State In Children Research Articles

Low-Cardiac Output State in Children and Young Adults on Maintenance Hemodialysis

Low-Cardiac Output State in Children and Young Adults on Maintenance Hemodialysis

Reversibility of Hyperglycemic States in Children with Obesity - Diagnostic Pitfalls in the Assessment of Glucose Metabolism in Children and Adolescents with Obesity

Disorders of glucose metabolism in children with obesity are less common than in adults. There is also evidence that they may be transient. The aims of this study were to determine the prevalences of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (DM2) and its reversibility in pediatric patients with obesity and to define the factors determining the reversibility of prediabetes or progression to diabetes. Retrospective analysis included of young patients with obesity. Patients presented and were treated between 2000-2022 at a single center. The study included 573 (316 girls; 55.15%) Caucasian patients with median body mass index (BMI) Z-score of 3.95 (range 2.0-9.9) and median age 13.9 (2.9-17.1) years old. OGTT results were normal in 90.8% (n=520) and signs of prediabetes occurred in 9.2% (n=53); IFG 17%, IGT 88.7%, DM 0%. Among those who underwent OGTT twice (n=53), impaired glucose regulation was present in 9.3% (n=5) (IFG 40%, IGT 80%, DM 0%) at baseline and in 14.8% subject (n=8) (IFG 25%, IGT 50%, DM 25%) at follow-up after lifestyle modification only. After 12-36 months of follow up, in those with a history of IGT, 60% reverted to normal glucose tolerance, while IFG and IGT persisted in 20% and 20%, respectively, and none progressed to DM. The risk factors for progression of glucose metabolism disorders were increase of BMI Z-score, higher insulin levels and elevated homeostatic model assessment-insulin resistance. IFG and IGT are common in pediatric patients with obesity, while the progression to DM2 is rare. Disorders of glucose metabolism have reversible character.

Polarised Worlds: Female and Male Inner States in Children’s Reading Anthologies

Abstract
 Experts on literature and pedagogy from a wide range of countries and traditions currently argue for including literary texts with diverse characters in the curriculum, in order to provide children with varied reading experiences and foster their outgroup empathy skills. In this article, our aim is twofold. Firstly, we contribute to the debate in question by examining how the inner states (emotions and cognition) of female and male characters are portrayed in a purposeful sample of 44 prose excerpts from Czech Year 3 reading anthologies. Secondly, we present an innovative procedure for analysing texts that allows for the exploration of a selection of literary texts as individual entities and at the same time their analysis as an aggregate whole. Our analyses show that female characters’ inner states tend to be underrepresented, especially regarding cognition. While we have not found significant differences in the overall quality of female characters’ inner states in comparison to their male counterparts, individual excerpts tend to strongly highlight the inner states of female or male characters, respectively, thus creating story worlds with a distinct female-vs-male orientation.
 Keywords: software-assisted literary analysis, emotion, cognition, gender, reading anthologies
 
 Resumen
 Expertos literarios y educativos de diferentes países y tradiciones argumentan actualmente a favor de incluir textos literarios con personajes diversos en la enseñanza, con el fin de proporcionar a los niños y niñas experiencias de lectura variadas y fomentar sus habilidades de empatía hacia aquellos que son diferentes a ellos. En este artículo nuestro objetivo es doble. En primer lugar, contribuimos al debate en cuestión examinando cómo se representan los estados internos (emociones y cognición) de los personajes femeninos y masculinos en una muestra cuidadosamente seleccionada de 44 fragmentos en prosa de antologías de lectura del tercer año de Educación Primaria en la República Checa. En segundo lugar, presentamos un procedimiento innovador de análisis de texto que permite explorar una selección de textos literarios como entidades individuales, pero también su análisis
 como un conjunto global. Nuestros análisis muestran que los estados internos de los personajes femeninos tienden a estar subrepresentados, especialmente en lo que respecta a la cognición. No hemos encontrado diferencias significativas en la calidad general de los estados internos de los personajes femeninos en comparación con los masculinos; sin embargo, los fragmentos individuales tienden a resaltar fuertemente los estados internos de personajes femeninos o masculinos respectivamente, creando así mundos narrativos distintos centrados en lo femenino o lo masculino. 
 Palabras clave: análisis literario asistido por software, emoción, cognición, género, antologías de lectura.
 Resum
 Experts literaris i educatius de diferents països i tradicions argumenten actualment a favor d’incloure textos literaris amb personatges diversos en l’ensenyament, amb la finalitat de proporcionar els infants experiències de lectura variades i fomentar les seues habilitats d’empatia cap als que en són diferents. En aquest article el nostre objectiu és doble. En primer lloc, contribuïm al debat en qüestió tot examinant com es representen els estats interns (emocions i cognició) dels personatges femenins i masculins en una mostra acuradament seleccionada de 44 fragments en prosa d’antologies de lectura del tercer any d’Educació Primària a la República Txeca. En segon lloc, presentem un procediment innovador d’anàlisi de text que permet explorar una selecció de textos literaris com a entitats individuals, però també la seua anàlisi com un conjunt global. Les nostres anàlisis mostren que els estats interns dels personatges femenins tendeixen a estar subrepresentats, especialment en allò que respecta a la cognició. No hem trobat diferències significatives en la qualitat general dels estats interns dels personatges femenins en comparació amb els masculins; tanmateix, els fragments individuals tendeixen a ressaltar fortament els estats interns de personatges femenins o masculins respectivament, tot creant així mons narratius distints centrats en allò femení o allò masculí.
 Paraules clau: anàlisi literària assistida per software, emoció, cognició, gènere, antologies de lectura

