Стаття колективу провідних вчених педіатрів та організаторів педіатричної охорони здоров’я України присвячена вивченню основних тенденцій у стані здоров’я дитячого населення країни за останні 22 роки. Аналіз захворюваності та поширеності хвороб серед дитячого населення України, рівнів малюкової смертності протягом останніх двох десятиліть свідчить про те, що вони залишаються значно вищими від середньоєвропейських показників на тлі прогресивного зменшення чисельності дитячої популяції на 3,16 млн осіб. Поширеність дитячих хвороб в Україні за останні 22 роки зросла на 41 %, захворюваність на дитячі хвороби — на 36 %. Розглянуті шляхи вирішення низки нових соціальних та медико-екологічних проблем, що негативно впливають на здоров’я дітей.
Allergic diseases, which have a certain stage in their development from food allergy to bronchial asthma / allergic rhinitis, are much more common in children than in adults. The aim of this study was to analyze data on the prevalence and incidence of atopic dermatitis, bronchial asthma and allergic rhinitis as components of the allergic march, in children of Ukraine from 1994 to 2017 to determine the possible impact of adverse environmental factors on their development. During the same period, due to the influence of a number of factors, in particular environmental, there were significant changes in the structure of allergic diseases making up the stages of the allergic march due to an increase in the proportion of allergic rhinitis with the reduced one of asthma and atopic dermatitis. Within 24 years, the incidence of atopic dermatitis in children aged 0-6 years including, increased by 27.6%, in adolescents - by 40.5% and significantly decreased by 39.5% in children aged 7-14 years including. Most cases of allergic rhinitis and bronchial asthma were observed in schoolchildren (47.6 and 54.0%, respectively) with a slight decrease compared to 1994. In general, allergic diseases in recent years have become more common in children from 0 to 6 years and their detection has decreased in school-age children and adolescents. Over the past 24 years, in children of Ukraine a steady increase in the incidence and prevalence of allergic diseases that form an allergic march has been noted: the prevalence of bronchial asthma has increased by 69.3% and the incidence has increased by 22.9%; the prevalence of atopic dermatitis increased by 43.9% and the incidence increased by 8.3%; the prevalence of allergic rhinitis increased by 488.3% and the incidence of allergic rhinitis increased by 380.3%, with a predominance of detection of this pathology in children from regions with developed infrastructure and industry, where there are significant emissions of pollutants into the atmosphere, that have a direct moderate effect on the increase in the prevalence of bronchial asthma, the incidence and prevalence of allergic rhinitis in children.
Bacterial, allergic, parasitic and fungal skin lesions are much more common among children than among adult patients. The aim of this study was to analyze data on the prevalence and incidence of diseases of skin and subcutaneous tissue with allergic and non-allergic origin among children of Ukraine in period from 1994 to 2017. Our main purpose was to determine the possible impact of different adverse environmental factors on children`s growth, including radiation, connected with the Chernobyl disaster in 1986. Over the past 24 years Ukraine has witnessed a 10.3% increase in prevalence of diseases of skin and subcutaneous tissue among children and 8.6% raise of incidence rate with a predominance of detection of this pathology in children affected by the Chernobyl accident and children from areas of radiological control. We have found a direct influence of moderate strength on the connection between population-weighted effective dose of total human exposure (in millizieverts) in different regions of the country in the period of 1997-2011 and the incidence and prevalence of skin diseases among children aged 0-14 years, including 2011 (p<0.05).This fact may indicate the impact of this disaster on the occurrence and pathogenesis of skin diseases and its consequences among children. During the same period, due to the influence of a number of environmental factors, there was a significant transformation in the structure of skin diseases in children. We have witnessed double increasing of the proportion of allergic lesions of the skin and its elements. The prevalence of diseases of the skin and its elements in general has reached 28.7% against the corresponding reduction of skin infections.
Purpose — to discover peculiarities of Wilson disease course in children dependently on the variant of liver affection. Materials and methods. Anamnesis of the disease and clinical and paraclinical peculiarities of the course of the disease with consideration of liver affection severity have been studied in 50 children aged 5–17 years. Results. It was estimated that in 52% of children the disease had a form of chronic hepatitis with minimal clinical symptoms, 44% of patients had liver cirrhosis with predominant signs of edematous and ascitic syndrome and 4% had fulminant hepatitis in a debut of the disease. Complicated family anamnesis was detected in 4% of patients. Syndrome of cytolysis predominated in patients with liver damage in the form of chronic hepatitis (р<0.05). Typical biochemical changes in cirrhotic patients were hepatocellular insufficiency with hypoalbuminemia and coagulopathy, hyperbilirubinemia and minimal hypertransaminasemia (р<0.05). Children with cirrhosis in contrast to patients with chronic hepatitis had reliably lower serum ceruloplasmin concentration and reliably higher excretion of copper with urine. Specific for Wilson disease Kayser—Fleischer rings were found out in 36% of patients only. Conclusions. Wilson's disease in children is characterized by progressing course in the form of either chronic hepatitis or liver cirrhosis or, rarely, fulminant hepatitis. Clinical and paraclinical symptoms of the disease are estimated by the severity of liver affection and vary from a course with minimal symptoms in patients with chronic hepatitis to edematous and ascitic syndrome and hepatocellular insufficiency in patients with cirrhosis and fulminant hepatitis. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Wilson's disease, children, chronic hepatitis, liver cirrhosis, course of the disease.
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