1. Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar 350001, Russia

Keywords: ecology, children and teenagers from Krasnodar region

Abstract:The aim of the research is to study the infl uence of diff erent pollution levels on clinical and epidemiologic aspects in erosive ulcerous diseases of gastric mucosa and duodenum in children and teenagers. Materials and methods: the research is carried out in Krasnodar region and it consists of two stages. At fi rst stage 47 territories of Krasnodar region are ecologically assessed, at second stage epidemiologic rate (prevalence and sickness rate) of erosive ulcerous diseases of gastric mucosa and duodenum in children and teenagers in Krasnodar region are studied according to data regarding visits to the health care centers and calls of the special medical crews against the ecological condition of the territory. Results. Ecological state of the territories in Krasnodar region diff ers as per anthropogenic load intensity. Low levels of pollution are indicative for regions with favorable ecology (15 regions), medium levels — for regions with conditional favorable ecology (17 regions), and high levels of pollution — for regions with unfavorable ecology (15 regions). There is a numeric dependency between number of children and teenagers visiting health care centers and the level of anthropogenic pollution of regions where they live. The number of children visiting health care centers in connection with erosive ulcerous diseases of gastric mucosa and duodenum is 2.3 times higher, of teenagers — 1.5 times higher against number of patients from regions with favorable ecology.

• References total 10 ⇓ :: .
  1. TSvetkova P.M., Gureev A. N., TSvetkova L.N., et al. Th e modern course of peptic ulcer in children. PEDIATRIA. 2008; 87 (6):31–33. (in Russ)
  2. Vasilieva T. G., Burmistrova T. I., Shishatskaya S. N. Rasprostranennost’ zabolevaniy organov pishchevareniya u detey i podrostkov Primorskogo kraya. Aktual’nyye problemy abdominal’noy patologii u detey: materialy XVIII Kongressa detskikh gastroenterologov Rossii i stran SNG. [Th e prevalence of diseases of the digestive system in children and adolescents of Primorsky Krai // Actual problems of abdominal pathology in children: materials of the XVIII Congress of Pediatric Gastroenterologists in Russia and the CIS]. Moscow, 2011, pp. 12–13. (in Russ)
  3. Panova I. V., Dudnikova E. V., Dombajan S. H. Endocrine status of boys and girls with chronic infl ammatory pathology of upper parts of alimentary tract in the period of puberty. Fundamental research. 2012, no № 12 (part 1), pp. 117–120. (in Russ)
  4. Kildiyarova R. R., Bazhenov E. L. Clinical and morphological comparisons of chronic gastritis, gastroduodenitis and peptic ulcer disease in children. Russian Pediatric Journal. (in Russ)
  5. Tsallagova R. B., Boraeva T. T., Khubaeva I. V. Struktura zabolevayemosti gastroenterologicheskoy patologiyey u detey po dannym detskoy Respublikanskoy klinicheskoy bol’nitsy. [Th e structure of the incidence of gastroenterological pathology in children according to the data of the Children’s Republican Clinical Hospital]. Detskoye zdravookhraneniye Rossii: strategiya razvitiya: materialy IX s’yezda pediatrov Rossii. [Child health care in Russia: development strategy: materials of the IX Congress of Pediatricians of Russia]. Moscow, 2001, 619 p.
  6. TSukanov V.V., Sokolskih T. V., Manchuk V. T., et al. Clinical and morphological characteristics of gastroduodenal zone diseases in families of children. PEDIATRIA. 2008; 87 (6):37–41. (in Russ)
  7. Doklad o sostoyanii okruzhayushchey prirodnoy sredy Krasnodarskogo kraya v 2011 godu. [Report on the state of the environment of the Krasnodar Territory in 2011]. Gosudarstvennyy komitet po okhrane okruzhayushchey sredy Krasnodarskogo kraya. [State Committee for Environmental Protection of the Krasnodar Territory]. Krasnodar. 2011, 170 p. (in Russ)
  8. Doklad o sostoyanii okruzhayushchey prirodnoy sredy Krasnodarskogo kraya v 2017 godu. [Report on the state of the environment of the Krasnodar Territory in 2017]. Gosudarstvennyy komitet po okhrane okruzhayushchey sredy Krasnodarskogo kraya. [State Committee for Environmental Protection of the Krasnodar Territory]. Krasnodar. 2017, 152 p. (in Russ)
  9. Shashel V. A., Nefedov P. V., Nastenko V. P. Sposob otsenki ekologicheskogo sostoyaniya okruzhayushchey sredy. [Th e method of assessing the ecological state of the environment]. Patent 2156975 G 01 № 33/00, Publ. 27.09.2000, no. 27.
  10. Krzyzanowski M. Environment and health of children in Europe // 4th Europaediatries. – M., 2009. – P. 37.

Full text is published :
Shashel V. A., Firsova V. N. Epidemiology of erosive and ulcer diseases of the stomach and duodenum in children and adolescents of Krasnodar Region. Experimental and Clinical Gastroenterology. 2019;161(1): 64–69. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-64-69
Read & Download full text

1. Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
2. Sechenov First Moscow State Medical University, Moscow, Russia
3. Children’s City Clinical Hospital № 9 named. G. N. Speransky, Moscow, Russia

Keywords: children, cholelithiasis, overweight, cytolysis, cholestasis

Abstract:The purpose of the study was to reveal the frequency and characteristics of the course of the cholelithiasis on the basis of studying the histories of children hospitalized in the Department of Gastroenterology of the State Children’s Hospital No. 9 named after GN Speransky in 2016–2017. Materials and methods: 3200 case histories of children were analyzed; in 32 children, cholelithiasis was diagnosed, among them 11 boys and 21 girls aged 1–9 months to 17 years 8 months. Anthropometric data, family history, duration of the disease, presence of abdominalgia, episodes of a sharp decrease in body weight were evaluated. Laboratory and instrumental studies were conducted. Results: cholelithiasis occurs in 10% of children with digestive tract diseases, mostly in girls, about half of patients had normal body weight and heredity of cholelithiasis, and in every fi fth child, relatives suff ered from excessive body weight. In 28% of cases, cytolysis syndrome (> 10 norms) and cholestasis (> 3 norms) were detected, clinical symptoms of cholelithiasis were noted within 3 months, in half of the children developmental abnormalities and a suspension in the gallbladder cavity were diagnosed. 25% of adolescent girls deliberately reduced body weight. Conclusion: when detecting stones in the gallbladder, it is necessary to determine the indicators of liver and pancreas function, despite the possible absence of complaints of pain in the right hypochondrium.

