Modern Methods for Diagnosing Pathology of the Cardio-Esophageal Transition in Children

The aim of this work is to determine the causes of chest pain in children with combined pathology and to develop an examination algorithm for chest pain. Materials and methods. Examined 20 children aged 7-18 years who consulted a pediatrician with pain complaints in the chest. To exclude the cardiac genesis of pain, all patients underwent electrocardiography and echocardiography; the rest of the examinations were prescribed, taking into account the anamnesis and clinical examination data. Results. According to the examination results, most patients were found to have gastrointestinal tract pathology: gastroesophageal reflux disease, chronic gastritis, biliary tract dysfunction. Against the background of adherence to a diet and taking medications prescribed by a gastroenterologist, their pain syndrome subsided, which confirmed the noncardial genesis of thoracalgia. A clinical analysis of cases of combined (cardiac and non-cardiac) pathology was carried out, an algorithm for examining children with chest pain was presented. Discussion. The causes of chest pain in children and the tactics of managing these patients are discussed, the clinical significance of the history and clinical examination data in drawing up a plan for the examination of such patients is determined.

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Differentiated approach to the examining children with chest pain

Berezneva

Stenina

Uglitskikh

2021

RPJ

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Malnutrition in pediatric surgical patients

Боровик

Fomina

Yatsyk

et al. 2023

RPJ

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Introduction. To improve the quality of surgical treatment and prevent postoperative complications, there is needed an integrated multidisciplinary professional approach including a combination of nutritional support with therapeutic methods and psychological assistance that reduces stress throughout the perioperative period. Clinical guidelines and standards to manage the patients on this issue in pediatric surgical hospitals have not been developed. Objectives: to assess the nutritional risk of malnutrition and nutritional status in children with surgical diseases, to elaborate algorithms for nutritional support over the pre- and postoperative periods. Materials and methods. The single center non-comparative study included sixty children aged from 1 month to 17 years 5 months, with diseases of the esophagus, intestine, and genitourinary system, were admitted for surgical treatment at the Research Institute of Pediatric Surgery of the Federal State Autonomous Institution «National Medical Research Center for Children’s Health» of the Ministry of Health of Russia. All patients underwent a nutritional risk screening according to a validated Russian version of the STRONGkids. Clinical and anamnestic data were analyzed. Anthropometric indices (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus program (2009), and biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were evaluated. Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 26 (43%) patients, 58% of them suffered from diseases of the esophagus, 37% — the intestine pathology, and 36% of the genitourinary disorders. Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications, and allow diminishing the length of the hospital stay.

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Enteral nutrition support for children with surgical pathology over the periooperative period

Боровик

Fomina

Yatsyk

et al. 2023

RPJ

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Introduction. The results of treatment of children who are preparing or have already undergone major surgery depend on many factors, including the nutritional status — the presence/absence of malnutrition. Aim: to assess the nutritional risk and nutritional status in children with surgical diseases during pre- and postoperative periods. Materials and methods. A prospective, single-center, non-comparative study included 60 children aged from 1 month to 17.5 years with diseases of the esophagus, intestines, urogenital system, admitted for surgical treatment. In all patients, the anamnestic data of life and disease were analyzed, screening of nutritional risk was assessed according to the validated Russian version of the STRONG-kids screening tool, nutritional status was evaluated using the WHO AnthroPlus program (2009) and the anthropometric indices (Z-scores: weight/age, height/age, BMI/age), the biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were estimated. Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 24 (40%) patients, 58% of them suffered from diseases of the esophagus, 37% had pathology of the intestine and 36% — the genitourinary system. Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications and decreasing the length of hospital stay.

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Modern Methods for Diagnosing Pathology of the Cardio-Esophageal Transition in Children

Cited by 3 publications

References 44 publications

Differentiated approach to the examining children with chest pain

Differentiated approach to the examining children with chest pain

Malnutrition in pediatric surgical patients

Enteral nutrition support for children with surgical pathology over the periooperative period

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