DSpace Collection: Materialele Conferinței ştiinţifice cu participare internaţională Bienala Chişinău-Sibiu „Accidente vasculare cerebrale la copii”, ediţia a II-a, organizată de Societatea de Pediatrie din Moldova de comun cu Facultatea de Medicină de la Universitatea “Lucian Blaga” din Sibiu (România), 4 mai 2018, Chișinău, Republica Moldova

Buletin de perinatologie. 2018, Nr. 1(77)

Mon, 01 Jan 2018 00:00:00 GMT

Title: Buletin de perinatologie. 2018, Nr. 1(77) Abstract: Revistă științifico–practică. Fondată în anul 1998. Description: Fondatori: Institutul Mamei și Copilului, Societatea de Pediatrie din Republica Moldova

Aspecte etiopatogenetice al accidentului vascular cerebral ischemic la copii

Mon, 01 Jan 2018 00:00:00 GMT

Title: Aspecte etiopatogenetice al accidentului vascular cerebral ischemic la copii Authors: Sprincean, Mariana; Revenco, Ninel; Bejan, Nadejda; Lupușor, Nadejda; Călcîi, Cornelia; Hadjiu, Svetlana Abstract: Summary. In this article, we will perform a bibliographic study on pediatric stroke etiopathogenesis. Pediatric stroke includes three subtypes: ischemic stroke, hemorrhagic and mixed. Ischemic stroke represents the loss of cerebral function caused by diminished cerebral blood flow in the affected area. Among the etiological factors in children, we can mention neonatal encephalopathies, some genetic syndromes, congenital heart malformations, hereditary dysplasia of connective tissue, vascular pathologies, cerebral vascular development abnormalities (the most common arterio-venous abnormalities), hereditary and acquired prothrombotic states, septicemia, sickle-cell disease, etc. Neuroinflammation is one of the main mechanisms underlying the development of stroke. In this context, it is important to study the inflammatory markers responsible for the onset and pathogenesis of stroke in children. Among the inflammatory biomarkers mentioned in the article are proinflammatory cytokines such as IL-6, IL-1β, but also other biological molecules and factors including vascular endothelial growth factor, ciliary neurotrophic factor, S100B protein, CD105 endoglin, antiphospholipid antibodies. It is important to know the neuroinflammatory mechanisms responsible for the onset and pathogenesis of pediatric stroke because this will help assess the post-stroke inflammatory responses in children.; Резюме. В данной статье проводиться библиографическое исследование этиопатогенеза церебрального инсульта (ЦИ) у детей. ЦИ у детей состоит из трех типов: ишемический ЦИ, геморрагический ЦИ и смешанный. Ишемический ЦИ определяется потерей церебральной функции, обусловленной уменьшением церебрального кровотока в пораженной области. Среди этиологических факторов ЦИ у детей упомянем: неонатальные энцефалопатии, некоторые генетические синдромы, врожденные пороки развития сердца, наследственные дисплазии соединительной ткани, сосудистые патологии, нарушения мозгового сосудистого развития (чаще всего артериовенозные аномалии), наследственные и приобретенные протромботические состояния, септицемия, сиклемия и т. д. Нейровоспаление является одним из основных механизмов, лежащих в основе появления и развития ВЦИ. В этом контексте важно изучить воспалительные маркеры, ответственные за начало и патогенез ЦИ у детей. В списке воспалительных биомаркеров, упомянутых в статье, состоят: провоспалительные цитокины, такие как IL-6, IL-1β, но также и другие молекулы, и биологические факторы, включая фактор роста эндотелия сосудов, нейротрофический цилиарный фактор, белок S100B, эндоглин CD 105, антифосфолипидные антитела. Знание нейровоспалительных механизмов, ответственных за начало и патогенез ЦИ, важно для оценки воспалительных реакций после ЦИ у детей. Description: Universitatea de Stat de Medicină şi Farmacie ”Nicolae Testemiţanu”, IMSP Institutul Mamei şi Copilului

Organ-preserving surgery on uterine appendages in women with infertility and functional activity of the ovaries

