Purpose - to study particular properties of the course of the infection among hospitalizedchildren depending on the nature of their treatment provided in pre-hospitalizationperiod in order to improve the results of treatment of children with COVID-19.Material and methods. In a random sample 263 children with COVID-19, admittedto the Department of infectious diseases of the Regional Children's Clinical Hospitalof Chernivtsi, have been examined. The first clinical group includes 68 patients thatreceived antiviral treatment as a part of symptomatic therapy (average age 6,5 ± 0,74years, male ratio 54,4%), and the comparison group - 195 children that did not receiveantiviral activity treatment (average age 6,4 ± 0,41 years, male ratio 50,8%).Results. Most patients with COVID-19 presented signs of moderate to severe medicalstate when admitted to hospital. Patients that did not receive any antiviral therapy in thepre-hospitalization period showed delayed body temperature normalization response (onaverage on the 5th day of the treatment) and, starting from the day 10 of hospitalization,experienced elevated body temperature again caused by infectious and inflammatoryprocess as a result of COVID-19 complications. Changes concerning hemostasisinclude an increase of absolute count of platelets in the blood, reduction in plasmarecalcification time and increase of plasma D-dimer levels (p <0,05). Administration ofantiviral therapy to the children with Covid-19 in the outpatient setting is accompaniedwith absolute risk reduction of a positive PCR test 25% on the 14th day of the disease.Conclusions. Therefore, administration of antiviral therapy to the children with Covid-19in the outpatient setting is characterized with slightly faster temperature normalizationresponse, better clinical signs, virus elimination (minimization of the possibility of apositive PCR test 25%), as well as less excessive hypercoagulable disorder.
Актуальність. Значний поліморфізм клінічних проявів інфекційного мононуклеозу, поліорганність ураження, часта відсутність чітких клініко-параклічних критеріїв та відстроченість результатів доступних лабораторних тестів, а іноді і неможливість їх проведення утруднюють діагностику захворювання на догоспітальному етапі та при надходженні до стаціонару. Мета дослідження: оптимізувати діагностику та лікування інфекційного мононуклеозу в дітей шляхом вивчення сучасних особливостей перебігу та аналізу діагностичної цінності клінічних та інструментальних показників у верифікації захворювання. Матеріали та методи. На базі інфекційного боксованого відділення крапельних інфекцій КМУ «Обласна дитяча клінічна лікарня» (м. Чернівці) обстежені 65 дітей, хворих на інфекційний мононуклеоз, які знаходилися на стаціонарному лікуванні в період 2014–2015 рр., першу клінічну групу (І) сформували 42 дитини, заключний клінічний діагноз захворювання у яких верифіковано на підставі комплексу клініко-гематологічних критеріїв, до другої (ІІ) клінічної групи порівняння увійшли 23 дитини, хворі на серологічно підтверджений інфекційний мононуклеоз. За основними клінічними ознаками групи спостереження вірогідно не відрізнялися. Результати. Установлено, що для хворих на інфекційний мононуклеоз дітей характерні клінічні особливості, зокрема раптовий початок захворювання (у 93,8 %) із лихоманки, вищої за 37,5 °С (у 80 %), наявність ексудативного тонзиліту (у 81,6 %), підщелепної та шийної лімфаденопатії (у 90,7 %), утрудненого носового дихання (у 78,4 %) та гугнявості голосу (у 73,8 %). У підтвердженні інфекційного мононуклеозу Епштейна — Барр-вірусної етіології явища ексудативного тонзиліту та лімфаденопатії виявилися високочутливими (90 та 95 % відповідно), проте із значною часткою хибнопозитивних результатів. Висновок. Таким чином, з урахуванням недостатньої діагностичної цінності клініко-анамнестичних та сонографічних показників у виявленні інфекційного мононуклеозу Епштейна — Барр-вірусної етіології в дітей, що підтверджувалося низькими значеннями відношення правдоподібності та показників ризику, використання їх доцільне лише в комплексі.
