- Details
Current research work (2018-2020)
Title: Medical and social support, clinical and laboratory and instrumental characteristics of juvenile idiopathic arthritis in patients in the course of therapy using genetic engineering biological drugs.
Responsibles:
|
Name |
Scientific degree, work place, position |
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Аuthor: Marushko Tetiana V. |
MD, Dr. Sc., Full Professor, Head of the Department of Pediatrics-2 |
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Executive researcher: Kurilina Tetiana V. |
MD, Dr. Sc., Full Professor |
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Hliadielova Nataliia P. |
MD, Ph.D., Associate Professor |
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Kozachuk Valentyna H. |
MD, Ph.D., Associate Professor |
|
Herman Olena B. |
MD, Ph.D., Assistant Professor |
Aim of the research:
Analysis of clinical and laboratory characteristics of patients with juvenile idiopathic arthritis in the course of therapy using genetic engineering biological drugs and improvement of medical and social support.
Research objectives:
- To evaluate the effectiveness of different treatment regimens at different terms of the juvenile idiopathic arthritis (JIA) (Criteria for evaluating the effectiveness of antireumatic therapy in patients with JIA).
- To evaluate the prescription algorithm of immunobiological drugs for juvenile idiopathic arthritis;
- To evaluate the results and the presence of adverse events in the treatment of juvenile idiopathic arthritis with immunobiological drugs;
- To assess the physical development of patients with juvenile rheumatoid arthritis (JRA) in the course of basic therapy with immunobiological drugs;
- To assess the bone age of pediatric patients with JRA in the course of basic therapy with immunobiological drugs by detecting ossification deficiency in the analysis of the hand radiographs.
- To assess the morphofunctional status of skeletal system in patients with JRA in the course of basic therapy with immunobiological drugs.
- To measure the serum level concentration of insulin-like growth factor and osteocalcin in children with JRA in the course of basic therapy with immunobiological drugs.
- To evaluate the factors contributing to impairment of physical development and the skeletal system status in patients with JRA and to consider ways of correction of the revealed deteriorations.
- To monitor the safety of pharmacological therapy of JIA.
- To establish the rehabilitation therapy protocol in various forms of JIA.
Expected results of research work:
Medical efficiency: to improve the diagnostic measures and prescription of adequate treatment using immunobiological drugs, which will prevent the progression of the pathological process and disability.
Social efficiency: To establish the rehabilitation therapy protocol in various forms of JIA.
Economic efficiency: to prevent the development of disability in patients and to preserve the patient ability to work.
During the last 3 years, 4 PhD students have been studying in the department, 2 of whom have started their studies in September 2017.
The department holds a monthly meeting of the pediatric cardiorheumatology scientific school, headed by Professor Tetiana V. Marushko.
In 2018, the department members made 9 presentations at national conferences, 17 presentations - at scientific forums with international participation, 3 - at the conferences abroad. A detailed list of reports, including works for the period from 2008 to 2017, can be found on the department page in Ukrainian.
In 2018, 2 textbooks and 24 articles were published by the Department and 1 utility model patent was obtained.
Conference "Complex Patient In Pediatric Practice" - Discussion Of Treatment Strategies In Pediatrics (2018)
The Department of Pediatrics-2 on March 15th 2018 in Kyiv, organized and conducted a scientific and practical conference with international participation "Complex patient in pediatric practice", which was dedicated to the 100th anniversary of the foundation of Shupyk National Medical Academy of Postgraduate Education.
The conference was attended by more than 400 practicing doctors in the fields of Pediatrics, General Practice - Family Medicine, Pediatric Infectious Diseases, Pediatric Immunology, Pediatric Ophthalmology, Pediatric Surgery, Neonatology, and Pediatric Gastroenterology.
The Vice-Rector for Clinical Work professor Raisa Moiseienko opened the conference. Greetings from the Ministry of Health of Ukraine were extended by the Head of the department of pediatric medical care organization of the Department of Medical care for mothers and children of the Medical Department of the Ministry of Health of Ukraine Irina Volosovets.
Director of the Institute of Family Medicine Professor Oleh Shekera congratulated the participants and expressed confidence in interdisciplinary cooperation to improve the prevention, diagnostic measures and treatment of complicated cases in pediatric practice.