Mon, 01 Jan 2018 00:00:00 GMT

Title: Organ-preserving surgery on uterine appendages in women with infertility and functional activity of the ovaries Authors: Dubchak, A.E.; Milevskiy, A.V.; Obeid, N.N. Abstract: Summary. The article presents data on the status of functional activity of the ovaries in women with infertility after organ-preserving operations on the pelvic organs. The aim of the study was to analyze the organ-saving operations on the uterine appendages in women with infertility and to study their effect on ovarian functional activity. Materials and methods. A total of 120 women of childbearing age with a tubal peritoneal infertility factor and benign ovarian formations, an ectopic pregnancy, who underwent surgical treatment for uterine appendages, were divided into groups: I group - 76 (63.7%) women, surgical treatment was carried out in the planned order on the ovaries (group 1a) and on the fallopian tubes (group 1b), 44 (36.7%) to the patients (group II) - surgical treatment was performed urgently on the ovaries (group 2a) and on the fallopian tubes (group 2) ). OV The arid reserve was studied on the basis of the definition of the Antimulyler hormone, the level of FSH, counting the number of antral follicles, determining the volume of ovaries. Results. Operative interventions in the tubal peritoneal factor of infertility inhibit the OR within the first month after the operation, which is manifested by a decrease in the concentration of AMH in all groups. It was revealed that in the 2-nd group after urgent surgery the value of this ghoul was 2.2 times lower than in group 1 in patients, the operation was carried out in a planned order (2.1 ± 0.1 ng/ml), (р≤0,05) and the volume of ovaries decreased to 5.9 ± 0.4 cm³ due to cystectomy and ovarian resection. A decrease in the AF was found to be 4.6 ± 0.2. In group 2b, in patients with urgent surgery performed on the fallopian tubes and ovaries, the concentration of AMG ranged from 1 to 1.5 g/ml, averaging 1.1 ± 0.2 ng/ml. The data obtained correspond to the ultrasound parameters of the assessment of the ovarian reserve. In the 2nd group, the volume of the ovaries decreased to 5.9 ± 0.4 cm³ due to cystectomy and ovarian resection. There was a decrease in AF to 4.6 ± 0.2, a decrease in AMH to 1.6 ± 0.3 ng/ml. The conclusion. The functional condition of the ovaries in women with infertility after organ-preserving operations on the uterine appendages largely depends on the planned surgical treatment and the concomitant volume of surgical intervention.; Резюме. Материалы и методы. Обследовано 120 женщин репродуктивного возраста с трубно-перитонеальным фактором бесплодия и доброкачественными образованиями яичников, внематочной беременностью, которым проведено хирургическое лечение на придатках матки, они были распределены на группы: I группа – 76 (63,7%) женщин, хирургическое лечение которым было проведено в плановом порядке на яичниках (1а группа) и на маточных трубах (1б группа), 44 (36,7%) пациенткам (II группа) - хирургическое лечение было проведено в ургентном порядке на яичниках (2а группа) и на маточных трубах (2бгруппа). Овариальный резерв изучен на основании определения антимюллерова гормона, уровня ФСГ, подсчета количества антральных фолликулов, определения объёма яичников. Результаты. Оперативные вмешательства при трубно-перитонеальном факторе бесплодия угнетают ОР в течении первого месяца после операции, что проявляется снижением концентрации АМГ во всех группах. Выявлено, что во 2-а группе после ургентных операций значение этого гормона было ниже в 2,2 раза, чем в 1-а группе у пациенток, которым операция проводилась в плановом порядке, (2,1±0,1 нг/мл), (р≤0,05) а объем яичников уменьшился до 5,9±0,4 см³ за счет цистэктомий и резекции яичников. Выявлено снижение АФ до 4,6±0,2. Во 2б группе у пациенток, у которых ургентные операции проводились на маточных трубах и яичниках, концентрация АМГ варьировала от 1 до 1,5нг/мл, составляя в среднем 1,1±0,2 нг/мл. Полученные данные соответствуют УЗ параметрам проведенной оценки овариального резерва. Во 2-а группе объем яичников уменьшился до 5,9±0,4 см³ за счет цистэктомий и резекции яичников. Выявлено снижение АФ до 4,6±0,2, снижение АМГ до 1,6±0,3 нг / мл. Заключение. Функциональное состояние яичников у женщин с бесплодием после органосохраняющих операций на придатках матки в значительной степени зависит от плановости хирургического лечения и сопутствующего объема оперативного вмешательства. Description: SI “Institute of Pediatrics, Obstetrics, and Gynecology of the National Academy of Medical Sciences of Ukraine” (Kiev), PL Shupik National Medical Academy of Postgraduate Education of Health of Ukraine, Communal Enterprise central city hospital № 1, Zhytomyr, Ukraine