• References total 09 ⇓ :: .
  1. Ilchenko A. A. Diseases of the gallbladder and biliary tract: A Guide for Physicians., 2nd ed. Moscow, LLC Publishing House Medical Information Agency, 2011, 880 p.
  2. Union of Pediatricians of Russia, clinical guidelines for gallstone disease, 2016
  3. Zaprudnov A. M., Kharitonov L. A. Biliary pathology in children. Moscow, Medical Information Agency. Publ, 2008, 376
  4. Pediatrics: national leadership in 2 tons. Moscow: GEOTAR-Media Publ., 2009, vol. 1, pp. 816–822.
  5. L. A. Haritonova, A. M. Zaprudnov. Diseases of the biliary tract in children – a modern approach to the problem. Pediatria. 2016; 95 (6): 130–139.
  6. Mazurin A. V., Vorontsov I. M. Propedeutics of childhood diseases. Moscow, Medicine Publ., 1986, 430 p.
  7. Volodin N. N., Mukhina Yu. G. Children’s diseases. Vol.2. Gastroenterology. Moscow, Dynasty Publ., 2011, 156–173
  8. Tepaev R. F., Obedin A. N. PAIN SYNDROME IN CHILDREN: DIAGNOSTICS AND TREATMENT (WITH COMMENTARY BY R.F. TEPAEV). Pediatric pharmacology. 2014;11(6):86–91. (In Russ.) https://doi. org/10.15690/pf.v11i6.1222
  9. Davidenko N. V. Kliniko-funktsional’naya kharakteristika, iskhody i prognoz ostrykh pankreatitov razlichnoy etiologii u detey: diss. kand. med. nauk [Clinical and functional characteristics, outcomes and prognosis of acute pancreatitis of various etiologies in children. diss. Cand. med. Sciences]. Moscow, 2006, 176 p.

Full text is published :
Dubrovskaya M. I., Lyalikova V. B., Romanova E. A., Davidenko N. V., et al. Cholelithiasis in the structure of nosology at the pediatric department of children’s city clinical hospital. Experimental and Clinical Gastroenterology. 2019;161(1): 70–74. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-70-74
Read & Download full text

1. Moscow Regional Research and Clinical Institute, Moscow 129110, Russia

Keywords: metabolic syndrome, obesity, children, pancreas, postprandial reaction, thyroid, carbohydrate metabolism, lipid metabolism, fatty liver disease

Abstract:Relevance. Pancreas refers to the organs, the functional state of which is the most signifi cant factor in the development of hormonal and metabolic disorders. Objective: to study the morphofunctional state of the pancreas in children with obesity and to evaluate its relationship with the main components of the metabolic syndrome (MS). Materials and methods. Surveyed 483 children with obesity from 6 to 16 years. Group I — 237 children with obesity complicated by MS, Group II — 246 children with obesity without signs of MS. A complex of clinical, laboratory and instrumental methods of examination was carried out using standard methods; 90 children (60 children from group I and 30 children from group II) underwent an ultrasound examination of the pancreas (RV) with the determination of the postprandial reaction. The results of the study. In 94.9% of children I gr. and 89.8% of children II g. various changes in the structure of the pancreas were revealed: an increase in acoustic density (77.6% and 63.8%, respectively), the presence of hyperechoic inclusions in the parenchyma (86.1% and 82.1%, respectively). The total size of the pancreas on an empty stomach in children in I group exceeded the normative fi gures and was more than that of II gr. (59.85 ± 6.27 mm and 53.11 ± 7.62 mm, respectively, p <0.05). After food stimulation, this indicator amounted to 65.75 ± 7.41 mm in I gr., and about 59.64 ± 5.40mm (p <0.05) in II gr. Exclusively in I gr. (16.7%) postprandial reaction was absent or was sharply reduced (less than 5%). The level of glucose, insulin, C-peptide and HOMA-IR index was higher than in the compared subgroups, and signifi cantly exceeded the standard indicators in children with a reduced postprandial reaction. Triglyceride levels were also signifi cantly higher, and high-density lipoproteins were lower than in other subgroups. In children with non-alcoholic fatty liver disease, the total size of the pancreas on an empty stomach was larger than in children with a normal organ structure (p <0.001), and the postprandial reaction of the pancreas was signifi cantly lower: 7.5% (6.8–8.5%), respectively and 10.4% (11.8–17.9%) (p <0.01). With an increase in the thyroid gland, the size of the pancreas head on an empty stomach was signifi cantly larger than in children with a normal thyroid volume. A decrease in the postprandial response of less than 5% was observed in 33.3% of children with an enlarged thyroid, and in 16.7% of children with normal thyroid size (p <0.05), the normal response of the pancreas (more than 15%) was determined solely in children with not Thyroid gland (11.9%). Findings. Most obese children (up to 95%), regardless of the presence of MS, revealed structural and functional changes in the pancreas. A signifi cant decrease in the postprandial pancreatic response was recorded in children with MS. Only in children with MS (16.7%), the postprandial pancreatic reaction was absent or was sharply reduced (less than 5%), which should be considered as a clinical sign of impaired adaptive capacity of the pancreas against the background of a latent chronic infl ammatory process. The relationship between carbohydrate metabolism and lipid metabolism with the total size and size of the pancreatic head on an empty stomach and after food load has been established. Children with NAFLD have a higher risk of developing CP. A close relationship between the morphofunctional state of the pancreas and thyroids has been established.

