Possibilities of ultrasonic methods of research in the diagnosis of non-alcoholic fat liver disease in children

The prevalence of non-alcohol fatty liver disease in a pediatric population over the past few decades is constantly increasing. The aim of the study - to describe the possibilities of ultrasound methods of research in the diagnosis of non-alcoholic fat liver disease in children. Materials and methods. 47 children with non-alcohol fatty liver disease, aged from 9 to 18 years were investigated: 25 boys (53.19 %) and 22 girls (46.81%). 19 children of prepubertal age (9-12 years old), which accounted for 40.43 % and 28 of puberty age (13-17 years) – 59.57 %. According to the index of body weight in 34 (72.34 %) of investigated children, an excessive body weight (85-95 percentile), and in 13 (27.66 %) children an alimentary-constitutional type of obesity (≥ 95 percentile) were registered. All patients had a laboratory-instrumental examination. Ultrasound examination of abdominal organs according to a generally accepted method, ultrasonic steatometry and ultrasound elastography for determining the signs of fibrous damage were carried out. 26 patients had the diagnosis of liver steatosis and 21 – steatohepatitis. Results of the research. Grayscale ultrasound recorded 2 degrees of echographic changes: with non-alcoholic fatty steatosis in 46.15 %, with non-alcoholic steatohepatitis in 85.71 % of cases. According to the results of steatometry, the greatest deviations were in children with excessive body weight and obesity in groups: S-1 (38.46 % – with steatosis and 33.3 % – with steatohepatitis) and S-2 (50 % – with steatosis and 52.38 % with steatohepatitis). A slight increase in the stiffness of the liver parenchyma, according to elastography, has been registered in 2 children with liver steatosis and in 3 patients with steatohepatitis. Conclusion. Ultrasonic methods are an important tool not only in screening diagnosis of the non-alcohol fatty liver disease, but in objective measurements of the fat damage degree and in determining the fibrotic changes in the liver as well.

Scientific research of the Institute of Nuclear Medicine and Diagnostic Radiology of the National Academy of Medical Sciences of Ukraine in 2020: hepatology, oncology and intellectual data processing

The main results of the scientific activity of the Institute in 2020 are presented: the study of the structural features of diagnostic images based on their heterogeneity for the purpose of differential diagnosis of malignant neoplasms; development of radiation diagnostic criteria for differential diagnosis of congenital and acquired liver diseases in children; development of urgent detailed ultrasound examinations for traumatic injuries of the human body, complex radiation examination of the wound channel in case of a gunshot injury; development of methodological foundations for the use of multiparametric high-field MRI of the brain to assess the state of the leading tracts and the functional capacity of the cerebral cortex. Methods for textural analysis of computed tomographic images, echograms of normal and tumor tissues based on the use of coefficients of one-dimensional heterogeneity, anisotropy coefficient, and verticality coefficient have been developed. For the first time in Ukraine, a mathematical system that provides in 93-98% of cases of recognition of fibrous (precision) liver changes based on ultrasound images (utility model patent No. 139916) has been developed; significant differences between the values of mathematical criteria for normal and damaged liver based on computer processing of echographic images allow solving the problem of recognizing diffuse liver diseases.

Covid-modulated emphysematous pyelonephritis against the background of a severe course of oxygen-dependent Covid pneumonia

EP is a rare form of acute purulent pyelonephritis caused by microorganisms that decompose glucose into acid and carbon dioxide, characterized by the development of an acute necrotizing process in the renal parenchyma. The disease is characterized by the accumulation of gas bubbles in the kidney tissues (in the kidney interstitium, its cavity or urinary system) and in the surrounding fiber. The disease is characterized by the accumulation of gas bubbles in the kidney tissues (in the kidney interstitium, its cavity or urinary system) and in the surrounding fiber. A clinical observation of a 66-year-old patient with emphysematous pyelonephritis of the left kidney, initiated by oxygen-dependent severe Covid pneumonia, is described. The comments indicate the possible pathogenesis of the pathology and the role of polymorbidity.

