Barcha maqolalar - Reanimatologiya

Tez-tez kasallanuvchi bolalar o‘tkir respirator kasalliklar (O‘RK) bilan kasallanish darajasi, tengdoshlariga nisbatan yuqori bo‘lgan, bolalar guruxini anglatadi. “Tez-tez kasallanuvchi bolalar” muammosi hozirgacha pediatriya amaliyotida dolzarb muammolardan biri bo‘lib qolmoqda. Tez tez kasallanuvchi bolalarda yuqori nafas yo‘llari kasalliklari-rinit, nazofaringit, quyi nafas yo‘llari kasalliklari – traxeit, bronxit, pnevmoniya, quloq burun-tomoq kasalliklari – otit, yevstaxiit, adenoidit, sinusit ko‘p uchraydi va boshqa somatik patologiyalar ham kuzatiladi.

Jahon Sog‘liqni saqlash tashkiloti ma’lumotlariga ko‘ra, ortiqcha vazn va semirish aholi o‘limining beshta eng muhim xavf omillaridan biridir [1]. Ushbu patologik holatning rivojlanishida ekologik, biologik va genetik omillar muhim rol o‘ynaydi. Hozirgi kunda notugri ovqatlanish bilan charilgan noinfection tufayli jamoani saqlash eng muhim muammolaridan biri bulib qoladi [2]. Ko‘pgina mamlakatlarda bolalar orasida semirish va ortikcha vazn muammosi allakaxon hhar uchinchi maktab o‘quvchisiga ta’sir kilgan [3]. Kupchilik mamlakatlarning aholisi o‘sib borish chastotasi si kam foidali ovqatlanish rationalini afzal biladi. Semirish muammosining tibbiyoty-izhtimoiy ahamiyati uning milliy keng tarkalishi, beaming the ogirligi bilan ham paydo bo‘lishi. Kupli son sezimizlikdan aziyat chakuvchi bollarda arterial hypertension, carbohydrates olishning shifo, hyperlipidemia va atherosclerosis, yogli gepatosis, osteoarthritis, reproduktiv salohiyati muammolar kabi kator patologoanatom chastotasi sining ortishini namoyon qiladi [4]. Ushbu jamoalarga kupchilik mualliflar morbid semizlikning yoki qarishi kabi karaidilar. Yana kator o‘sishi uchun sevenzlik o‘rganilgan ha – bronxial astma, gastroesophageal reflyuks kasalligi va sh.o‘. Semizlik, mutanosib ravish, kupchilik ishtirokining prognozini ogir rivojlanishi [5]. Bolalar semizligi vaqtidagi tadqikotlar uning ogir rivojlanishini erta olish, tashkhislash va davolash nuqtai nazaridan. ainiksa olib tashlash [6].
Tadqiqotning maqsadi bolalarda semirishning sabablarini aniqlash va bolalarda semirishning oldini olishni rivojlantirish.

COVID-19 bilan kasallangan bolalarning aksariyati tuzalib ketadi, biroq baʼzilarida uzoq muddatli, koʻp aʼzoli simptomlar va asoratlar mavjud boʻlib, ularning kasallanish darajasi ortib bormoqda [1]. Uzoq muddatli COVID yoki post-Covid sindromi (PCS) yoki post-o‘tkir COVID – bu tibbiyot hamjamiyati tomonidan tan olingan va xavotirga sabab bo‘lgan fanlararo ishtirokni talab qiladigan nisbatan yangi muammodir. COVID-19 bilan uzoq muddatli yurak oqibatlarini bashorat qilish qiyin. SARS-CoV-1 va SARS-CoV-2 ning genetik o‘xshashligi, shuningdek, 12 yillik kuzatuv davomida bemorlarning 40 foizida yurak-qon tomir kasalliklari aniqlangan oldingi virusli epidemiyalar tajribasi bu kasallikning uzoq muddatli oqibatlarini ko‘rsatadi. COVID-19 [2]. SARSCoV-2 virusi uchun ijobiy PCR testi (polimeraza zanjiri reaktsiyasi) bo‘lgan bemorlarning taxminan 10% 3 haftadan ko‘proq vaqt davomida tiklanmaydi, kichikroq qismi esa oylar davomida tuzalmaydi [3]. COVID-19 boshlanganidan 100 kun o‘tgach, bemorlarning 41 foizida hali ham doimiy alomatlar mavjud, nafas qisilishi eng keng tarqalgan simptom (36%). Chap qorincha funktsiyasining pasayishi va o‘pka gipertenziyasi belgilari kamroq tashxis qilinadi [4]. COVID-19 ning inson organizmiga uzoq muddatli oqibatlari hali ham noma’lum, ammo SARSCoV-2 virusi keltirib chiqaradigan pandemiyadan keyin tasvirlangan alomatlar xavotirga soladi va bemorlarni uzoq muddatli kuzatishni talab qiladi [5]. Prognoz nafaqat kasallikning o‘tkir davrida o‘pkaning shikastlanish darajasiga, balki ekstrapulmoner ko‘rinishlarga ham bog‘liq bo‘lishi mumkin. Shunday qilib, diagnostika, shoshilinch tibbiy yordam, kasallikning kechishini va uning asoratlarini o‘rganish va oldini olishga asosiy e’tibor uzoq muddatli oqibatlarga olib keladigan omon qolganlar tanasidagi o‘zgarishlarni o‘rganishga qaratildi [6].

