Rate of detection of endocrine diseases in children in the practice of a family doctor
DOI:
https://doi.org/10.34287/MMT.4(47).2020.7Abstract
Introduction. In the context of the reform of modern medicine, endocrine pathology is encountered not only by pediatric endocrinologists, but also by doctors of other specialties, primarily primary care doctors pediatricians and family doctors. Currently, there is a tendency to increase the prevalence of endocrine pathologists in all age groups of the children's population of Ukraine.
Purpose of the study. Assess the frequency and structure of endocrine pathology in children at the primary stage.
Materials and methods. In the conditions of children's outpatient clinics 4273 children aged from 0 to 18 years were consulted and examined with an expert assessment of maps of individual development of the child. Children were evaluated anthropometric indicators, the state of the thyroid gland and sexual development. Examination of all children for the presence of endocrine pathologists and confirmation of the diagnosis were carried out on the basis of the Order of the Ministry of Health of Ukraine № 254 of 04.27.2006 "On the approved protocol for the medical support of children for the specialty" Child endocrinology ".
Results. Among the total number of children consulted, endocrine pathology was manifested in 36,7 %. The diagnosis of newly diagnosed endocrine pathology was first confirmed in 29,9% of children. Among endocrine pathologists, perovism is occupied by obesity (39,9%), the second – thyroid pathology (36,4%), the third – impaired growth (18,3%), the fourth – impaired sexual development (7,4%). In 40% of cases, a violation of sexual development is combined with a violation of growth. It has been established that primary care doctors in 40–50% of cases do not perform anthropometry for children at all, the state of sexual development is not evaluated in 70% of cases, which leads to an untimely referral to a pediatric endocrinologist and complicates further treatment.
Conclusions. A high percentage of children with first diagnosed endocrine pathology at the stage of primary care and the late delivery by doctors of children to a pediatric endocrinologist was established, which is due to the lack of primary care physicians' assessment of anthropometric indicators of the child’s physical development, thyroid and sexual development.
References
Башнина Е.Б. Эндокринные заболевания у детей. Руководство. – М.: ГЭОТАР-Медиа, 2017. – 416 с.
Зелинська Н.Б., Ларін О.С. Патологія щитоподібної залози у дитячого населення України. Клінічна ендокринологія та ендокринна хірургія. 2016; 3 (55): 76–81.
Зелинська Н.Б., Руденко Н.Г. Дитяча ендокринологія в Україні: статистичні показники за підсумками 2016 року та їх динаміка. Український журнал дитячої ендокринології. 2017; 5 (17): 5–13.
Кузнецов Е. В., Жукова Л. А., Пахомова Е. А., Гуламов А. А. Эндокринные заболевания как медико-социальная проблема современности. Современные проблемы науки и образования. 2017; 4; URL: http://www.scienceeducation.ru/ru/article/view?id=26662.
Лембрик І. С., Цицюра О. О., Приймак Р. Ю. Клінічний перебіг та поширеність ожиріння в поєднанні з дисфункцією сфінктера Одді за панкреатичним типом у підлітків. Здоров’я дитини. 2019; 3 (14): 159–164.
Наказ МОЗ України Критерії оцінки фізичного розвитку дітей шкільного віку: прийнятий 13.09.2013 №802 [Інтернет]. 2013 [цитовано: 2018 Кві 7]. Доступно: http:// zakon2.rada.gov.ua/laws/show/z1694-13.
Шадрин С. А., Статова А. В. Эндокринные аспекты углубленной диспансеризации подростков Краснодара. Кубанский научный медицинский вестник. 2014; 7 (149): 84–88.
IDF Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation, 2015.
Styne D. M., Arslanian S. A., Connor E. L. Ожиріння в дітей – визначення, лікування, профілактика: клінічні практичні настанови Ендокринологічного товариства (частина 3)/D. M. Styne, S. A. Arslanian, E. L. Connor/The Journal of Clinical Endocrinology & Metabolism. 2017; 102 (3): 709–757. DOI: org/10.1210/jc. 2016–2573.
Worldwide trends in body mass index, under weight, over-weight and obesity from 1975–2016: a pooled analysis of 2416 populationbased measurement steadies in 128,9 million children, adolescents, and adults. Systematics review of the WHO. The Lancet. October 2017. Vol. 390. ISSUE 10113. P. 2627–2642.
