No abstract

Heterotopic pancreas (HPG) is an aberrant anatomical malformation that is most commonly located in the upper gastrointestinal tract. The presence of an aberrant pancreas in most cases is asymptomatic, but in a number of clinical situations it is accompanied by symptoms that require drug therapy, sometimes surgical or endoscopic intervention. Analysis of the clinical manifestations and symptoms of BPH is important in choosing the tactics of treating patients. The difficulty lies in the fact that there is not enough information on BPH in the literature, there are no data from a study in a large cohort of patients with BPH. The purpose of the publication is to review clinical cases, including our own observation, and compare them with a systematic review of the literature in order to draw conclusions about the features of clinical manifestations, pathomorphosis and modern principles of treatment of the disease.

Introduction. The circadian rhythms of the nasociliary system of children with bronchial asthma have not been practically studied.Objective. To evaluate seasonal variations of circa-annual rhythms of the nasociliary system in healthy children and children with year-round bronchial asthma.Materials and methods. 134 children were examined; the main group consisted of 99 children aged 1.5–7 years with mild and moderate bronchial asthma, the control group was represented by 45 healthy children of the same age. The biorhythms of the nasociliary system were studied for three years, 4 times during each year (in October, January, April, July): smears-prints from the nasal mucosa were studied with the calculation of the specific gravity of neutrophils, eosinophils, cylindrical and squamous epithelium as a percentage, the calculation of the cytolysis index of cells and the average destruction index for each type of cell. To study the near-seasonal rhythms, the KOSINOR program and the computer system of intra-laboratory control “VlCC” were used.Results. The presence of seasonal changes in cytological parameters of the nasal mucosa with the maximum values of the average values of the average destruction of the flat, cylindrical epithelium, neutrophils in January and acrophases in January was revealed. If eosinophils on the nasal mucosa were not detected in healthy children, then the presence of this type of cells was noted in children with asthma throughout the year. The period of fluctuations of the average destruction index in the flat epithelium (1.7 months) was 4 times shorter, and in the cylindrical epithelium (21.6 months) – 3.5 times longer in children with asthma compared with healthy children. The periods, amplitude and mesor of the average neutrophil destruction index in children with asthma and healthy peers did not differ significantly. Acrophases and bathyphases of the average index of destruction of the flat, cylindrical epithelium, neutrophils in patients with asthma and healthy children were recorded at different times.Conclusions. The study showed that in children with AD there are no patterns of rhythmological organization in the work of the nasociliary system, characteristic of healthy children.

The priority of the national health policy is to preserve the life and a high level of quality of life for every premature baby. The clinical focus is on children born with ELBW. Among this category of children, NEC makes the main contribution to the structure of infant mortality. Based on the analysis of the literature, the authors conclude that the study of cell markers that characterize different depths of damage to enterocytes allows: to assess the likelihood of developing NEC in infants with ELMT; conduct early diagnosis of NEC; rule out NEC in neonates with similar symptoms; predict the course of NEC; propose and substantiate personalized approaches to correcting the low supply of 25(OH)D; to analyze the influence of candidate genes on the implementation of NEC, its outcomes, and 25(OH)D metabolism. To assess damage at the level of the enterocyte, the authors selected the intestinal fraction of fatty acid binding protein (I-FABP) for literature analysis. To determine the depth of damage to intercellular junctions of the intestine - the expression of transmembrane (claudin-2, claudin-3, claudin-4, occludin) and cytoplasmic (zonulin) tight junction proteins. Analysis of the results of studies on the expression of fecal calprotectin, lipocalin-2 (LCN2) and eosinophilic neurotoxin, showing the activity of local inflammation, was carried out in order to assess both the risk of NEC and its course. Intestinal damage is associated with impaired 25(OH)D metabolism, and metabolic bone disease in preterm infants with damage to the intestinal barrier up to NEC is recorded ten times more often at the stage of nursing in the NICU. A huge number of studies have shown a decrease in survival, an increase in the risk of severe complications against the background of a low supply of 25(OH)D in the preterm population. The authors analyze the relationship between 25(OH)D availability, taking into account the influence of exogenous and endogenous factors, the nature of damage to the intestinal wall and the implementation of NEC, and focus on the existing preventive and therapeutic approaches to prescribing various doses of vitamin D in preterm infants with NEC.

Numerous epidemiological studies demonstrate that cystic fibrosis, the most common orphan disease in the world, can not occur in isolation, but can be combined with other serious diseases. The most common such combination in all populations is traditionally cystic fibrosis and celiac disease, which, on the one hand, differ in the leading mechanism of inflammation, in cystic fibrosis - chronic microbial inflammation, in celiac disease - autoimmune, on the other hand, these two diseases have a number of common pathogenesis links, in particular, realizing the syndrome of malabsorption, which only complicates the timely diagnosis of these combined pathological conditions. In addition, the authors of the literature review focus on clinical examples of late detection of autoimmune gluten intolerance against the background of cystic fibrosis. They also consider the combination of cystic fibrosis with other severe, disabling diseases (rheumatoid arthritis, phenylketonuria, oncological diseases), which sometimes require a serious change in therapeutic tactics.