Молоко матері є оптимальним продуктом харчування немовлят. Воно характеризується не лише унікальним збалансованим складом нутрієнтів, а і незамінними біологічними властивостями, що особливо важливо для передчасно народжених дітей. Якщо материнського молока немає або його кількість недостатня для задоволення харчових потреб дитини, замість нього рекомендується використовувати донорське молоко. Однак донорське молоко, як правило, отримують від жінок, які народили своїх дітей в термін (доношеними), а тому воно переважно містить недостатньо білка для сприяння належному росту передчасно народжених немовлят. Незалежно від того, використовується донорське або власне молоко матері, його збагачення необхідне для задоволення потреб у харчових речовинах передчасно народжених немовлят, які мають високий ризик затримки постнатального фізичного розвитку під час перебування в лікарні. Існує декілька стратегій і продуктів, які можна використовувати для підтримки бажаних темпів росту передчасно народженої дитини. Стандартне збагачення грудного молока (ГМ), яке наразі найчастіше використовують у відділеннях інтенсивної терапії новонароджених, може не забезпечувати підвищених потреб у білках у значної частини немовлят з дуже малою масою тіла при народженні. Натомість, індивідуалізоване збагачення може оптимізувати споживання поживних речовин. Індивідуалізувати харчове забезпечення можливо за допомогою регульованого або цільового збагачення ГМ. Важливими також є якість і походження комерційних збагачувачів ГМ. Для реалізації індивідуалізованого підходу до збагачення ГМ може бути корисним використання відповідних аналізаторів. Водночас, клінічні переваги окремих підходів до збагачення ГМ, так само, як і використання різних комерційних збагачувачів, здебільшого залишаються невідомими. У цьому огляді представлені результати найважливіших досліджень, які впливають на клінічну практику, а також описані сучасні підходи до збагачення грудного молока (ГМ) з відповідними практичними рекомендаціями.

Mother’s own milk is the optimal food for infants. It is characterized not only by a unique balanced composition of nutrients, but also by essential biological properties, which is especially important for preterm infants. If there is no mother’s milk or it is amount is not enough to meet daily needs, it is recommended to use donor human milk (HM) instead. However, donor HM is commonly obtained from the women who delivered at term and often does not contain enough protein to promote proper growth of preterm infants. Whether donor milk or the mother’s own milk, human milk fortifi cation is essential to meet the nutrient needs for growth and development of these preterm infants, who are at high risk of growth retardation during hospital stay. There are several strategies and commercially available HM fortifi ers that can be used to maintain the desired growth rate. Standard HM fortifi cation, which is currently most commonly used in neonatal intensive care units, may not meet the increased protein needs of a signifi cant proportion of very low birth weight infants. Instead, individualized fortifi cation can optimize nutrient intake. It is possible to individualize the food supply with the help of regu-lated or targeted HM fortifi cation. The quality and origin of commercially available HM fortifi ers are also important. To implement an individualized approach to the fortifi cation of HM, the use of milk analyzers can be useful. However, the clinical benefi ts of individual approaches to breast milk fortifi cation and the use of diff erent commercially available HM fortifi ers remain largely unknown. This review presents the results of the most important studies that infl uence clinical practice and describes current approaches to HM fortifi cation with relevant practical recommendations

Background. The spread of post-traumatic stress disorder (PTSD) and overcoming its consequences, including immune-related disorders, is one of the critical issues requiring extensive study and resolution in practical medicine, particularly under present conditions in Ukraine.

Materials and methods. The study group consisted of 79 (27.5%) patients with verified PTSD: 46 (58.2%) female and 33 (41.8%) male, with an average age of 38.7±7.2 years; a control group of 20 apparently healthy people was used. The National Institute of Mental Health (NIMH) American National Center for PTSD (2013) questionnaire was used to verify PTSD. In addition, history taking, clinical examination, general and biochemical laboratory tests, and statistical analysis were performed.

Results. All patients with PTSD experienced clinical disorders and changes in laboratory indicators, with a probable increase in absolute and relative values of neutrophils and mononuclear cells, an increase in the levels of acute phase proteins, and activation of transaminases. In addition, these patients were characterized as immunocompromised patients with the potential to study immunological disorders.

Conclusions. The results of the review of the scientific literature and the clinical and paraclinical manifestations that we found in patients with PTSD indicate the role of immune mechanisms in the development of this syndrome and necessitate expanding diagnostic measures among such patients with the different pathogenetic approach of their management.

