Perinatal Damage Of Central Nervous System Research Articles

EVALUATION OF PHYSICAL DEVELOPMENT IN CHILDREN WITH BRONCHIAL ASTHMA

Among the diseases capable of negatively affecting the course of bronchial asthma in children and adolescents, disruptions in nutritional status play an important role, including not only excess body weight and obesity, but also insufficient body weight. Since children with the consequences of perinatal central nervous system damage often exhibit signs of protein-energy deficiency, the aim of the research conducted was to assess the indicators of nutritional status of children with bronchial asthma depending on accompanying neurological symptoms by evaluating the body mass index. 126 children with bronchial asthma were examined, divided into two subgroups: the main group included 65 children (51.6%) with the disease occurring against the background of consequences of perinatal central nervous system damage; the comparison group included 61 patients (48.4%) without accompanying neurological symptoms. The average age of the children was 11.4±2.9 years. According to the results obtained, in 50.8% of observations, children in the main group had insufficient body weight and a decrease in body mass index, while in the comparison group, excess body weight was observed in 37.7% of cases. KEYWORDS: children, bronchial asthma, anthropometry, body mass index, nutritional status, central nervous system

PROFILE OF NITRIC OXIDE METABOLISM INDICATORS IN PRETERM INFANTS WITH PERINATAL CENTRAL NERVOUS SYSTEM INJURIES

Introduction. Premature infants often experience a heightened risk of brain damage, potentially leading to various disorders affecting motor, cognitive, behavioral, social, and sensory functions. The underlying pathological processes of hypoxic-ischemic central nervous system (CNS) injury predominantly stem from compromised cerebral blood flow and oxygen transport. Timely diagnosis and treatment options for prematurely born children with perinatal CNS damage remain limited. Nitric oxide, a universal regulator of physiological functions, plays a crucial role. Endothelial dysfunction, marked by the loss of the neurovascular protective functions of nitric oxide, could significantly contribute to the development of cognitive impairment in hypoxic-ischemic CNS damage. Objectives. The study aims to evaluate the specificities of nitrate metabolism indicators in premature infants with hypoxic-ischemic CNS lesions in the early neonatal period. This involves examining and comparing clinical indicators characterizing hemodynamics, as well as the levels of nitrites, nitrates, and nitrosothiols in urine among patients in the studied groups. Subjects and Methods. The study comprised 14 premature infants with hypoxic-ischemic CNS injury (main group), with a separate selection of 4 infants who did not survive during the neonatal period. The comparison group included 20 relatively healthy prematurely born children. Stratification was based on the results of a genetic study, specifically the determination of the rs61722009 polymorphism of the eNOS gene. The patients underwent routine clinical examinations, including blood pressure measurements, and assessments of nitrates, nitrites, and nitrosothiols in urine. Subgroups were identified as follows: 1st subgroup - 4bb (n=10), and 2nd subgroup - 4aa/4ab (n=10). Results. It was observed that newborns who did not survive had significantly lower systolic and diastolic blood pressure readings on the first day of life, in comparison to relatively healthy children in the two control subgroups (day 1 - p=0.018; p=0.027; p=0.036; p=0.053). Additionally, they exhibited lower heart rate indicators on the first day (p=0.001; p=0.002). However, overall, hemodynamic indicators in newborns with hypoxic-ischemic central nervous system damage did not show statistically significant differences from the corresponding indicators in relatively healthy children. The results indicate a significantly lower level of diuresis in children who died as a result of severe with hypoxic-ischemic central nervous system damage, probably due to the development of multiple organ failure immediately after birth. As a result, it was found that the levels of nitrites (p<0.001; p<0.0001) and nitrates (p<0.01; p<0.0001) were reduced in children with with hypoxic-ischemic central nervous system damage, compared to children in the control groups, regardless of genotype variant. While the level of nitrosothiols did not differ significantly, it was even much higher in children who did not survive, 3.55±0.39 vs 2.23±0.22; p=0.008. The differences found may indicate a disruption of the regulatory effect of nitric oxyde on vascular tone and the condition of neuroglia, particularly in children with hypoxic-ischemic central nervous system damage, as a result of its insufficient production, as well as insufficient mobilization from the depot due to nitrite and nitrate reductases. Conclusions. Hemodynamic patterns in children from the examined groups, except for those who did not survive, did not exhibit significant differences. The notably lower urine output in deceased children indicates the development of multiple organ failure due to severe hypoxia. In children with hypoxic-ischemic central nervous system damage, there is a reduction in the levels of nitrites and nitrates in urine compared to relatively healthy premature infants, while the level of nitrosothiols did not show significant differences and was even notably higher in children who did not survive. The outcome of studying the levels of nitrates, nitrites, and nitrosothiols in urine in a larger patient sample may lead to the development of an algorithm for early diagnosis and management, contingent on the severity of metabolic disorders resulting from hypoxia, considering the potential influence of nitric oxide on energy deficit and mitochondrial dysfunction.

