Development Of Disease In Children Research Articles

Determinants of tuberculosis disease development in children in central Ethiopia: A matched case-control study

Background The risk factors for tuberculosis (TB) disease development in children remained understudied, particularly in low-income countries like Ethiopia. The objective of this study was to identify determinants of TB disease development in general and in relation to BCG vaccination in children in central Ethiopia. Methods We employed a 1:1 age-matched case-control design to compare the characteristics of children who developed TB (cases) with those who did not (controls). Data were collected in healthcare facilities in Addis Ababa city, Adama, and Bishoftu towns between September 25, 2021, and June 24, 2022. Two hundred and fifty-six cases were drawn at random from a list of childhood TB patients entered into SPSS software, and 256 controls were selected sequentially at triage from the same healthcare facilities where the cases were treated. A bivariate conditional logistic regression analysis was performed first to select candidate variables with p-values less than or equal to 0.20 for the multivariable model. Finally, variables with a p-value less than 0.05 for a matched adjusted odds ratio (mORadj) were reported as independent determinants of TB disease development. Results The mean age of the cases was nine years, while that of the controls was 10 years. Males comprised 126 cases (49.2%) and 119 controls (46.5%), with the remainder being females. Ninety-nine (38.7%) of the cases were not BCG-vaccinated, compared to 58 (22.7%) of the controls. Household TB contact was experienced by 43 (16.8%) of the cases and 10 (3.9%) of the controls. Twenty-two (8.6%) of the cases and six (2.3%) of the controls were exposed to a cigarette smoker in their household. Twenty-two (8.6%) of the cases and three (1.2%) of the controls were positive for HIV. Children who were not vaccinated with BCG at birth or within two weeks of birth had more than twice the odds (mORadj = 2.11, 95% CI = 1.28–3.48) of developing TB compared to those who were. Children who ever lived with a TB-sick family member (mORadj = 4.28, 95% CI = 1.95–9.39), smoking family members (mORadj = 3.15, 95% CI = 1.07–9.27), and HIV-infected children (mORadj = 8.71, 95% CI = 1.96–38.66) also had higher odds of developing TB disease than their counterparts. Conclusions Being BCG-unvaccinated, having household TB contact, having a smoker in the household, and being HIV-infected were found to be independent determinants of TB disease development among children.

Protective Role of Vaccination against Tuberculosis and Hepatitis B in Prevention of Atopic Dermatitis: Report on Intermediate Results of Prospective Cohort Study

Background. Studies have shown that vaccination in the first hours/days after birth shifts the immune response from intrauterine Th2 towards Th1-type activation and reduces the risk of atopic conditions. However, we did not find published data from prospective studies on this topic.Objective. The aim of the study is to define the presence of negative correlation between vaccination against tuberculosis and hepatitis B in the first hours/days of life and atopic dermatitis development in infants.Methods. Continuous prospective study of children cohort born from April to June 2021 and observed in one outpatient’s clinic was carried out. Data from 307 infant’s records (F. 112/y), vaccination record cards (F. 063/y), prenatal and delivery records (F. 113/y-20, section № 3), and neonatal discharge summaries were analyzed for the decreed period. The child vaccination status (by the time of vaccination against tuberculosis and hepatitis B), presence of risk factors for allergic disease development, and presence of atopic dermatitis were evaluated.Results. Atopic dermatitis (AD) was significantly less likely to be diagnosed by the age of 1 year in infants from the group of BCG-M vaccinated at maternity hospital than in those vaccinated later or not vaccinated at all (15.2% versus 66% and 35.7%, respectively; p < 0,01). AD was less likely to develop in children with risk factors for allergic disease who were vaccinated against tuberculosis in the maternity hospital than in those vaccinated later or unvaccinated at all (18, 75 and 62.5%, respectively; p < 0.01). The ratio of children with diagnosed AD by the age of 12 months was significantly less in the group of children vaccinated against hepatitis B in the maternity hospital than in those vaccinated later or unvaccinated at all (17.6, 44.9 and 31.8%, respectively; p < 0.01). These ratios for children with risk of allergic disease development were 24%, 50% and 44.4%, respectively (p = 0.043). It has also been shown that timely vaccination with both vaccines in the early neonatal period significantly reduces the risk of AD in general infant population compared to non-vaccinated individuals or those who had only one vaccine (odds ratio [OR] 0.374; 95% confidence interval [CI] 0.253-0.552; p < 0.01). Whereas the disease development in children with allergic risk is less likely with timely vaccination (20.8% versus 53.3%; OR = 0.252; 95% CI 0.145–0.440; OR = 0.374; 95% CI 0,253–0,552; p < 0,01).Conclusion. The obtained results may indicate possible risk reduction for AD development due to timely preventive vaccination against tuberculosis and hepatitis B, especially in children with allergic risk. The study is currently ongoing.

