Sokolnyk S. Prognosing, prevention and treatment of gastrointestinal bleeding in children with peptic ulcer

Object - peptic ulcer disease in children (complicated by gastrointestinal bleeding and uncomplicated); purpose - to increase the effectiveness of preventive measures in children with gastrointestinal bleeding ulcers by implementing new methods of forecasting, prevention and treatment based on the study of exogenous and endogenous factors, genetic patterns of development indicators hemostasis, pro- and anti-inflammatory interleukins, metabolites of nitrogen monoxide with the development of prognostic and diagnostic and therapeutic algorithms; methods - еpidemiological, clinical, instrumental, biochemical, ELISA, molecular-genetic, statistical; results - first analyzed the epidemiology of uncomplicated and complicated peptic ulcer disease in children; studied clinically-endoscopic and genetic features of peptic ulcer complicated with bleeding, the nature of changes in interleukine homeostasis, hemostatic indices in the blood and the content of nitric monoxide metabolites; singled out a phenotype of peptic ulcer in children complicated with bleeding; established exogenous and endogenous predictors of bleeding risk, recurrences in a sick child and the onset of peptic ulcer out of bleeding in a healthy one; also determined their diagnostic and prognostic value; proved the necessity and efficiency of using a minimally invasive endosurgical method - argon plasma coagulation as endoscopic hemostasis in ulcerous bleeding in children, and determined indications for its application; developed a diagnostic constellation chart of the likelihood of bleeding in children with peptic ulcer, prognostic and diagnostic and therapeutic algorithms, prevention program for the possible onset of peptic ulcer with bleeding in children as well as step by step patient's routine in case of suspected ulcerous bleeding in order to improve the health care at different stages.