Pain syndrome is commonly a leading syndrome of oncological and oncohematological diseases in children. Whether the condition is curable or not, the pain syndrome can almost always be controlled that can significantly improve the quality of life of young patients and their families. The presented article highlights the causes and the mechanism of the pain syndrome development in children with oncological and oncohematological diseases. Adequate identification of pathogenetic mechanisms and assessment of pain syndrome is the main goal of the initial assessment of the patient's condition, taking into account the psychosocial characteristics of the patient and his family, thus it is important for clinicians to include these criteria in initial and follow-up examinations of patients in order to provide appropriate therapeutic management. We stress on the comprehensive understanding of the aetiology and pathogenetic mechanisms of the pain syndrome in children with oncological diseases, which directly affect the strategy of overcoming the pain associated with the tumour process, treatment, and carrying out medical and diagnostic manipulations in such children. It is important for specialists in paediatric oncology and oncohematology to diagnose the general pain syndrome, which accompanies cancerous diseases. Effective analgesia requires careful monitoring of the patient’s condition and his/ her syndromic reactions during treatment. The comprehensive assessment of the pain syndrome should include a discussion of the purpose and expectations of pain therapy, changes in pain intensity, characteristics and location. The article presents the basic principles of overcoming the pain syndrome, a three-step approach to the treatment of pain syndrome in children with oncological diseases and the main characteristics and combinations of analgesic groups for pain management.
The adaptation of late premature babies to the new life conditions is difficult and requires careful monitoring of all vital parameters in the postnatal period. The general immaturity of the newborns in combination with the metabolic and hypoxic disorders "leaves only a narrow corridor" to develop babies their compensatory possibilities. There is an urgent need to investigate posthypoxic myocardial ischemia in newborns due to the fact that in the neonatal period, early diagnosis and correct treatment can prevent long-term adverse consequences of existing disorders. The aim of this study was to develop an approach for early detection of cardiac rhythm disturbances and conduction disorders in late premature infants, who underwent perinatal hypoxia. A single-center study included 93 late premature babies who were born at the Perinatal Center, Poltava, in 2019 – 2020. Group I consisted of newborns (n = 47) with hypoxic-ischemic damage of the central nervous system; group II included premature babies (n = 46) with hypoxic-hemorrhagic damage of the central nervous system. Long-term monitoring of the electrocardiogram was performed with further conversion of the altered QRST-QRST complexes into 2D format with a multi-coloured representation of all components of the ventricular electrical systole. Among heterotopic cardiac arrhythmias, supraventricular extrasystoles were most often recorded in 89.4 ± 4.8% of the children of group I and in 67.4 ± 6.1% of newborns in group II with daytime distribution in both groups. Ventricular extrasystoles were found as significantly more frequent in newborns of group I (21.3 ± 6.3%) compared with children in group II (10.9 ± 6.1%), with a significant increase in the area of ectopic ventricular complexes (1492.2) that indicates a prolonged depolarization process. The study of the bioelectrical activity of the heart based on the findings obtained by monitoring the electrocardiogram with the qualitative and quantitative analysis of the convertible QRST-QRST complexes increases the efficiency of visual diagnosis of electrical instability of the myocardium in late premature infants with perinatal damage of the central nervous system.
GENETIC PROFILE OF THE RISK OF DEVELOPING FATAL CASES IN PREMATURE NEWBORNS WITH SEVERE INTRAVENTRICULAR HEMORRHAGES
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