• References total 14 ⇓ :: .
  1. Lazebnik LB, Zvenigorodskaya LA. Metabolicheskii sindrom i organi pishevarenia. – М. 2009,181p
  2. Bokova TA. Hepatobiliary system function in children with metabolic syndrome. Experimental and Clinical Gastroenterology Journal. 2016;125(1):14–20.
  3. Ivashkin VT, Shifrin OS, Sokolina IA. Steatos podjeludochnoi jelezi I ego klinicheskoe znachenie. rossiiskii jurnal gastroenterologii, gepatologii, koloproktologii. 2006;16 (4):32–7.
  4. Kucheryavy YA, Moskaleva AB. Vzaimosvyaz hronicheskogo pankreatita s jirovoy bolezniy pecheni I narusheniami uglevodnogo obmena y patientov s ojireniem. Eff ektivnaya farmakoterapia v gastroenterologii. 2011;2:44–9.
  5. Lohr J.-M. Exocrine pancreatic insuffi ciency. – 2-end edition – Bremen: UNI–MED. 2010: 91 p.
  6. Martinez J, Johnson CD, Sanchezрaya J., et al. Obesity is a defi nitive risk factor of severity and mortality in acute pancreatitis: an updatedmetaanalysis. Pancreatology. 2006;17(3):2069.
  7. Maev IV, Kazylin AN, Kucheryavy YA. Hronicheskiy pankreatit. М.: Medicina, 2005. – 504 p.
  8. Barishnikova OV. K voprosu lechenia bolnih hronicheskim pankreatitom s sopytstvyyshim gipotireozom. Vrach-aspirant. 2012;2(51):88–92
  9. Textbook of endocrine physiology. edited by Griffi n J., Ojeda S. M: Binom. 2008: 496 p.
  10. Bokova TA, Ursova NI, Rimarchuk GV, Lebedeva AV. Morphofunctional condition of the pancreas in children and teenagers with obesity and metabolic syndrome. Eksp Klin Gastroenterol. 2008;(7):24–8.
  11. Novikova VP, Usienko EA, Aleshina EI. Sostoyanie podjelydochnoy jelezi pri metabolicheskom syndrome y detei. Lechashiy vrach. 2011;7:71–3
  12. IDF (International Diabetes Federation). Th e IDF consensus defi nition of the metabolic syndrome in children and adolescents. Brussels: IDF, 2007. 24 p.
  13. Cuartero BG, Lacalle CG, Lobo CJ, Vergaz AG. et al. Th e HOMA and QUICKI indexes and insulin and C-peptide levels in healthy children. Cut off points to identify metabolic syndrome in healthy children. An. Pediatr. (Barc.). 2007;66 (5):481–90.
  14. Skude G., Errikson S. Serum isoamylases in chronic pancreatitis. Scand. J. Gastroenterology. – 1976;8:402–7.

Full text is published :
Bokova T. A.Relationship of functional state of pancreas and metabolic syndrome in children. Experimental and Clinical Gastroenterology. 2019;161(1): 75–80. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-75-80
Read & Download full text

1. Northern State Medical University (NSMU), Arkhangelsk 163000, Russia

Keywords: oxidative stress, blood antioxidant ability, metabolic active obesity, metabolic healthy obesity, metabolic syndrome, atherogenic disorders, chronic infl ammation, children, adolescents, schoolchildren

Abstract:The purpose of the study is to assess the level of oxidative stress and impaired blood antioxidant capacity in children and adolescents with metabolic active obesity and other components of the metabolic syndrome. Materials and methods. Surveyed 102 children and adolescents aged 10 to 15 years with obesity. According to the results of clinical and laboratory examinations, groups were identifi ed depending on the presence of metabolic disorders: metabolic active obesity (MAO) and metabolically healthy obesity (MHO). The comparison group consisted of 230 schoolchildren of secondary educational institutions of the city of Arkhangelsk. Results. When comparing groups with MAO, MHO and children without metabolic disorders, it was found that the highest average level of total peroxide (PPS) is observed in the group with MAO, the lowest in the comparison group (<0.001). Among the average indicators of the general antioxidant system (GAS), on the contrary, the lowest value is observed in the group with MAO, the highest — in the comparison group, in children and adolescents with MLO — intermediate values of AOS. The average levels of the studied parameters of proatherogenic metabolic disorders (uric acid (UA), lipid spectrum, glucose, C — reactive protein, blood pressure, HOMA index, insulin) were signifi cantly higher in the group with MAO, except for the average level of high density lipoprotein cholesterol (HDL cholesterol), which is signifi cantly lower. Conclusion. In children and adolescents with MAO, changes in the classic indicators of atherogenic disorders (blood lipid spectrum, blood pressure, insulin resistance, hyperinsulinemia, chronic infl ammation) and high levels of oxidative stress are found, along with a decrease in the activity of the antioxidant system, which may have not only pathogenetic signifi cance, but also reveals promising areas for the prevention and treatment of atherogenic disorders.

