Average Child Research Articles

The Effectiveness of the Buzzy Device for Pain Relief in Children During Intravenous Injection: Quasirandomized Study.

BackgroundIntravenous injection is the most common medical treatment and the main cause of pain in hospitalized children. If there is no appropriate health care for pain relief, the proportion of moderate and severe pain often exceeds 70%. With nonpharmaceutical-based pain management, Buzzy is recognized as an effective device for rapidly relieving injection pain in hospitalized children. However, Buzzy is not widely used in Asia and very few experimental studies in Asia have addressed the effectiveness of the Buzzy device at treating needle pain in hospitalized children.ObjectiveThe main purpose of this study was to investigate the effectiveness of the Buzzy device for diminishing pain levels among hospitalized children in Taiwan.MethodsWe applied a quasiexperimental design with random assignment. According to the time of admission, child participants were randomly assigned to treatment and nontreatment groups. The Buzzy device was applied as an intervention in this study. The samples size was 30 per group. The study participants were recruited from the pediatric ward of a medical center in northern Taiwan. The research data were collected longitudinally at three time points: before, during, and after intravenous injection. Three instruments were used for assessment: a demographic information sheet, the Wong-Baker Face Scale (WBFS), and the Faces Legs Activity Cry Consolability (FLACC) scale. The data were analyzed by descriptive analysis, the Mann-Whitney U test, the Wilcoxon signed-rank test, and the χ2 test.ResultsA total of 60 hospitalized children aged 3 to 7 years participated in this study, including 30 participants in the treatment group and 30 participants in the nontreatment group. The average age of children in the treatment and nontreatment groups was 5.04 years and 4.38 years, respectively. Buzzy significantly mitigated pain in children during intravenous injection with a significant difference between the two groups in pain-related response (FLACC) and actual pain (WBFS) (Z=–3.551, P<.001 and Z=–3.880, P<.001, respectively). The children in the treatment group had a significantly more pleasant experience than those in the nontreatment group (Z=–2.387, P=.02). When Buzzy was employed, the children experienced less pain than they did during previous intravenous injections (Z=–3.643, P<.001).ConclusionsThe intervention of using the Buzzy device was effective in reducing pain levels of intravenous injection among hospitalized children. The specific focus on children in Asia makes a valuable contribution to the literature. For clinical application, the reliable pain relief measure of Buzzy can be used in other Asian children to help health care providers improve noninvasive care among children. For future applications, researchers could integrate Buzzy into therapy-related games and a technology-based app to increase the efficiency of use and provide more data collection functions.

Clinical Characteristics and Distribution of Pediatric Fractures at a Tertiary Hospital in Northern France: A 20-Year-Distance Comparative Analysis (1999-2019).

Background and objectives: The epidemiology and distribution of pediatric fractures change over time and are influenced by a multitude of factors including geography, climate, and population characteristics. The aims of our work were to study the distribution of traumatic pediatric orthopedic injuries admitted to the Lille University Hospital (LUH) Pediatric Emergency Department in 1999 and in 2019 and to analyze the epidemiological differences 20 years apart. Materials and methods: This was a retrospective, comparative, monocentric, and epidemiological study involving all children between 0 and 15 years and 3 months of age who consulted the pediatric emergencies of LUH from 1 January 1999 to 31 December 1999 and from 1 January 2019 to 31 December 2019. On admission, the following data were collected: sex, age at the time of injury, month and time of the day the trauma occurred (4:00 a.m to 11:59 a.m, 12:00 p.m. to 19:59 p.m, and 20:00 p.m to 3:59 a.m.), mechanism of injury, laterality (right or left), anatomical location, type of injury, and whether the fracture was closed or open. The type of treatment (orthopedic or surgical) was collected from the medical records. Results: A total of 939 children were included in 1999 compared with 781 in 2019 (21% decrease); the average age of children with fractures was significantly higher in 1999 (8.81 years) than in 2019 (7.19 years). This difference was explained by the majority involvement of older children (10–15 years) in 1999 (43% of fractures in 1999 versus 25% of fractures in 2019). Conversely, small children (1–5 years) had significantly more fractures in 2019 (36%) than in 1999 (24%). Conclusions: Overall, the types and sites of fractures did not change over the studied time despite a change in the population and mechanism of injury. This suggested that the reflexes of breaking a fall still tended to implicate and damage the same bone segments. Finally, the proportion of fractures managed surgically versus orthopedically has not evolved since 1999. Exploring this is a possible area of further research that would complement our study.