Head Control Contributes to Prediction of Emergence From the Minimally Conscious State in Children Admitted to Inpatient Rehabilitation

ObjectiveTo examine the utility of head and trunk control, assessed using the Physical Abilities and Mobility Scale, for predicting emergence from a minimally conscious state (eMCS) among children with acquired brain injury admitted to inpatient rehabilitation in a disorder of consciousness (DoC). DesignRetrospective study. SettingPediatric inpatient rehabilitation hospital. ParticipantsForty patients (2-21 years-old) directly admitted from acute care to pediatric inpatient brain injury rehabilitation in a DoC (average length of stay=85 days; N=40). InterventionsNot applicable. Main Outcome MeasuresState of consciousness (eMCS vs not) at discharge from inpatient rehabilitation. ResultsForty-five percent of patients emerged from a minimally conscious state during inpatient rehabilitation. Admission state of consciousness and head control (but not trunk control) were significantly associated with eMCS and provided complementary prognostic information. Admission state of consciousness (ie, admitting in a vegetative state/unresponsive wakefulness syndrome) afforded the greatest negative predictive value (93.8%), whereas admission head control ability afforded the greatest positive predictive value (81.8% for any independent head control; 100% for maintaining head-up position for >30 seconds). Fifty percent of patients who emerged during the inpatient stay did not have independent head control at admission, highlighting the importance of exploring head control as a prognostic marker in conjunction with indicators with greater sensitivity (eg, state of consciousness at admission). ConclusionsA brief measure of head control at admission may contribute to identification of a subgroup of patients who are likely to emerge.

PD56 Conceptual Issues In The Valuation Of Health States In Children

IntroductionAssessing the cost utility of health technologies for pediatric patients requires robust utility values for child health states, but the methods for valuing these pediatric health states are much less established than those for valuing adult health states. This is partly because the elicitation of preferences for child health states poses many normative, ethical, and practical challenges.MethodsThis presentation examines the conceptual issues in the valuation of health states in children by addressing the following questions.(i)Normative theories of health state values: What are we attempting to elicit?(ii)Sources of preferences: Whose preferences should we elicit, and from which perspective?(iii)Valuation methodologies: How should we elicit preferences?(iv)Attaching different values to child and adult health: Is a lack of consistency problematic?To answer these questions, we used desk research (non-systematic literature reviews) and findings from a two-part workshop held in April 2021. The workshop included 25 participants with expertise in health economics, health state valuation, child health, health technology assessment (HTA) decision-making, and ethics.ResultsWe identified a lack of consensus on what is being elicited for both adults and children. Many HTA agencies recommend that the public be involved in utility generation exercises, but some criteria for defining who constitutes a member of the public exclude children. Of the many candidate sample types, perspectives, and methodologies, only a few were deemed relevant, acceptable, and feasible for use in the child health context. In addition, there were diverging views on whether it is possible to compare and integrate adult and child value sets with different properties.ConclusionsSeveral questions remain to be answered before the public and other stakeholders can have confidence in child health state valuation protocols. We propose a research agenda, including both empirical and conceptual work, to inform future methodological development and to help HTA agencies make recommendations about how child utility values should be generated.