• References total 25 ⇓ :: .
  1. Bertuccio P, Levi F, Lucchini F et al. Coronary heart disease and cerebrovascular disease mortality in young adults: recent trends in Europe. European Journal of Cardiovascular Prevention & Rehabilitation August. 2011;18:627–4.
  2. Kardiovaskulyarnaya profi laktika. Natsional’nye rekomendatsii. [Cardiovascular prevention. Th e national recommendations] Kardiovaskulyarnaya terapiya i profi laktika [Cardiovascular therapy and prevention]. 2011;10(6), prilozhenie 2:1–64 (in Russian).
  3. McCrindle BW, Urbina EM, Dennison BA et al. Scientifi c Statement From the American Heart. Association Atherosclerosis, Hypertension and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, With the Council on Cardiovascular Nursing. Circulation. 2007;115:1948–67.
  4. Profi laktika serdechno-sosudistykh zabolevaniy v detskom i podrostkovom vozraste. Rossiyskie rekomendatsii. [Prevention of cardiovascular disease in childhood and adolescence. Russian recommendations] Rossiyskiy kardiologicheskiy zhurnal [Russian cardiology journal]. 2012;6(98), prilozhenie 1:1–40 (in Russian).
  5. Hu G, Oiao O, Tuomilehto J. Prevalence of the Metabolic Syndrome and Its Relation to All-Cause and Cardiovascular Mortality in Nondiabetic European Men and Women. Arch Intern Med. 2004;164:1066–76.
  6. Problemy gipoksii: molekulyarnye, fiziologicheskie i medicinskie aspekty. [Problems of hypoxia: molecular, physiological and medical aspects]. Pod redakciej L. D. Luk’yanovoj i Ushakova I. B. [Edited by L. D. Lukyanova Ushakova] M 2004, pp 585.
  7. Suhorukov V. S. Ocherki mitohondrial’noj patologii [Study of mitochondrial pathology]. Moscow, Medpraktika-M, 2011. 287 p.
  8. Zimmeta P, Albertib KG, Kaufmanc F et al. Th e metabolic syndrome in children and adolescents – an IDF consensus report. Pediatric Diabetes. 2007;8(5):299–306.
  9. Chumakova GA, Veselovskaya NG, Gritsenko OV i dr. Metabolicheskiy sindrom: slozhnye i nereshennye problemy [Metabolic syndrome: a challenging and unsolved problems]. Rossiyskiy kardiologicheskiy zhurnal [Russian cardiology journal]. 2014;3(107):63–71. (in Russian).
  10. Malyavskaya S. I., Lebedev A. V. Metabolicheskij portret detej s ozhireniem [Metabolic profi le of children with obesity]. Rossijskij vestnik perinatologii i pediatrii [Russian journal of Perinatology and Pediatrics]. 2015, no 6 (60), pp 73–81.
  11. Rosen E. D., Spiegelman B. M. Adipocytes as regulators of energy balance and glucose homeostasis. Nature 2006; 444: 7121: 847–853.
  12. Kelley D. E., Leland T. F., Troost F. et al. Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance. Am J Physiol Endocrinol Metab 2000; 278: 5: E941- E948.
  13. Rosito G. A., Massaro J. M., Hoff mann U. et al. Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcifi cation in a community-based sample: the Framingham Heart Study. Circulation 2008; 117: 5: 605–613.
  14. Succurro E., Marini M. A., Frontoni S. et al. Insulin secretion in metabolically obese, but normal weight, and in metabolically healthy but obese individuals. Obesity 2008; 16: 1881–1886.
  15. Rishi P. Is it Finally Time to Dispel the Concept of Metabolically-Healthy Obesity? Journal of the American College of Cardiology. 2014;63(24):2687–88.
  16. Gusova ZR, Dzantieva EO, Khripun IA. Immunologicheskie aspekty ozhireniya [Immunological aspects of obesity]. Al’manakh klinicheskoy meditsiny [Almanac of clinical medicine]. 2015; spetsvypusk 1:30–5 (in Russian).
  17. Shaharyar S, Roberson LL, Jamal O et al. Obesity and metabolic phenotypes [metabolically healthy and unhealthy variants] are signifi cantly associated with prevalence of elevated C-reactive protein and hepatic steatosis in a large healthy Brazilian population. J Obes. 2015;2015:178526.
  18. Takahashi S., Moriwaki Y., Tsutsumi Z. et al. Increased visceral fat accomulation further aggravates the risk of insulin resistance in gout. Metabolism 2001; Apr. 50(4): 393–398.
  19. Nieto F. J., Iribarren С., Gross M. D., Comstock G. W. Uric acid and serum antioxidant capacity: а reaction to atherosclerosis. Atherosclerosis 2000; Vol. 148 (1): 131–139.
  20. Agudelo C. A., Wise C. M. Gout: diagnosis, pathogenesis, and clinical manifestations. Curr Opin Rheumatol 2001; Vol. 13, № 3: 234–239.
  21. Niskanen L. K., Laaksonen D. E., Nyyssonen K. et al. Uric acid level as a risk factor for cardiovascular and all–cause mortality in middle–aged men: a prospective cohort study. Arch Intern Med 2004; Vol. 164: 1546.
  22. Ames B. N., Cathcart R., Schwiers E., Hochstein P. Uric acid provides an antioxidant defense in humans against oxidant – and radical–caused aging and cancer: a hypothesis. Proc Natl Acad Sci USA 1981; 78: 6858–6862.
  23. Barskova V. G., Il’inyh E.V., Eliseev M. S., Zilov A. V., Nasonov E. L. Kardiovaskulyarnyj risk u bol’nyh podagroj [Cardiovascular risk in patients with gout]. Ozhirenie i metabolizm [Obesity and metabolism]. 2006, no 3(8), pp 40–44.
  24. Lebedev A. V., Malyavskaya S. I., Ternovskaya V. A. Rol’ giperurikemii v koncepcii oksidativnogo stressa pri metabolicheskom sindrome u detej. Novyj vzglyad na staruyu problemu [he Role of hyperuricemia in the concept of oxidative stress in children. A new look at the old problem]. Rossijskij vestnik perinatologii i pediatrii [Russian journal of Perinatology and Pediatrics]. 2012, no. 4 (2), pp 99–104.
  25. Cole TJ, Bellizzi MC, Flegal KM et al. Establishing a standard defi nition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240.

Full text is published :
Malyavskaya S. I., Lebedev A. V., Kostrova G. N. Oxidative stress level and blood antioxidant ability violation in children and adolescents with metabolic syndrome. Experimental and Clinical Gastroenterology. 2019;161(1): 81–87. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-81-87
Read & Download full text

1. Pirogov Russian National Research Medical University (RNRMU), Moscow 117997, Russia
2. City Clinical Hospital No 29 Named after N. E. Bauman, Moscow 111020, Russia

Keywords: diabetes, pregnancy, newborns, physical development

Abstract:Introduction: Every year, 50–150 thousand babies are born to mothers with diabetes. Currently, there is no doubt that the condition of newborns born in mothers with diabetes requires special attention because of the increased risk of developing diseases of the respiratory tract, cardiovascular system, brain, kidneys etc. Purpose: Evaluation of various types of diabetes during pregnancy in mothers infl uence at the physical development of newborn children. Materials and methods: 350 full-term babies from mothers with diabetes mellitus, which was born at the N. E. Bauman Hospital which is specialized in the management of such pregnant women. Assessment of the physical development of children was carried out according to WHO standards (2006) using the WHO Anthro program. Comparative analysis of indicators of children in diff erent groups using Student t-criterion. We used the program Statistica 10. Results: The body mass of 350 examined newborns varied within 1590–4710 g, on average, amounted to 3421.1 ± 543.99 g. There were 67 (19.1%) children who had a body weight less than 3000g and 46 (13.1%) more than 4000 g. Growth values of 350 newborns ranged from 40–57 cm, on average, amounted to 51.21 ± 2.54 cm. We analyzed the indicators of physical development of children in all groups depending on gender. We carried out a comparative analysis of the parameters of body mass (m), body length (H), BMI and the ratio of body mass to body length in the experimental and control groups. Conclusion: children born to mothers with various types of diabetes have a higher height, weight to body length ratio, WAZ and HAZ indicators than newborns from mothers with normal glycemia. The weight and height of newborns in the groups of GDM and DM-2 did not diff er signifi cantly among themselves. The shortest and most lightweight children are born to mothers with type 1 diabetes,