ИЗУЧЕНИЕ ОПЫТА ПРИМЕНЕНИЯ ИППОТЕРАПИИ В СОЦИАЛИЗАЦИИ ДЕТЕЙ С ОТКЛОНЕНИЯМИ В РАЗВИТИИ

Objective: to explore and to substantiate the possibility of a positive effect of the hippotherapy on children with mental deficiency and to test the effectiveness of such an activity. Materials and methods. The sociological method is a survey (questioning, interviewing) and direct observation of hippotherapy classes. The survey was conducted separately among family members of mentally retarded children (12 people) and their coaches (5 people) in order to compare the results obtained. The average age of children whose relatives and coaches participated in the survey and interviewing was 8 years. Results. To assess the impact of hippotherapy on children with mental retardation, a generalized criterion was proposed, for which a comparative analysis of the impact of hippotherapy was conducted based on a survey of family members and coaches of children engaged in hippotherapy. A comparative analysis of the assessment of the impact of hippotherapy showed the greatest positive effect of classes in the development of large motor skills-83% (75%) and communication - 67% (58%). Less noticeable results were noted in the field of speech improvement – 50% (25%) and learning ability – 25% (33%). During the observation, it was noted: the formation of skills of managing their own body in children is facilitated by the complexity of riding, the need to find balance; the features of classes provide conditions for learning children, stimulate their speech, reduce behavioral problems, have a positive impact on the psycho-emotional sphere, promote social adaptation. Conclusion: based on the studied experience in the use of hippotherapy and on the conducted analysis, the positive effect of hippotherapy on children with developmental disabilities (mental retardation) is justified, the effectiveness of such classes and the positive effect of hippotherapy as an additional method of rehabilitation are proved.

Mother's Characteristics and Socioeconomic Status as Possible Risk Factors for Children's Caries in Jordan.

Background Clinical oral health status of children affects their health-related quality of life. A major determinant of oral health is early childhood caries, which possesses a negative effect. Objective The primary objective of the study was to examine the association between socioeconomic status and different mother's characteristics and the risk of dental caries in children using the decay missing filled (DMF) score as an indicator. Methods This was a cross-sectional descriptive study that was in the pediatric dental clinic in Hashem Ibn Al-Hussein medical military hospital in Jordan. Pearson correlation was used to examine associations between two continuous variables. Linear regression was used to detect variables that might predict the decayed missing filled teeth (dmft) score of the child. Results A total of 264 children were enrolled in the study. Average age of children was 4.80 ± 1.99 years, and average mothers' age was 32.74 ± 5.68. Mothers had an average DMFT score of 8.84 ± 5.39, while children had an average dmft score of 6.17 ± 4.82. There was no association between the mother's age and the dmft score of the child (Pearson correlation = 0.08, and P value = 0.215). However, a moderate, statistically significant correlation was found between the mother's and the child's DMFT scores (Pearson correlation = 0.418, and P value = 0.001). Children who belonged to low and middle-income families had a higher dmft score compared to those that belonged to families with high income. Conclusion Socioeconomic status of the family, mother's habits, dental hygiene, and education level are important factors that influence the child's oral health. Strategies that focus on children with these characteristics can help them achieve better oral health.