Fibrosis-Related Gene Profiling in Liver Biopsies of PiZZ α1-Antitrypsin Children with Different Clinical Courses.

PiZZ (Glu342Lys) α1-antitrypsin deficiency (AATD) is characterized by intrahepatic AAT polymerization and is a risk factor for liver disease development in children. The majority of PiZZ children are disease free, hence this mutation alone is not sufficient to cause the disease. We investigated Z-AAT polymers and the expression of fibrosis-related genes in liver tissues of PiZZ children with different clinical courses. Liver biopsies obtained during 1979-2010 at the Department of Paediatrics, Karolinska University Hospital, Sweden, were subjected to histological re-evaluation, immunohistochemistry and NanoString-based transcriptome profiling using a panel of 760 fibrosis plus 8 bile acid-related genes. Subjects were divided into three groups based on clinical outcomes: NCH (neonatal cholestasis, favourable outcome, n = 5), NCC (neonatal cholestasis, early cirrhosis and liver transplantation, n = 4), and NNCH (no neonatal cholestasis, favourable outcome, n = 5, six biopsies). Hepatocytes containing Z-AAT polymers were abundant in all groups whereas NCC showed higher expression of genes related to liver fibrosis/cirrhosis and lower expression of genes related to lipid, aldehyde/ketone, and bile acid metabolism. Z-AAT accumulation per se cannot explain the clinical outcomes of PiZZ children; however, changes in the expression of specific genes and pathways involved in lipid, fatty acid, and steroid metabolism appear to reflect the degree of liver injury.

Prediction Models for Celiac Disease Development in Children From High-Risk Families: Data From the PreventCD Cohort

Screening for celiac disease (CD) is recommended in children with affected first-degree relatives (FDR). However, the frequency of screening and at what age remain unknown. The aims of this study were to detect variables influencing the risk of CD development and develop and validate clinical prediction models to provide individualized screening advice. We analyzed prospective data from the 10 years of follow-up of the PreventCD-birth cohort involving 944 genetically predisposed children with CD-FDR. Variables significantly influencing the CD risk were combined to determine a risk score. Landmark analyses were performed at different ages. Prediction models were created using multivariable Cox proportional hazards regression analyses, backward elimination, and Harrell's c-index for discrimination. Validation was done using data from the independent NeoCel cohort. In March 2019, the median follow-up was 8.3 years (22 days-12.0 years); 135/944 children developed CD (mean age, 4.3 years [range, 1.1-11.4]). CD developed significantly more often in girls (P= .005) and in Human Leukocyte Antigen (HLA)-DQ2 homozygous individuals (8-year cumulative incidence rate of 35.4% vs maximum of the other HLA-risk groups 18.2% [P < .001]). The effect of homozygosity DR3-DQ2/DR7-DQ2 on CD development was only present in girls (interaction P= .04). The prediction models showed good fit in the validation cohort (Cox regression 0.81 [0.54]). To calculate a personalized risk of CD development and provide screening advice, we designed the Prediction application https://hputter.shinyapps.io/preventcd/. Children with CD-FDR develop CD early in life, and their risk depends on gender, age and HLA-DQ, which are all factors that are important for sound screening advice. These children should be screened early in life, including HLA-DQ2/8-typing, and if genetically predisposed to CD, they should get further personalized screening advice using our Prediction application. ISRCTN74582487 (https://www.isrctn.com/search?q=ISRCTN74582487).