• References total 56 ⇓ :: .
  1. Aulamazyan E. K., Evsyukova I. I., Yarmolinskaya M.l. Th e role of melatonin in development of gestational diabetes mellitus. Journal of Obstetrics and Women’s Diseases. 2017; 67(1): 85–91.
  2. Burumkulova F. F., Petrukhin V. A. Gestacionnyj saharnyj diabet: vchera, segodnya, zavtra: obzor [Gestational diabetes mellitus: yesterday, today, tomorrow]. Terapevticheskij arhiv – [Th erapeutic archive], 2014, V. 86, no. 10, pp. 109–115.
  3. Pakin V. S. Molecular genetic aspects of gestational diabetes. Problems of Endocrinology 2017; 63(3): 204–207
  4. Alharthi A.S., Althobaiti K. A., Alswat K. A. Gestational Diabetes Mellitus Knowledge Assessment among Saudi Women. Open Access Maced J Med Sci. 2018 Aug 19;6(8):1522–1526. doi: 10.3889/oamjms.2018.284.
  5. Domanski G., Lange A. E., Ittermann T., Allenberg H., Spoo R. A., Zygmunt M., Heckmann M. Evaluation of neonatal and maternal morbidity in mothers with gestational diabetes: a population-based study. BMC Pregnancy Childbirth. 2018 Sep 10;18(1):367. doi: 10.1186/ s12884–018–2005–9.
  6. Ferreira A.F., Silva C. M., Antunes D., Sousa F., Lobo A. C., Moura P. Gestational Diabetes Mellitus: Is Th ere an Advantage in Using the Current Diagnostic Criteria? Acta Med Port. 2018 Aug 31;31(7–8):416–424. doi: 10.20344/ amp.10135. Epub 2018 Aug 31.
  7. Hosseini E., Janghorbani M., Shahshahan Z. Comparison of risk factors and pregnancy outcomes of gestational diabetes mellitus diagnosed during early and late pregnancy. Midwifery. 2018 Aug 2;66:64–69. doi: 10.1016/j.midw.2018.07.017.
  8. Goldstein R.F., Abell S. K., Ranasinha S., Misso M. L., Boyle J. A., Harrison C. L., Black M. H., Li N., Hu G., Corrado F., Hegaard H,. Kim Y. J., Haugen M., Song W. O., Kim M. H., Bogaerts A., Devlieger R., Chung J. H., Teede H. J. Gestational weight gain across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million women. BMC Med. 2018 Aug 31;16(1):153. doi: 10.1186/ s12916–018–1128–1.
  9. Kominiarek M.A., Saade G., Mele L., Bailit J., Reddy U. M., Wapner R. J., Varner M. W., Th orp JM. Jr., Caritis S. N., Prasad M., Tita A. T.N., Sorokin Y., Rouse D. J., Blackwell S. C., Tolosa J. E.; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU). Network Association Between Gestational Weight Gain and Perinatal Outcomes. Obstet Gynecol. 2018 Sep 7. doi: 10.1097/AOG.0000000000002854.
  10. Lekva T., Godang K., Michelsen A. E., Qvigstad E., Normann K. R., Norwitz E. R., Aukrust P., Henriksen T., Bollerslev J., Roland M.CP, Ueland T. Prediction of Gestational Diabetes Mellitus and Pre-diabetes 5 Years Postpartum using 75 g Oral Glucose Tolerance Test at 14–16 Weeks’ Gestation. Sci Rep. 2018 Sep 6;8(1):13392. doi: 10.1038/s41598–018–31614-z.
  11. Saccone G., Khalifeh A., Al-Kouatly H.B., Sendek K., Berghella V. Screening for gestational diabetes mellitus: one step versus two step approach. A meta-analysis of randomized trials. J Matern Fetal Neonatal Med. 2018 Sep 3:1–231. doi: 10.1080/14767058.2018.1519543.
  12. Ridha F., Houssem R., Latifa M., Ines M., Sabra H. Facteurs de risque et pronostic materno-fœtal de la macrosomie fœtale: étude comparative a propos de 820 cas Risk factors and materno-fetal prognosis of foetal macrosomia: comparative study of 820 cases. Pan Afr Med J. 2017 Oct 10; 28:126. doi: 10.11604/pamj.2017.28.126.8508.
  13. Noushin Ghalandarpoor-Attar S., Borna S., Mojgan Ghalandarpoor-Attar S., Hantoushzadeh S., Khezerdoost S., Ghotbizadeh F. Measuring fetal thymus size: a new method for diabetes screening in pregnancy. J Matern Fetal Neonatal Med. 2018 Aug 28:1–171. doi: 10.1080/14767058.2018.1517309.
  14. Basri N.I., Mahdy Z. A., Ahmad S., Abdul Karim A. K., Shan L. P., Abdul Manaf M. R., Ismail N. A.M. Th e World Health Organization (WHO) versus Th e International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria of gestational diabetes mellitus (GDM) and their associated maternal and neonatal outcomes. Horm Mol Biol Clin Investig. 2018 Feb 17;34(1). pii: /j/hmbci.2018.34.issue-1/hmbci-2017–0077/ hmbci-2017–0077.xml. doi: 10.1515/hmbci-2017–0077.
  15. Cristina B., Giovanni G., Matilde R., Michele A., Lorella B., Prato Stefano D., Alessandra B. Pre-pregnancy obesity, gestational diabetes or gestational weight gain: which is the strongest predictor of pregnancy outcomes? Diabetes Res Clin Pract. 2018 Sep 3. pii: S0168–8227(18)30972–0. doi: 10.1016/j.diabres.2018.08.019.
  16. Larkin D. M. Optimizatsiya akusherskikh i perinatal’nykh iskhodov u patsiyentok s gestatsionnym sakharnym diabetom. Dokt, Diss. [Optimization of obstetric and perinatal outcomes in patients with gestational diabetes mellitus. Doct. Diss.]. Yekaterinburg, 2016, 114 p.
  17. Lysenko S. N., Chechneva M. A., Petrukhin V. A., Burumkulova F. F., Ermakova L. B. Ultrasound diagnosis of diabetic fetopathy. Russian Bulletin of Obstetrician-Gynecologist. 2016; 3 (16): 23–30.
  18. Akhmetova E. S., Lareva N. V., Mudrov V. A., et al. Features of pregnancy with gestational diabetes mellitus and prediction of diabetic fetopathy. Journal of Obstetrics and Women’s Diseases. 2017;66(4):14–24.