Sex and age moderate the trajectory of guilt among children and adolescents with and without recent suicidal ideation

ABSTRACT We aimed to examine whether the trajectories of ecologically derived guilt differ among a transdiagnostic sample of youth with and without recent suicidal ideation and whether sex and age moderated this association. We assessed guilt 3 times a day over a 2-week period via ecological momentary assessment (EMA) technology in 102 children recruited from the community, outpatient, and inpatient settings. The average age of children was 10.95 y.o. (SD = 2.26, range 8–16) and the majority were male (54.9%) and White (76.5%). We found that the real-world guilt during a two-week EMA period was higher among youth with greater suicidal ideation severity in the past six months. Moreover, there was a significant moderating effect of sex and age on this association, such that the association between suicidal ideation severity and guilt was particularly strong among females compared to males and youth who were 10 years old or older. The findings were maintained when we adjusted for the relevant demographic and clinical characteristics, including age, minority status, parental income, EMA response rate, and current internalising symptoms. These preliminary findings highlight the clinical relevance of assessing and targeting feelings of guilt in the day-to-day lives of youth, particularly for females and older youth.

Parents\u2019 perceptions of their child\u2019s weight among children in their first year of primary school: a mixed-methods analysis of an Australian cross-sectional (complete enumeration) study

Background/ObjectivesTo describe trends in overweight/obesity in early childhood for all children and those whose parents are concerned about their weight. To describe parents’ perceptions of their child’s weight and differences by their child’s anthropometric and sociodemographic factors.Subjects/MethodsAnalysis of the Kindergarten Health Check, a survey of all children enrolled in their first year of primary education in the Australian Capital Territory. Analysis of detailed data for 2014–2017, including qualitative analysis of parents’ comments on weight, and trends for 2001–2017.Results71,963 children participated in the survey between 2001 and 2017 (20,427 between 2014 and 2017). The average age of children (2001–2017) was 5 years and 9.6 months at the time of their physical health check. 2377 children (3.5%) were classified as obese based on measured body mass index (BMI) between 2001 and 2017, and a further 7766 (11.6%) overweight. Similar proportions were seen for 2014–2017. Among children with overweight/obesity in 2014–2017, 86.4% of parents (2479/2868) described their children’s weight as healthy and 13.3% (382/2868) as overweight/obese. Just 11.5% (339/2946) of parents whose children were later measured with overweight/obesity identified having a concern about their child’s weight.Parental comments varied widely and were often incongruent with the known health risks associated with their child’s measured BMI. Comments from parents whose children were measured as obese often were normalising e.g., “born big, always big. Definitely NOT overweight, just bigger all over”, whilst parents of children in the healthy range expressed concerns about underweight.ConclusionParents do not accurately perceive their child’s weight and few document concerns, even among children measuring in the obese BMI category. This lack of concern makes early interventions challenging as parents are in the “pre-contemplative” stage of behaviour change and may see public health campaigns or clinicians’ attempts to address their child’s weight as irrelevant or unhelpful.

Significance of food allergy in atopic dermatitis in children

Background. Atopic dermatitis is the most common inflammatory skin disease in childhood, affecting almost 20 % of children. Food allergies affect one of three children with atopic dermatitis, and allergies to peanuts, eggs and milk are the predominant food allergies in the world. The purpose was to assess the prevalence of food allergies in the group of patients with atopic dermatitis, to determine the association of food allergies with anamnestic and clinical parameters of atopic dermatitis. Materials and methods. Children with atopic dermatitis (n = 116) were included in the study from September 2020 to August 2021 in Kyiv, Ukraine. Food sensitization was established by determining specific immunoglobulin E (sIgE) to food allergens using immunochemiluminescent method on the ImmunoCAP 100 system (Thermo Fisher Scientific Inc., Phadia, Sweden). Results. The average age of children in the main group (59 boys and 57 girls) was 6.8 years. All 116 patients at the time of examination had manifestations of atopic dermatitis in the form of erythematous itchy rash. The number of children with food allergy was 23 (19.8 %). Among food allergens, positive sIgE were found: in 14 patients (12 %) — to milk, in 13 (11.2 %) — to eggs, in 5 (4.3 %) — to fish, and in 4 people (3.4 %) — to hazelnuts. Food sensitization was significantly more common in children with moderate-to-severe atopic dermatitis than in the group of patients with mild atopic dermatitis (χ2 = 7.555, p &lt; 0.05). Children with food sensitization had an earlier onset of atopic dermatitis — the average age of manifestations onset was 8 months, and in the group of children without food allergy, it was 18 months. Children with a parental history of atopic diseases were significantly more likely to have concomitant food allergy (χ2 = 12.831, p &lt; 0.05). Conclusions. Given the significant association between early onset as well as moderate-to-severe atopic dermatitis and food sensitization, it is likely that food sensitization occurs primarily through an inflamed skin barrier in eczematous skin, which could potentially lead to clinical food allergy.

