Complications of the Early Neonatal Period in Children from Mothers with Gestational Diabetes Mellitus

Background: Changes in the course of gestational diabetes mellitus (GDM) at the present stage determine the emergence of a certain spectrum of completely new problems associated with the health status of newborns from mothers with GDM. The aim of the study was to investigate early neonatal complications in newborns from mothers with GDM. Methods and Results: The study included 404 pregnant women (gestational age of 37.0–41.0 weeks) with GDM. All patients with GDM were divided into 2 groups. Group 1 included 188 patients receiving insulin therapy; Group 2 included 216 patients receiving a well-balanced diet. The control group (Group 3) consisted of 68 pregnant women without disorders of carbohydrate metabolism. In Group 1, macrosomia occurred in 44(23.4%) newborns, in Group 2 - in 48(22.0%) newborns; in newborns from mothers of the control group, the frequency of macrosomia was only in 7.35% of newborns (P=0.01). Morpho-functional immaturity of newborns had the highest frequency of occurrence, despite the fact that all children were born on time; 80(42.6%) newborns from mothers of Group 1 and 77(35.6%) newborns from mothers of Group 2 had signs of morpho-functional immaturity. Conclusion: Diabetic fetopathy in newborns from mothers with GDM is manifested by morpho-functional immaturity of organs and systems developing in unfavorable hyperglycemic conditions.

Immune-histochemical indicators of the morpho-functional state of the thyroid gland in norm and after prenatal antigenic exposure

During the individual development and exposure to infectious agents of the organism, the structural components of the thyroid gland can change significantly. In modern research, great importance is attached to the study of mechanisms for maintaining morphological homeostasis of the thyroid gland and ideas about its structural and functional restructuring in response to the body's immune system to various infections. The morpho-functional features of the thyroid gland of newborn animals after prenatal action of thyroid-nonspecific antigen (staphylococcal toxoid) have been experimentally established. In antigen-premiumed rats, the timing of folliculogenesis changes, as well as the size, distribution and immunohistochemical expression of antibodies to thyroglobulin, the functional state of thyrocytes and follicles compared to normal. The detected immuno­histochemical changes indicate signs of morpho-functional immaturity of the organ with hypoactivity elements.

Diaper dermatitis: differential diagnosis and prevention issues

The skin of newborns and infants is characterized by structural and functional immaturity. Diaper dermatitis is one of the most common skin conditions in this age period. This condition has a complex and multifactorial etiology. The interaction of several causes, including high humidity under the diaper, skin maceration, and prolonged contact with irritants, leads to destruction of the immature epidermal barrier, microbial invasion, and inflammation. Diaper dermatitis should be differentiated from allergic contact dermatitis, candidiasis, atopic dermatitis, seborrheic dermatitis, psoriasis. Effective measures to prevent diaper dermatitis are to keep the skin dry, reduce friction, limit the time of contact with urine and feces, as well as the topical application of protective products. Today, of all the disposable diapers on the market, the high quality disposable diapers developed and produced by the Japanese company KAO Corporation are proven effective in preventing diaper dermatitis.

Innervated adrenomedullary microphysiological system to model prenatal nicotine and opioid exposure

The transition to extrauterine life results in a critical surge of catecholamines necessary for increased cardiovascular, respiratory, and metabolic activity. The mechanisms mediating adrenomedullary catecholamine release are poorly understood, given the sympathetic adrenomedullary control systems’ functional immaturity. Important mechanistic insight is provided by newborns delivered by cesarean section or subjected to prenatal nicotine or opioid exposure, demonstrating the impaired release of adrenomedullary catecholamines. To investigate mechanisms regulating adrenomedullary innervation, we developed compartmentalized 3D microphysiological systems (MPS) by exploiting the meniscus pinning effect via GelPins, capillary pressure barriers between cell-laden hydrogels. The MPS comprises discrete 3D cultures of adrenal chromaffin cells and preganglionic sympathetic neurons within a contiguous bioengineered microtissue. Using this model, we demonstrate that adrenal chromaffin innervation plays a critical role in hypoxia-medicated catecholamine release. Furthermore, opioids and nicotine were shown to affect adrenal chromaffin cell response to a reduced oxygen environment, but neurogenic control mechanisms remained intact. GelPin containing MPS represent an inexpensive and highly adaptable approach to study innervated organ systems and improve drug screening platforms by providing innervated microenvironments.

