Introduction. According to the results of available studies, health status of cadets is often higher than in general population, however, data shows unfavorable trends in the physical development of cadet boys.Aim. Analysis of cadets' physical development.Materials and methods. 122 cadet boys aged 12-15 were included in the study using the continuous sampling method. All children underwent anthropometry, bioimpedance analysis and measurement of the functional state of the body. The results were evaluated in accordance with centile chart.Results and discussion. The majority of children (80 - 65.6%) had 1st health group. The most common pathology was refraction disorders (14 - 11.5%) and urological pathology (9 - 7.4%). Height of the majority of the examined boys was in the average values, however, short stature was found out in 4 (3.3%) cases. According to BMI, 4.9% (6) of children were underweight, 32.0% (39) - overweight and 4.1% (5) had obesity. According to percentage of fat mass by bioimpedance analysis, 4.1% (5) were underweight, 27.0% (33) - overweight and 22.1% (27) were obese. Muscle strength values below the average were in 11.5% (14) of boys, and muscle strength by kg of weight - in 36.1% (44). Almost a third (33 - 27.0%) of children had high blood pressure, and another 10 people (8.2%) had arterial hypertension. According to the results of the Martinet-Kushelevsky test, nine children had pathological type of reaction to dosed physical activity. Low resistance to anaerobic exercise by Genchi test was found in 19.7% (24) of children. The results of the coordination test showed unsatisfactory results in the majority of children - 48.4% (59).Conclusion. Physical development of adolescent boys studying in the cadet corps was average. High percentage of boys, although less, then in general population, were overweight and obese. Despite seemingly optimal nutrition, daily routine and physical activity provided in cadet corps, 20% of children had low resistance to anaerobic exercise, low strength index and non-physiological response of the cardiovascular system to dosed physical activity.
Currently, the attention of the medical community to a non-invasive method of laboratory diagnostics - the study of oral fluid (oral, saliva, saliva test) in various fields of clinical medicine and mainly in adult patients has been updated. Saliva testing has shown good results, especially in the areas of genomics, microbiomics, proteomics, metabolomics, and transcriptomics. The review presents the possibilities of using a non-invasive method for infectious and non-infectious diseases in children. Saliva contains a wide range of protein DNA and RNA biomarkers that help detect many viral infections in children. Oral fluid tests for human immunodeficiency virus, hepatitis B virus have improved access to diagnostics for infants. Both serological and molecular analyzes of the oral fluid are suitable for routine examination and early detection of measles virus RNA, polyomaviruses. Angiotensin-converting enzyme-2 receptor expression was found in the saliva of children with COVID-19, which can be used to diagnose SARS-CoV-2. The saliva test is as effective as the standard test at identifying asymptomatic individuals in contact tracing. The possibilities of saliva diagnostics are positively assessed in transplantology. New biomarkers in saliva have been identified for the diagnosis of many somatic diseases in children. The role of oral fluid as an alternative to blood serum in patients with terminal renal failure, chronic kidney disease (determination of creatinine, urea) in both adults and children is shown. The data obtained may influence the recommendations for the treatment of patients. As a non-invasive method, the study of oral fluid is promising for the diagnosis, prognosis, monitoring of diseases, large-scale typing of children, and the search for new biomarkers.
Introduction. Currently, the coronavirus infection pandemic caused by the SARS-CoV-2 virus continues around the world. Research data from domestic and foreign authors indicate that the kidneys are a target organ for a new infection, lesions vary from proteinuria and hematuria to acute kidney injury.Aim of the study – to determine the frequency and nature of kidney damage in children with confirmed coronavirus infection.Materials and methods. A retrospective and prospective analysis of cases of confirmed COVID-19 infection in children (n = 441) admitted to the Samara Regional Children’s Infectious Diseases Hospital from March 2020 to July 2021 was carried out. SARSCoV-2 RNA was detected in all patients by a one-step reverse transcription reaction combined with a polymerase chain reaction. The changes in the kidneys that occurred in 57 children were studied. The research results were processed using the Statistica 7.0 software (StatSoft, USA).Results. The involvement of the kidneys in the infectious process was detected in every 8 children with COVID-19 (12.9%), more often in the form of isolated urinary syndrome, the detection rate of which correlated with the severity of the course of coronavirus infection: in severe cases, proteinuria was detected in 31.6% of patients, hematuria – in 21%, acute kidney injury – in 10.5%, diabetic nephropathy – in 5.3%. Kidney damage was combined with damage to the respiratory and gastrointestinal tract, characterized by rapid recovery of urine output and azotemia parameters without special renal therapy. A clinical case of the onset of nephrotic syndrome that developed 2 weeks after suffering a coronavirus infection is described.Conclusions. Children with COVID-19 require kidney function monitoring for early detection and correction in case of impairment. Patients with isolated urinary syndrome in the acute period require long-term observation in order to detect latent renal pathology.
