Background. The purpose was to study the nature of changes in the cardiorespiratory system in the case of short-term hypoxemia during functional tests with breath-holding. Materials and methods. The paper presents the results of a survey of school-age children with acute bronchitis with and without obstructive syndrome (60 patients) and a group of healthy children (52 people). Patients underwent pulse oximetry in combination with hypoxic tests for breath-holding with data recording on a computer and performed a Rufier test. Results. The severity of bronchitis in patients in the first days was average on the BSS-ped scale — 7.79 ± 0.19 points. The level of blood oxygen saturation was normal (above 95 %), but there was a difference between the groups: in patients with obstructive syndrome it was 98.60 ± 0.04 %, in the absence of this syndrome — 98.80 ± 0.03 %, which was lower than in the control group — 99.00 ± 0.01 % (p < 0.05). Time of breath-holding did not differ significantly between groups, but there was a slight decrease in saturation after them. There was greater reaction to breath-holding on exhalation. Level of oxygenation in patients with bronchitis achieved by increasing heart rate. Due to the phenomena of relative hypoxemia of peripheral tissues during convalescence, there was a decrease in tolerance to physical loading after the Rufier test. Conclusions. It is established that even in mild forms of acute bronchitis in children, according to functional tests, there is a decrease in gas exchange reserves, especially in the presence of obstructive syndrome. Compensatory mechanisms to maintain blood saturation are based on increasing systemic blood flow due to increased heart rate.

Introduction. Hypertension is in the focus of pediatricians worldwide, as it is one of the most common diseases in modern pediatric cardiology. Methods. 61 school-age children were examined. They were divided into three groups: the 1st group included children with hypertension, the 2nd group – children with prehypertension, and the control group consisted of children with normal blood pressure. Infrared thermography in children was performed on the back surface of the hands, remotely, using a certified thermal imager with professional software. Thermographic evaluation of the hands after the cold test was performed immediately after the end of the test, after 1 and 2 minutes, and the final degree of recovery of heat radiation was determined after 15 minutes. The study found that in children with hypertension, the decrease in temperature after a cold test was probably higher than in children from the control group. Children with prehypertension also had a slightly greater decrease in temperature compared with children in the control group. The obtained significant difference between the indicators of children with hypertension and children from the control group may be due to worse compensatory mechanisms of the microcirculatory tract, lower capillary density, the presence of local spasm of venules and arterioles in them. In addition, children with hypertension have increased vascular resistance, which also affects the level of fall and recovery of local temperature, because thermal emission is a direct reflection of microcirculation in the fingers of the child. Conclusion. Children with hypertension are likely to have a greater decrease in the maximum temperature of thermal emission on the fingers and a slower recovery of heat radiation after a cold test, in contrast to children in the control group, due to microcirculation disorders.

Background. Most experts agree that duodenal ulcers are much more common in children. In recent years, the research interest in the relationship between the thyroid system and duo­denal ulcer processes has become evident. The purpose of the study is to investigate the thyroid functional state in children with duodenal ulcer. Materials and methods. The observation group consisted of 56 children aged 7 to 18 years with a verified duodenal ulcer and 15 healthy children. All pediatric patients underwent fibroesophagogastroduodenoscopy with a targeted thyroid biopsy and examination for the presence of the Helicobacter pylori bacterium, intragastric pH-metry, ultrasound examination of the abdominal cavity and thyroid gland; the concentration of thyroid hormones (thyroid-stimulating hormone, T3, T4) was also stu­died. Reliability was assessed using Student’s t-test. The diffe­rence was considered significant at p < 0.05. Results. The average age of children with duodenal ulcer was 13.1 ± 3.1 years. In all age categories, duodenal ulcer occurred more often in boys — 58.9 %. During an in-depth ultrasound examination, the structure of the thyroid gland in 52 (92.8 %) children was homogeneous, in 4 (7.1 %) individuals it was heterogeneous, but without nodular formations. Serum concentrations of thyroid-stimulating hormone and T3 in children with duodenal ulcer also did not differ from the average levels in children of the comparison group. At the same time, a decrease in the concentration of T4 was no­ted, which can be considered as a variant of euthyroid sick syndrome — the syndrome of reduced T4. The average serum level of T4 (32.67 ± 3.84 nmol/l) was significantly lower (p = 0.001) in children infected with Helicobacter pylori than in those wi­thout infection (39.45 ± 4.23 nmol/l) and healthy individuals (89.12 ± 5.91 nmol/l). Conclusions. Children with a duodenal ulcer have a violation of the thyroid status due to a decrease in the thyroxine concentration. A functional shift in the thyroid status in these patients can be considered as a prognostically unfavorable sign of possible deterioration of the ulcer course.