Around the world, the corona viral infection pandemic is one of the pressing problems; the treatment of pregnant women and its consequences, both of the pregnant women themselves and of newborn children born from those who have had COVID-19, is of great importance. All over the world, bronchopulmonary pathology, in comparison with other diseases of the bronchopulmonary system in children, occupies one of the first places. COVID-19 in pregnant women and the condition of infants is of great interest not only to obstetricians and gynecologists, but also to pediatricians. On February 11, 2020, the World Health Organization assigned the official name to the infection caused by the new corona virus – COVID-19 (“Coronavirus disease 2019”). To study the course and treatment of children under 2 years of age with pneumonia born to women who had COVID-19 during pregnancy in comparison.

Effective and safe pharmacotherapy of recurrent bronchitis in children of different ages and prevention of its chronicization is important. More than 100 million cases of bronchopulmonary diseases among children are registered worldwide. Of all pathological conditions, today respiratory diseases account for more than 50% of the total morbidity in children of different ages. A high increase in bronchopulmonary diseases is observed especially among children of preschool and school age, and improper management and self-medication of such patients can subsequently lead to a protracted and recurrent course of the pathological process, which acquires medical and social significance. Recurrent bronchitis is characterized by repeated episodes of acute bronchitis 2-3 times or more during the year against the background of an acute respiratory infection. The criteria for diagnosing an acute episode correspond to the clinical and radiological signs of acute bronchitis – clinical data: increased body temperature, dry cough, sometimes wet, diffuse dry and variable moist rales in the lungs; X-ray picture: change in the pulmonary pattern without infiltrative and focal shadows in the lungs.

Overweight and obesity in children is a global problem in the world. According to WHO data for the period from 1975 to 2016 the number of obese children from 5 to 19 years of age in the world has increased more than 4 times (WHO. 2021 URL: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight ). The enormous increase in the incidence of obesity among children has led to an exacerbation of the problem of sleep disorders. From the point of view of brain electrophysiology, sleep is defined as a normal biological process of consciousness in which there are criteria for brain waves. A child spends more than 30% of his life sleeping, and this condition is critical for growth and development. For this reason, sleep pathologies and their clinical consequences have become priority areas of scientific research in recent years [Sánchez-López AM, Noack-Segovia JP., et al. 2020, Aguilar M.C., Sánchez A.L., et al. 2013].

Pleuropulmonary blastoma (PPB) is a rare, aggressive, and malignant tumor arising from the lungs or pleura. It is typically diagnosed in children under 5 years of age and is characterized by an unfavorable prognosis. Pathologically, PPB includes mesenchymal elements (undifferentiated cartilaginous, muscular cells, fibroblasts of varying degrees of differentiation) and epithelial cells. PPB classification proposed by L.P. Dehner, distinguishes three types of tumors: Type I – with cystic areas and a favorable prognosis; Type II – mixed type, including both cystic and solid areas; Type III – solid type, characterized by more complex treatment.

Плевропульмональная бластома (ППБ) представляет собой редкую, агрессивную и злокачественную опухоль, происходящую из легких или плевры. Она обычно диагностируется у детей в возрасте до 5 лет и характеризуется неблагоприятным прогнозом. Патологически ППБ включает мезенхимальные элементы (недифференцированные хрящевые, мышечные клетки, фибробласты разной степени дифференцировки) и
эпителиальные клетки. Классификация ППБ предложена L.P. Dehner, который выделяет три типа опухоли: Тип I – с кистозными участками и благоприятным прогнозом; Тип II – смешанный тип, включающий как кистозные, так и солидные участки; Тип III – солидный тип, характеризующийся более сложным лечением.

Cardiac activity has a double regulation system: humoral and neuro-vegetative, the latter controls not only the frequency and strength of heart contractions, but also, through the trophic function, has a major influence on adaptation mechanisms. Trophic function is the property of the nervous system to regulate the level of metabolism and corresponding tissue differentiation determined for age and functional state [1]. To date, the structure of nerve fibers and plexuses in adult patients with sudden cardiac death and coronary heart disease has been studied in sufficient detail [2], when, first of all, degeneration of the sympathetic component of innervation is detected to varying degrees. It correlates not only with age, but also with the stage of the disease. These studies have deepened knowledge of the pathophysiological mechanisms of the disease and allowed clinicians to select more adequate treatment at all its stages. The structural organization of the nerve plexuses in children has received much less attention in both domestic and world literature. Pre- and postnatal ontogenesis of the nervous autonomic system is normally described in detail by V.N. Shvalev et al. [3]. As for the study of cardiac innervation in congenital heart disease, only a few studies have been devoted to this issue [4]. It has been shown that at the age of 3 to 7 years, the innervation of the heart and great vessels becomes developed and the choline ratio of the adrenergic nerve plexuses reaches a state of relative stability. It has also been established that with congenital heart disease, the state  of the autonomic nervous system can be characterized as compensated, in contrast to acquired pathology, where degenerative and inflammatory changes predominate [5,6]. In children with correction of atrial septal defect, the features of autonomic regulation of heart rhythm at the primary stage of rehabilitation have not been sufficiently studied.

Neuroblastoma (NB) is an embryonal tumor of childhood arising from cells of the sympathetic nervous system. Clinically, the disease is characterized by high heterogeneity from spontaneous regression to aggressive progression, metastasis and patient death. It ranks fourth in frequency among solid tumors of childhood.