  19. Deryabina E. C., Yakornova G. V., Pestryaeva L. A., Sandyreva N. D. Premature labor in patients with gestational diabetes mellitus. Russian Bulletin of Obstetrician-Gynecologist. 2017; 3 (17): 27–32.
  20. Pivovarova O., Gögebakan Ö., Sucher S., Groth J., Murahovschi V., Kessler K., Osterhoff M., Rudovich N., Kramer A., Pfeiff er A. F. Regulation of the clock gene expression in human adipose tissue by weight loss. Int J Obes (Lond). 2016 Jun; 40(6): 899–906. doi: 10.1038/ijo.2016.34. Epub 2016 Feb 23.
  21. Lan T., Morgan D. A., Rahmouni K., Sonoda J., Fu X., Burgess S. C., Holland W. L., Kliewer S. A., Mangelsdorf D. J. FGF19, FGF21, and an FGFR1/β-Klotho-Activating Antibody Act on the Nervous System to Regulate Body Weight and Glycemia. Cell Metab. 2017 Nov 7; 26(5):709– 718.e3. doi: 10.1016/j.cmet.2017.09.005.
  22. Stamatouli A.M., Quandt Z., Perdigoto A. L., Clark P. L., Kluger H., Weiss S. A., Gettinger S., Sznol M., Young A., Rushakoff R., Lee J., Bluestone J. A., Anderson M., Herold K. C. Diabetes. Collateral Damage: Insulin-Dependent Diabetes Induced With Checkpoint Inhibitors. Diabetes. 2018 Aug; 67(8):1471–1480. doi: 10.2337/ dbi18–0002.
  23. Petry C.J., Koulman A., Lu L., Jenkins B., Furse S., Prentice P., Matthews L., Hughes I. A., Acerini C. L., Ong K. K., Dunger D. B. Associations between the maternal circulating lipid profi le in pregnancy and fetal imprinted gene alleles: a cohort study. Reprod Biol Endocrinol. 2018 Aug 29;16(1):82. doi: 10.1186/s12958–018–0399-x.
  24. Simpson S., Smith L., Bowe J. Placental peptides regulating islet adaptation to pregnancy: clinical potential in gestational diabetes mellitus.Curr Opin Pharmacol. 2018 Sep 7;43:59–65. doi: 10.1016/j.coph.2018.08.004.
  25. Nikonova T. V., Vityazeva l. l., Pekareva E. V., Barmina 1.1., Alekseeva YU.V., Shestakova M. V. Th e successful in vitro fertilization in the patient with type 1 diabetes on insulin pump therapy (a case report). Russian Journal of Human Reproduction. 2015; 3(21): 75–80.
  26. Borovik N. V., Potin V. V., Rutenburg E. L. Diabeticheskie mikrososudistye oslozhneniya (retinopatiya i nefropatiya) i beremennost’ [Diabetic microvascular complications (retinopathy and nephropathy) and pregnancy]. Zhurnal akusherstva i zhenskih boleznej – [Journal of obstetrics and women’s diseases], 2013, V. LXII, pp. 75–82.
  27. Bender W., Hirshberg A., Levine L. D. Interpregnancy Body Mass Index Changes: Distribution and Impact on Adverse Pregnancy Outcomes in the Subsequent Pregnancy. Am J Perinatol. 2018 Sep 7. doi: 10.1055/ s-0038–1670634.
  28. Vieira M.C., Begum S., Seed P. T., Badran D., Briley A. L., Gill C., Godfrey K. M., Lawlor D. A., Nelson S. M., Patel N., Sattar N., White S. L., Poston L., Pasupathy D.; UPBEAT Consortium. Gestational diabetes modifi es the association between PlGF in early pregnancy and preeclampsia in women with obesity. Pregnancy Hypertens. 2018 Jul; 13:267–272. doi: 10.1016/j.preghy.2018.07.003.
  29. Huet J., Beucher G., Rod A, Morello R., Dreyfus M. Joint impact of gestational diabetes and obesity on perinatal outcomes. J Gynecol Obstet Hum Reprod. 2018 Aug 25. pii: S2468–7847(18)30217–4. doi: 10.1016/j.jogoh.2018.08.003.
  30. Reichelt A.J., Weinert L. S., Mastella L. S., Gnielka V., Campos M. A., Hirakata V. N., Oppermann M. L.R., Silveiro S. P., Schmidt M. I. Clinical characteristics of women with gestational diabetes – comparison of two cohorts enrolled 20 ears apart in southern Brazil. Sao Paulo Med J. 2017 Jul-Aug;135(4):376–382. doi: 10.1590/1516– 3180.2016.0332190317.
  31. Collins K., Oehmen R., Mehta S. Eff ect of obesity on neonatal hypoglycaemia in mothers with gestational diabetes: A comparative study. Aust. N. Z. J. Obstet Gynaecol. 2017: 13. DOI: 10. 1111/ajo.12717.
  32. Moen G.H., Sommer C., Prasad R. B., Sletner L., Groop L., Qvigstad E., Birkeland K. I. Mechanisms in endocrinology: Epigenetic modifi cations and gestational diabetes: a systematic review of published literature. Eur J Endocrinol. 2017 May; 176(5): R247-R267. doi: 10.1530/ EJE-16–1017.
  33. Abell S.K., De Courten B., Boyle J. A., Teede H. J. Infl ammatory and Other Biomarkers: Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus. Int J Mol Sci. 2015 Jun 11; 16 (6): 13442–73. doi: 10.3390/ ijms160613442.
  34. Sureshchandra S., Marshall N. E., Wilson R. M., Barr T., Rais M., Purnell J. Q., Thornburg K. L., Messaoudi I. Infl ammatory Determinants of Pregravid Obesity in Placenta and Peripheral Blood. Front Physiol. 2018 Aug 7;9:1089. doi: 10.3389/fphys.2018.01089.
  35. Miehle K., Stepan H., Fasshauer M. Leptin, adiponectin and other adipokines in gestational diabetes mellitus and pre-eclampsia. Clin Endocrinol (Oxf). 2012 Jan;76(1):2– 11. doi: 10.1111/j.1365–2265.2011.04234.x.
  36. Fasshauer M., Blüher M., Stumvoll M. Adipokines in gestational diabetes. Lancet Diabetes Endocrinol. 2014 Jun;2(6):488–99. doi: 10.1016/S2213–8587(13)70176–1.