Determining the Oxidative State in Children with Enterobiasis Infection

The objective of current study is determining the oxidative state in children with Enterobiasis infection. The current study was done among children aged 3 years to 10 years in Tikrit city, Iraq. 135 children were used in current work at January 2020 to November 2020. The number of males was 57 and female was 78. The cello tape method was to detect infection of Enterobiasis vermicularis. The findings demonstrated that the levels of Malondialdehyde (MDA) in an infected children show significant (p is less than 0.05) elevated compared with healthy children. The levels of Glutathione (GSH) and catalase in an infected children show significant (p is less than 0.05) reduce compared with healthy children. Otherwise, the levels of IL-2 in an infected children show significant elevated compared with healthy children. So, the study found that there is a direct relationship between E. vermicularis and oxidative status in children with a direct effect on interleukin 2.

Strength and VO2max Changes by Exercise Training According to Maturation State in Children.

The health benefits of physical activity (PA) are widely recognized; however, biological maturation contributions are a subject that has been little studied, which is why the aim of this study was to analyze the effect of a six-week training program at moderate-intensity on the muscular strength and aerobic capacity in children between nine and 13 years (13 ± 1.0 years) according to their maturation state. Twenty-six schoolchildren (15 girls) participated in a six-week physical exercise program based on aerobic/anaerobic capacity and coordination skills. Maximal oxygen uptake (VO2max), trunk-lift, push-ups, curl-ups, and handgrip strength (both hands) were measured as response variables. Body mass index (BMI), skeletal maturity indicator (SMI), peak height velocity (PHV), age on peak height velocity (APHV) and sex were considered as covariates. The results of VO2max, push-ups, curl-ups, and handgrip strength were higher after the exercise program in the whole group (p < 0.05). The VO2max showed a greater increase in the normal-weight than in the overweight-obesity children (p = 0.001). Higher results in dominant handgrip strength were observed in girls (p = 0.003). The PHV before intervention presented a positive correlation with the dominant handgrip strength in all kids (r = 0.70, p = 0.001). As a conclusion, the six-week training program improved the physical fitness of children independent of the maturation state. Somatic maturation increases the physical abilities in schoolchildren.

Adverse Respiratory Events After Removal of Laryngeal Mask Airway in Deep Anesthesia Versus Awake State in Children: A Randomized Trial.

BackgroundThe advent of the laryngeal mask airway (LMA) has reduced respiratory events in comparison to the conventional endotracheal tubes. Any manipulation under a light plane of anesthesia predisposes to increased airway sensitivity followed by adverse events. The reduced airway sensitivity in the deeply anesthetized state makes LMA removal feasible. In the past, the respective advantages and disadvantages of extubation in two planes of anesthesia have led to conflicting results. The primary objective of this study is to compare the incidence of adverse respiratory events at the time of LMA removal, in deeply anesthetized and awake groups. Our secondary objective was to record the management of complications.Materials and methodsWe conducted a prospective randomized control trial in 106 American Society of Anesthesiologists (ASA) I and II patients undergoing lower umbilical surgeries over a period of one year. The demographic details and intraoperative and postoperative variables, i.e., airway obstruction, laryngospasm, peripheral oxygen desaturations, cough, straining and vomiting, along with corrective measures were recorded by the primary research assistant in both groups. Regarding the management of peripheral oxygen desaturation (less than 90%), airway obstruction, and laryngospasm, 100% fractional inspired oxygen support and chin lift/jaw thrust were used.ResultsThe average age was 32.58±15.81 months. The demographic characteristics of the patients were not significant between the two groups. The rate of adverse respiratory events like laryngospasm and airway obstruction was relatively high in the deep group but not statistically significant between the groups. A total of 7 (6.6%) patients had laryngospasm, 21 (20%) had airway obstruction, 16 (15%) had a cough and 11 (10%) patients had observed peripheral oxygen desaturation (less than 90%) between both groups. ConclusionWe concluded that adverse respiratory events could happen in both awake and deep planes of anesthesia after the removal of LMA in children. Furthermore, both techniques have an acceptably low frequency of complications, and it does not affect the current clinical practice.

