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Table 1. The distribution of risk factors for osteopenic syndrome development by diagnostic coefficient and informative signs
The risk factor The presence of factor CCC CC BD CVH
DF IX1 DF IX1 DF IX1 DF IX1
Body Mass Index < 18.45 kg/m2 6 1.53 3 0.34 4 01.02 4 1.00
> 18.45 kg/m2 -8 2.44 -5 0.4 -7 1.79 -6 1.50
Level of rumalon antibodies in the blood < 24.0 cu. -7 1.82 -3 0.54 -3 0.47 -3 0.45
> 24.0 cu. 6 1.06 6 0.72 3 0.47 2 0.3
The pathology of bone system Absent -2 0.27 -1 0.19 -1 0.32 -2 0.37
Incorrect posture -1 0.21 -1 0.18 -1 0.12 -3 0.56
Scoliosis 6 1.35 2 0.62 1 0.12 9 2.76
Caries 5 1.23 2 0.56 1 0.18 7 0.8
Hypocalcemia Present 1 0.08 5 1.83 7 1.79 9 02.05
Absent -1 0.12 -2 0.33 -4 1.22 -4 01.11
Pain in the spine and legs Present 7 1.63 3 0.33 2 0.24 9 1.76
Absent -1 0.19 -1 0.16 -1 0.13 -3 0.68
Oxyproline level in the blood < 35.24 mkmol/l -3 0.48 -2 0.76 -2 0.36 -3 0.23
> 35.24 mkmol/l 3 0.48 3 0.57 5 0.88 1 0.08
The body weight of the child at birth < 2900 g 4 0.46 3 0.38 7 01.09 3 0.36
> 2900 g -1 0.19 -1 0.19 -2 0.31 -1 0.23
Mitral valve prolapse Present 4 0.54 1 0.37 5 0.9 3 0.54
Absent -2 0.27 -1 0.26 -2 0.54 -4 0.72
The level of bilirubi-nemia Raised 3 0.42 2 0.29 3 0.38 1 0.14
Normal -2 0.32 -1 0.18 -2 0.25 -1 0.08
Notes: CCC — chronic cholecystocholangitis, CC — chronic cholangitis, BD — biliary dyskinesia, CVH — chronic viral hepatitis, DF—
diagnostic factor, IX1 — indicator informativity.
KOVALCHUKT., BOYARCHUK O., HARIYAN T. Ternopil State Medical University named after I.Ya. Gorbachevsky, Ternopil, Ukraine
Joint Pain Perception Features in Children with Juvenile Rheumatoid Arthritis and Their Parents
Introduction. Juvenile rheumatoid arthritis (JRA) is a chronic disease that requires a doctor's constant assessment of the patient's condition for timely decision about important changes in therapeutic tactics. In the clinical picture of the disease the center place pain is belongs.
The aim of the research was to determine peculiarities of pain perception by suffering from juvenile rheumatoid arthritis children and their parents.
Materials and methods. The 99 children were examined — 60 sick by JRA patients and 39 healthy children. Selected groups were matched by the sex, age, and nationality. The intensity of joint pain was assessed by the using of visual analogue scale (VAS) in children and their parents. Children aged 6—10 years were interviewed by VAS with pictures that reflect the grimaces of pain. Patients above 10 years and their parents were interviewed by simple VAS.
Results. Established that patients with JRA and their parents had given the same assessment of articular pain
intensity (3.5 ± 0.3 cm, 4.5 ± 0.6 cm; p > 0.05). In the group of healthy children the average body pain during the last week was 0.5 ± 0.2 cm by children assessment, and 0.6 ± 0.2 cm by parents assessment (p > 0.05). The level of pain intensity determined in accordance with the VAS gradation revealed the following features. 7.1 % of patients with JRA didn't feel joint pain during last week (0 cm). 41.1 % of children had mild pain (0.1-3.9 cm), 33.9 % had moderate pain (4.0-5.9 cm), 17.9 % had severe pain (6.07.9 cm). Their parents indicated absence of joint pain in 6.8 % of children, mild pain in 42.4 %, moderate pain in 33.9 %, severe pain in 10.1 %, very severe pain in 6.8 % (8.0-10.0 cm).
Depending on the therapy all patients were divided into two groups. Children of the first group (n = 24) received basic therapy with a low-dose of methotrexate (7.5 mg/m2 of body surface per week). Kids of the second group (n = 29) received nonsteroidal anti-inflammatory drugs monotherapy. The monitoring of pain syndrome during treatment showed significant reduction of pain intensity in the first group only. Children felt decrease joint pain 2 years after the date of initiation a low-dose of methotrexate (4.1 ± 0.4 cm, 1.6 ± 0.3 cm; p < 0.05). However parents indicated that the level of pain decreased already one year after conducted basic treatment (4.3 ± 0.4 cm, 3.3 ± 0.3 cm; p < 0.05).
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In some foreign studies were conducted a comparative analysis of the results VAS use by parents and their children. S.D. Lal et al. have shown that the results of the evaluation of pain perception between parents and children coincide in 71 % of cases [1]. In the articles of P. Garcia-Munitis and others, G.J. Reid et al. were shown that parents very often underestimate the value of children's pain [2, 3]. In our study we obtained the opposite results. Calculation of the coefficient of diagnostic value by the Zemskov formula showed equally informative results of pain perception assessed by sick JRA patients and their parents (Ki = 3.41 in both cases).
