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"Child`s Health" 6 (57) 2014

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Clinical and anamnestic features of pathology of the gastrointestinal tract in children with connective tissue dysplasia syndrome heart, born to parents irradiated during childhood as a rsult of the chernobyl accident

Authors: Kondrashova V.G., Kolpakov I.E., Vdovenko V.Yu. , Gritsenko T.V., Shepeliuk T.V., Studenikina O.N., Stepanova Ye.I. - State Institution "National Research Center for Radiation Medicine National Academy of Medical Sciences of Ukraine"

Categories: Pediatrics/Neonatology

Sections: Clinical researches

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Introduction. Literary data on the problem of chronic diseases of the upper gastrointestinal tract, which are formed on the background of connective tissue dysplasia syndrome heart, although not numerous enough in the general child population and no respect of children born to exposed parents.

Objective: To analyze the clinical features of chronic diseases of the upper gastrointestinal tract in children with connective tissue dysplasia syndrome, heart, born of parents who were exposed in childhood as a result of the accident.

Material and methods. To perform the tasks examined 195 children and adolescents who were born from parents who were exposed in childhood as a result of the Chernobyl accident, chronic inflammatory and destructive diseases of the upper gastrointestinal tract  [including 120 children and adolescents with the syndrome cardiac connective tissue dysplasia and 75 patients without evidence of connective tissue dysplasia syndrome heart]. The presence of connective tissue dysplasia was determined by assessing the phenotype. Ultrasound examination of the heart was performed on the apparatus Aloka SSD-630 with the use of echocardiography in B- and M- mode and dopplerokardiography with frequency 3.5 MHz transducer. In order to verify the diagnosis of all patients was conducted endoscopy research with the help of flexible endoscope GIF-P3 firms "OLYMPUS". Conclusion was formulated in accordance with the minimum standard terminology endoscopy of the digestive tract (1998).

Results. It was established that the structure of the digestive system diseases of children born to parents who were exposed in childhood, dominated pathology of the upper gastrointestinal tract, such as chronic gastroduodenit that is usually connected to the nature of the pathological process involving several areas of the alimentary canal. In clinical genetic testing of children in group I found 7,1 ± 0,87 minor birth defect per child, which was significantly higher than the number of 1 child in group II children (4,29 ± 0,40, p < 0,05). The structure of minor birth defect 1 -3rd places with almost equal frequency recorded anomalies of internal organs                 ( 27.82 %), musculoskeletal ( 27.11 %) and dysmorfy of the head and neck ( 26.17 %); 4 th place were minor birth defect skin appendages and muscle (18.9 %). Abnormalities of internal organs were mainly represented by small structural abnormalities of the heart (mitral valve prolapse and abnormally located chordae ); excesses and constrictions of the gallbladder; Wire cup – tub expansion of the kidneys and nephroptosis .

Determination of ancestral history index with disorders of the gastrointestinal tract with relatives I - II degree relatives of children in group I showed that 42.50 % it was moderate in 12.37 % - expressive and 14.43% - high, significantly did not differ from that of children in Group II.

In children with connective tissue dysplasia syndrome heart occurs earlier disease manifestation of the upper gastrointestinal tract, ( from pre-school age ) and with age, more systemic damage observed in various organs and systems, as evidenced by such indicators as the number of nosology forms of diseases per child (children group I - 6,8; II - 4,9). Clinical manifestations of chronic diseases of the upper gastro duodenal zone in children with the syndrome of cardiac connective tissue dysplasia characterized by more frequent exacerbations in the background of psycho-emotional and physical overload; not intensive, recurrent pain; more frequent symptoms of gastric dyspepsia, intestinal motor dysfunction and often accompanied by disorders of the nervous system (80.0 %) and chronic foci of infection  ( 62.2 %).

Conclusions. The presence of connective tissue dysplasia in children born from parents who were exposed in childhood as a result of the Chernobyl accident causes an earlier demonstration upper gastrointestinal tract pathology, motor dysfunction, involvement in the pathological process of multiple zones of digestive tract and related organs



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