Coronavirus Disease in Children and Adolescents: Symptoms, Treatment, Consequences

The article examines the causes, symptoms and consequences of the development of coronavirus disease in pediatrics. It has been determined that coronavirus disease is usually easier in children than in adults; symptoms usually include headache, fever and cough. Severe variants of the development of coronavirus disease in children with concomitant diseases are possible. Multisystem inflammatory syndrome in children is a postinfectious complication of severe acute respiratory syndrome of coronavirus infection with pronounced cardiovascular and gastrointestinal symptoms.

Critical study of Haritakyadi Yoga in Mutrakricchra (Urinary Tract Infection) - A Review

Urinary tract infections (UTI), the second most common type of infection. It is one of the most serious health problem affecting millions of people each year. UTI have been considered a risk factor for the development of end stage renal diseases in children. It is of greatest concern as recurrent infection of UTI can threat to the normal course of growth and development of children. The term Mutrakricchra comes under the disorders of Mutravaha Strotas. ‘Dukhen mutra pravritti’ (Difficulty while micturition-disurea) is cardinal symptom of Mutrakricchra vyadhi. Due to nidana sevana, doshas gets vitiated by their own causes and they enters in basti (Urinary bladder) and produce srotorodha, sankocha and kshobha at mutra marga which further causes Basti pradesh shotha and produce pain and difficulty while passing urine. Ayurveda has significant remedy in the management of Mutrakricchra. Haritakyadi yoga is one of the Ayurvedic formulation used in treatment of Mutrakricchra by means of Shamana chikitsa. Conclusion: Effect of ‘Haritakyadi Yoga’ was seems to be significant in reducing symptoms of Mutrakricchra as well as decreases possibility of drug resistance and recurrence of UTI.

Ювенильный артрит: этиология, патогенез, современные аспекты (обзор литературы)

В статье даны современные представления об этиологии, наследственной предрасположенности, иммунопатогенезе ювенильного ревматоидного артрита (ЮРА), одного из наиболее частых и самых инвалидизирующих ревматических заболеваний, встречающихся у детей. Этиология заболевания в настоящее время окончательно не расшифрована, существует лишь ряд более или менее обоснованных гипотез. Среди предрасполагающих факторов важную роль отводят персистирующим вирусам. Артротропные персистирующие вирусы — вирусы Коксаки, Эпштейна — Барр, цитомегаловирус, вирусы герпеса, парвовирусы, обладающие тропизмом к тканям суставов, способны длительно в них персистировать и вызывать иммунное воспаление на фоне иммунологических дефектов. Также имеются данные о связи ЮРА с инфекцией, вызванной Mycoplasma pneumoniaе и Chlamydоphila pneumoniaе. В возникновении и развитии ЮРА играет роль генетическая предрасположенность и особенности иммунной системы. Имеются сведения об ассоциации генов гистосовместимости HLA с ЮРА в целом и с отдельными вариантами заболевания. HLA А2, DR5, DR8 являются маркерами олигоартрита у девочек, имеющих увеит, с серопозитивностью по антинуклеарному фактору. HLA В27 — маркер риска развития ЮРА у мальчиков с олигоартритом или ограниченным полиартритом, с преимущественным поражением суставов нижних конечностей, с наличием энтезопатий в школьном или подростковом возрасте. HLA DR4, DR5, DRВ1-04 являются маркерами ЮРА у девочек с поражением мелких симметричных суставов кистей, серопозитивных по ревматоидному фактору, с дебютом заболевания в старшем школьном возрасте. Основу патогенеза ЮРА составляют дефекты Т- и В-клеточных иммунных реакций, приводящие к гиперпродукции провоспалительных цитокинов. Гиперпродукция провоспалительных цитокинов лежит в основе повреждения синовиальной оболочки сустава, хряща, а также в основе развития системных проявлений болезни. Среди большого количества провоспалительных цитокинов центральное место в развитии заболевания занимает фактор некроза опухоли α (ФНО-α), интерлейкины — ИЛ-6, ИЛ-1β. ФНО-α приводит к развитию хронического воспаления, деструкции хряща и кости. ИЛ-6 принадлежит исключительная роль в генезе системного варианта заболевания. С его гиперпродукцией связывают такие внесуставные проявления болезни, как лихорадка, гипохромная анемия, тромбоцитоз. ИЛ-6 стимулирует продукцию гепатоцитами острофазовых белков, играет роль в развитии ряда осложнений, таких как остеопороз и амилоидоз. Состояние цитокиновой сети при различных вариантах ЮРА до конца не изучено. Некоторые авторы указывают на максимальное повышение ИЛ-6 и ИЛ-1 при системном варианте заболевания. Значительное повышение ФНО-α выявлено у пациентов с полиартикулярным вариантом ЮРА, особенно с высокими значениями ревматоидного фактора. Уровень провоспалительных цитокинов коррелирует с активностью воспаления и отражает тяжесть заболевания, определяет дальнейший прогноз. В основе развития ревматических заболеваний у детей существенную роль играет не абсолютное количество образования тех или иных цитокинов, а дисбаланс про- и противовоспалительных цитокинов. Данный дисбаланс может возникнуть под действием повреждающего фактора: бактериальной или вирусной инфекции, переохлаждения, инсоляции, профилактических прививок, травмы суставов, неблагоприятных экологических факторов, хронических психоэмоциональных стрессов. Но у большинства детей после ликвидации действия повреждающего фактора восстанавливается нормальное соотношение цитокинов, а у детей с генетической предрасположенностью дисбаланс сохраняется, что ведет к развитию ревматической патологии.