  37. Retnakaran R., Ye C., Hanley A. J., Connelly P. W., Sermer M., Zinman B., Hamilton J. K. Eff ect of maternal weight, adipokines, glucose intolerance and lipids on infant birth weight among women without gestational diabetes mellitus. CMAJ. 2012 Sep 4; 184(12):1353–60. doi: 10.1503/cmaj.111154.
  38. Korkmazer E., Solak N. Correlation between inflammatory markers and insulin resistance in pregnancy. J Obstet Gynaecol. 2015 Feb;35(2):142–5. doi: 10.3109/01443615.2014.948408.
  39. Herrera E., Ortega-Senovilla H. Lipid metabolism during pregnancy and its implications for fetal growth. Curr Pharm Biotechnol. 2014; 15(1): 24–31.
  40. Yanai S., Tokuhara D., Tachibana D., Saito M., Sakashita Y., Shintaku H., Koyama M. Diabetic pregnancy activates the innate immune response through TLR5 or TLR1/2 on neonatal monocyte. J Reprod Immunol. 2016 Sep;117:17–23. doi: 10.1016/j.jri.2016.06.007.
  41. Shaposhnikova E. V., Vedmed A. A., Batchinina O. V. Th e eff ects of gestational diabetes on pregnancy and the neonate: complication and outcomes in births. Smolensk medical almanac. 2017; 4: 57–60.
  42. Aksenov A. N., Bocharova I. I., Bashakin N. F., Troitskaya M. V., Yakubina A. A., Burumkulova F. F., Guryeva V. M. Specifi c features of early postnatal adaptation and management of neonates born to mothers with gestational diabetes mellitus. Russian Bulletin of Obstetrician-Gynecologist. 2015; 4: 75–80.
  43. Nikitina I. L., Konoplya I. S., Polyanskaya A. A., Liskina A. S., Popova P. V. Characterization of psychological and physical development in children of gestation diabetes pregnancies. Meditsinsky Sovet. 2017; 9: 14–20.
  44. Derraik J.G., Ayyavoo A., Hofman P. L., Biggs J. B., Cutfi eld W. S. Increasing maternal prepregnancy body mass index is associated with reduced insulin sensitivity and increased blood pressure in their children. Clin Endocrinol (Oxf). 2015 Sep;83(3):352–6. doi: 10.1111/cen.12665.
  45. Wang J., Pan L., Liu E., Liu H., Liu J., Wang S., Guo J., Li N., Zhang C., Hu G. Gestational diabetes and off spring’s growth from birth to 6 years old. Int J Obes (Lond).2018 Sep 4.doi: 10.1038/s41366–018–0193-z.
  46. Antikainen L., Jääskeläinen J., Nordman H., Voutilainen R., Huopio H. Prepubertal Children Exposed to Maternal Gestational Diabetes Have Latent Low-Grade Infl ammation. Horm Res Paediatr. 2018 Aug 15:1–7.doi: 10.1159/000491938.
  47. Kawasaki M., Arata N., Miyazaki C., Mori R., Kikuchi T., Ogawa Y., Ota E. Obesity and abnormal glucose tolerance in off spring of diabetic mothers: A systematic review and meta-analysis. PLoS One. 2018 Jan 12; 13(1): e0190676. doi: 10.1371/journal.pone.0190676.
  48. Patro Golab B., Santos S., Voerman E., Lawlor D. A., Jaddoe V. W.V., Gaillard R.; MOCO Study Group Authors. Infl uence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis. Lancet Child Adolesc Health.2018 Sep 7.pii: S2352– 4642(18)30273–6. doi: 10.1016/S2352–4642(18)30273–6.
  49. Shanina O. M., Mikhalev E. V., Saprina T. V. Hemostasis regulation and metabolic (hormonal, electrolyte) disturbances in term newborns from women with gestational diabetes. Diabetes Mellitus. 2015; 1: 78–86
  50. Bellatore A., Scherzinger A., Stamm E., Martinez M. et al. Fetal ovemutrition and adolescent hepatic fat fraction: the exploring perinatal outcomes in children study. J. Pediatr. 2017 Oct 15. pii: S0022–3476(l7)31169–1. DOI: 10.1016/j.jpeds.2017.09.008.
  51. Li S., Zhu Y., Yeung E., Chavarro J. E., Yuan C., Field A. E., Missmer S. A., Mills J. L., Hu F. B., Zhang C. Off spring risk of obesity in childhood, adolescence and adulthood in relation to gestational diabetes mellitus: a sex-specifi c association. Int J Epidemiol. 2017 Oct 1; 46(5):1533–1541. doi: 10.1093/ije/dyx151.
  52. Nikitin A. G., Potapov V. A., Brovkin, Lavrikova E. Y., Khodyrev D. S., Shamhalova M. Sh., Smetanina S. A., Suplotova A. N., Shestakova M. V., Nosikov V. V., Averyanov A. V. Association of the polymorphisms of the FTO, KCNJ11, SLC30A8 and CDKN2B genes with type 2 diabetes. Molecular Biology. 2015; 1 (49): 119–128.
  53. Lin Z., Wang Y., Zhang B., Jin Z. Association of type 2 diabetes susceptible genes GCKR, SLC30A8, and FTO polymorphisms with gestational diabetes mellitus risk: a meta-analysis. Endocrine. 2018 Aug 8. doi: 10.1007/ s12020–018–1651-z.
  54. Troshina E. A., Pokuseava V. N., Andreeva V. N. Ozhirenie u zhenshchin [Obesity in women] / pod redakciej G. A. Mel’nichenko, N. K. Nikiforovskogo [edited by G. Melnichenko, N. K. Nikiforovsky]. Moscow, Medical information Agency, 2017. 272 p.
  55. Hjort L., Martino D., Grunnet L. G., Naeem H., Maksimovic J., Olsson A. H., Zhang C., Ling C., Olsen S. F., Saff ery R., Vaag A. A. Gestational diabetes and maternal obesity are associated with epigenome-wide methylation changes in children. JCI Insight. 2018 Sep 6; 3(17). pii: 122572. doi: 10.1172/jci.insight.122572.
  56. Haertle L., El Hajj N., Dittrich M., Müller T., Nanda I., Lehnen H., Haaf T. Epigenetic signatures of gestational diabetes mellitus on cord blood methylation. Clin Epigenetics. 2017 Mar 27; 9:28. doi: 10.1186/s13148– 017–0329–3.

