EDITORIAL
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www. strobe-statement.org/) should be helpful resources to improve reporting of observational research. Present article is Russian-language translation of the original manuscript edited by Doctor of Medicine R.T. Saygitov.
Present translation was first published in Digital Diagnostics. doi: 10.17816/DD70821. It is published with minor changes related to the literary editing of the translation itself.
Diagnostic accuracy studies are, like other clinical studies, at risk of bias due to shortcomings in design and conduct, and the results of a diagnostic accuracy study may not apply to other patient groups and settings. Readers of study reports need to be informed about study design and conduct, in sufficient detail to judge the trustworthiness and applicability of the study findings. The STARD statement (Standards for Reporting of Diagnostic Accuracy Studies) was developed to improve the completeness and transparency of reports of diagnostic accuracy studies. STARD contains a list of essential items that can be used as a checklist, by authors, reviewers and other readers, to ensure that a report of a diagnostic accuracy study contains the necessary information. STARD was recently updated. All updated STARD materials, including the checklist, are available at http://www.equator-network.org/reporting-guidelines/stard. Here, we present the STARD 2015 explanation and elaboration document. Through commented examples of appropriate reporting, we clarify the rationale for each of the 30 items on the STARD 2015 checklist, and describe what is expected from authors in developing sufficiently informative study reports. Present article is Russian-language translation of the original manuscript edited by Doctor of Medicine R.T. Saygitov.
Present translation was first published in Digital Diagnostics. doi: 10.17816/DD71031. It is published with minor changes related to the literary editing of the translation itself.
HISTORY OF PEDIATRICS
This article presents a narrative that reveals the state of life and health of children in the first months of the Great Patriotic War. Special place goes to the analysis of archival documents indicating the distressful situation of evacuated children, faced unsanitary conditions, lack of food, and difficulties with settling in new places of residence. The activity of the Council of People's Commissars of the USSR, the People's Commissariat of Health of the USSR and the RSFSR on carrying out measures of social support for minors in the first period of the Great Patriotic War is presented. The maximum possible conditions for the protection of minors’ health were implemented as consequence of the execution of orders on places. Difficulties with the implementation of measures for the arrangement of evacuated children in various regions of the country are described depending on local resources and taken measures efficacy (Tula, Ryazan, Yaroslavl, Kuibyshev regions). The ongoing activities are clearly illustrated by the example of the work of the Middle Volga Institute for the Protection of Motherhood and Infancy.
SOCIAL PEDIATRICS AND HEALTH CARE
Background. Child and adolescent suicides remain one of the most painful public issues. The COVID-19 pandemic has aggravated this topic as the number of suicides among children population has increased in this period. Research and practice guidelines identify the leading role of primary care physicians in the prevention, identification, and routing of patients with suicidal behavior. At the same time, there were no studies on pediatricians’ competence in the field of suicides.
Objective. The aim of the study is to study pediatricians’ competence in prevention, risk determination or and detection of suicidal behavior.
Methods. Cross-sectional study was conducted with the usage of original electronic questionnaire aimed on identifying the level of pediatricians’ competence in evaluating suicidal behavior in children. Questionnaire included 18 questions.
Results. We have received 208 electronic questionnaires. 97.1% of specialists have confirmed that they evaluate emotional status of their patients during admission. During admission: 86.1% of specialists have considered the characteristics of children appearance, facial expression, voice intonation, 65.4% — have asked questions about mood, 62.5% — have interviewed parents. 98.6% of specialists pay attention to the presence of self-inflicted injuries marks, 88.4% — ask about the origin of these injuries. Only 36.1% of respondents ask patients about suicidal thoughts, intentions, or actions. Only 69.3% of specialists are ready to refer their patients to psychologist, and 51.7% — to psychiatrist.
Conclusion. Even though most surveyed pediatricians notice signs of suicidal intent (low mood, self-inflicted injuries), they avoid discussing the topic of suicide during admission. Increasing the competence of pediatricians should be aimed on destigmatisation in the field of mental health, increasing the knowledge level, and developing practical skills in working with children with suicidal behavior.