Взаимосвязь показателей взаимодействия детей и близких взрослых с возрастом и длительностью проживания детей в доме ребенка и замещающих семьях

According to data from scientific literature, children who experience living in child institutions (or baby homes) with social and emotional deprivation are significantly behind their peers in development, but after moving to a foster family (FF), this gap can lessen. Further published information shows, there is evidence that age of a child and time characteristics in the form of length of stay in an institution or in family play a significant role in “catching up”. The aim of this research was to study the relationship of the age of children, as well as length of stay in the baby home (BH) and in a FF with indicators of caregiver-child interaction at both stages (1) in the BH before transfer to post-institutional care and (2) after transfer to FF. The study involved 21 children with experience of institutionalization (the average age of children at the assessment in the BH was 21.6 ± 12.7 months; at the foster families stage was 49.8 ± 16.7 months) and their caregivers (personnel of BH and substitute parents in FF). The quality of caregiver-child interaction was studied using the PCERA (The Parent - Child Early Relational Assessment) method based on analysis of video recordings of caregiver-child free play. The results obtained in the BH before transfer to post-institutional care indicate the presence of a positive relationship between individual caregiver and child indicators of interaction, as well as the overall total indicator of interaction with the age of children at the time of assessment. The indicator of interaction on the part of children "Positive emotions, eye contact" is associated with the age at which children entered the BH. After the transition of children to FF, most of the indicators on the part of children are associated with the age at which they entered the BH, while “Emotional stability, absence of negative affect, compliance” shown by the children is associated with the age of transition to FF. The data obtained in the work are discussed from the point of view of the influence of the social and emotional experience of children on the indicators of their interaction with the caregivers.

Acute urticaria in children: course of the disease, features of skin microbiome.

IntroductionQuantitative and qualitative changes in the microbiome of the skin affect the emergence and course of allergic diseases, in particular, of acute urticaria.AimTo investigate the taxonomic composition of the skin microbiota in children with acute urticaria and to study its effect on the course of the disease.Material and methodsIn total, 75 children with diagnosed acute urticaria at the age of 7–-14 years were examined. The average age of children was 10.83 ±0.95, of which 44 (58.7%) were boys, and 31 (41.3%) were girls. The control group consisted of 30 virtually healthy children of the appropriate age, of whom 16 (53.3%) were boys, and 13 (46.7%) were girls.ResultsRegardless of the severity of the disease, the examined children suffering from acute urticaria had sensitization in history with a significant prevalence of food sensitization (p < 0.05). The occurrence of a severe episode of acute urticaria is associated with allergens of drug origin in 52.6% of cases and the action of unidentified triggers in 47.4% of cases. In children with acute urticaria, S. epidermidis, S. aureus, bacteria of the genus Peptococcus, and Peptostreptococcus dominated on a non-affected skin area, while for the affected skin area, the Propionibacterium, S. aureus, S. epidermidis, bacteria of the genus Peptococcus, Propionibacterium, and Peptostreptococcus were denoted as dominating.ConclusionsHigh frequency of S. aureus detection on affected and non- affected skin areas in children with acute urticaria is a predictor of the disease severity.

The pediatric asymptomatic SARS-CoV-2 IgG seropositivity in the Turkish Republic of Northern Cyprus.

While children were initially thought to have serious contributions to the coronavirus disease 2019 (COVID-19) transmission, recent studies suggest otherwise. However, the possible effect of asymptomatic pediatric spread still has not yet received enough attention. The aim of our study was to estimate asymptomatic infection rates among children in the Turkish Republic of Northern Cyprus, by using pediatric patients admitted to a university hospital without any COVID-19-associated symptoms. Blood samples collected from 80 pediatric patients with no symptoms and history of COVID-19 infection, who were admitted to a university hospital between September 2020 and January 2021, were included in the retrospective study. Isolated serum samples were tested by Dia.Pro SARS-CoV-2 IgG ELISA assays. The patient group included 40 (50%) male and 40 (50%) female patients. The average age of children was 7.6 ± 4.0 years, with min-max ages ranging from 2 to 15 years. Among the 80 patients tested, only one (1.3%) was detected positive by the Dia.Pro IgG ELISA kit. The asymptomatic seropositivity reported in our study suggests the use of randomly performed serologic tests to monitor SARS-CoV-2 infection among the pediatric population in schools that would contribute to the public health fight against COVID-19.