Однонуклеотидний поліморфізм rs510432 гена автофагії 5 та розвиток «атопічного маршу» у дітей

Мета: визначити зв’язок між однонуклеотидним поліморфізмом rs510432 гена автофагії 5 (ATG5) та розвитком «атопічного маршу» у дітей, з’ясувати ймовірність маніфестації клінічних проявів та особливості клінічного перебігу атопічних захворювань в осіб із різними алельними варіантами поліморфізму. Методи. Генотипування поліморфізму rs510432 гена ATG5 у дітей з атопічними захворюваннями та практично здорових дітей із застосуванням методики полімеразної ланцюгової реакції в реальному часі. Результати. Мінорна алель Т rs510432 гена ATG5 вірогідно частіше виявляється у пацієнтів з атопічними захворюваннями, ніж у практично здорових дітей (χ2 = 6,36; р &lt; 0,05). За результатами логістичної регресії ризик розвитку атопічних захворювань у дітей із мінорним генотипом у 2,4 раза вищий, ніж у дітей із мажорним генотипом. Середні значення об’єму форсованого видиху за 1 секунду (ОФВ1) у хворих на бронхіальну астму з мінорним генотипом вірогідно нижчі, ніж з мажорним генотипом (Q = 2,71; р &lt; 0,05). Не виявлено статистично значущих відмінностей у розподілі алельних варіантів поліморфізму rs510432 гена ATG5 залежно від тяжкості бронхіальної астми, атопічного дерматиту та алергічного риніту у дітей. Висновки. У дітей з мінорним генотипом ТТ поліморфізму гена ATG5 виявлено підвищений ризик розвитку атопічних захворювань, що становить 72 %. У хворих на бронхіальну астму мінорний генотип ТТ поліморфізму гена ATG5 асоційований зі зниженим показником ОФВ1. Поліморфізм rs510432 гена ATG5 доцільно використовувати з метою прогнозування розвитку атопічних захворювань у дітей.

Значення однонуклеотидного поліморфізму rs4769628 гена РОМР у розвитку атопічних захворювань у дітей

Метою даного дослідження було визначити зв’язок між наявністю однонуклеотидного поліморфізму rs4769628 гена РОМР та розвитком алергічних захворювань у дітей. Методи: генотипування поліморфізму rs4769628 гена POMP у дітей з маніфестацією атопічного маршу та практично здорових дітей із застосуванням методики ПЛР в реальному часі. Результати. У 62,26 % дітей, хворих на атопічні захворювання, і 53,06 % здорових дітей зустрічається мажорна алель rs4769628 гена РОМР. 33,67 % і 37,76 % дітей відповідно мають гетерозиготний варіант АG. Мінорний генотип GG у дітей, хворих на атопічні захворювання, не зустрічається, 9,18 % здорових осіб є носіями мінорної алелі (р &lt; 0,05). Висновки. Мінорна алель G rs4769628 гена РОМР асоційована зі зниженим ризиком розвитку атопічних захворювань у дітей. Поліморфізм rs4769628 гена РОМР може використовуватись як важливий прогностичний маркер розвитку атопічних захворювань у дітей.

