No abstract

Acute meningitis in children is a common cause of complications and leads to developmental disabilities. That is the reason why it is important to look for possible markers that indicate nerve tissue damage for early diagnosis, their prevention and prognosis of CNS complications.Objective. To examine neuron specific enolase (NSE) and its diagnostic significance as an indicator of neuronal damage in children with acute meningitis. Materials and methods.Blood samples of 40 children with acute meningitis and 30 of healthy children between the ages of 1 month to 18 years old were studied. The measurement of NSE was made from a blood serum during the first 24 hours after hospitalization by the enzyme-linked immunosorbent assay test performing. The degree of impaired consciousness was determined by the Glasgow Coma Scale. The results were processed with the Student's t-test, correlation and regression analysis methods with constructing confidence intervals.Results. NSE levels in children with acute meningitis was 7.6 times higher than the results of healthy children, which was 22.56 ± 1.14 and 2.95 ± 0.16 ng/ml, respectively, (P < 0.0001) (95 % CI; 19.19 to 20.03). CNS complications of the disease in patients were detected in 22 (55 %). Patients with complications had significantly higher level of NSE than patients without complications and it was 25.35 ± 1.61 and 18.60 ± 1.49 ng/ml, respectively, (P < 0.01) (95 % CI; 5.74 to 7.75). Impaired consciousness was observed in 21 (52.5 %) patients. The content of NSE in patients with impaired consciousness was within 20.72 ± 7.33 ng/ml and it was higher than NSE content in patients with normal consciousness that was within 16.56 ± 4.69 ng/ml (P < 0.05) (95 % CI; 0.17 to 8.14). Reliable inverse and strong correlation was detected between the NSE level and the level of consciousness by the Glasgow Coma Scale, where the coefficient of determination R 2 = 0.624 and coefficient of correlation r -0.785 (P < 0.001) (95 % CI; -1.08 to -0.48).Conclusions. Thus, the data indicates that acute meningitis occurs with the brain matter damage. The blood NSE content in acute meningitis can be used as a biochemical marker for the neuronal damage severity and as a prognostic marker for the CNS complications development.Нейрон-специфічна енолаза як можливий показник нейронального пошкодження при гострих менінгітах у дітей Л. В. Пипа, Р. В. Свістільнік, Г. С. Московко, Ю. М. Лисиця, М. М. МургінаГострий менінгіт у дітей -часта причина виникнення ускладнень і розвитку інвалідизації. Тому важливим є пошук можливих маркерів пошкодження нервової тканини для ранньої діагностики та прогнозу ускладнень із боку ЦНС і їх запобігання.Мета роботи -вивчити вміст нейрон-специфічної енолази у крові та її діагностичне значення як показника нейронального пошкодження в дітей із гострими менінгітами.Матеріали та методи. Виконали дослідження зразків крові 40 дітей із гострими менінгітами, 30 здорових дітей віком від 1 місяця до 18 років. Нейрон-специфічну енолазу (НСЕ) визначали в сироватці крові в першу добу пі...

The aim: To determine the anxiety disorders in children suffering from organic diseases and functional disorders of the respiratory tract in the clinical settings of the pulmonology department, as well as to assess their impact on disease course and quality of life. Materials and methods: 131 pediatric patients aged 6-17 years old have been studied. The patients were divided into three groups: the children with somatoform respiratory disorders (SRD) – 33,6 % (n = 44), those with bronchial asthma (BA) – 34,3 % (n = 45) and those with pneumonia - 32,1 % (n = 42). Spielberger-Khanin test questionnaire was used to study anxiety, and Nijmegen questionnaire was used to diagnose hyperventilation syndrome (HVS). Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q) was used to determine the quality of life. Results: Severe trait anxiety was observed more often in the subgroup of children with SRD (65,9 %) than in those with asthma (40,0 %) and pneumonia (21,5 %). HVS occurred in 19.1% of patients. Direct moderate correlations were found between Spielberger scale (trait anxiety, r = 0,426; p<0,0001), (state anxiety, r = 0,393; p<0,0001) and Nijmegen HVS questionnaire, as well as inverse moderate correlations between Spielberger scale (state anxiety, r = -0,321; p<0.0001), (trait anxiety, r = -0.429; p<0,0001) and Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Conclusions: Severe trait and state anxiety was found in 42,8 % and 19,1 % of children, respectively. Severe state and trait anxiety was observed more often in patients with SRD (65,9 % and 27,3 %, respectively), being twice as common in girls as in boys (57,6 % versus 32,1 % for trait anxiety and 24,8 % versus 12,6 % for state anxiety, respectively). Anxiety disorders are supposed to be the basis for HVS development and the cause of low satisfaction with the quality of life in patients with pulmonary diseases.

Introduction:. The problem of mood disorders in adolescents has recently become acute due to the high frequency of encounter and social significance. The aim: To investigate the screening of anxiety and depressive disorders and their manifestations in adolescent children to determine risk factors and to develop measures for their prevention. Materials and methods: The study was attended by 189 students aged 16-17 years of the educational institutions of the Khmelnytskyi region. For study it was used: Spielberger questionnaire in adaptation A. Andreeva and questionnaire for child depression M. Kovacs, 1992. Results: A high level of personal anxiety was detected in 44 adolescents (23,3%) and situational in 76 (40,2%) adolescents. In 48 (25,4%) adolescents there were signs of depression, in 11 (5,8%) - severe depression. The level of depression in girls was significantly higher compared to boys (95% CI, 2,6-8,8) (p<0,0004), which was manifested in the form of aggressive behavior (95% CI, 3,3-9,4) (p<0,0001) and anhedonia (95% CI, 1,7-7,0) (p<0,001). Signs of depression more often were appeared in adolescents who had an incomplete family (95% CI, 0,7-8,5) (p<0,02) and manifested in the form of aggressive behavior (95% CI, 0,6 (p<0,02), anhedonia (95% CI, 0,7-7,3) (p<0,01) and negative self-esteem with the presence of suicidal thoughts (95% CI, 0,3-7,5) (p<0,03). Conclusions: Mood disorders are quite common among adolescents and require timely detection and correction in order to improve their social adaptation and prevent suicidal behavior. The main factors of mood disorders in adolescents can be an incomplete family and a female.

Проведено аналітичний огляд світової літератури, у якій висвітлено епідеміологію, етіологію, сучасні погляди на патогенез, клініку, діагностичні критерії депресивного розладу в дітей та підлітків, а також пов’язану з ним суїцидальну поведінку та соціальне значення цього захворювання і його наслідків. Розглянуті ключові рекомендації з лікування й профілактики депресії в дітей та підлітків згідно з останніми європейськими та американськими рекомендаціями, що ґрунтуються на позиції доказової медицини.