Clinical assessment of urination in young children

The aim of the study was to study the formation of urination in young children, taking into account perinatal factors. Material and methods. the pattern of urination was studied in 42 patients at the stages of antenatal observation, after birth during the first year of life and at the age of three. Clinical evaluation of urination was performed in young children using a developed qualimetric table that takes into account the volume of the bladder and frequency of urination, the nature of urination, the presence of urge to urinate and behavioral reactions. At the age of three, a qualimetric table was used to evaluate E. L. Vishnevsky’s urination (2001). The observation group consisted of 42 patients whose urination pattern was studied at the stages of antenatal observation, during the first year of life and at the age of three. The features of the course of the antenatal and postnatal period of children’s development were taken into account: pregnancy complications, fetal pathological conditions, features of the morpho-functional state of infants, and neurological comorbidities. Results. According to the results of clinical evaluation of urination in children at 3 years of age, 3 groups of children were identified: with “Mature”,”delayed formation of “Mature” type of urination”, as well as “dysfunctional type of urination”. Conclusions. the manifestations of “maturity of urination” in infants at the age of 1 year are the compliance of hydrodynamic indicators with age standards, the formation of continuous urination, signs of controlling behavior: behavioral reaction to the urge, the absence of” missing urine “during the day, during daytime and nighttime sleep, “urination on request”. The “delay in the formation of mature urination type”, the formation of “dysfunctional urination type “ revealed the determining influence of the pathological course of the antenatal period of child development, the implementation of signs of pathological fetal urination, the presence of neurological symptoms and signs of morpho-functional immaturity of the postnatal period. “Dysfunctional urination” was manifested by: a decrease in the capacity of the bladder and the discrepancy between the hydrodynamic characteristics of the age parameters; monotony of the volume characteristics of the bladder during the day; imperative contractions of the bladder, that is, the presence of “wet gaps” between urination; urination during sleep; as well as a delay or lack of urge to urinate, behavioral responses and neatness skills.

Infantile colic from the perspective of evidence-based medicine: prevalence, principles of differential diagnosis and diet therapy algorithm

The article presents data on the prevalence of infant colic, etiological factors, diagnostic criteria, differential diagnosis and therapy with justification of approaches to the choice of formula in children on artificial feeding. When choosing a formula, it is necessary to take into account the compositional features aimed at overcoming the functional immaturity of the gastrointestinal tract, enteric nervous system, and the ongoing formation of the intestinal microbiome – the presence of a partially hydrolyzed protein, a reduced lactose content, the presence of prebiotics (fructooligosaccharides) and probiotics. The formula Similac Comfort is fully compliant. This formula additionally contains oligosaccharide of the breast milk 2 fucosillactose (2’-FL), 0.2 g / l – identical to that found in breast milk, which has proven positive effects in the form of an immunomodulating effect, anti-infectious effect, is involved in the regulation of growth and maturation of intestinal epithelial cells, in the development of the nervous system.

Pancreatic β-cell-specific deletion of insulin-degrading enzyme leads to dysregulated insulin secretion and β-cell functional immaturity

Inhibition of insulin-degrading enzyme (IDE) has been proposed as a possible therapeutic target for type 2 diabetes treatment. However, many aspects of IDE's role in glucose homeostasis need to be clarified. In light of this, new preclinical models are required to elucidate the specific role of this protease in the main tissues related to insulin handling. To address this, here we generated a novel line of mice with selective deletion of the Ide gene within pancreatic beta-cells, B-IDE-KO mice, which have been characterized in terms of multiple metabolic end points, including blood glucose, plasma C-peptide, and intraperitoneal glucose tolerance tests. In addition, glucose-stimulated insulin secretion was quantified in isolated pancreatic islets and beta-cell differentiation markers and insulin secretion machinery were characterized by RT-PCR. Additionally, IDE was genetically and pharmacologically inhibited in INS-1E cells and rodent and human islets, and insulin secretion was assessed. Our results show that, in vivo, life-long deletion of IDE from beta-cells results in increased plasma C-peptide levels. Corroborating these findings, isolated islets from B-IDE-KO mice showed constitutive insulin secretion, a hallmark of beta-cell functional immaturity. Unexpectedly, we found 60% increase in Glut1 (a high-affinity/low- Km glucose transporter), suggesting increased glucose transport into the beta-cell at low glucose levels, which may be related to constitutive insulin secretion. In parallel, IDE inhibition in INS-1E and islet cells resulted in impaired insulin secretion after glucose challenge. We conclude that IDE is required for glucose-stimulated insulin secretion. When IDE is inhibited, insulin secretion machinery is perturbed, causing either inhibition of insulin release at high glucose concentrations or constitutive secretion.

Comparison of clinical, electroencephalographic and tomographic data in children with epilepsy with controlled and uncontrolled seizures

The article presents the results of a examination of 124 children with epilepsy aged 1 month to 18 years to detect clinical electroencephalographic (EEG) and tomographic correlations in patients with controlled and uncontrolled seizures. It was shown that clinical manifestations (seizure types) are not always correlated with local changes on EEG and focus on MRI. In children, especially with uncontrolled seizures, even in the case of a focal onset of the seizure, secondary generalization is often observed, which is due to the functional immaturity of the brain and the tendency to rapid generalization of the epileptic potential. In general, the coincidence between the EEG data and morphological MRI is determined in 66 % of patients, when performing high-fi eld magnetic resonance tomography (on devices with a magnetic fi eld of 1.5 T or more) in the "Epilepsy" mode — in 71 %, and using MR-spectroscopy rises to 73 %. Key words: children, epilepsy, EEG, MRI