Дисметаболічна нефропатія як фактор ризику розвитку пієлонефриту в дітей

Актуальність. Дисметаболічні нефропатії (ДН) сприяють розвитку сечокам'яної хвороби у дітей, виникненню інфекції сечовидільної системи та розвитку вторинного пієлонефриту, тубулоінтерстиціальних змін в нирках. Мета. Аналіз частоти та структури ДН як фактора ризику формування пієлонефриту у дітей. Матеріали та методи. Проведено аналіз 297 випадків у дітей із дисметаболічними нефропатіями. Всім дітям було здійснено загальноклінічне обстеження, ультразвукову діагностику сечовидільної системи, лабораторне обстеження. Результати. Спостерігалося значне переважання чисельності дівчаток (72,6 %) у порівнянні з хлопчиками (27,4 %). У 88,1 % дітей переважали оксалатні нефропатії, що реєструвалися ізольовано. Значно рідше зустрічалися фосфатні й уратні ДН, як ізольовано, так і в поєднанні з оксалатними нефропатіями. Звертало на себе увагу збільшення чисельності дітей із ДН з віком. Питома вага оксалатних, фосфатних і уратних ДН з віком у дітей суттєво не змінювалася та була приблизно однаковою в усіх вікових групах. У 73 % випадків ДН поєднувалися з інфекційно-запальними захворюваннями сечовидільної системи. Так, більше ніж дві третини дітей (68,9 %) мали пієлонефрит. У половини дітей раннього віку відзначалося поєднання ДН з гострим пієлонефритом. Поступово з віком питома вага гострого пієлонефриту зменшувалася та кількість випадків хронічного пієлонефриту (в групі хворих віком 11–17 років він реєструвався у 58,3 % дітей) збільшувалася. Досліджено поширення ДН серед дітей Дніпропетровської області у зв’язку з місцем проживання. Висновки. Серед дитячої популяції відзначається висока частота ДН, серед яких переважають ізольовані оксалатно-кальцієві нефропатії. Ризик розвитку ДН зростає пропорційно віку дитини. Виявлення ДН у дітей перших років життя, особливо у дівчаток, повинне розглядатись як фактор ризику інфекційно-запальних захворювань сечовидільної системи. Найчастіше ДН реєструються у великих промислових центрах області, що є екологічно забрудненими.

Relationship of Physical Activity and Sedentary Time with Metabolic Health in Children and Adolescents Measured by Accelerometer: A Narrative Review.

The purpose of this study was to summarize the associations of physical activity (PA) and sedentary time (SED) with metabolic health and examine the effects of time reallocation on metabolic health in adolescents using accelerometer data. A literature search was conducted using PubMed, ScienceDirect, Web of Science, Cochran Library, and Google Scholar, and 27 articles were reviewed. Recent research generally confirms the associations of PA and SED with metabolic health. High PA levels and low SED levels had a positive relationship with metabolic health. Moreover, reallocating 10 min of daily SED to PA was associated with better metabolic health indicators. These results were stronger for moderate-to-vigorous physical activity than for light intensity PA. Thus, efforts to convert SED into PA of at least moderate intensity appear to be an effective strategy to prevent metabolic disease development in children and adolescents. However, some of the associations between PA and metabolic health indicators were inconsistent, depending on age, obesity degree, and PA intensity. Additionally, various accelerometer data collection and processing criteria impact the interpretation of the results. Therefore, consistent accelerometer data collection and analysis methods are needed in future studies. Further, intervention studies are required to verify the causality and effectiveness of the isotemporal substitution model.