Background:Similarities in risk factors, initial stages, progression and final stage of both atherosclerotic cardiovascular disease (ACVD) and chronic kidney disease (CKD) allowed formulating a concept of cardiorenal continuum.1ACVD and CKD remain the main causes of mortality in rheumatoid arthritis (RA) patients.2,3Objectives:To evaluate the effects of rituximab (RTM) therapy on cardiorenal continuum of RA patients.Methods:Biologics-naïve RA patients (n=92; age 49.5±9.9) were followed up for 72 months after commencing and continuing RTM therapy (1–10 standard courses) compared with 50 control RA patients (age 49.2±9.8). All control and 63% of RTM patients received methotrexate or leflunomide.Results:There were no baseline differences between two groups – Table. At year 6, RTM patients have fewer incidences of hypertension, anxiety/depression, atherosclerosis and diastolic dysfunction than controls. RTM decreased prevalence of albuminuria and CKD.Table.Cardiorenal continuum of rheumatoid arthritis patients (%)FeaturesRituximab groupControl grouppRTM–C1 year n=923 years n=476 years n=311 yearn=503 years n=266 years n=16Risk factorsHypertension52.238.325.8p6–1=0.02250.038.550.0p6=0.032Dyslipidaemia44.636.238.748.046.250.0>0.05Pre-diabetes41.336.241.944.034.656.3>0.05Metabolic syndrome12.06.43.210.07.712.5>0.05Diabetes mellitus3.2002.000>0.05Anxiety/depression78.341.5p3–1=0.00535.3p6–1<0.00176.073.168.8p3=0.009p6=0.008Initial stages (asymptomatic organ damage)Atherosclerosis34.821.312.9p6–1=0.04536.034.637.5p6=0.02Left ventricular hypertrophy8.74.308.07.70>0.05Diastolic dysfunction57.638.322.6p6–1=0.01856.050.056.3p6=0.04Albuminuria19.600p6–1=0.03812.006.3>0.05Kidney impairment6.52.106.000>0.05ProgressionAngina6.5004.000>0.05Chronic kidney disease26.18.59.7p6–1=0.04212.000>0.05End stageMyocardial infarction000000>0.05Stroke000000>0.05Heart failure4.400000>0.05Acute/chronic renal failure000000>0.05Death000000>0.05There were no significant differences in frequencies of other risk factors, signs of organ damage and cases of established heart, cerebrovascular and renal diseases/complications.Conclusion:RTM may be effective in delay of the movement of RA patients on cardiorenal continuum. The clinical implications of RTM for cardiorenal correlations in RA patients need to be confirmed in large-scale clinical outcome trials.References:[1]Sarnak MJ, Levey AS. Cardiovascular disease and chronic renal disease: a new paradigm.Am J Kidney Dis2000;35(4, Suppl. 1):117–31.[2]Avina-Zubieta JA, Choi HK, Sadatsafarvi M,et al.Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies.Arthritis Rheum2008;59:1690–7.[3]Gullick NJ, Scott DL. Co-morbidities in established rheumatoid arthritis.Best Pract Res Clin Rheumatol2011;25:469–83.Disclosure of Interests:Ilshat Gaisin Speakers bureau: Boehringer Ingelheim, KRKA, Berlin-Chemie Menarini, Sanofi, Larisa Ivanova Speakers bureau: Bayer, Novartis, KRKA, Nikolay Maximov Speakers bureau: Pfizer, KRKA, Rosa Valeeva: None declared, Dilara Yurk: None declared, Anastasia Vedekhina: None declared, Nuriya Garaeva: None declared, Irina Sabelnikova: None declared
The aim of the study - to study the diagnostic significance of clinical and laboratoryparameters in the verification of acute non-streptococcal tonsillopharyngitis in childrenin order to determine rational treatment tactics.Material and methods. To achieve this aim, two clinical groups were formed. The first (I,main) group consisted of 66 patients with acute tonsillopharyngitis of non-streptococcaletiology, as evidenced by the negative result of bacterial examination of the lavage ofthe pharynx and posterior pharyngeal wall. The second (II) clinical group included 32children diagnosed with "streptococcal acute tonsillopharyngitis".Results. The total score on the McIsaac scale, which did not exceed 2 points, wasregistered in 15.2 ± 4.4% of group I patients and 6.2 ± 4.2% of patients in the comparisongroup. The sensitivity of the method was 15.2%, specificity – 93.7%, positive and negativepredicted value – 83.3% and 34.8%, respectively, with odds ratio – 2.6 [95% CI: 0.5-13,0]. The average content of leukocytes in the blood less than 8.9 × 109/l was registeredin 57.6% of patients of group I and 48.8% of representatives of the second (P˃0.05). Thesensitivity of this laboratory test in the detection of non-streptococcal tonsillopharyngitiswas 57.6%, specificity – 55.6%, predicted value of a positive result – 54.1%, predictedvalue of a negative result – 59.1%. The relative risk of non-streptococcal etiology of ATPwhen registering a patient with less than 8.9 × 109/l of peripheral blood leukocytes was1.7 (95% CI 0.9-2.9), the absolute risk – 0.1 with odds ratio of 1.7 (95% CI 0.9-2.9).Conclusions. The proposed clinical scales and some paraclinical parameters haveinsufficient diagnostic value, so they cannot be used independently for early verificationof non-streptococcal etiology of tonsillopharyngitis in children.
The aim of the study - to study the clinical features and indicators for asthma control inoverweight children to optimize treatment strategies.Material and methods. 200 schoolchildren with asthma who were treated in the pulmoallergy department of the Chernivtsi Regional Children's Clinical Hospital have beenexamined. 52 patients with excess body weight (body mass index was greater than 25,0)belonged to group I, and children with body weight corresponding to the age norm (bodymass index from 18,0 to 24,9) were included into clinical group II under observation.Results. It has been found that the average number of points according to the ASTquestionnaire in patients of group I reached 14,0 ± 1,33 points, and in the comparisongroup – 16,3 ± 0,54 points (p˃0,05). At the same time, the share of patients withuncontrolled course of the disease among the overweight children reached 61,5% incomparison to 48,3% in the comparison group (p˃0,05).Indices of the risk of uncontrolled asthma (the sum of AST test scores <16) in childrenwith overweight have shown the following results: odds ratio = 1,6 (95% CI: 0,29-8,59),relative risk = 1,4 95% CI: 1,00-2,08) and attributive risk = 6,8%. Before treatment theindex of AKDNFG - 2,4 dinitrophenylhydrazones (AKDNFG) of the main character in thegroup of excess body weight children was 60,8 mmol /g of protein, and in group of normalbody weight children – 59,6 ± 9 mmol /g of protein. After the course of basic therapy,these indices gave next results – 47,2 ± 4,18 mmol/g of protein in group I and 4,3 ± 0,29mmol /g of protein (p> 0,05) in group II.Conclusions. Bronchial asthma in overweight children is more likely to debut at an earlyage and characterized by a persistent course. Predisposition to the body overweight inpatients with bronchial asthma has a negative effect on the indices of the disease controlachievement, although it is accompanied by an evidence decrease of the inflammatoryprocess of the respiratory tract in the course of treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.