Diagnostic role of positron emission tomography in patients with ovarian cancer

The review deals with the effectiveness of the use of positron emission tomography (PET) with 18F-fluorodeoxyglucose in the diagnosis, staging, assessment of treatment results, prognosis and monitoring of ovarian cancer. It is shown that the adequate use of PET in diagnostic algorithms can improve the accuracy of complex diagnostics, optimize the tactics of examination and treatment of patients. The opinions of researchers on the limitations of the method are presented, leading to false positive and false negative conclusions. Key words: ovarian cancer, positron emission tomography, 18F- fluorodeoxyglucose.

Perinatal predictors and ultrasound diagnostics of newborn respiratory disorders

Respiratory distress is one of the most common causes of neonatal morbidity and mortality. The aim of this study was to determine perinatal factors and ultrasonographic features of newborn respiratory disorders. We examined 49 children aged 0-28 days who had manifestations of type 1 RDS (group 1 – 24 children) and pneumonia caused by intrauterine infection or massive meconium aspiration syndrome (group 2 – 25 children). The control group consisted of 20 newborn. The control group consisted of 20 newborns. Data analysis showed that the presence of extra genital pathology that had mother, significantly influenced on the development of respiratory disorders (group 1 – 75 % ,and group 2 – 60 % compared to the control group – 20 %), as well as a high frequency of chronic fetal hypoxia and placental dysfunction complicated by fetal distress (in group 1 – 75 % of cases, in group 2 – 40 %) It was found that ultrasound examination of the lungs is an informative, safe method for diagnosing pneumonia, pneumothorax, the presence of fluid in the pleural cavity of newborn respiratory disorders, and provides an opportunity to monitor pathological changes during treatment.

Human body: new organs

The use of medical imaging technologies, bioimaging, digitized archives of scientific and medical literature, the special mentality of researchers, going beyond the skills of professional education have led to the discovery of new organs of the human body. The aim of the review is to present in the first iteration the basic information about the new organs of the human body and the need for their identification for complete scientific and practical work. Anterolateral ligament of the knee is present in 97.56 % of people. It was first described in 1879, rediscovered in 2013. The juxta-oral organ was first described in 1885, and again in 2015-2020. Description of the lymphatic drainage system of the brain was published in 1787 and 1816, rediscovery and detailing already in the 21st century. It was proposed to identify the interstitium as a special organ that deposits and transports about 20 % of the interstitial fluid in the body. It is assumed that the interstitium can act as a shock absorber and keeps tissue from rupture. The vision of the mesentery as a whole continuous organ will make it possible to modify many operations, reduce their invasiveness, implement full-fledged rehabilitation after surgery, and improve the quality of life of patients.

The effectiveness of personalized kinesitherapy on an inclined plane at degree I scoliosis in children: X-ray monitoring

The purpose is to evaluate the effectiveness of complex treatment of grade I scoliosis in children on an inclined plane. Material and methods. Throughout 2021, 42 children with degree I scoliosis aged from 8 to 13 years old (average age 10.5 years) were under observation. All patients with degree I scoliotic disease were prescribed complex treatment, which included personalized kinesitherapy on an inclined plane (Evminov's board), massage, electrical stimulation of the back muscles, and cholecalciferol intake (if indicated). Two groups of patients were identified: Group I – children with grade I scoliosis before treatment (42 persons) and Group II – children with grade I scoliosis in the process of treatment (37 persons). Re-examination was carried out 4-5 months after the start of the course. Results. 45.2 % of children in Group I had complaints of cerebroasthenic nature, which remained in only 12 % of patients in Group II. No clinical signs of hypocalcemia were revealed in the examined children during the initial and repeated laboratory examination. When analyzing the indicators of ultrasound densitometry, 14.3 % of children in Group I had initial signs of osteopenia (Z-Score); 25-hydroxycalciferol was at the lower limit of the normative values in children before the start of treatment. Regression of scoliosis was noted in 80.9 % of children of Group II, according to X-ray data, in 3 patients of this group there was a stable clinical and instrumental picture. Conclusions. The application of an inclined plane for children in the treatment of degree I scoliosis gives a positive result – regression of the spinal deformity. The results indicate the need to develop medical and social programs for the prevention and treatment of degree I scoliotic deformity of the spine in children in general educational institutions at physical education lessons. Key words: children, degree 1 scoliosis, inclined plane, kinesitherapy, radiography, densitometry.

