ASTHMA PREDICTIVE INDEX AND NITRIC OXIDE PROGNOSTIC VALUE IN YOUNG CHILDREN WITH RECURRENT WHEEZING.

The study was aiming at investigation of Asthma Predictive Index (API) and predictive value of quantitative changes in nitric/nitrogen oxide (NO) in children with recurrent wheezing of different phenotypes. An observing cross-sectional clinical study where 120 patients 5 to 7 years of ages with wheezing syndrome were involved has been conducted. In the group of patients with multifactorial wheezing, 77%-positive results revealed in 65% of patients indicated to high probability of asthma formation. 59%-positive response to the API index prevailed in patients with episodic wheezing (28%). 77%-positive response sensitivity was 81% and specificity -93%, respectively. The increase in NO concentration (27.8±0.71) was fixed in 27.5% of patients with multifactorial wheezing, especially at 77% positive response to the API index. Measurement of API index and NO levels at early ages to reveal the contingent with high probability of asthma formation, especially in young children with multifactorial wheezing is of great importance.

[MITOCHONDRIAL DYSFUNCTION: MODERN ASPECTS OF THERAPY (REVIEW)].

Mitochondrial diseases are considered as one of the major problems of modern interdisciplinary neonatology and pediatrics. Mitochondrial pathology can be revealed as refractory myoclonic or multifocal seizures, craniofacial dysostosis, dysmetabolic manifestations and respiratory disorders. Central nervous system (CNS), muscles, heart, liver and kidneys is involved in this pathological process. An important criterion for diagnosis of mitochondrial dysfunction is increases in blood lactate and pyruvate levels; the absolute criterion - molecular genetic diagnostic studies of mitochondrial DNA. Polymorphism of clinical symptoms complicates the process of early diagnostics, the lack clear recommendations complicates therapy. Modern aspects of treatment of mitochondrial dysfunction in various neurological syndromes are based primarily in improving the efficiency of the processes of oxidative phosphorylation at the system level. Dietary carbohydrate restriction, and medication (Coenzyme Q10, Idebenonum, Cofactors, drugs which reduce lactic acidosis- Dimephosphon, Dichloroacetate, Antioxidants, Anticonvulsants and Antidiabetic agents, vitamins C, E, K, hemotransfusions) is prescribed. Such complex approach allows us to achieve a reduction in lactate-acidosis, and improve the condition of patients in 70% of cases.

[The role of lactate acidosis in the development and treatment of various neurologic syndromes in children and adolescents].

The aim of the study was to detect the role of lactate acidosis, also to find the share of mitochondrial insufficiency in development of various neurologic syndromes in children and adolescents. The detection of cellular energetic metabolism and acid based imbalance is also important for finding the specific method of management. We have studied 200 patients with various degree of neurodevelopment delay with epilepsy and epileptic syndromes, headache, vertigo, early strokes, floppy infant syndrome, atrophy of ophthalmic nerve, cataracta, neurosensory deafness, systemic myopathy, cerebral palsy. In 27% of cases with various ages we have detected lactate acidosis and increase level of pyruvate. Mitochondrial insufficiency was seen in 8% of cases which gives us opportunity to find the specific method of treatment in this group of patients. Each patient with neurological symptoms requires correction of parameters of energetic and oxidative metabolism.