Physical rehabilitation of children with perinatal lesion of the central nervous system

The relevance and social significance of the problem of medical rehabilitation of children with perinatal damage to the central nervous system is determined by the high prevalence of this pathology and the possibility of severe disabling diseases in such children. In the complex treatment of such patients, preference is given to non-drug methods. The leading place in the system of rehabilitation measures for children with perinatal central nervous system damage belongs to kinesiotherapy technologies, as the most gentle and pathogenetically justified.
 To study the results of research conducted by Russian and foreign authors on the issues of physical rehabilitation of children with perinatal damage to the central nervous system and to conduct an analysis of the effectiveness of the proposed technologies. The literature review for this article was conducted from the eLibrary, PubMed, Cochrane Library databases with a search depth of 20 years. The selection of publications was carried out using keywords: medical rehabilitation, non-drug technologies, perinatal damage to the central nervous system; perinatal hypoxic-ischemic encephalopathy, kinesotherapy, neurodevelopmental therapy, massage, thin finger training method, dry immersion, fitball gymnastics, Vojta therapy; Bobat therapy.

Modern approach to infusion therapy of pregnant women with gestational hypertension

To date, there are no effective treatment for placental dysfunction in pregnant women with gestational hypertension. Therefore, the purpose of our study was to investigate the clinical efficacy of proposed method of infusion therapy for pregnant women with gestational hypertension, which included a complex of drugs: pentoxifylline, arginine hydrochloride with levocarnitine and rheosorbilact. We observed 73 pregnant women with single fetation, starting from 28 weeks of gestation, who were observed before and during childbirth, and in the postpartum period by the time of discharge from the hospital. All examined women were divided into 3 groups. The first group included 30 pregnant women with gestational hypertension, who received (along with the basic therapy of methyldopa drugs) a complex of infusion solutions: pentoxifylline 0.05% – 100 ml; solution containing arginine hydrochloride 4.2% and levocarnitine 2.0% – 100 ml; reosorbilact preparation – 100 ml. The infusion was carried out once a day in the specified sequence for 10 days. The second group included 20 patients with gestational hypertension on basic therapy with methuldopa only. The control group included 23 women with physiological pregnancy. The data of our study show that in patients receiving the proposed infusion therapy there was a significant decrease in the development of placental dysfunction by 38.3%, the threat of premature birth – by 18.3% and fetal distress – by 30.0%, premature rupture of the membranes – by 35.0%, weakness of labor – by 28.3%, a decrease in the risk of perinatal central nervous system damage – by 33.3% and the frequency of cephalohematomas – by 30.0% compared with women who received only antihypertensive therapy.

Special Medical Food in Premature Child with Postnatal Malnutrition: Clinical Case

Background. Protein-calorie deficiency is common multifactorial medical condition in infants. Nutrition therapy of protein-calorie deficiency in premature infants with special medical food is not always quite effective. It can be associated with residual manifestations of overlapping perinatal pathology.Clinical case description. Extremely premature child with severe protein-calorie deficiency in the late period with combined perinatal pathology (perinatal central nervous system damage and bronchopulmonary dysplasia) was administrated with therapeutic highly nutritious (high-protein/high-energy) milk formula according to individual plan. The positive dynamics in clinical manifestations of the main and associated diseases was noted on nutrition therapy.Conclusion. High-calorie and protein-enriched therapeutic formula can effectively correct protein-calorie deficiency in premature infants with associated perinatal pathology in the recovery period (disfunction compensation).

Особенности микробного пейзажа верхних дыхательных путей у детей с микроаспирационным синдромом на фоне поражения центральной нервной системы