The impact of habitual aspiration accidents on respiratory system in children

Mon, 01 Jan 2018 00:00:00 GMT

Title: The impact of habitual aspiration accidents on respiratory system in children Authors: Selevestru, Rodica; Colţa, Ana; Rusu, Andriana; Garbi, Ina; Guzgan, Mariana; Rascov, Victor; Ianoş, Adam; Toma, Liliana; Şciuca, Svetlana Abstract: Summary. Actuality. Injury due to foreign body aspiration (FBA) is a common and serious pediatric emergency, requiring prompt recognition and early treatment to minimize the potentially serious and sometimes fatal consequences. FB aspiration continues to be a cause of childhood morbidity and mortality, usually in pre-school children. Materials and methods. A cohort study includes 106 patients hospitalized during 2011-2016 in Pneumology, Mother and Child’s Institute, diagnosed with FBA, confirmed via bronchoscopy. Foreign body extraction was carried out by means of rigid bronchoscopy after thorough aspiration and prevention of mucosal bleeding. Results. The average age (aa) is 1,9±0,17 years. The lot was divided into 3 groups according to childhood stages: the most frequent FBA was estimated in toddlers - 88,9%: 95 CI, 81,1-94 cases, aa 1,57±0,06 years; in children >3 y.o. – 8,5%: 95CI, 4-15,5 cases, aa 6,4±1,1 years; and rarely in infants – 2,8%: 95CI, 0,6-15,5 cases, aa 0,76±0,11 years (F statistic = 93,5; p<0,0001). The majority of foreign bodies were found in bronchial tree 89,6%: 95CI, 82,2–94,7; without designation – in 6 children – 5,7%: 95CI, 2,1-11,9; in trachea and larynx 2 and 3 cases (1,9%: 95CI, 0,2-6,6 and 2,8%: 95CI, 0,6-8). Conclusion. FBA predominates in girls – 57,5%: 95CI, 47,6-67,1 cases. The most vulnerable age is from 1 to 3 y.o. when children are more often exposed to habitual accidents (F statistic = 93,5; p<0,0001). There is evidence of a critical situation in the countryside, compared with urban localities. By localization the most frequent lodgement of foreign bodies were in bronchi.; Rezumat. Actualitatea. Leziune datorată aspiraţiei de corp străin (ACS) este o urgenţă pediatrică majoră şi serioasă, ce necesită identificarea promtă şi tratamentul precoce pentru a minimiza consecinţele potenţiale grave dar uneori şi fatale. Aspiraţia de corp străin continuă să fie cauza morbidităţii şi mortalităţii infantile, mai ales a copiilor de vârstă antepreşcolară şi preşcolară. Materiale şi metode. Studiul de cohortă include 106 pacienţi internaţi în perioada anilor 2011-2016 în secţia Pneumologie, IMSP Institutul Mamei şi Copilului, diagnosticaţi cu aspiraţie de corp străin, confirmată bronhoscopic. Corpurile străine au fost îndepărtate prin intermediul bronhoscopiei rigide după aspiraţia minuţioasă şi profilaxia hemoragiei din mucoasa bronşică. Rezultate. Vârsta medie a pacienţilor este 1,9±0,17 ani. Lotul a fost divizat în 3 grupe după perioadele copilăriei: cel mai frecvent ACS a fost evidenţiată la antepreşcolari - 88,9%: 95 CI, 81,1-94 cazuri, vârsta de 1,57±0,06 ani; la copii cu vârsta mai mare de 3 ani - 8,5%: 95CI, 4-15,5 cazuri, 6,4±1,1 ani; şi rar la sugari – 2,8%: 95CI, 0,6-15,5 copii cu vârsta 0,76±0,11 ani (F statistic = 93,5; p<0,0001). Majoritatea corpilor străini au fost depistaţi în arborele bronşic 89,6%: 95CI, 82,2–94,7; fără precizare – la 6 copii - 5,7%: 95CI, 2,1-11,9; în trahee şi laringe 2 şi 3 cazuri respectiv (1,9%: 95CI, 0,2-6,6 şi 2,8%: 95CI, 0,6-8). Concluzie. ACS predomină la fete – 57,5%: 95CI, 47,6-67,1 cazuri. Cea mai vulnerabilă vârstă este cuprinsă în intervalul 1–3 ani când copiii sunt predispuşi accidentelor habituale (F statistic = 93,5; p<0,0001). Există dovezi de situaţie critică în localităţi rurale comparativ cu cele urbane. După localizare mai frecvent a fost depistat sediul corpilor străini în bronhii. Description: State University of Medicine and Pharmacy „N. Testemiţanu”, Clinics of Pneumology, Department of Pediatrics, Chişinău, Republic of Moldova, IMSP Mother and Child’s Institute, Department of pediatric Endoscopy, Chişinău, Republic of Moldova