Sensory profile of children with Central Auditory Processing Disorder (CAPD).

To analyze the sensory profile of children with auditory sensory processing disorder according to the Child Sensory Profile 2 and to verify potential associations between central auditory processing and sensory processing. Sixty children from two public schools in the city of João Pessoa, state of Paraíba, were evaluated. All children had their cognitive skills tested and their socioeconomic and demographic information collected. The children's hearing, central auditory processing, and sensory processing were evaluated. SPSS Statistics version 25.0 was used for data analysis and the significant value adopted was 0.05. Descriptive analysis was performed using the central tendency method. The similarities among the test variables were measured by Student's t-test and Mann-Whitney U test. The effect size (ES) between the groups was measured by Cohen's d or Rosenthal's r coefficient. The average age of children with CAPD was 8.4 years, and their families had lower levels of income and education when compared to those without the disorder. Children with CAPD present more sensory differences than their peers with normative CAP. The Child Sensory Processing 2 results didn't show any statistic associations with central auditory processing, and the effect size was of moderate magnitude for the visual system. Children with CAPD have more sensory differences than their peers according to the normative results of the Child Sensory Profile 2. An association between sensory and central auditory processing was not observed, except for the visual system.

Efficient Feature Selection and Machine Learning Based ADHD Detection Using EEG Signal

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric and neurobehavioral disorders in children, affecting 11% of children worldwide. This study aimed to propose a machine learning (ML)-based algorithm for discriminating ADHD from healthy children using their electroencephalography (EEG) signals. The study included 61 children with ADHD and 60 healthy children aged 7–12 years. Different morphological and time-domain features were extracted from EEG signals. The t-test (p-value < 0.05) and least absolute shrinkage and selection operator (LASSO) were used to select potential features of children with ADHD and enhance the classification accuracy. The selected potential features were used in four ML-based algorithms, including support vector machine (SVM), k-nearest neighbors, multilayer perceptron (MLP), and logisticregression, to classify ADHD and healthy children. The overall prevalence of boys and girls with ADHD was 48.9% and 56.5%, respectively. The average age of children with ADHD was 9.61.8 years. Our results illustrated that the combination of LASSO with SVM classifier achieved the highest accuracy of 94.2%, sensitivity of 93.3%, F1-score of 91.9%, and AUC of 0.964. Our results also illustrated that MLP was the second-best ML-based classifier, which gave 93.4% accuracy, 91.7% sensitivity, 91.1% F1-score, and 0.960 AUC. The findings indicated that the combination of the LASSO-based feature selection method and SVM classifier can be a useful tool for selecting reliable/potential features and classifying ADHD and healthy children. Our proposed ML-based algorithms could be useful for the early diagnosis of children with ADHD.

Glycemic control in children and young adults with different types of diabetes mellitus in Ukraine

Introduction. Until recently, glycated hemoglobin (HbA1c) has not been studied in children with different types of diabetes mellitus (DM). With the development of molecular genetics, new types of diabetes have been diagnosed, including neonatal (ND) and maturity onset diabetes of the young (MODY), which usually require specific pathogenetic therapy, including sulfonylureas (SU), which improve glycemic control in patients with certain mutations. The aim of this study, which was conducted for the first time in Ukraine, was to analyze glycemic control in patients with different types of DM, including ND and MODY and changing their treatment after genetic testing. Materials and methods. We studied conducted the analysis of glycemic control in patients depending on the type of diabetes, namely: type 1 diabetes (n = 9282), type 2 diabetes (n = 23), ND (n = 16) with mutations KCNJ11, ABCC8 and MODY (n = 16) with mutations in HNF1A/HNF4A and ABCC8 genes. To confirm the nature of monogenic diabetes, targeting next-generation sequencing (tNGS) of all known neonatal and monogenic diabetes genes was performed. Results. According to the Register in 2018, in Ukraine the average age of children with type 1 DM was 11.5 ± 1.4 years, and the level of HbA1c was unsatisfactory (8.8 ± 2.01 %). The proportion of children who had ideal or optimal glycemic control (HbA1c