Physiological Detection of Affective States in Children with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is associated with emotion processing difficulties, including limitations in understanding the emotional states of others and processing one's own internal experiences. The nature of these difficulties remains largely unknown. This is due, in part, to challenges in acquiring reliable self-reports of emotional experiences from this population. Automatically characterizing emotional states with the use of physiological signals is a potential means of overcoming this problem, as physiological signals can provide an objective and nonverbal method for assessing affective states. However, this approach has not been well considered with ASD to date. To this end, we investigated detection of autonomic responses to positive and negative stimuli in children with ASD using four physiological measurements. Electrocardiograms, respiration, skin conductance and temperature were measured while 15 children with ASD viewed standard images known to evoke varying levels of valence (positive and negative) and arousal (low and high intensity). Using an ensemble of classifiers, affective states induced by stimuli of positive and negative valence or high and low arousal was differentiated at average accuracies approaching or exceeding 80 percent. These results suggest the feasibility of discerning affective states in individuals with ASD objectively using physiological signals.

Case Studies Using the Electroencephalogram to Monitor Anesthesia-Induced Brain States in Children.

For this child, at this particular moment, how much anesthesia should I give? Determining the drug requirements of a specific patient is a fundamental problem in medicine. Our current approach uses population-based pharmacological models to establish dosing. However, individual patients, and children in particular, may respond to drugs differently. In anesthesiology, we have the advantage that we can monitor our patients in real time and titrate drugs to the desired effect. Examples include blood pressure management or muscle relaxation. Although the brain is the primary site of action for sedative-hypnotic drugs, the brain is not routinely monitored during general anesthesia or sedation, a fact that would surprise many patients. One reason for this is that, until recently, physiologically principled approaches for anesthetic brain monitoring have not been articulated. In the past few years, our knowledge of anesthetic brain mechanisms has developed rapidly. We now know that anesthetic drug effects are clearly visible in the electroencephalogram (EEG) of adults and reflect underlying anesthetic pharmacology and brain mechanisms. Most recently, similar effects have been characterized in children. In this article, we describe how EEG monitoring could be used to guide anesthetic management in pediatric patients. We review previous evidence and present multiple case studies showing how drug-specific and dose-dependent EEG signatures seen in adults are visible in children and infants, including those with neurological disorders. We propose that the EEG can be used in the anesthetic care of children to enable anesthesiologists to better assess the drug requirements of individual patients in real time and improve patient safety and experience.

Age-related and Gender Characteristics of the Content of Subjective Experiences of Mental States in Children with Developmental Disorders

Introduction. This study addresses age-related and gender characteristics of subjective experiences of mental states in children with developmental disorders.&#x0D; Methods. The authors examined subjective experiences of mental states such as joy, anger, and calmness. Children were asked to retrospectively and prospectively describe their mental states. The method of content analysis of texts was employed to identify semantic units and calculate the frequency of their occurrence.&#x0D; Results. Subjective experiences of mental states in children with developmental disorders depend on their gender and age. Subjective experiences of certain mental states may have similar content in boys and girls. Subjective experiences of mental states are more pronounced in younger boys with infantile cerebral palsy than in younger girls and in adolescent boys. Experiences of mental states are significantly enriched in adolescent girls with infantile cerebral palsy. Adolescents’ subjective experiences depend on gender and mental state. Subjective experiences of the state of joy are significantly more pronounced in younger boys with severe speech impairments than in adolescent boys. Boys’ experiences of calmness have a similar content. Younger girls’ experiences of calmness are much more intense than that of the boys of the same age. Projecting into the future, subjective experiences of mental states are transformed, losing some substantial components.&#x0D; Discussion. The study of subjective experiences of mental states in children with developmental disorders expands the format of available research in the field of psychology of mental states. The present study appears to be the first on characteristics of the experience of mental states in children of different nosological groups. The results of this study do not contradict the available data on mental states in school-age children provided earlier by A. O. Prokhorov.

