Background. The purpose of the work is to study the blood content of biologically active substances — peptides and hormones that can affect blood pressure and the development of hypertension, depending on the gender and disease course in adolescents aged 17 years by comparing them with healthy individuals. Materials and methods. There were examined 87 adolescents (37 boys and 50 girls) who were divided into 4 main groups with stable and labile hypertension and 2 control groups with normotension. All patients underwent daily blood pressure monitoring and a comprehensive clinical examination, which ruled out symptomatic hypertension. The serum concentrations of biologically active substances were determined, namely endothelin, renin, copeptin, testosterone, estradiol, osteocalcin and protein induced by vitamin K absence (PIVKA-II), by enzyme immunoassay. Results. It was found that the most important feature that distinguishes hypertensive adolescents from normotensive peers was renin, which serum concentrations were almost 1.5 times higher in boys with labile hypertension and twofold — with stable hypertension. Girls with stable hypertension had the same patterns, with a twofold increase in renin level. Regardless of hypertension course, female adolescents had higher endothelin levels. In addition, girls with stable hypertension had high serum content of PIVKA-II. Conclusions. The elevated serum renin level in boys and girls at late stages of puberty as an indicator of renal dysfunction can be considered an essential cause of hypertension development. Determining the importance of renal dysfunction with increased levels of vasopressor hormones directs therapeutic efforts in the treatment of adolescents with hypertension precisely to the correction of this link in the pathogenesis of juvenile hypertension.
Метою дослідження було вдосконалення своєчасної діагностики кишкових ускладнень антибіотикотерапії, обумовлених Clostridium difficile-інфекцією у дітей. Обстежили дітей віком від 6 місяців до 18 років (n = 131), які отримували антибактеріальні препарати з приводу мікробно-запальних захворювань. У 116 з них були бактеріально-запальні захворювання, які потребували лікування антибіотиками в умовах стаціонару або поліклініки; контрольну групу становили 15 клінічно здорових дітей. Використали загальноклінічні та імуноферментні методи. Установлено, що в дітей iз соматичними захворюваннями, які отримували лікування антибіотиками у стаціонарi, найбільш поширеним кишковим ускладненням є гостра діарея, і доведено, що діарея обумовлена в більшості випадків інфекцією Clostridium difficile. Визначено частоту та особливості клінічного перебігу кишкових ускладнень антибіотикотерапії у дітей. Виявлено існування субклінічної форми кишечного клостридіозу. Доведено, що рецидивуючий діарейний синдром у дітей, які отримували повторні курси антибактеріальних препаратів в амбулаторних умовах, також обумовлений Clostridium difficile-інфекцією.
The aim of the study was to investigate the fecal levels of lactic acid and short-chain fatty acids (SCFAs) in children with acute diarrhea and to identify their role in the development of infectious or non-infectious diseases.
Materials and methods. The study included 42 children aged 6–24 months with an episode of acute bacterial, rotavirus, symptomatic or functional diarrhea hospitalized in the infectious biosafety unit of the Children’s Hospital. The control group comprised 18 children without symptoms of intestinal disease, matched to the main group for age, sex and stool consistency scored according to the Bristol Stool Scale of 4–6. All the children underwent comprehensive clinical, laboratory, virological examinations and stool cultures. Additionally, fecal calprotectin, reducing substances, lactic acid and short-chain fatty acids were studied.
Results. It was found that the lactic acid levels were low in healthy children and often approached the trace concentrations. In children with diarrhea, lactic acid was detected in all fecal samples, and the highest its level was in children with functional (non-infectious) diarrhea. Opposite results were obtained in the study of SCFA. A deficit of SCFA was revealed in patients with diarrhea, but least of all in functional one, in comparison with the control group. The role of microbiome damage and intestinal wall hypoxia was suggested based on the results obtained.
Conclusions. The use of lactic acid and SCFA as coprological tests can be helpful in the differential diagnosis of infectious or non-infectious causes of diarrhea in children aged 6–24 months.
Цель работы-установление частоты выявления токсинов C. difficile в стуле у детей, длительно получающих антибиотик рифампицин, а также у медицинского персонала, осуществляющего уход за этими детьми в условиях противотуберкулезного закрытого стационара.
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