Introduction. The problem of early diagnosis of arterial hypertension in children is extremely urgent. According to some foreign scientists, the prevalence of this disease among school-age children in the world has been increasing over the past ten years. Children of prepubertal and pubertal age are most prone to the development of arterial hypertension, which is largely determined by vegetative dysfunctions and microcirculation disorders characteristic of these periods of childhood.It has been proven that changes in microcirculation are determined by the variant of arterial hypertension and are a fairly early marker of the degree of damage to target organs.The aim of the study is to study microcirculatory predictors of the formation of primary arterial hypertension in childhood.Material and methods.113 school-age children from the residents of Chernivtsi region and Chernivtsi were examined. The examined children were divided into two groups: the main group consisted of 30 children with arterial hypertension and the control group - 83 children with a normal level of blood pressure.Blood pressure was measured with automatic pressure gauge with removable cuffs, in the morning on both arms, three times with an interval of 2 minutes. Results were evaluated according to percentile tables for age, sex, and height.The recommendations of the American Academy of Pediatrics (AAR) were used to diagnose hypertension in children.Capillaroscopic examination of the nail bed was used to assess the state of peripheral microcirculation in the examined children. Quantitative and qualitative parameters of microcirculation were evaluated.The research was carried out in compliance with the "Rules of Ethical Principles of Conducting Scientific Medical Research with Human Participation" approved by the Declaration of Helsinki (1964-2013), ICH GCP (1996), EU Directive No. 609 (from 24.11.1986), orders of the Ministry of Health of Ukraine No. 690 from 23.09.2009, No. 944 from 14.12.2009, No. 616 from 03.08.2012.Statistical processing of the data was performed using nonparametric methods of evaluation. Mathematical processing of the data was performed using Microsoft Office Excel and Statistica 10.0.The work was performed within the framework of the planned research work of the Department of Pediatrics, Neonatology and Perinatal Medicine of Bukovinian State Medical University: Chronobiological and adaptation aspects and features of autonomic regulation in pathological conditions in children of different age groups, (№ 0122U002245, term of execution 2022 - 2026).Results. When comparing the quantitative capillaroscopic indicators of the nail bed between the groups, it was found that the children from the main group showed probable differences in individual indicators (reduced linear density, greater distance between capillaries, 2 times less number of anastomoses, change in the shape of capillaries) compared to the control group, which indicates on changes in peripheral microcirculation in children with elevated blood pressure.After conducting a correlation analysis of the obtained data, we found correlations between changes in the microcirculation of the nail bed and indicators of the functional state of the cardiovascular system in the form of changes in the linear density of capillaries and the distance between them, the presence of increased tortuosity of capillaries and "sweetening". Thus, the linear density of capillaries had high correlations with the level of systolic blood pressure (r=0.73, p<0.05) and the level of diastolic blood pressure (r=0.69, p<0.05).When conducting a multifactorial analysis, a clear relationship between changes in the indicators of the state of the cardiovascular system, on the one hand, and the capillaries of the nail bed, on the other, can be traced.Conclusions. 1. Microcirculatory disorders in the capillaries of the nail bed reflect the changes in central hemodynamics and may be early signs of arterial hypertension in children.2. According to the results of the epidemiological analysis, the presence of predictors of the development of primary arterial hypertension in children was established. These factors are a reduced number of capillaries per unit area (OR = 2.54; RR = 2.12; 95% CI 2.06-4.98) and their pathological tortuosity (OR = 1.75; RR = 1.44; 95% CI 1.18-2.63).