ВЛИЯНИЕ ДЕФИЦИТА ЖЕВАТЕЛЬНОЙ НАГРУЗКИ НА СОСТОЯНИЕ ЗУБОЧЕЛЮСТНОЙ СИСТЕМЫ У ДЕТЕЙ

Subject. A review of the literature is presented on the topical problem of pediatric dentistry — the development of major dental diseases in childhood due to the existing deficiency of chewing load.&#x0D; The aim of the study was to study the materials of publications on the influence of the deficit of chewing load in childhood on the development of dental pathology.&#x0D; Methodology. The effect of the deficit of the chewing load on the structures of the dentition in children, leading to hypofunction and a decrease in resistance to dental diseases, is described.&#x0D; Results. It was found that in children in the period of mixed bite, the occlusal load is distributed unevenly. One of the reasons for this is malocclusion. As a result, the functional state of the temporal and masticatory muscles changes. The simultaneous presence in the mouth of deciduous teeth that have lost their stability due to root resorption and permanent teeth, which are at various stages of eruption and root formation, leads to a significant decrease in chewing function, leading to poor oral hygiene, uneven training of the chewing muscles, abnormal growth of the jaw bones and the formation of dentoalveolar anomalies. Violation of the chewing function has a negative impact on the growth and development of the child, causing pathological adaptation of all structures to occlusion anomalies. Therefore, the question of the importance of active chewing, full load on the dentition is important for the prevention of periodontal disease, dental caries and the development of dentoalveolar anomalies.&#x0D; Conclusions. The results of the review indicate that there is a connection between the development of major dental diseases in children with a deficit in chewing load due to the widespread consumption of soft foods.&#x0D; In the available literature, there is an insufficient number of works devoted to the influence of the deficit of the chewing load on the development of major dental diseases.&#x0D; In our opinion, one of the ways to solve this problem can be the use of dentoalveolar training in childhood.

Участие детоксикационной системы организма в возникновении негладкого течения и утяжелении псевдотуберкулеза у детей

Objective. To analyze possible role of changes in the level of erythrocyte glutathione S-transferase (GST), serum γ-glutamyltransferase (GGT), and serum 5'-nucleotidase (5'-NT) in aggravation of pseudotuberculosis and development of complicated disease in children, as well as to identify prognostic factors to predict complicated pseudotuberculosis. Patients and methods. This prospective study included 125 children with pseudotuberculosis of different severity and disease course and 45 healthy children (control group). We measured the activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST), 5'-NT, GST, GGT, as well as the level of total and conjugated bilirubin. Results. We observed increased levels of ALT, 5'-NT, GST, GGT, and conjugated bilirubin in children with mild and moderate pseudotuberculosis during the acute period, as well as in patients with moderate disease during early convalescence. Children with severe pseudotuberculosis during the acute period and early convalescence demonstrated elevated activity of ALT, AST, 5'-NT, GGT, and maximum increase in the level of bilirubin along with comparable activity of GST. Conclusion. We found that an imbalance of detoxification enzymes in the acute period of pseudotuberculosis has a prognostic value for predicting severe and complicated disease later. Key words: children, pseudotuberculosis, glutathione S-transferase, γ-glutamyltransferase, 5'-nucleotidase

Prenatalni i perinatalni faktori rizika za razvoj alergijskih bolesti

For allergic diseases to develop, three components must be present: heredity, allergen contact and environmental factors. Allergic diseases are the most common chronic diseases in children and adolescents. This paper aims to present the latest findings on prenatal and perinatal risk factors for the development of atopic disease. The analysis was conducted by researching papers from the MEDLINE and PubMed databases published before September 2021. It has been determined that a mother's immune system during pregnancy plays a key role in the development of the fetus and affects the overall well-being of her offspring later in life. Immune dysregulation during the gestation period is proven to be associated with adverse maternal, fetal and neonatal outcomes. Contrary to the long-established belief that amniotic fluid is a sterile medium, it is now known that the fetus receives its first dose of probiotics by swallowing amniotic fluid. In connection with that, the microbiota of the mother greatly affects the microbiome of the newborn. Premature birth, cesarean delivery, intrapartum administration of antibiotics and other drugs can all harm the formation of the baby's microbiome. Understanding the importance of environmental factors in the pathogenesis of allergic diseases as well as the old hygiene hypothesis concept in the light of microbial disorders, it is clear that all previously mentioned parameters can have a very important impact on the development of allergic diseases in children.