Electrocardiographic Changes in Type-1 Diabetes Mellitus Children with Diabetic Ketoacidosis Presenting to Tertiary care Hospital, Karachi

Introduction: Cardiac arrhythmias and arrest have been described in children with diabetic ketoacidosis and generally have been presumed to be caused by electrolyte abnormalities. The rationale of this study was to assess the role and importance of ECG monitoring, as a simple, quick, non-invasive and readily available tool in the diagnosis and confirmation of hypokalemia and hyperkalemia in patients with DKA in the Emergency Department Objective: To Assess the Frequency of electrocardiographic changes in Type-1 diabetes mellitus children with diabetic ketoacidosis presenting to tertiary care hospital, Karachi. Materials and Methods: This retrospective cross sectional study was carried out at the department of pediatric medicine, NICH Karachi. At the time of presentation, the standard 12-lead ECG was recorded by a single pediatric cardiologist having more than 2 years of experience, QT and RR intervals were measured. Three separate measurements were obtained from each ECG, and the mean of these measurements was used as the value for QTC. QTC of at least 0.45s (450ms) was considered as prolonged QTC. QTD was also assessed at the same time and QTD&gt;50 ms was considered as prolonged QTD. Results: One hundred cases of T1DM with DKA were included in this study. Average age of children was 7.9 ±3.5 years (Min – Max = 0.5 – 14 years), male to female ratio was 1: 0.96. Prolong QTc and QTd interval was observed in (56%) and (38%) children respectively, Mean (±SD) QTc and QTd interval was 449.4 ±36.6 mc and 39.3 ±16.1 mc respectively. While ECG changes were found in (58%) cases. Association between ECG changes and the cases with higher RBS (&gt;350 mg/dl) was statistically significant 81 (81%) cases with ECG changes had higher RBS (p&lt;0.0001) while ECG changes were statistically similar in both age groups and gender (p-values &gt; 0.05). Conclusion: The frequency of ECG changes was higher in T1DM children with diabetic ketoacidosis. ECG changes was significantly associated with higher RBS (&gt;350 mg/dl). Key words: T1DM, Diabetic Ketoacidosis, ECG, QTc, QTd

RELATIONSHIP BETWEEN PICKY EATING AND NUTRITIONAL STATUS IN PRESCHOOL CHILDREN

AbstractBackground : Picky eating is a condition when children refuse to eat certain foods. Picky eating usually stops within 2 years as part of the growth process, those who stop picky eating after more than 2 years tend to be more difficult to accept new types of food. This may be unfavorable for a child's growth and nutritional status. The study was conducted to analyze the relationship between picky eating with nutritional status in preschool children. Method : This research method was observational analytic quantitative with cross sectional research design. Sampling used a total sampling technique. Data was collected in 3 preschool in October 2019 using primary and secondary data. Primary data was collected using a questionnaire given to parents to measure picky eating used Child Eating Behavior Questionnaire (CEBQ). Nutritional status was measured bytaking anthropometric measurements of children. Data analysis used fisher exact correlation tests. Results : The results obtained a sample of 78 respondents from 3 preschool. The average age of children was 48,37 months with a median was 49,00. The result showed 62,8% of children were female, 55,1% were second or more children, 88,5% had routine growth monitoring, 53,8% were in extended families, and 73,1% of children were taken care by their parents. The prevalence of children with picky eating was 70,5%. Nutritional status measurements found 1.3% of children included in underweight category and 83,3% normal. Results of the analysis of the relationship between picky eating and nutritional status showed p value = 0,819. Conclusion : There was no relationship between picky eating with nutritional status in preschool children.