The program report "The Role of Interdisciplinary Collaboration in the Management of Patients with Autoimmune Diseases" was presented by the Head of the Pediatrics-2 Department Professor Tetiana Marushko. The report highlighted the need for a team approach in complicated clinical cases ensuring the use of only necessary and safe diagnostic and therapeutic interventions, which greatly increases the chances of patients’ recovery. Head of the Department of Pediatric Endocrinology of the Ukrainian Center of Endocrine Surgery of the Ministry of Health of Ukraine Professor Zelinskaya held a master class "Differential diagnosis of children with different forms of nanism. Growth hormone in treatment of children with different forms of nanism". A great interest was aroused by the report of Professor Tadej Avčin (Slovenia) “Features of the management of patients with JRA”, in which he shared his experience and problems in treating children with juvenile arthritis.
Head of the Department of Ophthalmology, expert of the World Health Organization (WHO) from the Global Program "VISION 2020" Professor Sergiy Rykov drew attention to the importance of prompt diagnosis of eye diseases in children in his report "Inflammatory eye diseases in pediatric patients". Special attention was given to the unresolved questions of uveitis. The topic was continued by Professor Natasha Vidovic-Valentinovic (Slovenia) and Professor M. Panchenko (Kharkiv) respectively.
Alla Volokha, Head of the Department of Pediatric Infectious Diseases and Pediatric Immunology, in the report "Autoimmune pathology in children with primary immunodeficiency" described the problems of vaccination in children with immune response disorders, which is very important in patient monitoring by pediatricians and family medicine doctors.
The conference participants duly appreciated the report "Allergic enterocolitis in children of early age: the difficulties of diagnosis” by Professor Oleh Shadrin, "Implementation of the Treat-to-Target strategy in the treatment of joint diseases in children" by Professor Liudmila Bogmat, "New approaches to modern treatment of enuresis in children" by Professor Mityuriayeva-Korniyko, "Characteristics of nutritional support and correction of nutritional deficits in palliative group children" by Professor Tetiana Kurilina, Professor Yurii Marushko "Primary arterial hypotension: self-assessment of functional status and daily blood pressure profile in pediatric patients" and "Visualization of joint damage: the role of ultrasound examination" by Professor Natalia Shevchenko.
Young scientists (clinical residents and PhD students of Shupyk National Healthcare University of Ukraine and Bogomolets National Medical University) had the opportunity not only to listen to the reports of leading scientists, but also to demonstrate their personal scientific achievements. The best reports were awarded with diplomas and valuable gifts.
The conference participants sincerely thanked the organizers for the high level of scientific level, the opportunity of professional development, the possibility of communication and training within the model of continuous medical education.
- Details
The main research activities of Pedaitrics-2 Department are focused on resolving current and possible future problems in pediatric cardiorheumatology. This scientific direction was chosen with regard to:
- Many years of experience of the Department, which is the main and only department in Ukraine conducting the specialty training program and refresher training courses for pediatric cardiorheumatologists;
- Head of the Department professor Tetiana Marushko is the chief expert of the Ministry of Health of Ukraine in the field of pediatric cardiorheumatology;
- Breakthrough achievements at the national and foreign countries’ level in the field of pediatric rheumatology, namely conducting the therapy using genetic engineering biological drugs;
- A significant need of the health care system in the development of pediatric cardiorheumatology.
According to the main results of scientific research, a lecture course, skill building lessons and seminars, which are taught during the special training programs and theme-based advanced training for specialists (pediatric cardiorheumatologists, pediatricians and general practitioners - family medicine doctors) have been worked out and updated.
In 2017, the research work "Improvement of diagnostic methods and treatment of juvenile arthritides" (2015-2017) was completed.
The scientific hypothesis of this direction is to increase the medical care effectiveness for children with juvenile arthritis, namely diagnostic improvement (using radiologic methods at early disease stage), shortening the turnaround time for diagnosis in the early disease stage and early start of adequate therapy to prevent the progression of the pathological process in the joints and development of disability.
Real-life impact:
– the quality of diagnostics and treatment of juvenile arthritis increased by 35% due to the provided comprehensive clinical and laboratory instrumental characteristics of juvenile arthritis, starting from the first months of disease onset (up to 6 weeks) and in the next 1-2 years;
- the probability of complications and disability decreased by 92% due to the determination of factors influencing the outcome and prognosis of juvenile arthritis, namely prompt diagnostic measures in the early disease stage with the prescription of an appropriate therapy.
Prospects of scientific research development in the coming years: to implement the improved diagnostic measures and to prescribe early an aggressive immunosuppressive therapy, including genetic engineering biological therapy to reduce the likelihood of disability in patients with juvenile rheumatoid arthritis.