Conclusion. The results helps to conclude that in Ukraine parents interested in their children's well-being and well informed in their real state of health. If
necessary the results of evaluation of pain in patients and their parents with help of VAS can be interchangeable.
References
1. Agreement between proxy and adolescent assessment of disability, pain, and well-being in juvenile idiopathic arthritis / S.D. Lal, J. McDonagh, E. Baildam [et al.] // J. Pediatr. — 2011. — Vol. 158, № 2. — P. 307-312.
2. Level of agreement between children, parents, and physicians in rating pain intensity in juvenile idiopathic arthritis / P. Garcia-Munitis, M. Bandeira, A. Pistorio [et al.] // Arthritis Rheum. — 2006. — Vol. 55, № 2. — P. 177-183.
3. Reid G.J. Parent-child interactions among children with juvenile fibromyalgia, arthritis, and healthy controls / G. J. Reid, P.J. McGrath, B. A. Lang // Pain. — 2005. — Vol. 13, № 1. — P. 201-210.
LEVASHOVM.I., SAPHONOVS.L., CHAKA E.G., YANKO R.V. Institute of Physiology of NAS of Ukraine named after A.A. Bogomolets, Kiev, Ukraine
Age-Dependent Differences in Static Bone Electrogenesis
Introduction. The relevance of the research. Bioelectric properties of bone tissue are determined by static and dynamic electrogenesis. Static electrogenesis is causing slowly time-varying electric potentials (EP) in bones which include potentials of resting, growth and regeneration [1, 2].
The aim of this study was to examine age-dependent differences in values and distribution of the EP on the periosteal surface of the femur of young and old rats.
Materials and methods. Studies were performed using 42 male Wistar rats at the age from 1 to 24 months. Freshly isolated femurs obtained from the pre-anesthe-tized and decapitated animals served as materials for the study. Femurs were skeletonized and immersed in sodium chloride 0.9% solution. Measurement of EP was performed on electrophysiological device [3]. Ag-AgCl electrodes with agar salt bridges were used in the studies. While measuring, the reference electrode was placed on the distal epiphysis of femur and the measuring electrode was moved along the periosteal surface of bone using a micromanipulator. The measuring electrode was fixed in the following anatomical and topographical areas of femur: the distal epiphyseal-metaphyseal, the distal me-taphyseal-diaphyseal, the center of diaphysis, the proximal metaphyseal-diaphyseal and the proximal epiphy-seal-metaphyseal.
Results. The negative polarity electric potentials were recorded on the periosteal surface of the rats' femur. Their absolute values ranged from —0.1... 0.2 to —2.0... —3.0 mV. The distribution of the electric potential magnitude on the bone surface of young and old rats had general patterns. At all ages the maximum values of EP were recorded in epiphyseal-metaphyseal growth plate, and the minimum — in the center of diaphysis. However, the value of EP for older rats was significantly lower than for young ones. It was typical for all anatomical and
topographical areas of the femur. The maximum value of the negative potential reached up to —2.96 ± 0.50 mV among 1-2-month old rats. The values of the EP were -2.60 ± 0.22 mV among 3-4-month old rats, and at the age of 14-15 months — 0.61 ± 0.19 mV. The maximum values of the EP did not exceed -0.30 ± 0.09 mV among 18-19-month old rats, and -0.20 ± 0.05 mV among 22-24-month old ones. The most expressed age-dependent differences in the EP magnitude were typical for the epiphyseal-metaphyseal growth plate. It is known that this area of growing bone has the highest rate of metabolic processes. The values of EP in bones epiph-yseal plates decreased after their closure among older rats. But it remained higher than in other parts of the femur as a rule.
The maximum differences in the magnitude of EP have reached up to -2.51 mV among young rats, whereas they did not exceed -0.32 mV among old ones. The degree of individual variability values of EP decreased with age. The differences in the EP magnitude in separate regions on the bone surface are also decreased. The maximum dispersion of EP within the group reached up to 1.99-1.85 for young rats. But it was only 0.47 among 14-15-month rats and not more than 0.09-0.06 for old rats.
Conclusion. The effectiveness of static electrogenesis among rats reduces with age. It appeared in decreasing of the EP values on the periosteal bone surface. Differences in the values and distribution of slowly time-varying electric potentials among young and old rats reflected the age-dependent changes in metabolic activity and sates of the physiological remodeling processes in bone tissue.
References
1. McDonald F. Electrical effects at the bone surface / McDonald F. // European J. of Ortodontics. — 1993. — Vol. 15. — P. 175-183.
2. Levashov M.I. Bioelectric properties of bone / Leva-shov M.I. — Kiev: Inf.-analyt. Agency, 2015. — 276 p. (Rus.).
3. Levashov M., Berezovskii V., Saphonov S. The bone quasi-static electrical potencials in hypokinetic rats: Book of Absracts / ELGRA Joint Life Sciences Meeting. 13-18 June 2010. — Trieste, Italy. PS I, Seq. 12.
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Brnb. CyMOÔM. Xpe6eT, ISSN 2224-1507
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