Aim: To determine the prevalence and to estimate factors associated with food hypersensitivity in young children of the Lviv region in Ukraine.
Methods: A prospective cross-sectional survey study was conducted between 2016 and 2017 in the Lviv region of Ukraine. A specially designed questionnaire about food hypersensitivity of young children developed and validated by M. J. Flokstra-de Blok was used after translation into the Ukrainian language. The questionnaire included 34 questions, grouped into general and detailed information. Parents of children aged 0–3 years were asked to complete the questionnaire at pre-schools and medical institutions.
Results: Among 4,500 distributed questionnaires, 3,214 (71%) were completed and processed. Parents reported that 25% of their young children had food hypersensitivity. According to the survey the most common agents involved in food hypersensitivity in young children were cow’s milk (34%), egg (28%), and wheat (24%). Hypersensitivity to milk occurred in 50% of children in the age group of 1–2 years. Regional differences associated with food hypersensitivity were also found. Namely, in the Carpathians, there was more hypersensitivity to fish (27%) and honey (22%) than in other regions, while
hypersensitivity to soy was detected mostly in Lviv City residents (8.5%). Unknown causes of food hypersensitivity were highly reported (34%) in the Carpathians.
Conclusion: Prevalence and some distinctiveness of food hypersensitivity revealed in four geographic and climate zones as well as in Lviv City have a considerable practical use for formulation of recommendations for children with food hypersensitivity.

Pediatric tuberculosis is a health problem of special significance because it is a marker for current transmission of tuberculosis in society.

The research aimed at analyzing the peculiarities of detection and course of pediatric extrapulmonary tuberculosis (EPTB) taking into account the profile of drug resistance. A retrospective study of medical charts of children with EPTB (n = 47; 1st group) and pulmonary tuberculosis (PTB) (n = 49; 2nd group) aged 0-15 for 2013-2020 has been conducted. 2 subgroups with EPTB were identified separately: resistant (EPRTB) (n = 23) and sensitive (EPSTB) (n = 24).

Results and discussion. The frequency of EPTB was 9.8%. Tuberculosis of peripheral LN (40.5%), CNS (27.7%), bones and joints (23.4%) was significantly more often diagnosed, than other lesions. Almost half of children with EPTB had a miliary distribution. In 44.7% of children with EPTB contact with a patient with tuberculosis was not established. EPRTB was significantly more common among children under 1 and up to 3 years of age than EPSTB. The resistance to combination of HR (73.6%) was found more often than to HRES (10.5%), HRS, H and Z (5.3% each; p<0.01). In 73.9% of children with EPRTB was detected when seeking medical care, in 13.0% the time to diagnosing lasted 6 months. Among children with EPRTB, gradual course was more frequent and in 47.8% intoxication syndrome was dominating. 78.3% of children with EPRTB were not vaccinated.

Conclusion. The above indicates the need to intensify preventive measures against tuberculosis among children, especially at risk groups, make monitoring of contacts and their treatment.

UDC 616-002.5-053.2(477.83)

Pediatric tuberculosis (TB) is a serious infectious disease that affects many children worldwide and is more likely to be extrapulmonary than adult TB.
The purpose — to analyze the profile of drug resistance of Mycobacterium tuberculosis and clinical features of extrapulmonary resistant (EPR) TB among children from Lviv region, Ukraine.
Materials and methods. We analyzed all cases of EPR TB (n=23) and extrapulmonary sensitive (EPS) TB (n=24) among 478 medical charts of children, who were hospitalized in the Lviv Anti-TB hospital during 2013–2020.
Results. It was found out that EPR TB was diagnosed significantly more often at the age of 1 year and up to 3 years old than EPS TB and significantly less often — among children aged 4–7 years. The children with EPR TB were significantly more likely to live in rural areas and they were significantly more likely to be from families with less than 2 children, compared to EPS TB. The children with EPR TB were more often diagnosed with meningeal and central nervous system (CNS) TB, less often — with TB of the bones and joints, only they had TB of the intestine, compared to EPS TB. Miliary pulmonary TB and the predominance of bilateral process were more common at EPR TB. Among children with EPR TB, rifampicin-resistant TB was significantly more common found than the risk of multidrug-resistant TB (MDR-TB) and monoresistant TB. The resistance profile of MDR-TB showed that 17.4% are resistant to the combination of HR (H-isoniazid, R-rifampicin), 8.6% - to HRES (E-ethambutol, S-streptomycin), 4.3% – to НRS. Among 43.5% of children with EPR TB the contact with a TB patient was not established. At the same time, only a third of children who had came into contact with bacterial exсretors were under dispensary observation and only about 9% received chemoprophylaxis.
Conclusions. In order to prevent the development of EPR TB, it is necessary to improve TB prevention measures among the most vulnerable segments of the population.

In etiopathogenetic terms, premature birth is considered as a clinical syndrome characterized by polyetiological factors, the participation of the fetus in pathogenesis, a variety of clinical symptoms, and the involvement of genetic and environmental factors. At the same time, there is increasing evidence that the composition of a woman’s vaginal microbiota significantly affects her sexual and reproductive health, including the risk of adverse pregnancy outcomes, including miscarriage and preterm birth. The purpose of the work was to assess the state of the vaginal microbiota in women with risk factors and the threat of spontaneous premature birth. 150 women of reproductive age took part in the study. The inclusion criteria for the study were the presence of risk factors for preterm birth or the threat of preterm birth. Determination of the pH of vaginal contents, molecular biological, and bacterioscopic methods were used to assess the state of the vaginal microbiota.