Актуальность. Бронхолегочная патология занимает ведущее место в структуре заболеваемости детей всех возрастных групп. Одним из факторов, способствующих затяжному течению бронхитов или рецидивирующему бронхообструктивному синдрому, является микроаспирация. Высокий риск развития как острой, так и хронической микроаспирации имеют дети с неврологическими расстройствами. Цель исследования: изучение особенностей течения респираторной патологии и микробного пейзажа верхних дыхательных путей у детей с микроаспирационным синдромом на фоне поражения центральной нервной системы (ЦНС). Материалы и методы. Проведено комплексное обследование 30 детей в возрасте от 1 мес. до 12 лет (средний возраст пациентов — 4,60 ± 0,03 года) с патологией ЦНС. Основную группу составили 18 детей с перинатальным поражением ЦНС, имеющие в анамнезе затяжные и рецидивирующие бронхиты, группу сравнения — 12 респираторно-асимптомных детей с перинатальным поражением ЦНС. Исследование включало детальный сбор анамнеза, объективное обследование детей и лабораторно-инструментальные методы. У всех больных изучали микробный спектр верхних дыхательных путей, полученный путем глубокого мазка из ротоглотки. Для статистической обработки полученных результатов использовалась программа Statistica 13.0. Результаты. Установлено, что микроаспирационный синдром встречается преимущественно у детей с тяжелой сочетанной патологией ЦНС. Респираторная патология у данной категории пациентов характеризуется рецидивирующими бронхитами (средняя частота за год — 5,9 ± 0,4), их ранней манифестацией (средний возраст начала бронхитов — 4,4 ± 0,5 мес.) и затяжным течением (средняя продолжительность бронхитов — 1,5 ± 0,1 мес.). Особенностью микробного пейзажа верхних дыхательных путей у детей с микроаспирационным синдромом на фоне поражения ЦНС является доминирование кишечной условно-патогенной микрофлоры (Klebsiella pneumoniae, Proteus vulgaris и Proteus mirabilis), а также Pseudomonas aeroginosa и дрожжеподобных грибов рода Сandida. Выводы. Полученные результаты имеют важное практическое значение при выборе стартового антибактериального препарата для лечения затяжных бактериальных бронхитов у детей с микроаспирационным синдромом на фоне поражения ЦНС.

Results of complex treatment with the inclusion of osteopathic correction of somatic dysfunctions in perinatal CNS lesions in children of the first year of life

Introduction . According to Russian and foreign studies, the frequency of perinatal central nervous system (CNS) lesions continues to grow. The highest percentage of perinatal pathology and more significant deviations in subsequent development are observed among premature babies. An actual task is to expand non-drug methods of medical rehabilitation. The goal of research — was to study the effectiveness of osteopathic correction of somatic dysfunctions in children with diagnosed perinatal CNS damage. Materials and methods . In the period from 2015 to 2019 a prospective controlled randomized study was performed on the basis of ANO TIMM. The work is based on the results of observation and treatment of 125 children aged from 6 to 12 months with a diagnosis of perinatal CNS damage. Depending on the gestational age, all patients were divided into two comparable groups: main group (ex-term) and comparison group (ex-preterm) of 90 and 35 people, respectively. Patients of both groups received osteopathic care provided in accordance with the developed algorithm. All patients, before the start of treatment, during the course of therapy and at its completion, underwent osteopathic diagnostics in accordance with the approved clinical guidelines, as well as an assessment of neuropsychic development (NPD) and neurological status. Results. The study showed that children of the first year of life with perinatal CNS lesions, regardless of gestational age at the time of birth, are characterized by the presence of somatic dysfunctions of all three levels — global, regional and local, with a dominating global somatic dysfunction. Dysfunctions of the head and neck region, diaphragm, and local somatic dysfunctions of the cranial sutures were most often observed. During treatment, patients of both groups showed a statistically significant decrease in the frequency of regional somatic head and neck dysfunctions and local somatic dysfunctions of the cranial sutures (p<0,05). Conclusion. Osteopathic correction of somatic dysfunctions in children of the first life year with perinatal CNS damage, while following a certain sequence of methods for eliminating connective tissue disorders, including obligate decompression and elimination of edema and hypoxia, makes it possible to achieve a statistically significant (p<0,05) decrease in the clinical manifestations of perinatal CNS damage, and positive dynamics of NPD indicators, regardless of the gestational age at the time of birth.

Chemical characteristics of peripheral blood granulocyte biomembranes in frequently ill children with autonomic dysfunction syndrome

