Measurement of nitric oxide and assessment of airway diseases in children: an update

Prevalence and Regional Factors in the Development and Course of Allergic Diseases in Children in Southern Kyrgyzstan

Background: The prevalence of allergic diseases in children worldwide has increased rapidly over the past 30 years. This study aimed to identify regional factors influencing the development and course of allergic diseases for further prevention, control, and reduction of the risk and frequency of complications. Methods: To investigate the issue, 104 studies by different authors and countries, as well as topics related to allergy in children, air pollution, and regional factors of detection and prevalence of this disease in Kyrgyzstan, were selected. Of these, 52 studies were noted and analysed, which met the selection criteria and were of direct importance in this topic. Results: This study of allergic diseases in children found that more than 35% of children worldwide suffer from allergic diseases. Of these, allergic rhinitis occurs in 12% of children, atopic dermatitis is less common, but its incidence is 10-20%, and bronchial asthma, according to statistics, covers more than 14% of children. Conclusion: The results of the study helped to investigate the prevalence of allergic diseases relative to the region of residence, the impact of environmental pollution, geographical significance, and the effect of smoking on the development of allergies in children.

The Inner World and Formation of the Paranoid Personality Type in Persons with Intellectual Disabilities

This study investigates the progression of paranoid personality disorder (PPD) and its influence on social interactions. Contemporary research indicates that genetic predispositions and extrinsic variables, such as crisis events, play a role in the development of PPD. Individuals with PPD frequently struggle to form enduring social relationships as a result of their prevailing negative thoughts, hostility, and unwillingness to compromise. The study emphasizes the need for prompt psychological support in overcoming stereotyped cognition and diminishing social seclusion among individuals with personality disorders. The study employs a theoretical and methodological framework that integrates analytical research methodologies and content analysis of psychotherapy interventions for individuals with neuropsychiatric conditions. The findings uncover challenges about psychological adjustment, emotional control, and interpersonal communication abilities among patients with PPD. This article also presents contemporary psychotherapy approaches that aid in recovering mental well-being. Furthermore, a pragmatic framework for the diagnosis and treatment of PPD in psychotherapy has been created. The findings collected in this study hold great importance for professionals in the fields of education and social work, as well as practical value for psychologists and psychotherapists who offer support to those at risk of developing neuropsychiatric illnesses.

Factors in preventing violence in schools

Relevance. It becomes important to search for factors and determine their role in the organization of a favourable educational environment in schools in Kosovo, to develop a methodology that contributes to the prevention of violence among schoolchildren based on mutual help and mutual respect. Purpose. The purpose of the article is to substantiate the factors that can influence the eradication of bullying, mobbing and cyberbullying in the school environment of Kosovo. Methodology. The methodological approach of the research is based on theoretical methods (comparative analysis, synthesis and generalization of theoretical data); empirical (questionnaires, testing, observations, surveys, heuristic conversation, dialogue, discussion, psychological and pedagogical trainings, seminars, debates); diagnostic (pedagogical observation and pedagogical experiment (diagnostic, formative, control). Results. In the course of an experimental study conducted at the stage of ascertainment among students of 6-9 grades in Lower Secondary School No. 1, Lower Secondary School No. 2, Lower Secondary School No. 3, problems of violence between schoolchildren in classes were identified, and methods of creating a favourable educational environment to prevent bullying were outlined. A methodological toolkit was developed to improve the educational environment, which will contribute to the eradication of bullying among students of 6-9 grades. In particular, four elements of creating a favourable educational environment were highlighted: creating a favourable psychological climate, updating the content of education and learning technologies; favourable about food environment; providing opportunities for development. The outlined levels were assessed at high (5 points), medium (4 points) and low (1-3 points) levels. Conclusions. After conducting an experimental study, promising directions for improving the favourable educational environment in schools in Kosovo were formed. The practical value of the work lies in the development of methods of organization and implementation of a favourable educational environment in schools in Kosovo, which contributes to the eradication of bullying among students.