The conducted studies indicate a high risk of preterm birth in the presence of dysbiotic and inflammatory changes in the vaginal microbiota - odds ratio (OR) = 2.962 (95% CI 1.32-6.645). At the same time, for pregnant women with risk factors for preterm birth, OR makes up = 8.120 (95% CI 2.149-30.686), and for pregnant women with diagnosed threatened preterm birth - OR = 10.133 (95% CI 3.149-32.604). Thus, one of the risk factors for the development of spontaneous premature and threatened premature births is changes in the state of the vaginal microbiota, which requires the development of diagnostic and therapeutic measures to prevent premature termination of pregnancy and reduce the frequency of obstetric and perinatal complications.

616.34-018-002-003.235:577.112]-078.73-079.4-053.32

Захворюваність, пов’язана з незрілістю травного каналу, є однією з найважливіших причин смертності передчасно народжених дітей з дуже малою масою тіла при народженні (< 1500 г). Надмірна запальна відповідь у поєднанні з недостатнім місцевим захистом, підвищеною проникністю слизової оболонки травного каналу, зниженою моторною функцією, недостатнім кровопостачанням кишок, а також ентеральним харчуванням  передчасно народжених немовлят у відділеннях інтенсивної терапії новонароджених (ВІТН) пов’язана з виникненням некротизуючого ентероколіту (НЕК) [1,2]. Ці чинники також можуть відігравати певну роль в патогенезі інших захворювань, насамперед, сепсису внаслідок ураження слизової оболонки кишок і потрапляння мікроорганізмів у кров’яне русло [3].

Фекальний кальпротектин (ФК) – це білок, який складає до 60% розчинного білка в нейтрофілах людини. Його також знаходять в моноцитах, макрофагах й епітеліальних клітинах [10]. ФК вивільняється під час запального процесу в травному каналі і в результаті трансепітеліальної міграції мієлоїдних клітин легко виявляється в калі. Завдяки наявності кальцію структура кальпротектину є дуже стабільною. Стабільна форма білка може зберігатись в калі до 7 діб [11]. Концентрація кальпротектину в калі відображає інтенсивність міграції нейтрофілів у стінку кишки, та, відповідно, безпосередньо корелює з тяжкістю запального процесу в тонкому кишечнику. Враховуючи патогенез НЕК та ПНС, ФК може бути потенційним маркером цих захворювань, оскільки може вказувати на наявність субклінічного запального процесу [12].

Лактоферин (ЛФ) – це поліфункціональний залізозв’язувальний глікопротеїн, який в найбільшій кількості міститься у грудному молоці та відіграє ключову роль у природженому імунітеті [13]. Окрім противірусних та бактерицидних властивостей ЛФ здатний запобігати виникненню надмірної запальної відповіді [14], а також стимулювати процеси проліферації та диференціації епітелію тонкої кишки, що у свою чергу впливає на її масу і довжину, а також продукцію у ній травних ферментів [15,16]. Ентеральне застосування ЛФ є одним з потенційних засобів модуляції постнатальної адаптації травного каналу та профілактики захворювань, пов’язаних з незрілістю травного каналу у передчасно народжених немовлят. 

Метою даного дослідження було оцінити зв’язок між рівнями ФК, ентеральним застосуванням ЛФ і виникненням НЕК і сепсису у передчасно народжених немовлят. 

Morbidity associated with an immature digestive tract is one of the most important causes of mortality in very low birth weight (BW) <1500 g infants. Excessive inflammation in combination with insufficient local immunity, increased permeability of the intestinal mucous membrane, reduced motor function
 as well as enteral nutrition of preterm infants in neonatal intensive care units (NICU) are associated with the occurrence of necrotizing enterocolitis (NEC). These factors can also play a critical role in the pathogenesis of other diseases, primarily sepsis, due to damage to the mucous membrane of the intestines and the subsequent entry of microorganisms into the bloodstream [17].
Fecal calprotectin (FC) is a protein that makes up to 60% of the soluble protein in human neutrophils, it is also found in monocytes, macrophages
and epithelial cells [28]. FC is released during the inflammatory process in the digestive tract and is easily detected in feces. Due to the presence of calcium, the structure of calprotectin can remain stable in feces for up to 7 days.  The FC concentration  in feces directly correlates with the severity of the inflammation in the intestine.  Considering the pathogenesis of NEC and neonatal sepsis, FC can be a potential marker of these diseases, as it can indicate the presence of a subclinical inflammatory process. 
   Lactoferrin (LF) is a multifunctional iron-binding glycoprotein, which is found in the largest amount in breast milk and plays a key role in innate immunity [26]. In addition to antiviral and bactericidal properties, LF can prevent the occurrence  of an excessive inflammatory response, stimulate the proliferation and differentiation processes of the epithelium of the small intestine, which affects its weight and length, as well as the production of digestive enzymes [12,13]. Enteral use of LF is one of the potential means of modulating postnatal adaptation of the digestive tract and
prevention of diseases associated with its immaturity in preterm infants.
Purpose of this study — to evaluate the associations between FC levels, enteral LF administration, and the occurrence of NEC and sepsis
in preterm infants.