Assessment of Nutrition State in Children with Heart Diseases

Background: It is well- known that children with congenital heart diseases (CHD) are at high risk for nutrition and growth restrictions. Objective: The purpose of this study was to assess growth restriction in infants and young children with heart disease and investigate the relationship between poor growth, feeding difficulties, cardiac classification, and nutrition intervention on outcomes. Materials and Methods: This study was performed on 100 children, 50 of them with symptomatic CHD (patient group). They were recruited from the Pediatric Cardiology Outpatient Clinic at Aswan Heart Center from March to August, 2016. A group of 50 apparently healthy children matched in age and sex represented our control group. CHD was diagnosed or excluded by clinical findings and echocardiographic and other routine tests. Results: We found there was some growth restriction in children with CHD compared to normal children in same age group. The growth deficiency was wasting rather than stunting and it was found to be the most common type of malnutrition in our study. No relationship between cardiac complexity, classification (cyanotic vs. acyanotic) and variables including growth parameters. Close nutritional monitoring should be included routinely for all children with CHD regardless of cardiac classification. Age at time of corrective surgery affects the potential for nutritional recovery and catch-up growth. Conclusion: Children with CHD require unique nutritional challenges. It is important to start dealing with nutrition status in congenital heart diseases as a preventable association rather than common consequence. Nutritional screening for diagnosed CHD cases will help in early detection of growth faltering, consequently it will provide access to early nutrition intervention and improve patient outcomes.

Assessment of Nutrition State in Children with Heart Diseases

Background: It is well- known that children with congenital heart diseases (CHD) are at high risk for nutrition and growth restrictions. Objective: The purpose of this study was to assess growth restriction in infants and young children with heart disease and investigate the relationship between poor growth, feeding difficulties, cardiac classification, and nutrition intervention on outcomes. Materials and Methods: This study was performed on 100 children, 50 of them with symptomatic CHD (patient group). They were recruited from the Pediatric Cardiology Outpatient Clinic at Aswan Heart Center from March to August, 2016. A group of 50 apparently healthy children matched in age and sex represented our control group. CHD was diagnosed or excluded by clinical findings and echocardiographic and other routine tests. Results: We found there was some growth restriction in children with CHD compared to normal children in same age group. The growth deficiency was wasting rather than stunting and it was found to be the most common type of malnutrition in our study. No relationship between cardiac complexity, classification (cyanotic vs. acyanotic) and variables including growth parameters. Close nutritional monitoring should be included routinely for all children with CHD regardless of cardiac classification. Age at time of corrective surgery affects the potential for nutritional recovery and catch-up growth. Conclusion: Children with CHD require unique nutritional challenges. It is important to start dealing with nutrition status in congenital heart diseases as a preventable association rather than common consequence. Nutritional screening for diagnosed CHD cases will help in early detection of growth faltering, consequently it will provide access to early nutrition intervention and improve patient outcomes.

Free Fatty Acids as an Indicator of the Nonfasted State in Children.

Ensuring children are fasting for blood draws is necessary to diagnose abnormalities in glucose homeostasis. We sought to determine if serum free fatty acid (FFA) concentrations might be a useful marker to differentiate the fed and fasted states among children. A total of 442 inpatient (fasting) and 323 (postglucose load) oral glucose tolerance test samples of glucose, insulin, and FFA from children (age 5-18 years) who had healthy weight, overweight, or obesity were examined by receiver operating characteristic (ROC) curve analysis to identify a cut point for nonfasting. In a cross-sectional study, we compared mean FFA and percentage of FFA values below this cut point as a function of inpatient (n = 442) versus outpatient (n = 442) setting. The area under the curve of FFA was significantly better (P values < .001) than the area under the curve of glucose or insulin for identifying nonfasting. FFA <287 mEq/mL had 99.0% sensitivity and 98.0% specificity for nonfasting. Mean FFA was lower in outpatients than inpatients (P < .001); only 1.6% inpatient but 9.7% outpatient FFA values were consistent with nonfasting (P < .001). Clinicians cannot assume that pediatric patients are adequately fasted on arrival for fasting blood work. On the basis of having significantly lower outpatient than inpatient FFA values and more frequently suppressed FFA, children appeared less likely to be fasting at outpatient appointments. FFA value <287 mEq/mL was a sensitive and specific cutoff for nonfasting in children that may prove clinically useful.

Physiological Responses of Continuous and Intermittent Swimming at Critical Speed and Maximum Lactate Steady State in Children and Adolescent Swimmers.

