Childhood arterial hypertension (AH) has become a global problem not only for pediatrics, but also for public health in general.Objective. The aim of this study was to determine the prevalence of arterial hypertension among school-age children and diagnostic value of pulse pressure. Materials and methods.In total 848 children in 10-17 years of age (mean age -13.9 ± 0.06 years, 45.4 % boys and 54.6 % girls) from urban and rural areas of Chernivtsi region were examined in schools during screening for elevated blood pressure (BP). School-based ambulatory seated BP was measured by oscillometric automated recording devices with the age selection of cuffs. Elevated systolic (SAP) or diastolic (DAP) pressure was diagnosed in those children with indicators above the 95 th percentile of age norms in accordance with the national normative values. In cases of elevated BP the measurements were verificated by aneroid device.Results. It has been established that the frequency of high blood pressure in the examined school students was 25.2 %, including 17.7 % of arterial hypertension (BP above 95 percentile) and 7.5 % -pre-hypertension (90-95 percentile). The prevalence of hypertension varied with age subgroups and the highest level was in 16 years of age -29.9 % with high blood pressure (21.9 % above 95 percentile and 8.0 % between the 90 th and 95 th percentiles). Increased SAP was combined with an increased DAP in 47.3 % of cases and in the study had a positive correlation with overweight (r = 0.27, p < 0.05) and negative with physical performance (r = -0.21, p < 0.05). The pulse pressure had significant correlations with SAP, AH and overweight and it could be used as additional diagnostic index of AH.Conclusions. The prevalence of elevated BP in our study is higher than in European countries and exceeds 20 % of the child population. The elevated BP in our children has positive correlation with overweight and the negative with physical performance. The level of pulse pressure has significant correlation with SAP and overweight and it could be used as additional diagnostic index of AH.Артеріальна гіпертензія та пульсовий тиск у дітей шкільного вікуДитяча артеріальна гіпертензія (АГ) стала глобальною проблемою не тільки для педіатрії, але й для охорони громад-ського здоров'я загалом.Мета роботи -визначити поширеність артеріальної гіпертензії (АГ) серед дітей шкільного віку та діагностичну значу-щість пульсового тиску.Матеріали та методи. Обстежено у школах під час скринінгу на підвищений артеріальний тиск 848 дітей віком від 10 до 17 років (середній вік -13,9 ± 0,06 року, 45,4 % хлопчиків і 54,6 % дівчаток) із міських і сільських районів Чернівецької області. В умовах школи у дітей у положенні сидячи вимірювали кров'яний тиск осцилометричними автоматизованими тонометрами з віковим підбором манжет. Підвищений систолічний або діастолічний тиск діагностували в дітей із по-казниками вище 95 перцентиля вікової норми відповідно до національних нормативних значень. У випадках гіпертензії тиск верифікувався за допомогою анероїдного т...
Childhood obesity has become a global public health problem. This paper describes the current prevalence of school-age children obesity in Chernivtsi region. We examined 848 children (mean age-13,9±0,06 years) from different parts of the region. Body mass index (BMI) and waist-to-hip index were calculated, Z-index of BMI was estimated according to the local anthropometric percentiles standards. The prevalence of total overweight was 19,9 % including 13,6 % of obesity. The prevalence also varies by age, gender and place of living. In boys overweight was in 20,8 % and 19,2 %-in girls, obesity-14,6 % and 12,3 % respectively. The prevalence of obesity is the highest in age 12 and 13 years-more than 20 %. The overweight in our children has positive correlation with higher systolic blood pressure (r=0,27, p<0,05) and negative with physical performance (r=-0,21, p<0,05).
