. However, there is currently no generally accepted set of biomarkers and assessment scales for early diagnosis of the risk of complications and monitoring of osseointegration processes. Accordingly, the possibility of early prevention and treatment in an adequate time frame is reduced to prevent the development of implant rejection. To improve the forecasting and evaluation of the effectiveness of dental implantation based on the molecular profile of patients an analytical review of publications over the past decade devoted to the use of biomarkers for predicting and evaluating the effectiveness of dental implantation was conducted. The tissue response to an implant in peri-implantitis is a complex pathophysiological process that involves the interaction between the implant, surrounding tissues, and the body’s immune system. Based on the analysis of literature data, a panel of biomarkers has been substantiated that can be used to predict complications after dental implantation and assess the severity of peri-implantitis from the perspective of modern views on the pathophysiological molecular and cellular mechanisms of peri-implantitis: α-tubulin, β-tubulin, cyclooxygenase-1,2,3, vascular endothelial growth factor and its receptor, melatonin and its receptors, nerve cell nuclear protein, nitric oxide, vascular cell adhesion molecule-1, neuron-specific enolase, claudine-1 and E-cadherin. The use of this panel of molecular markers will improve the accuracy of predictions, individualize treatment approaches, and ensure the long-term stability of implants.

Emery–Dreyfus muscular dystrophy is a genetically heterogeneous disease with X-linked recessive, autosomal dominant and autosomal recessive forms, which can be caused by mutations in the EMD, LMNA, SYNE1 and SYNE2 genes. Emery–Dreyfus muscular dystrophy caused by a mutation in the SYNE2 gene is characterized by an autosomal dominant mode of inheritance with the onset of clinical symptoms in childhood. This form is characterized primarily by proximal muscle weakness of the upper and lower extremities and cardiac complications. The article describes a patient with Emery–Dreyfus muscular dystrophy caused by a mutation in the SYNE2 gene. The article presents clinical and instrumental examination methods, the dynamics of the course of the disease. During the observation period of 6 months, the patient showed a significant decrease in motor functions — a decrease in the distance of the 6-minute walking test, the ability to walk and move (D1) on the scale “motor function measure”, the results of speed tests. The patient also has a steadily progressive impairment of respiratory and bulbar functions, which requires regular dynamic monitoring, every day monitoring of oxygen saturation, and night and daytime non-invasive artificial ventilation is indicated. Taking into account the literature data and previously described clinical cases, the patient is characterized by a high risk of developing heart rhythm disturbances and dilated cardiomyopathy, which requires proper monitoring at least once every 6 months.

BACKGROUND: The occurrence of a serious (disabling) illness in one of the family members and/or the need to provide care for a chronically ill person often becomes a difficult ordeal for his inner circle. However, the impact of traumatic events may also be associated with experiencing positive personal transformations, such as posttraumatic growth. Currently, there is an acute shortage of psychodiagnostic techniques that simultaneously assess both negative (destructive) and positive (developmental) changes in the personal functioning of informal caregiver in situation of chronic illness of a loved one. The creation of valid psychodiagnostic tools is important to form a holistic view of how traumatic events affected person’s values and beliefs.

AIM: Verification of the factor structure of the Posttraumatic Growth and Depreciation Inventory — Expanded version on a Russian-speaking sample of relatives of patients with cerebral pathology.

MATERIALS AND METHODS: Validation of factor structure was performed on a sample of relatives of patients with cerebral pathology (n = 151, mean age 51.77; SD = 14.01 years). To determine the structure of the Russian-language version of the Posttraumatic Growth and Depreciation Inventory — Expanded version, factor analysis was used. The suitability of scales, obtained as a result of factor analysis, was calculated using the Cronbach’s alpha coefficient.

RESULTS: The analysis demonstrated the mismatch of the factor structure of the original construct with the factor structure obtained on the Russian-speaking population. A four-factor structure was obtained for both the “Posttraumatic Growth” (PTG) and the “Posttraumatic Depreciation” (PTD) blocks: 1 factor “Inner freedom/harmony” (PTG) — “Inner stiffness/increasing dissonance” (PTD), 2 factor “Energetic fullness of relationships/ability to empathize” (PTG) — “Interpersonal exhaustion” (PTD), 3 factor “Meaningfulness of life” (PTG) — “Loss the meaning of existence/the growth of chaos and emptiness” (PTD), factor 4 “Interpersonal optimism” (PTG) — “Disappointment/skepticism” (PTD). The analysis indicates sufficient reliability (Cronbach’s alpha coefficient) of scales obtained as a result of factor analysis.

CONCLUSIONS: Differences in the factor structure of the original and adapted Posttraumatic Growth and Depreciation Inventory — Expanded versions may indicate the specificity of the Posttraumatic Growth / Posttraumatic Depreciation, depending on the intensity and nature of the traumatic experience. The Russian-language version of the Posttraumatic Growth and Depreciation Inventory — Expanded version obtained during the verification of the factor structure can be used to work with relatives providing assistance and care for seriously and/or chronically ill loved ones.