The results of a laboratory examination of 520 children aged 1—3 years are presented. The examination was conducted to determine the DNA of cytomegalovirus in children with acute cytomegalovirus infection in various biological media by polymerase chain reaction. The differences in the virus shedding  into the blood, saliva, and urine are established: the median of the viral load for saliva is 4.9 lg copies of DNA/ml, the blood 3.4 lg copies of DNA/ml, urine — 3.85 lg copies of DNA/ml. The cut of extreme values of the viral load are determined with the help of mathematical modeling which determine the clinical probability of developing acute CMV infection which allows for more accurate and timely assignment of etiotropic therapy.

Objective. To study the possibility of using N-terminal pro-BNP fragment as a screening criterion of hemodynamic significant of the functioning arterial duct in extremely premature newborns. Hemodynamically significant functioning arterial duct (HSFAD) is a reason of the development of various complications in extremely premature newborns. The basic method for HSFAD diagnosis is Echo CG. The limited technical abilities of ultrasound devices can prevent from an early diagnosis and timely treatment of this state. The search of additional markers of hemodynamic significance the functioning arterial duct (FAD) is actual. Materials and methods. A continuous prospective observational study included patients aged 1 to 3 days with FAD, gestation period of 2532 weeks and birth weight from 500 to 1500 g. Hemodynamic significance of FAD was determined according to generally accepted Eco CG criteria. The level of NT-pro-BNP was identified with IFA on the third day of life. Mathematical modelling was used to calculate a threshold value of NT-pro-BNP, corresponding to 6500 pg/ml, at which the probability of hemodynamic significance of the functioning arterial duct exceeds 80 %. Results. The assessment of NT-pro BNP concentration on the third day of life permitted to establish the following reliable differences: in the main group, the median concentration for NT-pro BNP was 15000 [IQR 2 587; 26 500] pg/ml, in the comparison group 1920 [IQR 1379; 3467] pg/ml, р = 0.001. Mean force direct correlation, r = 0.52, between Echo CG results and NT-pro-BNP values was stated. Conclusions. The obtained results make it possible to use NT-pro-BNP as a screening criterion of FAD hemodynamic significance in extremely premature newborns.

Hemodynamically significant patent ductus arteriosus (hsPDA) in premature newborns is associated with a risk of PDA-related morbidities. Classification into risk groups may have a clinical utility in cases of suspected hsPDA to decrease the need for echocardiograms and unnecessary treatment. This prospective observational study included 99 premature newborns with extremely low body weight, who had an echocardiogram performed within the first three days of life. Discriminant analysis was utilized to find the best combination of prognostic factors for evaluation of hsPDA. We used binary logistic regression analysis to predict the relationship between parameters and hsPDA. The cohort’s mean and standard deviation gestational age was 27.6 ± 2.55 weeks, the mean birth weight was 1015 ± 274 g. Forty-six (46.4%) infants had a PDA with a mean diameter of 2.78 mm. Median NT-pro-BNP levels were 17,600 pg/mL for infants with a PDA and 2773 pg/mL in the non-hsPDA group. The combination of prognostic factors of hsPDA in newborns of extremely low body weight on the third day of life was determined: NT-pro-BNP, Apgar score, Silverman–Anderson score (Se = 82%, Sp = 88%). A cut-off value of NT-pro-BNP of more than 8500 pg/mL can predict hsPDA (Se = 84%, Sp = 86%).