Background: The purpose of this study was to compare physiological responses during continuous and intermittent swimming at intensity corresponding to critical speed (CS: slope of the distance vs. time relationship using 200 and 400-m tests) with maximal lactate steady state (MLSS) in children and adolescents. Methods: CS and the speed corresponding to MLSS (sMLSS) were calculated in ten male children (11.5 ± 0.4 years) and ten adolescents (15.8 ± 0.7 years). Blood lactate concentration (BL), oxygen uptake (O2), and heart rate (HR) at sMLSS were compared to intermittent (10 × 200-m) and continuous swimming corresponding to CS. Results: CS was similar to sMLSS in children (1.092 ± 0.071 vs. 1.083 ± 0.065 m·s−1; p = 0.12) and adolescents (1.315 ± 0.068 vs. 1.297 ± 0.056 m·s−1; p = 0.12). However, not all swimmers were able to complete 30 min at CS and BL was higher at the end of continuous swimming at CS compared to sMLSS (children: CS: 4.0 ± 1.8, sMLSS: 3.4 ± 1.5; adolescents: CS: 4.5 ± 2.3, sMLSS: 3.1 ± 0.8 mmol·L−1; p < 0.05). O2 and HR in continuous swimming at CS were not different compared to sMLSS (p > 0.05). BL, O2 and HR in 10 × 200-m were similar to sMLSS and no different between groups. Conclusion: Intermittent swimming at CS presents physiological responses similar to sMLSS. Metabolic responses of continuous swimming at CS may not correspond to MLSS in some children and adolescent swimmers.

Peculiarities of the Factorial Structure of the Functional State in Children Aged 9–10 Years

The factors that determine the functional state (FS) as an integral characteristic of the total body were identified in children aged 9–10 years (n = 168) and included the autonomic regulation of physiological functions (factor I), the efficiency of cognitive activity (factor II), physical working capacity (factor III), hemodynamic support of cognitive activity (factor IV), nonspecific resistance of the body (factor V), and overall working capability (factor VI). The factors were considered as separate FS aspects that reflects activities of different functional systems. Using a systemic approach, the physiological contents of the factors were established, the most informative indices were identified for FS evaluation, and reference values were proposed for comparisons and diagnosis of the FS in children of the age group in question in a school setting. Aerobic and anaerobic components of the physical working capacity and motor fitness were shown to correlate with the efficiency of cognitive activity and nonspecific resistance to catarrhal diseases as FS aspects. The factorial structure of the FS in children aged 9–10 years was found to be similar to that in subjects of 5–6 and 13–14 years of age. Based on the finding, the factors were assumed to be the most stable FS components forming during ontogeny.

Effect of Oral Iron Administration on Mental State in Children With Low Serum Ferritin Concentration.

Serum ferritin is an iron-binding protein and is the target of the most sensitive and specific tests used for the identification of iron deficiency.1,2 In recent years, serum ferritin levels <30 ng/mL were considered to indicate iron deficiency even if the hemoglobin (Hb) content was within the reference range. In clinical practice, it is recommended that individuals with serum ferritin levels <40 ng/mL are considered iron deficient.1 In the field of pediatrics and child psychiatry, reduced serum ferritin is known to be associated with sleep disorder due to restless legs syndrome (RLS),3 attention-deficit/hyperactivity disorder,4 and tic severity.5 For RLS, iron administration is recommended when serum ferritin is <50 ng/mL.3 However, few studies have focused on serum ferritin itself to investigate the effect of reduced serum ferritin on psychological and physical symptoms of children. This study evaluated psychiatric features of children with reduced serum ferritin concentration and elucidated the effect of iron administration on the psychological and physical symptoms of the children who visited outpatient clinic.