The problem of frequently ill children has extreme relevance in medical practice. A special group is FIC with autonomic dysfunction syndrome, born prematurely with perinatal damage of the central nervous system (CNS). In previous studies, we found that FIC who were born prematurely with perinatal damage of the central nervous system exhibit lower immunoreactivity than their healthy peers. Purpose of the work – to study the biochemical indicator of immunocompetent cells (the study of the phospholipid composition of granulocyte membranes) of the frequently ill children with autonomic dysfunction syndrome, born prematurely with perinatal damage to the central nervous system (CNS). Materials and methods. 68 children in the age of 6-7 years who are belonging to the group of frequently ill were examined. Out of 68 children, there were 36 children with autonomic dysfunction syndrome (SVD) born prematurely with perinatal hypoxic-ischemic damage to the central nervous system (group 1) and 32 children without autonomic dysfunction syndrome born on time without central nervous system damage (group 2). Results. A study of the phospholipid composition of blood granulocyte membranes of patients of the studied groups revealed significant differences comparison with the control group. The revealed changes in granulocyte biomembranes were more pronounced for FIC with SVD born prematurely with perinatal CNS damage than for children born on time without CNS and SVD damage. Conclusions. The obtained data allow us to conclude that FIL who were born preterm with perinatal damage of the central nervous system, changes in the biochemical characteristics of membranes are observed to a slightly greater extent than for children who were born on time without central nervous system damage. The revealed changes in immunocompetent cells are characterized by an increase in the polarity of the lipid component of biomembranes and a decrease in the relative content of neutral lipids in them. These violations lead to a change in protein-lipid interactions, which, as a result, leads to a change in the microviscosity of biomembranes and their structural and functional properties. At these children forme an inferior immune response to an infectious agent.

Optimization of correction of sleep, speech and cognitive development in children as a result of perinatal injury of the central nervous system

The article presents the results of a clinical study on the efficacy and tolerability of the Anantavati® Kids dietary supplement (Ananta Medicare, UK) in children with speech, cognitive and sleep disorders as a result of perinatal lesions of the central nervous system (CNS). The peculiarities of the effect of Bacopa Monier and Vitania sleeping pills on functional changes in the brain in the main group of children receiving Anantavati® Kids and the comparison group are shown. During the study of the results of the use of the phytocomplex Anantavati® Kids (a fixed combination of Bacopa Monier - 150 mg and Vitania sleeping pills - 300 mg), 38 children aged 4 to 12 years were examined who received Anantavati® Kids in addition to rehabilitation psychological and speech therapy measures. For comparison, 20 children were examined who had similar syndromes and received only rehabilitation psychological and speech therapy measures, the groups were comparable in terms of gender and age. The efficacy, tolerability and safety of the dietary supplement "Anantavati® Kids" for behavioral disorders, impaired speech cognitive development and sleep disturbances due to perinatal CNS damage in children were assessed using neurophysiological methods and neuropsychological indicators, statistical methods. Children of the main group received Anantavati® Kids syrup for 30 days, and underwent two clinical-neurological, neuropsychological, speech therapy and neurophysiological examinations: immediately before the start of the course and 1 month after taking Anantavati® Kids. A positive effect, according to an individual assessment of the clinical state in dynamics after 1 month of using Anantavati® Kids, was registered in most children. In the main group, the prevalence of complaints of sleep disorders decreased by 71%, speech impairment – by 47.37%, hyperactivity – by 55.26%, memory impairment - by 42.11%, attention impairment - by 65.79%, emotional disorders spheres by 63.16%. Positive dynamics of speech therapy indicators, in the form of an increase and active use of vocabulary, an increase in the structure of the word and the volume of coherent speech, was observed in 18 (47.37%) children. After the end of the course Anantavati® Kids in 28 (73.68%) children of the main group, a pronounced positive dynamics of EEG indicators was determined. A good safety profile was noted with the use of Anantavati® Kids, which is manifested by good tolerance during the study. Thus, the analysis of the data obtained after the use of Anantavati® Kids in children with the consequences of perinatal CNS lesions demonstrate the profound effect of the Anantavati® Kids phytocomplex on sleep disturbances, symptoms of cognitive and speech and psychoemotional disorders against the background of a course intake.

Features of proteomic profi le of blood serum of children with bronchial asthma who underwent perinatal central nervous system damage

Objective: proteomic analysis of blood serum of children with bronchial asthma with a history of indication of the pathology of the perinatal period.Materials and methods: a comprehensive examination of children suffering from asthma and patients of the control group using proteomic analysis of blood serum was carried out. Proteomic analysis of blood serum was performed using two-dimensional high-resolution gel electrophoresis followed by staining of gels with fl uorescent dye and time-of-fl ight MALDI mass spectrometry. The proteins were identifi ed using Mascot MS peptide fi ngerprint analysis algorithm and Swiss-Prot protein database.Results: comparative analysis of the proteomic profi le of blood serum of children with pathology of the central nervous system in the perinatal period and developed in the subsequent bronchial asthma and control group patients allowed to establish that number proteins products were reduced in this disease. The proteins in the molecular mass range 16-33 kDa (p<0.05) were identifi ed: glutathione peroxidase 3, transthyretin and system components compliment С4В and C3.Conclusion: modifi cation of the production of these proteins indicates the presence of damage at the molecular level, leading to metabolic and functional disorders in the body of a patient with asthma having a history of indicating the pathology of the perinatal period.