Markers of eosinophilic airway inflammation in patients with asthma and allergic rhinitis

Background: Measurement of airway inflammation is an important step to determine phenotype of asthma and allergic rhinitis (AR). Objective: To assess the level of nitric oxide in exhaled air (FeNO), nasal fraction of nitric oxide (nasal NO), their relationship with clinical control and blood eosinophils in patients with steroid-naive mild and moderate asthma and AR. Methods: One hundred forty-seven patients (65 men), ages 26-49.5 years (mean age, 32 years) with AR (n = 81) or AR and concomitant asthma (n = 46) and 20 healthy subjects were included in a single-center cohort study. All the patients underwent spirometry with reversibility test. Control of asthma and AR was assessed by using the Asthma Control Questionnaire and the visual analog scale, respectively. Levels of FeNO and nasal NO were measured by chemiluminescent analyzer, peripheral blood eosinophils were counted by automatic analyzer. Results: The FeNO level was significantly elevated in the patients with asthma and concomitant AR compared with the healthy subjects and was associated with control of both asthma and AR. There was no correlation between nasal NO and control of AR. Receiver operating characteristic analysis revealed that the level of eosinophils of 150 cells/μL may be a cutoff for lower airway eosinophilic inflammation. Blood eosinophils count was unable to distinguish eosinophilic and non-eosinophilic upper airway inflammation. Conclusion: We confirm that FeNO but not nasal NO is a marker of eosinophilic airway inflammation in patients with mild-moderate steroid-naive AR and concomitant asthma. A blood eosinophil level of ≥150 cells/µL may be a simple marker of eosinophilic airway inflammation in patients with asthma. However, its low specificity requires repeated measurements and use in combination with other biomarkers.

Nasal Nitric Oxide in Children: A Review of Current Outreach in Pediatric Respiratory Medicine

Nasal nitric oxide (nNO) is a gas synthesized by the inducible and constitutive NO synthase (NOS) enzyme in the airway cells of the nasal mucosa. Like lung nitric oxide, it is thought to be associated with airway inflammation in various respiratory diseases in children. The aim of our review was to investigate the current state of use of nNO measurement in children. A comprehensive search was conducted using the Web of Science and PubMed databases specifically targeting publications in the English language, with the following keywords: nasal NO, children, allergic rhinitis, chronic rhinosinusitis, acute rhinosinusitis, primary ciliary dyskinesia (PCD), and cystic fibrosis (CF). We describe the use of nNO in pediatric allergic rhinitis, chronic rhinosinusitis, acute rhinosinusitis, PCD, and CF based on the latest literature. nNO is a noninvasive, clinically applicable test for use in pediatric allergic rhinitis, chronic rhinosinusitis, acute rhinosinusitis, PCD, and CF. It can be used as a complementary method in the diagnosis of these respiratory diseases and as a monitoring method for the treatment of allergic rhinitis and acute and chronic rhinosinusitis.

Nasal microbiome in chronic rhinosinusitis

Chronic rhinosinusitis (CRS) is defined as an inflammatory disorder of the paranasal sinuses and of the nasal mucosa that lasts 12 weeks or longer. In CRS microbes contribute to the disease pathogenesis. Clinical microbiology is focused on finding single pathogens that causes the disease and the main goal is the use of antibiotics to kill bacteria. Efforts to achieve a better understanding of CRS include the study of the sinus microbiome, and to evaluate the ability of probiotics to augment homeostasis and modulate the immune response of the host mucosa. This review provides an update on the role of the microbiome in CRS. The study was conducted using two databases: PubMed and Science Direct. We searched for articles in English that matched the review topic. We first used the abstracts of articles to assess whether they met the inclusion criteria. We also reviewed the references of the selected articles and read those with titles that might be of interest. Several studies have shown that endogenous microbiome dysbiosis can impact mucosa health and disease severity. Some bacterial species presenting protective or pathogenic effect. Antimicrobial agents can create a similar disruption and impact the nasal microbiome balance. On the other hand, probiotics offers a promising avenue for developing systemic and topical therapies geared towards strategic manipulation of the biological host load, thereby augmenting immune homeostasis. A better comprehension of sinus-nasal microbiome in healthy and in CRS patients and the link with different CRS phenotype can help in developing new prognostics, diagnostics, and therapeutics strategies. Going forward, the use of probiotics can restore the native sinus ecology with significant therapeutic and preventive implications.

Effects of secondary infections on the multidrug-resistant Tuberculosis: A cohort study

Background: Tuberculosis (TB) causes over a million deaths annually and is still one of the most important public health problems worldwide. According to the World Health Organization estimates, the highest rates of TB in the European Region are in Tajikistan, Kazakhstan, Moldova, Kyrgyzstan, Romania, and Uzbekistan. The purpose of this study was to investigate the spectrum of nonspecific microorganisms isolated in patients with multidrug-resistant TB in Central Kazakhstan and to assess their susceptibility to antimicrobial drugs.