The paper reports a systematic assessment of the radiation-hard Hall probes (RHP) magnetic diagnostic system of the JET tokamak, which is based on InSb semiconductor thin films, and describes the path that lead to the proposal of an innovative magnetic probe concept. A relevant account of RHP operation during the recent deuterium–tritium experimental campaign is also provided, showing correct operation under ITER-like intense neutron flux. The period considered for the systematic assessment of the RHP system ranges from October 2009 to March 2021, during which the machine produced more than 19 000 pulses. The RHP system consists of six three-dimensional Hall probes, which have built-in recalibration capability, thanks to the presence of microsolenoids that produce a local known field during a tailored automatic pre-pulse calibration sequence, that can also be initiated manually. During pulses, the microsolenoids can also be used as inductive sensors as their signals are recorded as well. Moreover, the system provides temperature measurements at the location of the probes, which are continuously recorded too. The assessment demonstrates accurate long-term operation of the RHP system. All the diagnostic channels reliably provide pre-pulse calibration data and pulse signals and the original sensitivities of the Hall sensors are preserved.  Integration considerations and a data fusion analysis lead to the proposal of a high performance, compact, broadband, hybrid field probe, consisting of the combination of an inductive coil and a Hall sensor, to be manufactured by means of the coil technology developed for ITER or an alternative concept with improved radiation-hardness. The hybrid probe is expected to deliver the advantages of both inductive and Hall sensing technologies, essentially in the same package size of a single ITER magnetic discrete probe. In particular, it would solve the problem of the drift of the integrator for long lasting burning plasma discharges. The signals produced by the coil and the Hall sensor, processed by means of a Luenberger–Kalman observer, provide a magnetic field measurement which is non-drifting and low-noise. For these reasons, the hybrid probe has been proposed as the potential primary magnetic diagnostic sensor for future burning plasma experiments and demonstration fusion power plants.

BACKGROUND: Beta (β)-lactam antibiotics (BLAs) are the first-line therapy for non-nosocomial and nosocomial bacterial infections and are
most commonly reported to cause allergic reactions. Approximately 50% of all allergic patients in Europe and the USA suffer from drug
allergies and BLA allergies. The AIM of the study was to assess cross-reactivity reactions between 2nd and 3rd generation cephalosporins in patients with a medical history of BLA reactions and the risk of adverse reactions to BLAs based on the results of the basophil activation test.
MATERIALS AND METHODS: we examined 48 females and 8 males (in all 56 patients) aged 26 to 61 with primary reactions to BLAs and
24 healthy volunteers (control group). 19 (34%) patients were treated with amoxicillin, 18 (32,1%) patients were receiving amoxicillin+clavulanic acid, 6 (10,7%) patients were treated with cefuroxime, and 13 (23,2%) patients with ceftriaxone. Quantitative determination of the CD63 marker of basophil degranulation upon antigen stimulation in whole blood was performed with the use of Flow CAST (FK-CCR) (Bühlmann Laboratories AG, Switzerland). Based on the obtained ВАТresults, the patients were divided into two subgroups: the first group included 33 patients with positive stimulation index but lower CD63 expression (<10%), and the second group included 15 patients with a significantly higher level of CD63 expression (>10 %).
THE RESULT: We showed that patients from the second subgroup had the highest level of CD63 expression and stimulation index when
amoxicillin, whereas the level of CD63 expression and stimulation index were lower whith ceftriaxone; at the same time, the level of CD63 expression and stimulation index were the lowest with cefuroxime. The patients who treated with and reacted to amoxicillin, as shown by high
BAT, also had high CD63 expresiion after ceftriaxone and cefuroxime stimulation. In the first subgroup, urticarial and bronchospasm disappeared within 3 hours of the onset of symptoms in 51.5% of patients, the symptoms persisted for 2-3 days in 42.4% of patients with urticaria and angioedema, whereas maculopapular exanthema persisted for more than a week in 6.1% of the patients. Patients from the first subgroup (with low CD63 expression) had a weak reaction to the culprit antibiotic. Patients from the second subgroup had the strongest reaction to culprit antibiotics: anaphylaxis – 60.0%; Stevens-Johnson syndrome – 6.7%. We established that in patients with hypersensitivity to antibiotics the higher the baseline test scores after in vitro stimulation, the more severe clinical symptoms.
CONCLUSION: for patients with clinical manifestations of BLA in case of conflicting anamnesis data, it is recommended to establish true sensitization to antibiotics and to predict the occurrence of cross-reactions

The article provides a brief description of the heroic work of Ukrainian physicians- volunteers, including allergists, during Russia' s brutal war against Ukraine. Examples of the evacuation of Ukrainian residents, including patients with bronchial asthma, respiratory allergies, COVID-19 and other diseases that worsened under the influence of stress, are given. It briefly described the destroyed hospitals throughout the territory of Ukraine. In such a critical situation, Ukrainian doctors continue to provide assistance to patients, improve their scientific level, each in his place does everything to Victory. The light will defeat the darkness!