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.

УДК: 378+37.04+614.2

В статті оговорені форми онлайн-комунікацій, що забезпечують інтерактивну взаємодію викладачів та студентів-медиків на різних етапах навчання та інформаційну роботу з матеріалами інформаційної мережі. Обґрунтовано доцільність застосування різних форм онлайн-комунікацій у період карантину та переваги й недоліки у звичайній ситуації.

The aim: To determine the significance of multidisciplinary approach to management of pediatric patients with skin symptoms of food allergy.
Materials and methods: The study included of 36 patients aged 4 to 6 years with skin manifestations of food allergy, of which 18 were randomly included in the study group and had a multidisciplinary approach to treatment and the other 18 patients constituted a comparison group and used a standard therapy regimen. Observation of children was carried out for 3 months.
Results: Assessment of the severity of the cutaneous form of food allergy by SCORAD score showed the average degree of disease activity in the groups of the study at the beginning of treatment and significantly better dynamics in patients of the study group (p=0.0055). In 88.9% (n=16) of patients in the study group and 61.1% (n=11) of the control group, the process became mild.
Conclusions: The application of a multidisciplinary approach allows the integrated implementation of medical, nutritional, and psychological aspects, which significantly increases the effectiveness of treatment and improves the quality of life of patients and their parents.

УДК: 577.27:616-056.3:613.287.5]-053.3

Introduction. Cow’s milk protein allergy is an urgent problem in pediatrics and aff ects from 0.5% to 3% of infants under one year. IgE-dependent form is present in 60% of children with cow’s milk protein allergy and occurrence of symptoms is usually observed from several minutes to several hours from the time of allergen consumption. Molecular diagnostics opens many new opportunities for diagnosing diff erent forms of allergy and prognosticating effi cacy of treatment.
Purpose. To assess the eff ectiveness of molecular diagnostics in children with cow’s milk allergy in diff erent therapeutic tactics.
Materials and methods. Inclusion criteria of the investigation: children from six month to three years old, positive skin test to milk (papule ≥3 mm with prick method) and specifi cIgE to milk ≥0.35  kUa/L in the serum, positive oral provocation test (OPT). The children  had clinical changes associated milk consumption. The research did not include patienwith anaphylaxis in anamnesis, present severe concomitant or autoimmune diseasescontraindications to OPT. All 60 patients and their parents or custodians gave written consent to participation in the investigation. Assessment of a molecular profi le was performed for detecting major components of milk (Bos d 8 – casein, Bos d 5 – β-Lactoglobulin, Bos d 4 α-lactalbumin), minor (Bos d 6 – bovine serum albumin) and cross-reactive ones with serum albumin (Fel d 2 – felis domesticus allergen 2, Can f 3 – canis familiaris allergen 3).
Results. The study cohort consisted of 60 cow’s milk allergic patients, randomized into two groups, compared based on age (p=0.88) and gender (p=0.3).
Analysis of a molecular profi le of milk components permitted to detect the highest indices in the group of major molecules: Bos d 4 (2.10 kUa/L in specifi c oral tolerance group and 2.00 kUa/L in elimination diet group), Bos d 8 (1.90 kUa/L and 1.55 kUa/L respectively) and Bos d 5 (0.85 kUa/L and 1.60 kUa/L respectively). A skin prick test papule diameter had a statistically signifi cant correlation with sIgE to milk (r=0.51) and Bos d 8 (r=0.44). Bos d 8 had a statistically signifi cant correlation with papule diameter (r=0.44), as well as with Сan f 3 (r=0.39) and Bos d 4 (r=0.28). Bos d 6 had a statistically signifi cant correlation with Fel d  2 (r=0.64) and Can f  3 (r=0.44). The obtained data confi rm that bovine serum albumin indicates cross-reactivity with animals, particularly a cat and a dog. The children were observed for three years.

Conclusions. 1.Assessment of a molecular profi le is important for diagnosis and treatment of cow’s milk protein allergy irrespective of a choice of therapeutic tactics – specifi c oral tolerance induction or elimination diet. Identifi cation of individually signifi cant food allergens makes it possible to determine individual indications and contraindications for oral provocation test and select the most appropriate treatment, in particular, specifi c oral tolerance induction as a disease-modifying immunotherapy. 2. Cow’s milk protein allergy is basically accompanied by the presence of major molecules, in particular α-lactalbumin (Bos d 4), casein (Bos d  8) and β-lactoglobulin (Bos d  5). 3.  Casein (Bos d  8) is a major thermostable component of cow’s milk protein and has a statistically signifi cant positive correlation with a papule diameter (r=0.44), Сan f 3 (r=0.39) and Bos d 4 (r=0.28). 4. Bovine serum albumin (Bos d 6) is a minor component of milk and has a statistically signifi cant positive correlation with Fel d  2 (r=0.64) and Can f  3 (r=0.44), which indicates crossreactivity with animals, particularly a cat and a dog. 

Objective: The aim: The prevalence analysis of three ways of tobacco use among young adults: traditional (smoking of cigarillos or cigars) and alternative (hookah smoking and use of E-cigarettes) as well as the development of ways of tobacco smoking prevention.

Patients and methods: Materials and methods: Cross-section anonymous survey among young adults 18-44 years of age (n=410) has been conducted. The obtained results were compared with the data of the similar studies from different countries. The statistical methods (analysis of the mean and relative values), structural and logical analysis and systemic approach.

Results: Results: Among those who were interviewed, aged 18-44 years, there are 24.15±2.11 % of respondents - hookah smokers, 9.02±1.42 % persons prefer the traditional method of tobacco use (smoking of cigarillos or cigars), while 6.34±1.20 % ones use E-cigarettes. Such forms of smoking are more common among males. The smokers of cigarillos, cigars and hookahs have appreciated their high availability when buying - 9 (7;10) points out of 10 possible. The study has found that 11.54±1.58 % of smokers of E-cigarettes and 8.08±1.35 % of hookah smokers consider them safe types of smoking and harmless to their health.

Conclusion: Conclusions: The prevention methods of smoking prevalence among young people must be based on the tougher rules of tobacco market and latest devices for smoking at the legislative level.