New coronavirus infection (COVID-19) in children: clinical, laboratory and diagnostic aspects

The study of a new coronavirus infection (COVID-19) in children is relevant and of interest for practical health care.Purpose: to identify the clinical and laboratory features of COVID-19 in the context of the six-month dynamics of the pandemic in children of the Orenburg region and to formulate recommendations for optimizing the diagnosis of this disease.Materials and methods. A retrospective analysis of 2661 results of detecting SARS-CoV-2 RNA (including 170 children) was carried out on the basis of the microbiological laboratory of the Orenburg State Medical University. Age and sex, structure of preliminary diagnoses, main clinical manifestations, frequency of testing and dynamics of the PCR threshold cycle in September 2020 and January 2021 were assessed.Results. The proportion of children examined in the Orenburg region from September 2020 to January 2021 increased from 4.6 ± 0.6% to 8.1 ± 0.7%. At the same time, the number of PCR + results also significantly increased from 5.0 ± 2.8% to 8.2 ± 2.6% (χ2 = 54.81; p = 0). The average age of children was 9—10 years old. The main reason for referral was pre-hospitalization screening not related to COVID-19. The proportion of PCR + results in this cohort was significantly lower in children than in adults. Among the clinically manifested forms in adults, the leading diagnosis was «pneumonia», and in children «ARVI». In childhood, a predominantly asymptomatic course of the disease was recorded. In children, unlike adults, PCR Ct values did not correlate with the severity and duration of the clinical manifestations of COVID-19.Conclusion. Due to the low diagnostic value of symptoms in children, it is more expedient to focus on epidemiological data and data from the results of laboratory examination methods. When interpreting the results of PCR diagnostics of COVID-19 for prognostic purposes, it is important to take into account the patient's age.

Treatment of the hidden penis in boys

Introduction. “Hidden penis” (HP) is a developmental malformation of the penis characterized by normally developed, but abnormally located cavernous bodies in the surrounding tissues of the symphysis or scrotum, manifested by the visually shortened penis trunk. The most common type is «buried» penis (BP). This pathology requires, as a rule, surgical treatment.Purpose. To assess outcomes of BP treatment with an improved surgical technique.Material and methods. 40 boys, aged from 2 to 16 (average age 9 ± 1.59) and diagnosed with HP, were treated in 2014-2019. BP was diagnosed in 35 children (87.5%), webbed penis (WP) – in five (12.5%). Primary BP was in 18 children (51.4%) and BP in combination with the suprapubic obesity - in 17 patients (48.6%). Two children (5%) were operated after the previous circumcision. Indications for surgery were: congenital primary HP, secondary HP in adolescents with insufficient visualization of the penis, psychological discomfort of the patient and the absence of significant clinical effects after conservative care. The average age of children with primary HP was 3.9 ± 2.48; with secondary HP and pubic obesity - 12 ± 3.84 years. During surgery, circular or circular and ventral midline incisions to the middle of the scrotum were used; they were followed by mobilization of the penis from adhesions, excision of adipose tissue in the bosom, fixation of the pubopenile and penoscrotal angles with a non-absorbable surgical thread. The authors have proposed a new technique for foreskin fixation using 2 ventral and 2 dorsal incisions, through which the skin was sutured to the deep fascia of the penis to prevent its distal slipping.Results. All patients had good anatomical and functional results. The authors describe the developed surgical technique in details; they also make literature review on the discussed problem.Conclusion. In the treatment of HP an improved surgical technique with the additional use of incisions allows you to reliably fix the skin of the foreskin on the trunk of the penis, avoiding its distal displacement.

