No abstract

У статті наведено клінічне спостереження дитини, хворої на муковісцидоз. Діагноз муковісцидозу встановлений своєчасно під час проведення неонатального скринінгу. Дитина отримувала базисну замісну ферментну терапію постійно. З 3-го місяця відмічено ураження респіраторної системи, колонізація Pseudomonas aeruginosa — з 7-го місяця, часті загострення бронхолегеневого процесу у вигляді пневмоній з формуванням бронхоектазів. Антибактеріальну терапію отримувала тільки під час перебування у стаціонарі та короткими курсами амбулаторно у зв’язку з соціальними причинами, що й стало причиною смерті дитини у віці 2 роки 5 міс.

Cystic fibrosis (CF) is a genetic disease with a multiple organ type of lesion. Liver cirrhosis is ranked the third in the general list of death causes in CF patients. The purpose of the study was to improve medical care for patients with CF by treatment individualization according to the prognosis of the gastrointestinal tract complications development. The study was performed on 42 children with CF. Patients were divided into 2 groups: group A (with liver cirrhosis) and group B (control, without or with moderate organic liver damage). One hundred twelve indicators were analyzed. After that the logistic regression method with the step by step incorporation of predictors was used to analyze the features and to select meaningful criteria for the mathematical model creation. The math ematical model for predicting of the liver cirrhosis development in children with CF was created. It should help to make an individual algorithm for treating using non specific research methods in order to prevent the progression of liver damage in patients with CF.

The high prevalence of pigmented skin neoplasms, due to the peculiarities of tumor progress, including melanoma of the skin, in the pediatric population, brings the problem of rational removal of pigmented skin objects in one of the most relevant. Given the existing complications and negative treatment results, it requires an immediate solution, taking into account the capabilities of modern equipment and minimally invasive treatment approaches to the treatment of this complex pathology. Purpose - to improve the quality of treatment of patients by clarifying the indications for surgical treatment of skin pigmented nevi and the method without recurrent removal. Materials and methods. The paper analyzes 550 clinical cases of melanocytic nevus of the skin of different localization in children of different ages who were hospitalized in the pediatric surgery clinic of Vinnytsya National Medical University M.I. Pirogov during 2009-2020. All observations were divided into two periods: retrospective (2009-2017) - 350 patients; prospective (2018-2020) - 200 patients. Among patients with a retrospective period, 11 patients were diagnosed with melanoma, and among children with a prospective period - 3 patients. Analysis of medical records revealed 18 (3.85%) cases of recurrent (prolonged) melanocyte nevi in children of different ages, 10 (55.56%) girls and 8 (44.44%) boys. Results. In the prospective study group 138 patients regardless of age and sex based on the obtained data on the optimal configuration of the postoperative wound and the most rational way to remove pigmented skin tumors, managed to avoid incomplete removal of the object with good aesthetic results. According to the data obtained, the index of validity of biopsies is needed to determine melanoma of the skin during the entire study period was 39.29. At the same time, for the retrospective period of observation index of validity of biopsies was in the range of 31.82, in the prospective period - 66.66, namely the decrease in the value of the index was 2.09 times, or 52.27%. Conclusions. The use in clinical practice of the proposed method of incisional biopsy has reduced the number of recurrences of the pathology by 5.2 times from 2.60% in retrospect to 0.50% in the prospective period (p<0.05). The rational individual approach to clarify the indications for surgical treatment of pigmented skin nevi allowed to reduce by 52.7% the index of validity of biopsies. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: pigmented skin neoplasms, children, biopsy, recurrences.

В работе представлены результаты лечения 58 больных с нейропатической и смешанной формой синдрома диабетической стопы (СДС) и наличием ран на стопе с помощью местного применения богатой тромбоцитами плазмы (БТП). Установлено, что клетки крови оказывают благоприятное воздействие на патоморфоз раны, стимулируя развитие грануляционной ткани, источником которой является коллаген I типа и упорядоченный неоангиогенез. Благодаря этому происходит формирование полноценной соединительной ткани и полноценного слоя эпителия, способствующих качественному заживлению ран у больных с осложненными формами СДС.