Clinical and Instrumental Assessment of the Intestinal State in Children with Respiratory Pathology and Correction of the Revealed Violations

The need for frequent and long-term use of antibiotic therapy for respiratory pathology of bacterial origin often leads to the development of the intestinal microflora disorders and requires the inclusion of probiotics in treatment regimens. Probiotics containing Bacillus clausii have proven themselves in the treatment of antibiotic associated diarrhea.The objective: to assess the state of the intestine according to clinical data and the results of hydrogen breath test with lactulose in children with acute respiratory diseases and the effectiveness of the revealed violations correction by adding probiotic containing B. Clausii to the complex therapy.Materials and methods. Under the supervision there were 38 children of 4–10 years old, who in the course of antibiotic therapy of acute respiratory diseases were added probiotic containing B. Clausii (Probiz kids). In the І group of the study (20 children), probiotic was used simultaneously with antibiotic therapy for 7–10 days course. The ІІ group was formed by 18 children, for 7–10 days they received Probiz kids after completing a course of antibiotics. At the beginning of treatment, at 10–12 and for 25–30 days from the start of therapy, the presence of intestinal manifestations was evaluated and a hydrogen respiratory test with a load of lactulose was performed (HRTLL).Results. In the first group, on the 10–12th day from the beginning of the study, the syndrome of excessive bacterial growth disappeared in half of the children. But among the children of group II, the normalization of indicators in a repeated study of HRTLL did not occur in one child. On the 25–30 day from the start of treatment, the absence of excessive bacterial growth was detected in 80% of children of the first group and 50% of children of the second group.Conclusion. The results of the study indicate that probiotic Probiz kids has a positive effect on the intestinal state in children against the background of antibacterial therapy.

High Blood Pressure States in Children, Adolescents, and Young Adults Associate Accelerated Vascular Aging, with a Higher Impact in Females' Arterial Properties.

The aims of the study were to determine (1) whether the presence of High blood pressure (HBP) states in the youth associate a steeper rate of age-related change in arterial geometrical and wall properties with respect to subjects with no previous cardiovascular risk factor (CRF) exposure, (2) in which parameters and in what magnitude, and (3) the existence of a gender-related difference in the impact of this condition on arterial properties. 300 individuals (mean/range: 15/4-29 years; 133 females) were included. Two groups were assembled: (1) Reference: nonprevious exposure to traditional CRF and (2) HBP: subjects with arterial hypertension and/or elevated blood pressure (BP) levels during the study. Additionally, HBP subjects were separated in BP-related subgroups. Measured parameters were (1) central (aortic) arterial BP and aortic pulse wave analysis parameters, (2) carotid and femoral artery local (pressure-strain elastic modulus) and regional (pulse wave velocity; PWV) stiffness, and (3) arterial diameters and carotid intima-media thickness (CIMT). Age-related changes in these parameters (absolute values and z-scores) were explored by obtaining simple linear regression models for each group. HBP presented a steeper rate of change (accelerated vascular aging; VA) for most of the parameters assessed, mainly in central (aortic) hemodynamics. VA increased as the HBP level got higher. Both males' and females' aging rates were affected by this condition, but females presented a more marked relative age-related increase with HBP exposure. HBP states in the youth gradually associate accelerated VA, with a progressive hemodynamic-structural-functional onset of damage, with females presenting a more marked relative HBP-associated arterial repercussion.

Beyond Proteinuria: Apoptosis and Vitamin D3 State in Children with Diabetic Nephropathy

Diabetic nephropathy (DN) is the leading cause of death in patients with diabetes mellitus type I (T1D). Formation of diabetic nephropathy depends on the quality of blood glucose control. The aim of the study was to investigate the level of metabolic-hypoxic disorders, condition of apoptosis controlling system and Vitamin D3 levels in children with diabetic nephropathy. The study involved 36 children with type I diabetes and diabetic nephropathy (aged 6 to 17 years). The affinity of haemoglobin to oxygen determined by spectrophotometric method. The levels of the marker of cellular hypoxia HIF-1alfa, levels of the apoptotic factor caspase-3 studied by Western Blotting, Vitamin D3 levels were analyzed using ELISA assay. In the group of children with newly diagnosed T1D an increased rate of dissociation of oxygen and haemoglobin compared to the control group was detected. Children with DN the levels of this index were significantly lower than the control group. We show stage-dependent manner in increase of the cellular hypoxia and apoptotic effector caspase-3 levels. Both markers detected at significantly higher rate in DN patients as compared to T1D. Vitamin-D3 deficiency is documented in patients with DN. Thus, the development of DN in children is associated with violation of Hb/oxygen dissociation, a sign of the high degree of the Hb glycosylation resulting to the formation of cellular hypoxia and activation of apoptosis, as one of the basic mechanisms of cell damage kidneys in DN. All mentioned above disorders accompanied by Vitamin D3 deficiency.