Methods: The patients were divided into 2 groups: group 1 with multidrug-resistant forms of pulmonary TB (n = 107 patients); group 2 with sensitive forms of pulmonary TB (n = 122 patients). Gender, age, and social status of the patients were studied. Microorganisms were identified using the MALDI-TOF method. The statistical significance of different values for binary and nominal parameters was determined using the chi-square test. Changes in binary variables were analyzed using the McNeimer test.

Results: During the study, an expectedly high proportion of tetracycline-resistant pneumococcal strains (66.7% and 60%, respectively) was isolated, which was a consequence of a long-term and practically uncontrolled use of these drugs in Kazakhstan. Fluoroquinolones showed low activity. The results showed that beta-lactam antibacterial drugs maintained their high activity against the causative agents of pneumococcal infection.

Conclusion: It was concluded that secondary microorganisms isolated in patients with multidrug-resistant TB were represented by the strains that were resistant to modern antibacterial drugs. Therefore, for appropriate antibiotic prescription, it is necessary to study materials from the respiratory system in all patients admitted for TB treatment to study the spectrum of nonspecific microorganisms and assess their susceptibility to antimicrobial drugs.

Nasal Nitric Oxide and Nasal Cytology as Predictive Markers of Short-Term Sublingual Allergen-Specific Immunotherapy Efficacy in Children with Allergic Rhinitis

BACKGROUND

Few studies have been conducted on the short-term response to sublingual immunotherapy (SLIT).

OBJECTIVE

The purpose of our experimental trial was to evaluate if two markers such as nasal nitric oxide (nNO) and nasal cytology could be useful to identify a precocious clinical efficacy of SLIT treatment.

METHODS

We enrolled 34 children aged 6 to 14 years old with diagnosis of allergic rhinitis (AR) and documented sensitization towards house dust mites. We started allergoid-monomeric tablets immunotherapy along with any conventional therapy for AR and we evaluated at baseline (T0), after one (T1), two (T2), three (T3), and six months (T6) the effects of the treatment through the study of: i) a visual analogue scale (VAS 1-10); ii) measurement of nNO; iii) measurement of FeNO; iv) nasal cytology; v) spirometry; and vi) evaluation of any conventional therapy.

RESULTS

We observed an improvement in symptoms evaluated by global VAS (T0 vs. T6: 47.13 vs. 17.57; p < .05) and a statistically significant reduction of nNO (1035.2 ± 956.08 vs. 139.2 ± 59.01; p < .05). In this case, significance was reached when the patients completed the 6 months of treatment. Cytological evaluation revealed significant reduction in nasal eosinophils (T0 vs. T6: 87% vs. 16%; p < .01). Moreover, at T0, 56% of patients had also neutrophils that were reduced up to the 8% at T6 (p < .05).

CONCLUSIONS

Our data confirm the effectiveness of SLIT treatment from a clinical perspective and identifies two biomarkers, such as nNO and nasal cytology, as predictive of treatment efficacy in the short term.

Single Vibroacoustic Impact Effect of Singing Bowls over the Psycho-Emotional State and Cardiovascular System Work

This article presents a two-stage study result of the author's method of vibroacoustic massage using singing bowls application. At the first stage, the effect of vibroacoustic massage single application over psycho-emotional characteristics was studied. 19 studied volunteers took part in our study. The testing results before and after exposures were compared according to the WAM (Weighted average mark), Zung, and Spielberg-Khanin tests. The study of the psycho-emotional sphere showed that after the vibroacoustic massage procedure, the indicators of "well-being" and "activity" of the WAM test significantly improved (p = 0.002). In addition, the depression level determined by the Zung test, personal anxiety indicators (p = 0.004), and situational anxiety ones (p = 0.028) decreased. At the second stage, 62 volunteers were divided into two groups. The first group underwent a vibroacoustic massage session according to the patented author's method. The second group received only acoustic exposure using only singing bowls. Differences in the Kerdo index were revealed in the dynamics, and in the first group, the changes were less significant than in the second one. Changes in heart rate variability characteristics for both groups were similar: there was an increase in parasympathetic influences at rest and during the orthostatic test (increased levels of RMSSD (Root Mean Square of Successive Differences), NN50, pNN50) and a decrease in sympathetic effects at rest and their slight increase with orthostatic loading (TINN, RR triangular index). The dynamics were more significant in the first group that received a vibroacoustic massage session. When assessing changes in the neurovegetative regulation levels activity of the heart rhythm, the main difference was associated with very low-frequency waves power dynamics during the orthostatic test. Thus, vibroacoustic massage using singing bowls improves the psycho-emotional state, reduces depression and anxiety, and increases Parasympaticus (autonomic nervous system) activity.

