Pediatrician (St. Petersburg)

BACKGROUND: The need for resuscitation at birth depends on the gestational age — the shorter the gestational age, the more often resuscitation is required.

AIM: to determine risk factors and possible methods for preventing preterm birth.

MATERIALS AND METHODS: A retrospective analysis of medical documentation data was carried out on 12,342 women whose delivery was carried out at the Perinatal Center of the Pediatric University. The main group included 680 patients whose pregnancy ended with delivery at 22 weeks — 36 weeks 6 days, the control group included 11,662 patients whose pregnancy ended with term birth.

RESULTS: When analyzing anamnestic factors, it was found that the age of the patients at the time of registration for pregnancy in the main group was statistically significantly higher, height was statistically significantly lower, the serial number of both pregnancy and childbirth was statistically significantly higher, VI or more pregnancies, IV or more births, obesity, arterial hypertension, and a burdened obstetric history (miscarriage, premature birth) are statistically significantly more common than in the control group. In the main group of symptoms, the following are most often noted: pregnancy resulting from the use of assisted reproductive technologies, moderate and severe preeclampsia, isthmic-cervical insufficiency, abnormal indicators of the umbilical cord artery, breech presentation of the fetus. Meconium staining of amniotic fluid was 2 times more common in full-term pregnancies.

CONCLUSIONS: Ascending infection of the placenta, mycoplasma, herpetic and chlamydial choriodeciditis, sub- and decompensated chronic placental insufficiency were statistically significantly more common in premature births. Based on discriminant analysis, a model for predicting the risk of preterm birth was built.

BACKGROUND: The intestinal microflora has an important role in the human body by influencing metabolic processes. It is proved that changes in intestinal microbiocenosis can cause the development of diseases. To date, the state of the intestinal microflora in children with impaired oxalate metabolism in combination with allergic pathology remains insufficiently studied.

AIM: The aim of the research was to study the intestinal microflora in children with secondary hyperoxaluria and allergic respiratory diseases.

MATERIALS AND METHODS: We examined 50 children aged 3 to 7 years with a diagnosis of secondary hyperoxaluria. The children were divided into two groups: group I — children with secondary hyperoxaluria and allergic respiratory diseases (n = 21); group II — children with secondary hyperoxaluria without allergic respiratory diseases (n = 29). All patients underwent a study of the state of intestinal microflora using fecal analysis by real-time PCR with fluorescence detection. The high-performance liquid chromatography method was used to determine the level of short-chain fatty acids in the feces of patients with secondary hyperoxaluria and allergic respiratory diseases.

RESULTS: The level of oxaluria is higher in patients with a combination of secondary hyperoxaluria and allergic respiratory diseases than with isolated secondary hyperoxaluria (p = 0.018). Changes in the intestinal microflora were detected in all patients with secondary hyperoxaluria (100%, n = 50). Сhildren with secondary hyperoxaluria and allergic respiratory diseases had a lower intestinal content of Faecalibacterium prausnitzii (p = 0.004) and Ruminococcus spp. (p = 0.017), there were also violations of the metabolic activity of bacteria, manifested by a decrease in the concentration of monocarboxylic acids: acetic (0.18 ± 0.09), butyric (0.006 ± 0.003), valerian (0.003 ± 0.001).

CONCLUSIONS: Secondary hyperoxaluria in children aged 3 to 7 years is combined with a violation of the intestinal microflora, more pronounced in allergic respiratory diseases.

BACKGROUND: During many years of intensive training, professional athletes may experience manifestations of stress due to significant physical and emotional stress, which require corrective measures.

AIM: The aim of the study is to evaluate the effectiveness of mesodiencephalic modulation of the brain to increase stress resistance in athletes.

MATERIALS AND METHODS: A prospective study was conducted, in which 57 athletes of complex coordination sports took part, of which 42 were girls and 15 were young men, the average age of the subjects was 18 ± 5,4 years. Two groups were formed: main (n = 35) and control (n = 22). To assess the functional capabilities of the body, all subjects included in the study were assessed for nonspecific adaptation responses by the percentage of lymphocytes and the ratio of leukogram elements in peripheral blood, and the level of adaptation and anxiety was assessed using structured questionnaires. Athletes of the main group (n = 35) underwent a course of mesodiencephalic modulation of the brain.

RESULTS: The increase in adaptation capabilities in the control group was due to an increase in the frequency of the increased activation reaction, and in the main group — a calm activation reaction, which, in the presence of stress, is a more favorable adaptation state.