Breast-Milk Microbiota Linked to Celiac Disease Development in Children: A Pilot Study From the PreventCD Cohort.

Celiac disease (CeD) is an immune-mediated disorder triggered by exposure to dietary gluten proteins in genetically predisposed individuals. In addition to the host genome, the microbiome has recently been linked to CeD risk and pathogenesis. To progress in our understanding of the role of breast milk microbiota profiles in CeD, we have analyzed samples from a sub-set of mothers (n = 49) included in the PreventCD project, whose children did or did not develop CeD. The results of the microbiota data analysis indicated that neither the BMI, HLA-DQ genotype, the CeD condition nor the gluten-free diet of the mothers could explain the human milk microbiota profiles. Nevertheless, we found that origin country, the offspring’s birth date and, consequently, the milk sampling date influenced the abundance and prevalence of microbes in human milk, undergoing a transition from an anaerobic to a more aerobic microbiota, including potential pathogenic species. Furthermore, certain microbial species were more abundant in milk samples from mothers whose children went on to develop CeD compared to those that remained healthy. These included increases in facultative methylotrophs such as Methylobacterium komagatae and Methylocapsa palsarum as well as in species such as Bacteroides vulgatus, that consumes fucosylated-oligosaccharides present in human milk, and other breast-abscess associated species. Theoretically, these microbiota components could be vertically transmitted from mothers-to-infants during breastfeeding, thereby influencing CeD risk.

РЕАЛИЗАЦИЯ РИСКОВ РАЗВИТИЯ ЗАБОЛЕВАНИЙ ОРГАНОВ ДЫХАНИЯ У ДЕТЕЙ, ПОДВЕРГАЮЩИХСЯ ВОЗДЕЙСТВИЮ ХИМИЧЕСКИХ ФАКТОРОВ ЭКСПОЗИЦИИ, СВЯЗАННОЙ С ХОЗЯЙСТВЕННОЙ ДЕЯТЕЛЬНОСТЬЮ СУБЪЕКТА ПО ПРОИЗВОДСТВУ ГЛИНОЗЕМА

Alumina refineries are among the leading sources of atmospheric air pollution with a wide range of pollutants hazardous to human respiratory organs. It is relevant to study and evaluate the occurrence of the risks for development of respiratory diseases in children living in the area affected by the emission components of an alumina refinery. We assessed air quality of the area under observation and comparison according to monitoring observations, risk of non-carcinogenic effects from the respiratory organs. The content of chemicals in the blood and urine adequate to risk factors was quantified. The structure of individual groups of respiratory diseases was analyzed. The causal relationships of violations of laboratory parameters with an increased content of chemicals in biological media were evaluated. It was found that an aerogenic exposure of chemical pollutants is formed on the territory with the production of metallurgical alumina. It determines the risk for development of respiratory diseases, exceeding an acceptable level up to 49.9 times. In the exposed children, the content of manganese, chromium, nickel, copper, xylenes, formaldehyde and aluminum, fluoride ion in the urine was increased to 4.2 times in relation to the indices in the comparison group. A high level of additional respiratory morbidity(1.8 times) was revealed. Chronic lymphoproliferative diseases of the nasopharynx and inflammatory diseases of the upper respiratory tract (up to 6.6 times more often), inflammatory diseases with a predominance of the mechanism of allergic inflammation ( up to 2.1 times more often)are more often detected in the framework of the respiratory diseases. Negative effects on the part of the respiratory system in the form of activation of antioxidant processes, the development of an inflammatory reaction, local, general and specific sensitization of the respiratory tract were established. It confirms the occurrence of the risks for the development of respiratory diseases in children in the exposure area of the chemical factors of alumina refinery-associated economic activity.