Full text is published :
Kharitonova L. A., Papysheva O.V., Bogomaz L. V., Bogomaz D. S. Physical development of newborns born to mothers with diff erent carbohydrate metabolism disorders. Experimental and Clinical Gastroenterology. 2019;161(1): 88–98. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-88-98
Read & Download full text

1. Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar 350001, Russia

Keywords: pancreas, children, treatment

Abstract:Purpose of the study. To study the peculiarities of treatment of children with pancreatic diseases on the background of allergic enteropathy in children in out-patient and polyclinic conditions. Materials and methods: 349 children aged 5–18 years with pancreatic diseases were screened against allergic enteropathy. Clinical, biochemical and instrumental methods of examination of sick children were used. Results. Timely diagnosis and treatment of pancreatic diseases on the background of a gastrointestinal form of food allergy (allergic enterocolitis) leads to a persistent improvement in the clinical state and normalization of biochemical parameters in most children.

• References total 06 ⇓ :: .
  1. Belmer S. V., Gasilina T. V., Kovalenko A. A. Lectures on pediatrics. Gastroenterology. Moscow, Russian State Medical University Publ., 2003, vol. 3, pp. 254–264
  2. Rimarchuk G. V. Modern diagnostics and therapy of chronic pancreatitis in children. Pediatric release. 2008;2:34–42
  3. Rylova N. V. A diagnostic algorithm for pancreatic pathology in children Russian Bulletin of Perinatology and Pediatrics. 2010;55(4):54–57
  4. Poleshchuk L. A. Childhood pancreatitis: Current aspects of etiology, pathogenesis, and diagnosis. Russian Bulletin of Perinatology and Pediatrics. 2010;55(4):58–65.
  5. Tsuman V. G., Rimarchuk G. V. et al. Acute pancreatitis in children (clinic, diagnosis, treatment). Manual for doctors. Moscow, 2001. 40 p.
  6. Safdi M, Bekal PK, Martin S et al. Th e eff ects of oral pancreatic enzymes (creon 10 capsule) on steatorrhea: a multicenter, placebo-controlled, parallel group trial in subjects with chronic pancreatitis. Pancreas, 2006, 33: 156–162.

Full text is published :
Shashel V. A., Levin P. V. Management of children with diseases of pancreas, occurring on the background of allergic enteropatia in ambulatory and polyclinical conditions. Experimental and Clinical Gastroenterology. 2019;161(1): 99–102. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-99-102
Read & Download full text

1. North-Western State Medical University named after I.I. Mechnikov, St. Petersburg 191014, Russia

Keywords: caries, celiac disease, bone metabolism indicators

Abstract:The aim of this study was to assess the cariesogenic situation in the oral cavity and bone metabolism in children with celiac disease. It is established that in children with early identifi ed with celiac disease, indicators of a cariogenic situation of the oral cavity and the indicators of bone metabolism signifi cantly better than children with later identifi ed with celiac disease. The violation of bone metabolism and a high risk of caries in children with celiac disease were found, and therefore early diagnosis of the disease and compliance with the diet are necessary. And in the treatment of a dentist, a special role is played by medical examination and preventive measures.

• References total 05 ⇓ :: .
  1. Acar S, Yetkıner AA, Ersın N, Oncag O, Aydogdu S, Arıkan C. Author information Oral fi ndings and salivary parameters in children with celiac disease: a preliminary study.//Med Princ Pract. 2012;21(2):129–33. doi: 10.1159/000331794.
  2. Shteyer E, Berson T, Lachmanovitz O, Hidas A, Wilschanski M, Menachem M, Shachar E, Shapira J, Steinberg D, Moskovitz M. Oral health status and salivary properties in relation to gluten-free diet in children with celiac disease.// J Pediatr Gastroenterol Nutr. 2013 Jul;57(1):49–52. doi: 10.1097/MPG.0b013e31828b3705.
  3. Cheng J, Malahias T, Brar P, Minaya MT, Green PH. Th e association between celiac disease, dental enamel defects, and aphthous ulcers in a United States cohort.// J Clin Gastroenterol. 2010 Mar;44(3):191–4. doi: 10.1097/ MCG.0b013e3181ac9942.
  4. Macho VMP, Coelho AS, Veloso E Silva DM, de Andrade DJC. Oral Manifestations in Pediatric Patients with Coeliac Disease – A Review Article.// Open Dent J. 2017 Oct 24;11:539–545. doi: 10.2174/1874210601711010539
  5. Nieri M, Tofani E, Defraia E, Giuntini V, Franchi L. Enamel defects and aphthous stomatitis in celiac and healthy subjects: Systematic review and meta-analysis of controlled studies.//J Dent. 2017 Oct;65:1–10. doi: 10.1016/j.jdent.2017.07.001.

Full text is published :
Silin A. V., Satygo E. A., Melnikova I. Yu. Bone metabolism condition impact on the development of oral cavity caries in children with celiac disease. Experimental and Clinical Gastroenterology. 2019;161(1): 103–105. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-103-105
Read & Download full text