Introduction: Critically ill neonates are at high risk of developing renal impairment (RI), including acute kidney injury (AKI), which is associated with short- and long-term pathological outcomes and increased mortality. The incidence of acute kidney injury varied by gestational age (GA) group. Aim: Identify laboratory diagnostic criteria of RI in premature newborns (PNs) with different GA who had severe heterogeneous perinatal pathology. Methods: The study was a prospective cohort of patients admitted electively to the III level Neonatal Intensive Care Unit at the Clinical Maternity Hospital 2 (Chernivtsi, Ukraine) between December 2015 and January 2018. One hundred sixty three PNs were treated at the hospital, from which a total of 68 patients were recruited into the study. Inclusion criteria: the GA is more than 24 weeks and less than 37 weeks; birth body weight is more than 500 g and less than 2500 g; presence of clinical signs of severe perinatal pathology. The severity of the perinatal pathology was classified on the basis of the neonatal Therapeutic Intervention Scoring System. The PNs were divided into three groups according to the GA: Group I consisted of 25 newborns born at the GA of 24-31 weeks, Group II – 25 newborns born at the GA 32-33 weeks, Group III – 18 newborns were born in a GA of 34-36 weeks. The levels of sodium, potassium, calcium and chlorine, alanine aminopeptidase, and aspartate aminopeptidase were measured in serum. The levels of creatinine and urea were measured in serum and urine. The concentration of total protein, albumin, α1-microglobulin, and β2-microglobulin was measured in urine. Findings and results: All PNs had signs of severe perinatal pathology and a neonatal Therapeutic Intervention Scoring System score of 10 or higher during the early neonatal period. There was no statistically significant difference in most serum biochemical parameters between groups of the study, excluding the level of serum chlorine. Our results demonstrated no significant difference in levels of urinary total protein and albumin between groups of the study, but showed a progressive increase the level of urinary creatinine and urea with increasing GA. The maximum level of urinary β2-microglobulin was found in “Late-Preterm” newborns who were born at 34-36 weeks, the minimal level of urinary α1-microglobulin was detected in patients with GA 32-33 weeks. Conclusions: Our results demonstrated that most PNs with severe perinatal pathology have some aspects of impaired tubular and glomerular functions. This is evidenced by changes in urinary new biomarkers. We found direct correlations between GA and serum creatinine (r=0.31, p<0.05), urinary creatinine (r=0.40, p<0.05), urinary α1-microglobulin (r=0.37, p<0.05), and urinary β2-microglobulin (r=0.51, p<0.05). Longer longitudinal cohort studies on PNs are required to determine the prognostic and diagnostic criteria of RI in these patients.
Актуальность. Основную группу диетозависимых заболеваний составляют гастроэнтерологическая патология, ожирение, метаболический синдром и сахарный диабет. Одним из ведущих механизмов в течении этих видов патологии является дисбаланс вегетативной сферы, сопровождающийся нарушениями системного кровообращения, включая регуляцию артериального давления. Цель. Анализ особенностей питания и оценка состояния артериального давления у детей с диетозависимыми заболеваниями. Материалы и методы. Обследованы 142 ребенка школьного возраста, находившихся на стационарном лечении по поводу: хронического гастродуоденита (первая группа — 90 детей), эндокринной патологии — гипоталамический синдром с ожирением (вторая группа — 21 ребенок), сахарного диабета (третья группа — 31 ребенок). Особенности режима и качество питания изучались по специально разработанной анкете. Состояние системного кровообращения изучали при помощи офисного измерения и суточного мониторинга артериального давления. Полученные результаты обследования детей обрабатывались с помощью программы «Статистика 6.0». Результаты. Анализ питания детей установил существенную несбалансированность и значительную разницу в частоте потребления школьниками пищи. Согласно оценке уровня артериального давления у детей с помощью перцентильных таблиц, наблюдается достоверно большее количество выявленных предгипертензий и гипертензий у лиц во второй и третьей группах по сравнению с первой группой. У этих детей отмечается вариабельность показателей суточного мониторинга артериального давления, которые могут быть связаны с дисбалансом вегетативной нервной системы. Выводы. Несбалансированное питание способствует развитию диетозависимых заболеваний. Изменения со стороны системного кровообращения у обследованных детей связаны с особенностями вегетативной регуляции как эндокринной, так и пищеварительной системы, что указывает на сочетанные патогенетические механизмы развития патологии обеих систем.
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