Green Environments and Allergic Diseases in Children: a Scoping Review

Urbanization and urbanization-related detrimental exposures are commonly indicated as responsible determinants for the dramatic increase in allergy and asthma, and one of the main urbanization factors that have been recently associated with the development of allergic sensitization is the reduced access to natural and biodiverse spaces. The present review aimed to compile and discuss the recent findings from studies focused on neighbourhood greenspace effect on asthma and allergic disease development in children. Green areas neighbouring children residences play a role on the prevalence of allergy and asthma. However, whether greenness is a protective factor, or an exacerbation driver, is yet to be elucidated. This may be due to the confounding factors associated with greenspace exposure, such as vegetation biodiversity, environmental microbiome, human behaviour, or the region itself. It is not possible to concretely discern the importance of early life exposure to green areas on asthma and allergy development. More studies on determinant factors associated with green areas, such as biodiversity or environmental microbiome, may help to elucidate these associations.

Intrauterine growth restriction and overweight, obesity, and stunting in adolescents of indigenous communities of Chiapas, Mexico.

Intrauterine growth restriction (IUGR) and low-birth-weight (LBW) are determinant factors in the development of metabolic diseases in children and adolescents. To estimate the magnitude of the association between LBW and IUGR with stunting or obesity among adolescents of two indigenous regions of the southern State of Chiapas, Mexico. We assessed a random sample of 303 adolescents selected from a birth cohort study (2003) conducted in three hospitals serving urban and rural communities of Tzotzil-Tzeltal and Selva regions of Chiapas, Mexico. Sociodemographic and anthropometric data from a sample of adolescents were correlated with their anthropometric data at birth (weight, length for age). Logistic regression models were fitted to estimate odds ratios (OR) with 95% confidence intervals to measure the magnitude of the association among the variables of interest. Models were adjusted for potential confounders. In all, 12% of the sample had LBW and 28.8% IUGR. In total, 29% of adolescents were overweight/obese and 21% were stunted. We found a statistically significant association between IUGR and a lower risk of being overweight/obese. A higher probability for stunting was observed for LBW and IUGR. Stunting and overweight/obesity prevalence in this population of adolescents was high and was associated with IUGR.

Bone Marrow Fat Physiology in Relation to Skeletal Metabolism and Cardiometabolic Disease Risk in Children With Cerebral Palsy.

Individuals with cerebral palsy exhibit neuromuscular complications and low physical activity levels. Adults with cerebral palsy exhibit a high prevalence of chronic diseases, which is associated with musculoskeletal deficits. Children with cerebral palsy have poor musculoskeletal accretion accompanied by excess bone marrow fat, which may lead to weaker bones. Mechanistic studies to determine the role of bone marrow fat on skeletal growth and maintenance and how it relates to systemic energy metabolism among individuals with cerebral palsy are lacking. In this review, we highlight the skeletal status in children with cerebral palsy and analyze the existing literature on the interactions among bone marrow fat, skeletal health, and cardiometabolic disease risk in the general population. Clinically vital questions are proposed, including the following: (1) Is the bone marrow fat in children with cerebral palsy metabolically distinct from typically developing children in terms of its lipid and inflammatory composition? (2) Does the bone marrow fat suppress skeletal acquisition? (3) Or, does it accelerate chronic disease development in children with cerebral palsy? (4) If so, what are the mechanisms? In conclusion, although inadequate mechanical loading may initiate poor skeletal development, subsequent expansion of bone marrow fat may further impede skeletal acquisition and increase cardiometabolic disease risk in those with cerebral palsy.

THE ROLE OF ROTAVIRUS IN THE DEVELOPMENT OF ACUTE DIARRHEAL DISEASES IN CHILDREN IN UZBEKISTAN

The article presents the results of epidemiological studies of the role of rotavirus in the development of acute diarrheal diseases in children in the Republic of Uzbekistan. Practice of new epidemiological criteria allowed to differentiate the different intensity of the epidemic process and the manifestation of epidemiological patterns of rotavirus infection depending on the region of the republic. The probability of participation of rotaviruses in the formation of the epidemic process in acute diarrheal diseases is proved. The study was conducted in two regions of the republic differing from each other by economic and social conditions. The material for this study was the data obtained as a result of a serological study of feces samples taken from patients with acute diarrheal diseases before the age of 5 years. When examining 1597 children with acute diarrhea in 532 (33.3%) cases, we were able to establish the presence of rotavirus antigens in the feces. Summarizing the above, we can assume that in the Republic of Uzbekistan, rotaviruses occupy one of the leading places in the etiological structure of acute diarrheal diseases, especially in younger age groups.