Emotional Intelligence and Burnout of Teachers of Higher Education Institutions

Emotional intelligence is an important resource for overcoming professional stress in members of socionomic professions. The research objective is to determine the role of its components in the development of emotional burnout. A natural experiment was conducted, which determined the manifestations of emotional burnout of 56 university teachers at the end of the academic year. The author used the questionnaire. Two experimental groups were identified in the general sample: teachers with burnout and those resistant to burnout (16 and 30 people, respectively). At the end of the academic year, signs of burnout were detected in one-third of university teachers. The leading symptoms are emotional exhaustion and depersonalisation, with no reduction in professional achievement. The dynamics of emotional life during the annual professional cycle are shown. The integrated indicator of emotional intelligence (EI) remains at the same level, but there are structural changes in the components of intrapersonal intelligence. At the end of the year, teachers' attention to their emotional states, work roles, and communication increase significantly. At the same time, there is a decrease in the ability to manage their own emotions. Resistance to burnout is accompanied by a high ability to realise and control their own emotions with a relatively vague focus on the emotional states of others. It was concluded that individual components of EI (intrapersonal and interpersonal, understanding and management) have different effects on burnout symptoms.

Cooperation with Parents on Environmental Education of Preschool Children with Speech Disorders

This article presents a comprehensive pedagogical technology for correctional and developmental work with parents and their preschool children with speech disorders. The purpose of this article is also to consider the change in parents' attitude to the environmental education of a child with speech disorders. The project is designed to involve parents and increase their interest in the environmental education of preschoolers with speech disorders. It is investigated to what extent the involvement of parents and teachers in joint research projects increases competencies in terms of knowledge, abilities, and attitudes to educational processes. The article uses several methods of synthesis and analysis in research. The descriptive method and the experimental method were also used. The hypothesis is that using a comprehensive program involving parents for research and experimental activities in environmental education of preschool children with speech disorders promotes the more successful acquisition of knowledge about nature, improves therapy, and strengthens family relationships. In technology, attention is paid to the actual educational activities and the reflection of teachers' and parents' internal structures of competencies. The presented technology systematizes the instrumental-methodical, expressive (behavioral) aspects of teaching and raising a child with speech disorders and provides a universal basis for any intervention program to change attitudes and involve parents in educational work.

Fundamentals and Main Provisions of the Functional-Procedural Concept of Mental Deprivation

Science still does not have a single scientifically sound concept of mental deprivation, which would explain its psychological essence, this mental phenomenon cannot be adequately assessed, or measures to prevent or eliminate negative mental phenomena it provoked cannot be developed. The article aims to reveal the basic principles and substantiate the main provisions of the functional-procedural concept of mental deprivation. Psycho-energetic and energy-psycho-functional approaches were used, as well as methods of analysis, synthesis, abstraction, specification, comparison, generalisation, and grouping of knowledge about the human psyche. The functional-procedural concept of mental deprivation of humans covers an interconnected system of provisions. According to them, mental deprivation is a course of more or less powerful destructive processes in the functioning of his psyche. Such processes arose from the destruction of mental parameters in various areas due to long-term unfulfilling necessary for normal functioning and development. The development of a functional-procedural concept of mental deprivation of a human will make it possible, first, to adequately define its essence and content in the scientific dimension as a phenomenon of the psyche; secondly, to assess its impact on the functioning of the whole psyche; third, to disclose the impact on development or its delay, actions, behaviour, and activities of an individual; fourth, to develop psychotherapeutic measures to prevent the occurrence of mental deprivation and eliminate its negative consequences.

Formation Mechanisms of Emotional Intelligence of a Future Psychologist in the Context of Vocational Education

Objective: Emotional intelligence is an indicator of a person's ability to communicate, the ability to be aware of their emotions and understand the feelings of others. Background: The development of the emotional intelligence of junior university students occurs through various activities, especially in the process of specially organised training and education. This work aims to study the mechanisms of formation of emotional intelligence and stages of formation of emotional intelligence in psychology  students. Method: Data analysis, synthesis and pedagogical modelling were used. Scientific works on the formation of emotional intelligence were studied. Results: This paper presents a model of the formation of emotional intelligence in students of psychology and practical recommendations for the formation of emotional intelligence in students. Conclusion: The results obtained in this work can be used in practice during the training of psychological and pedagogical faculties students. Also, the materials presented in this paper can be used by teachers of psychology and pedagogy.

