Background. Juvenile myelomonocytic leukaemia is a malignant disease with clonal impairment of haematopoiesis, characterized by excessive proliferation of monocytic and granulocytic sprout. Currently, the only way to cure it is hematopoietic stem cell transplantation. Vigorous treatment is accompanied by the development of a large number of complications, including nutritional ones. Nutritional support for these patients is fraught with many difficulties due to the treatment characteristics, patient’s condition, and complications of therapy.Description of a Clinical Case. A child diagnosed with juvenile myelomonocytic leukaemia, 1 year and 11 months old, received antineoplastic therapy — chemotherapy and bone marrow transplantation. In the course of treatment and after it, severe complications developed, which required various types of nutritional support, depending on the clinical situation. It is illustrated how important timely nutritional support is and how long and difficult nutritional disorders can proceed in these children even after termination of the main therapy.Conclusion. Preventive nutritional support with infant formulas is advisable for children with oncological diseases prior to treatment even with normal nutritional indicators. With the potential long-term impossibility of adequate alimentation per os, it is advisable to consider the placement of a gastrostomy tube for enteral nutrition since problems with appetite can be very long.
Objective:COVID-19 has been identified as a possible risk factor for hypertension. It may be associated with new onset hypertension or aggravate pre-existing hypertension. The objective of the study was to evaluate systolic (SBP) and diastolic blood pressure (DBP) pattern in COVID-19 patients discharged from the hospital and followed for over 3 months.Design and method:This is a prospective single-center observational cohort study of 1442 hospitalized COVID-19 patients including 259 ICU patients followed over 3-months (52.4 ± 12.3 years, 49.8% male) in Uzbekistan January-June 2021. Patients were subclassified according to JNC 8 hypertension stages. For patients who died, the last confirmed BP was used.Results:In the whole cohort, all-cause mortality was 137 (9.5%). At 3-months in ospitalisat patients (no ICU treatment), mean SBP was raised on 7.4 mmHg, DBP 5.7 mmHg compared to the 1st day of admission due to COVID-19, in ICU patients SBP increased by 12.5 mmHg and DBP 7.2 9 mmHg (Table 1). The prevalence of hypertension in the whole cohort subclassified according to JNC8 criteria is presented in Table 2. In the whole cohort at the baseline, according to JNC8, hypertension was detected in 713 (49.4) patients, and by 3-months follow-up new incidence of hypertension was observed in 254 (17.6%) patients. 483 (65%) patients with diagnosed hypertension at the baseline were required to increase the doses of antihypertensive medications after discharge during 3-months follow-up.Conclusions:COVID-19 necessitating ospitalisation is a powerful risk factor for new onset hypertension or for aggravating pre-existing hypertension.
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