Structure of Neurological Pathology in Children with Impaired Visual Functions

In children’s neurology, problems of diagnosis and correction of the effects of perinatal lesions of the central nervous system, having a different structure and severity depending on the age of patients, are relevant. Comorbid conditions, to which, to a certain extent, neurological diseases in children associated with functional and structural disorders of the visual system can be attributed.Aim. To study the features of neurological pathology, concomitant to violation of visual functions in children of different age groups.Methods. A neurological examination of 549 children from 3 to 16 years old with various diseases of the visual system was performed. To assess the age characteristics the patients were divided into three groups of preschool, junior and senior school age. The study included a retrospective analysis of ambulatory cards, an interview with parents and an assessment of objective neurological status. If there were indications, additional examination was prescribed (spondylography with functional tests, electroencephalography and others).Results. The features of the structural distribution of neurological pathology in children, which differed from those in the general population, were identified. The dominant disorders are neuro-orthopedic disorders in the form of dorsopathies at the level of the cervical spine.Conclusion. In the structure of neurological pathology in children with structural and functional changes in the visual system, the symptom complex prevails, which is typical for minimal effects of natal damage to the cervical spine, confirmed by X-ray studies. Also a certain relationship of neurological and ophthalmic pathology was identified. The consequences of perinatal central nervous system damage and peripheral cervical insufficiency, as manifestations of dorsopathy, were more often associated with strabismus. In the same group, the maximum number of children with partial atrophy of the optic nerve was revealed.

RISK FACTORS FOR GASTRODUODENAL PATHOLOGY IN CHILDREN WITH PERINATAL DAMAGE TO THE CENTRAL NERVOUS SYSTEM

It is generally accepted the risk factors for the development of the gastrointestinal tract (GIT) diseases to have a hereditary predisposition, unfavorable environmental conditions, eating disorders, emotional stress, excessive body weight, and inactivity. Also in a number of studies, it was convincingly shown the perinatal central nervous system (CNS) damage to be a risk factor for the development of GIT diseases; in the history of children with perinatal CNS lesions, chronic gastrointestinal diseases develop 3-4 times more often than in children without it in the history. Perinatal CNS damage leading to the development of a number of disorders of the nervous system is revealed in the history of the majority of children with gastrointestinal diseases, while the severity of neurological manifestations is directly related to the duration and severity of gastroenterological diseases.

Opportunities for Prevention and Rehabilitation Treatment of the Consequences of Perinatal Central Nervous System Damage in Premature Infants

научный биометрический журнал, который знакомит читателя с клиническими рекомендациями и особенностями применения лекарственных и вакцинных средств у детей, предоставляет исчерпывающую информацию о воздействии лекарственных средств на плод, о проводимых в

Peculiarities of the course of perinatal central nervous system damage of undefined etiology during the newborn period (clinical case)

The problem of perinatal morbidity and mortality remains one of the main medical problems of today in all countries of the world. The prevalence of perinatal pathology is constantly increasing. The damage to the nervous system is about 50% in the structure of childhood disability with 70-80% of cases of perinatal lesions. We present our own observations of child with perinatal damage of the central nervous system of undefined etiology.

MANAGEMENT OF SPECIALIZED AUDIOLOGIC MEDICAL CARE AND SIMULTANEOUS MEDICAL AND EDUCATIONAL FOLLOW-UP OF PREMATURE CHILDREN IN THE OUT-PATIENT DEPARTMENT OF A LARGE HOSPITAL

Background: The authors set a goal to analyze the problem of management of simultaneous medical and educational follow-up of premature children during the 1st year of life under the conditions of out-patient department of a large hospital (by the example of consulting and diagnostic centre of Morozov Children Municipal Clinical Hospital). Patients and methods: Audiologic examination was performed in 293 premature children. Ninety three children with the consequences of perinatal central nervous system damage were included into the program of correctional diagnostic medical and educational rehabilitation (they were examined by otolaryngologist-audiologist, neurologist and logopedist). Results: Premature children even with normal hearing function at the age of 3 months have very high level of prespeech development retardation (from 75 to 96%), depending on their gestation age. Conclusion : Logopedics examination of premature children at the age of 3 months allows to reveal signs of their mental retardation (motor activity, aural perception, communicative, cognitive and emotional spheres, prespeech activity) in the overwhelming majority of cases.