Correlations between exhaled nitric oxide, rs28364072 polymorphism of FCER2 gene, asthma control, and inhaled corticosteroid responsiveness in children with asthma

In children with asthma, the responsiveness of inhaled corticosteroids (ICS) is depended on asthma endotype and phenotype. This study aimed to describe the clinical and biological characteristics, and its correlation with polymorphism of rs28364072 in FCER2 of asthmatic children. This work aimed to study the correlation between fractional concentration of exhaled nitric oxide (FE_NO) level and rs28364072 polymorphism of FCER2 gene with ICS responsiveness and disease control in children with asthma. This study was a prospective and descriptive study. All clinical characteristics, FE_NO, blood eosinophil counts (BEC), skin prick test (SPT), total IgE, asthma control test, and FCER2 gene polymorphism were performed for each patient. One hundred and seven asthmatic children who were over 5 years old (9.2 ± 2.6), were included. Patients with FE_NO > 20 ppb had higher percentage of positive SPT, total IgE level, and BEC (89.2 vs 80.0%, 851.1 vs 656.9 UI ml^-1, and 785 ± 576 G L^-1 vs 425 ± 364 G L^-1; respectively). Among them, there were 54.2% of homozygous TT, 36.4% of heterozygous TC, and 9.4% of homozygous CC of rs28364072 polymorphism in FCER2. The percentage of patients with controlled asthma was increasing after 1 month and 3 months (47.1% and 58.8%; respectively). During the study, the ICS was decreasing as indicated by asthma control (348 ± 118 mcg at 1st month vs 329 ± 119 mcg at 3rd month; p < 0.05). CC genotype had the lowest level of increasing FEV1 compared to that in genotype TC and TT (8.4% vs 8.7% and 27.1%; p > 0.05 and p < 0.05; respectively). The percentage of polymorphism in rs28364072 of FCER2 was significant higher in patients with controlled asthma compared to uncontrolled asthma. Asthmatic children with high FE_NO and rs28364072 polymorphism in FCER2 gene are good responders to ICS; however, asthmatic children with homozygous variant CC of rs28364072 are poorly responsive to ICS.

TRIM59 suppresses NO production by promoting the binding of PIAS1 and STAT1 in macrophages

Macrophages, which can secret various inflammation mediators, have an essential role in tumor growth and metastasis. However, the mechanism(s) to regulate the production of inflammation mediator is not completely clear. Here we found that TRIM 59 could inhibit the production of NO and the expression of inducible nitric oxide synthase (iNOS), cytochrome c oxidase subunit2 (COX2) and TNFα. TRIM59 mediated suppression on nitric oxide (NO) production is through inhibiting the activation of JAK2-STAT1 signal pathway. In response to LPS, TRIM59 in macrophages was translocated from cytoplasm to nucleus and directly bound with STAT1. During this process, TRIM59 could recruit much more PIAS1 to bind with STAT1 to suppress the activation of STAT1. Finally, TRIM59 modified macrophages could promote tumor growth. Thus, TRIM59 mediated suppression on NO production by promoting the binding of PIAS1 and STAT1 in macrophages may regulate tumor growth.

Severe uncontrolled asthma in children: practical approach on diagnosis and management

Severe uncontrolled asthma in children is a complex and heterogeneous disease and is considered a challenge for the pediatricians. Although nearly 5% of children with asthma present with a severe uncontrolled disease, these patients and their caregivers face a significant burden, including troublesome persistent symptoms, life-threatening acute attacks, medication side effects, impaired school performance, neuropsychological problems, and lower quality of life (QoL). Moreover, these patients also account for substantially higher healthcare resource use and costs than average patients with asthma. Thus, it is essential to accurately define and diagnose severe asthma in children as they potentially need close monitoring and additional treatment with advanced therapies. This review aims to update knowledge on diagnosis and management of severe uncontrolled asthma in childhood. We describe a practical approach to differentiate children with difficult-to-treat asthma from those with true severe therapy-resistant asthma. Moreover, the recent advances in the understanding of the pathogenetic mechanisms and inflammatory mediators involved in asthma have paved the way for the development of a precision medicine approach. In this context, we analyze approved personalized therapies for severe uncontrolled asthma, focusing on the pediatric indications.