ORIGINAL ARTICLES
Background. Childhood obesity is topical global healthcare issue. The correlations between variable regions of genes encoding leptin and its receptor, ghrelin and neuropeptide Y, and the risk of obesity development in children have not been confirmed completely. Mechanisms for implementing such correlation via the influence of genes on children’s behavior remain unexplored.
Objective. The aim of the study is to examine the correlation between leptin, leptin receptor, ghrelin and neuropeptide Y gene variants and obesity in adolescents and their eating behavior.
Methods. The study included children aged from 10 to 18 years with exogenous constitutive obesity and normal body weight. Variants in genes for leptin LEP rs2167270, leptin receptor LEPR rs1137100, ghrelin GHRL rs696217 and rs27647, neuropeptide Y NPY rs16147 were determined. Adolescents’ eating behavior was evaluated via psychometric questionnaires DEBQ (Dutch Eating Behavior Questionnaire) and TFEQ (the Three Factor Eating Questionnaire).
Results. Gene variant distribution analysis in 150 obese and 150 normal weight children has revealed correlation with obesity for the variant rs1137100 of the LEPR gene (p = 0.001). Variants rs2167270 of the LEP gene (p = 0.015), rs696217 of the GHRL gene (p = 0.040), and rs16147 of the NPY gene (p = 0.020) were associated with adolescent eating behavior predisposing to obesity.
Conclusion. The leptin receptor gene variant rs1137100 is associated with obesity in adolescents, and the variants rs2167270 of the leptin gene, rs696217 of the ghrelin gene, and rs16147 of the neuropeptide Y gene are associated with changes in eating behavior.
CLINICAL OBSERVATIONS
Progeria, or Hutchinson-Gilford Syndrome is a rare disease from the group of laminopathies characterized by premature aging with skin, bones and cardiovascular system lesions. Pathogenesis is based on pathogenic variants in the LMNA gene leading to anomalies in the nuclear membrane morphology, gene expression disruption, chromatin structure changes, mitochondrial dysfunction, DNA repair and alternative splicing defects, and telomere shortening acceleration. Major manifestations of the disease are: skin lesions (scleroderma-like syndrome and pigmented lesions), lipodystrophy, late teeth eruption, teeth crowding, alopecia, nail dystrophy, osteolysis of distal phalanges, hip joints valgus deformation, joints contractures, atherosclerosis, hearing loss, early heart attacks and strokes. Scleroderma-like skin changes, osteoporosis, flexion contractures of hands’ interphalangeal joints, and hip joints osteoarthritis require differential diagnosis with rheumatic diseases. The basic strategy in management of patients with progeria is the prevention and treatment of its cardiovascular manifestations (early strokes and heart attacks, arterial hypertension, and atherosclerosis), as well as the increase of patients’ quality of life and daily activity. The efficacy of therapy in patients with progeria via the use of farnesyltransferase inhibitors (monotherapy; combination with bisphosphonates or statins), retinoids, and 1,25(OH)2 — vitamin D3 is studied. This literature review is updated with clinical case description of a girl with progeria. The diagnosis was confirmed by sequencing of the LMNA gene (Sanger), and previously described pathogenic variant in exon 11 (c.1824C>T, rs58596362) in the heterozygous state (p.Gly608Gly, NM_170707.3) was revealed.
Background. Systemic onset juvenile arthritis is a chronic disease of childhood. Its severity is determined by systemic manifestations, high risk of complications, such as macrophage activation syndrome, interstitial lung disease, and persistent polyarthritis with severe functional disorders. Genetically engineered biological drugs administration significantly improves the prognosis in these patients, thus, there are many questions about the possibilities of successful treatment correction in order to maintain long-term remission in real clinical practice.
Clinical case description. The results of long-term (9 years) administration of tocilizumab in female patient with early onset of systemic onset juvenile arthritis are presented. It has been shown that control over disease activity can be achieved via adjusting the drug dosage and the intervals between infusions.
Conclusion. Tocilizumab significantly improves prognosis of patients with systemic onset juvenile arthritis at good safety profile of this treatment.
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