Chronic kidney disease and a decrease in its progression is a global health problem. However, the risk factors associated with the primary nosology of glomerular diseases of children have not been sufficiently studied.Purpose. To determine early risk factors for the progression of chronic kidney disease for more effective prevention of chronization of the process, based on the analysis of clinical and anamnestic data, the features of the manifestation of the primary developed glomerular pathology, and taking into account nosological forms.Material and methods. The experience of own clinical observations, retro- and prospective, related to the formation of chronic kidney disease of children with glomerular pathology is summarized. The study was conducted on the basis of the children’s uronephrological center of the Samara Regional Clinical Hospital named after V.D. Seredavin.Results. The universal risk factors are systematized: transferred critical conditions in the perinatal period with the development of acute kidney injury; prenatally established CAKUT syndrome; the presence of a genetic predisposition to kidney diseases, a complex of allergic diseases in the family; the carriage of persistent infections, hemolytic strains of streptococcus, social determinant, environmental conditions, etc. Specific early risk factors for disease progression, features of the onset of kidney pathology and biomarkers of progression that determine early kidney damage have been identified. The features of nephroprotection are formulated: interdisciplinarity with the inclusion of organizational, social components; operational communication with the outpatient link; the use of social networks for educational processes — the patient’s family, training of first-contact doctors.
Transition of an adolescent patient with chronic kidney disease (CKD) from pediatric to adult healthcare system is an urgent problem Worldwide. The purpose of this research was to generalize the idea of readiness of adolescents with CKD to transfer into adult nephrology healthcare system, to describe the challenges of such transition period and to determine the roles of participants in the process and their mutual interactions in order to develop and implement the working regional model for organizing the transition of adolescents with CKD within a clustered system of provision of specialized healthcare services. Materials and methods used: a single-center cross-sectional questionnaire surveying of adolescents and young adults with CKD regarding their readiness to transition in two observation groups was carried out on the basis of both adult and pediatric sections of the Samara Oblast Regional Clinical Hospital named after V.D. Seredavin (Samara, Russia) in Jan. 2021-March 2023. Group 1 consisted of young adults aged 18 to 22 y/o with CKD stages 2 to 3; and Group 2 included adolescents aged 13 to 18 y/o with CKD stages 2 to 5. The results were then evaluated with the TRxANSITION Index (formerly TRxANSITION Scale), PedsQL and the SF-36 questionnaire. Adolescents’ parents/caretakers took a survey on the independence of their children as well. Results: the data on the insufficient independence of adolescents were obtained, as follows: 66.7% [34.9-90.1%] (n=8) “never” took medication on their own, 50.0% [21.1-78.9%] (n=6) have never asked their physicians questions (p<0.001), 50.0% [21.1-78.9%] (n=6) “never” and 33.3% [9.9-65.1%] (n=4) “almost never” did they agree to meet with the physician (p=0.005). Adolescents experienced difficulties in both communicating and working together with a physician: 33.3% [9.9-65.1%] (n=4) and 25.0% [5.5-57.2%] (n=3) “difficult,” respectively; 50.0% [21.1-78.9%] (n=6) and 58.3% [27.7-84.8%] (n= 7) “almost difficult,” respectively (p<0.001). On the other hand, “almost everything” and “everything” do they know about their health status 47.1% [23.0-72.2%] (n=8) and 35.4% [14.2-61.7%] (n=6), respectively, of young adults with CKD vs. adolescents (p<0.001). Conclusion: structurization of the participants’ roles in the communication system “patient and his family members - medicine professionals - psychologists - social workers” contributes to the stabilization of an adolescent with CKD during the transition period.
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