Modern approaches to the treatment of radioiodine-refractory differentiated thyroid cancer

Radioiodine therapy is the main post-operation method of treatment of advanced differentiated thyroid cancer, but the loss of ability of iodine uptake causes the poor prognosis. The follow-up of patients with radioiodine-refractory differentiated thyroid cancer (RRDTC) is a serious problem. In review the definition, genesis, diagnostics and treatment of RRDTC were revealed. Taking into account the ineffectiveness of traditional methods of redifferentiation therapy, the perspectives of administration of targeted therapies with tyrosine kinase inhibitors were showed. Key words: radioiodine-refractory differentiated thyroid cancer, radioiodine therapy, targeted therapies with tyrosine kinase inhibitors.

Diagnostic role of gastrin-releasing peptide receptors in oncology

Tumor receptor-targeted diagnostic imaging is an area of research that identifies a biomarker that is overexpressed on the surface of cancer cells and binds its ligand to carriers, allowing imaging of the tumor process. The success of this approach depends on the selectivity of the receptor for certain malignant cells, as well as on its ability to specifically bind to the target ligand. This review examines the diagnostic role of the bombesin family of receptors, which focus on gastrin-releasing peptide receptors (GRPR), which are overexpressed in various cancers. For tumors expressing GRPR, the diagnostic informativeness of the detection of both primary tumor foci and metastases is high. The well-known concept of tumor heterogeneity has led to the development of bivalent prostate cancer - target peptides with the ability to target two receptors. Radiolabeled bombesin analogues are promising theranostic agents for tumors that express GRPR, which opens the possibility of early detection of primary tumors and metastatic lesions with high sensitivity and specificity. At the same time, further forward-looking clinical trials are needed to improve understanding of the relationship between GRPR expression and the biological behavior of different cancer cells. Key words: gastrin-releasing peptide receptors, bombesin, theranostic, oncology

Radiation diagnostics of thoracic gunshot wounds

The frequency of thoracic injuries in the general structure of combat surgical trauma remains at the level of 7-12 % and unchanged from the time of the Second World War to the current armed conflicts. The overwhelming majority of them (up to 72 %) are shrapnel gunshot wounds. The formation of a gunshot wound occurs due to the action of a shock wave; a wounding projectile; energy of side impact and vortex wake. The shape, size, features of the wound canal are determined by the kinetic energy of the wounding agent and the physical properties of the damaged tissues. The lung parenchyma is loose and elastic, so small-caliber bullets with low energy cause minimal damage. The wound canal is well differentiated on CT-slices. Its cavity is filled with blood, fragments of destroyed tissue, air bubbles. On the periphery, the contusion zone is determined (area of increased attenuation in the lung-ground-glass opacity). Shrapnel wounds can be accompanied by ruptures of the pulmonary parenchyma with hemorrhages, bilateral pulmonary contusion, damage to the bone frame and soft tissues of the chest. Vascular injury with massive hemorrhage into the pleural cavity and tense hemopneumothorax are one of the main causes of mortality in penetrating wounds. Transmediastinal gunshot wounds, armor trauma and bullet embolism require special attention during radiation examination of victims. The purpose of radiation diagnostics of modern combat trauma is to identify and fully characterize injuries and their complications. The amount of diagnostic information is determined by the level of medical care. Key words: gunshot wounds, chest cavity organs, radiation diagnostics.