Вміст есенціальних мікроелементів в плазмі крові дітей із синдромом біологічно неактивного гормона росту

Метою роботи було підвищення ефективності лікування дітей і підлітків із синдромом біологічно неактивного гормона росту (СБНГР) на основі вивчення вмісту есенціальних мікроелементів (ЕМ) у плазмі крові. Матеріали та методи. В дослідження включено 206 дітей і підлітків з різними формами низькорослості. Діти, хворі на СБНГР, увійшли до групи з 29 осіб (14,08 %): 21 хлопчик (72,41 %) і 8 дівчаток (27,59 %), відставання у зрості яких становило від –2,0 до –4,6 SD. Середній вік дітей — 9,01 ± 0,60 року. Діагноз СБНГР підтверджений наявністю нормальних/підвищених показників гормона росту (ГР) на тлі проведення стимуляційних тестів, різким зниженням рівня інсуліноподібного фактора росту 1 (ІФР-1) та позитивною пробою на чутливість до ГР. Мікроелементний статус оцінювали шляхом визначення рівнів ЕМ (цинку, селену, марганцю, хрому, міді) у плазмі крові методом рентгенофлуоресцентної спектрометрії за допомогою спектрометра ElvaX-med (Україна). Рівні ІФР-1 в плазмі крові визначали імунорадіометричним методом за допомогою стандартних наборів IRMA IGF-1 (Immunotech® kit, Чеська Республіка). Результати. В групі дітей з СБНГР рівень цинку становив 0,57 ± 0,04 мкг/мл, селену — 0,05 ± 0,01 мкг/мл, що вірогідно нижче, ніж у загальній групі дітей з низькорослістю (р &lt; 0,001 та р &lt; 0,05 відповідно). Середні рівні хрому та міді в плазмі крові були зниженими порівняно з показниками дітей з іншими формами низькорослості й становили 0,040 ± 0,003 мкг/мл і 0,79 ± 0,05 мкг/мл відповідно, та були вірогідно нижчими, ніж у дітей контрольної групи (р &lt; 0,001). Середній рівень марганцю в плазмі крові становив 0,06 ± 0,02 мкг/мл, що дещо нижче, ніж у контрольній групі, але невірогідно (р &gt; 0,01). Висновки. У пацієнтів із СБНГР встановлено вірогідне зниження рівнів цинку, селену, хрому та міді у плазмі крові. Отже, на наш погляд, до комплексу обстеження дітей з низькорослістю доцільно включати визначення рівнів ЕМ. При виявленні знижених рівнів ЕМ рекомендовано комбіноване лікування препаратами рекомбінантного ГР та такими, які містять відповідні ЕМ, що значно підвищує ефективність ріст-корегуючої терапії.

ACQUISITION OF PRACTICAL SKILLS UNDER CONDITIONS OF EMERGENCY CARE IN CHILDREN’S PULMONOLOGY

A retrospective analysis of medical histories of 121 children diagnosed with destructive pneumonia of various localizations and various degrees of complications, who were treated in the surgical department of Chernivtsi City Children’s Clinical Hospital in the period from January 1, 2016 to January 1, 2020. From 121 children, 67 boys (54.4%), 54 girls (44.6%), 62 had right- sided pneumonia (52.2%), 46 left-handed (38%), 13 bilateral (10.8%) bilateral, pulmonary -pleural complications 61 (50.4%), thoracentesis 39 (32%), drainage 22 (18%), the average age of children was 8.1 years.The results show that in the last 5 years in Chernivtsi region the frequency of pulmonary pleural complications in children with destructive lung diseases has increased, which in turn requires rapid diagnosis and resolution of the optimal treatment option by general surgeons.

Estimation of Risk of Child Death and Average Children Ever Born

Objectives: To understand the pattern of child death (death before their fifth birthday), in this study an attempt has been made to develop a probability model. Methods: Mortality especially child death is one of the important and interesting areas for population scientists. In this paper, an attempt has been made a probability model to study the pattern of child deaths and also try to estimate the average number of children ever born. The parameters involved in the model under consideration have been estimated with the method of moments. Findings: Some real data sets from NFHS are used for checking the suitability of the proposed model. The performance of proposed model is outstanding for the considered set of data. The risk of child death in Uttar Pradesh is estimated as 63 per thousand and the estimated number of children ever born is about 7 in the reproductive life of a female. In the urban area, the risk of child death and average children ever born is estimated lower than the estimate of rural area. We observed risk of child death and the average number of children ever born is decreasing over time. Novelty: The proposed model is competent to estimate the risk of child death and the average children ever born to a female through the distribution of number of child death. Keywords: Child Death; Average Children Ever Born; Probability Model; Marginal Probability; Method of Moment