Department of Pediatrics №5
Department of Pediatrics № 5 continues the research areas of the previous years – pediatric gastroenterology, cardiology, and neonatology. Research interests of the department staff cover a wide range of issues.
The fundamental researches in pediatric gastroenterology deal with the study of the mechanism of regulation of gastric secretion and gastric aggression factors combined with mechanisms of mucous membranes protection. The authors proved that antisecretory drugs, in addition to their direct antisecretory actions also provide hastroprotective effect; justified the advantages of blockers of H2-receptors of histamine in rehabilitation programs for children with chronic gastro-duodenitis and duodenal cancer compared to other antisecretory drugs and proved effectiveness of short courses on the basis of cholate-forming liver function. The publications on methodological activities are related to training of pediatricians in residence, training of pediatricians – graduates from the Medical Faculty, teaching pediatrics for medical students of medical preventive faculty and pediatrics teaching at the Comprehensive Department of Pediatrics of the Medical Faculty. As the department ensures work of the Medical Psychological Faculty, the department staff studies the provision of psychological assistance to children with psychosomatic disorders. In 2005, there was completed the planned research work ‘Psychological disturbances in case of child’s chronic gastroduodenal diseases and their correction’.
In 2000-2005, the department staff conducted a study which formed the basis of dissertation of I. Kossak. In case of CGD there is a disorder of iron metabolism at the stage of latent iron deficiency and IDA of Hp-infected children.
In 2005-2009, the department staff conducted a study which formed the basis of dissertation V.Babyak ‘Pathogenetic justification of treatment of chronic gastro-duodenitis associated with Helicobacter Pylori infection of children including disorder of iron metabolism and hastroprotective potential of mucous membrane.
It is proposed to use in pediatric practice the HpSA-test for the diagnosis of Hp infection as a non-invasive (for detection of Hp antigens in decrements).
The eradication therapy of CGD associated with Hp infection completely eliminates sideropenia with latent iron deficiency, eliminating Hp contamination and inflammation of the mucous membrane of the stomach – the disorder of iron metabolism are removed without ferrotherapy, at the same time the combination of eradication therapy with iron drug for IDA children eliminates both sideropenia and hematologic manifestations of anemia.
There are developed the complexes of eradication therapy with antibiotics, metronidazole, bismuth in combination with individually chosen antisecretory drugs, which allowed to increase the effectiveness of treatment of chronic gastro-duodenitis associated with Hp infection as they positively influence not only the elimination of inflammation of the mucous membrane of the stomach and duodenum, but also normalize gastrin level, reduce the early relapse rate.
It is recommended to take the eradication therapy in the acute stage of chronic gastro-duodenitis associated with Hp infection considering:
– to use antisecretory drugs (ranitidine, omeprazole) as part of the eradication complex at high or reserved acid-forming function;
– to add de-nol in case of reserved acid-forming function of the stomach;
– in case of sideropenia, the eradication Hp therapy removes latent iron deficiency, eliminating Hp contamination and inflammation of mucous membrane – without ferrotherapy;
– in case of iron deficiency anemia, the combination of eradication therapy with Hp ferrotherapy ensures the removal of both sideropenia and hematological manifestations of anemia; – to use HpSA-test as criteria of evaluation of efficiency of eradication therapy.
In case of disorders of iron metabolism of children with CGD is desirable to assess the sideropenia nature:
– in case of Hp-associated CGD, they are caused by Нр-agent which is siderophilic microbe;
– in case of CGD which is not associated with HP, violations nature in the form of iron overload syndrome requires exclusion of hereditary hemochromatosis;
– in case of long-term iron deficiency anemia or sideropeniawhich are not removed by ferrotherapy it is necessary to examine a child one more in terms of Hp-associated CGD.
In 2010, the department staff completed scientific research work ‘Improvement of the diagnostics and treatment of chronic gastro-duodenitis associated with Hp infection in children, including gastroprotective potential of the gastric mucosa.’ The purpose of this study is to improve the diagnostics and treatment of chronic gastro-duodenitis in children, taking into account gastroprotective potentia of the stomach.