CONCLUSIONS: The use of non-invasive mesodiencephalic modulation of the brain to increase stress resistance in athletes is advisable. Course of mesodiencephalic modulation of brain by cycle consisting of 10 procedures, duration 30 min, average intensity — 1.19 mA, allows to reduce level of psychoemotional tension, to improve general well-being, to increase speed of recovery processes after training. The course of mesodiencephalic modulation contributed to an increase in the adaptation capabilities of the body of athletes.

Modern society requires the adoption and use of digital programmes and technologies in all spheres of activity, including health care and education. Healthcare professionals need to adapt to the digital age in order to provide quality professional care. In order to develop digital competences in the process of studying biological chemistry, there is a need to add new additional knowledge, skills and abilities to the basic mandatory requirements, which causes the need for a special level of teacher training in this field, as well as the availability of modern technologies. This article considers possible ways and methods of incorporating digital technologies into the processes of lecturing, conducting laboratory and practical classes, selecting literature, performing independent work and controlling the knowledge obtained by students. Available digital tools and services for adapting students’ learning in the discipline of “Biological Chemistry” within the framework of digital transformation are proposed. Thus, the use of digital technologies and special equipment in education changes the ways of learning, search, collection, analysis and transfer of educational, professional and scientific information, the nature of students’ independent work, as well as the control of knowledge and skills.

The article is a review of scientific research on the influence of the vestibular system on human cognitive functions. The vestibular apparatus is well studied. Research in recent decades using functional tomography techniques has shown that it has extensive connections with the subcortical and cortical structures of the brain that provide cognitive activity. Hypotheses are put forward that the conduction and processing of bioelectric impulses by the brain, which are recorded by the vestibular apparatus, creates the necessary background for the course of all cognitive processes. The vestibular apparatus has connections with the limbic system, hippocampus, striatum and neocortex. Therefore, vestibular dysfunctions can reduce the ability to learn, cause impaired attention, memory, executive functions, cause disorientation, and affect stress levels. An urgent area of research is the study of the influence of vestibular sensory reactivity on children’s learning ability. This influence has long been underestimated, since it was generally assumed that motor and cognitive development occur independently of each other. The mechanisms linking vestibular dysfunction with cognitive impairment have not yet been sufficiently studied. Further studies are needed to assess the possible impact of vestibular dysfunctions on attention, memory, and speech. Such studies are already underway. Their results are most relevant for patients with neurodegenerative disorders and for children with special needs.

Epidemiological, clinical, biochemical and molecular-genetic characteristics of lysosomal leukodystrophies are presented, which include metachromatic leukodystrophy, globoid cell leukodystrophy, or Krabbe disease, combined saposin and multiple sulfatase deficiency. The pathogenesis of metachromatic and globoid cell leukodystrophy is based on hereditary deficiency of two lysosomal enzymes — arylsulfatase A and galactocerebrosidase, accompanied by excessive accumulation of galactosphingosulfatides and galactosylceramide, respectively. The consequence of this is demyelination of the central and peripheral nervous system and damage to the white matter of the brain. Experimental models show effectiveness of pathogenetic approaches, such as hematopoietic stem cell transplantation and gene therapy, only if treatment is started before the development of severe neurological anomalies. In this regard, neonatal screening methods for these two forms of leukodystrophy are being developed, which have been particularly successful in the early diagnosis of Krabbe disease. For each of the two leukodystrophies (metachromatic and globoid cell), rare genetic variants have been described due to the absence of activator proteins for arylsulfatase A and galactocerebrosidase (saposins B and C), respectively, due to specific mutations in the gene of the precursor of saposins, prosaposin (PSPA). Mutations in the PSPA gene resulting in the absence of all four saposins (A, D, C and D) are the cause of combined saposin deficiency, characterized by the development of severe neurological disorders soon after birth and death before the age of 1 year. The pathogenesis of multiple sulfatase deficiency is based on the accumulation of sulfatides, sulfated glycosaminoglycans, sphingolipids, and steroid sulfates, caused by inactivating mutations in the SUMF1 gene of the sulfatase-modifying factor 1 involved in the biosynthesis of all sulfatases. The disease is characterized by a combined manifestation of metachromatic leukodystrophy and mucopolysaccharidosis in combination with severe neurological disorders, mental retardation, sensorineural hearing loss and ichthyosis. Clinical guidelines for the diagnosis, management and therapy of combined saposin and multiple sulfatase deficiency have not yet been developed. The article presents a description of a clinical case of Krabbe disease in a child observed in the medical genetic center of St. Petersburg.