Infantile hypertrophic pyloric stenosis (IHPS) remains the most often cause of projectile non-bilious vomiting in infants during first month of life. IHPS typically manifests between 2 and 6 weeks of age where the pyloric channel became narrowing, resulting in gastric outlet obstruction [1, 2]. The exact etiology of IHPS remains unknown. The failure of pyloric muscle relaxation has been attributed to inadequate innervation, defect of nitric oxide metabolism [3], hyperacidity in the stomach [4], and various environmental and genetics factors [5, 6] have been implicated as risk factors for IHPS occurrence. Despite the identification of these factors, conservative therapies to reverse the muscle hypertrophy have still not been established in most European clinics and if implemented have shown poor outcomes, leaving surgical management as the only option to alleviate this pathology. The medical management is usually reserved for patients who are deemed unfit to undergo general anesthesia due to severe medical co-morbidities [1]. Extramucosal pyloromyotomy for the treatment of pyloric stenosis was first described by Ramstedt in 1912 and during many years this method remains the «gold standard» of the treatment [7]. The open approach is effective at providing excellent exposure of the pylorus but results in an abdominal scar that grows with the patient and may becomes quite significant with time. In 1991, Alain et al. described the laparoscopic approach [8] and this surgical modality gradually accepted by pediatric surgeons [2, 9]. There are still contradictory results in the literature with regard to the benefits and disadvantages of laparoscopic compared to the open procedure to treat infants with IHPS. Some authors claimed that laparoscopic pyloromyotomy associated by a shorter hospital stay, shorter postoperative recovery, and less postoperative pain [10-12], however these advantages were not confirmed [9, 13, 14]. Besides that, some authors have questioned the safety of laparoscopy because of increased frequency of surgical complications compared with open pyloromyotomy [15, 16].

Meckel diverticulum (MD) is one of the most common congenital anomalies of the small intestine [1]. MD results from an incomplete obliteration of the vitelline (omphalomesenteric) duct, which connects the midgut to the yolk sac in the fetus, usually between the fifth and sixth weeks of gestation as the bowel settles into normal anatomical position [2]. Some authors characterized MD by the rule of “twos”: frequency of 2%, 2 times more predominate in males, diagnosed most in children below of 2 years old, located within 2 feet (60 cm) of the ileocecal valve, commonly 2 cm in diam[1]eter, 2 inch (5 cm) of length, and may content of 2 types of ectopic mucosa (gastric and pancreatic) [3-6]. Being in most cases remains asymptomatic [6-8], but in some cases, MD may provoke life-threating complications, such as intestinal obstruction, intestinal bleeding, intraabdominal infection, and umbilical anomalies [4, 5, 9]. The lifetime risk for an MD[1]related complication varies from 4% to 34% [10, 11], and this risk decreases with age [12]. The clear preoperative diagnosis of MD in patients with acute abdominal pain or signs of intestinal obstruction is challenging, despite the availability of modern imaging. Due to that, the lot cases of MD diagnosed intraoperatively [13, 14]. Symptomatic MD always required its removing [7, 15], whereas in cases of incidentally discovered MD there is controversy regarding surgical resection [11, 16, 17]. Traditionally operative management of MD involves laparotomy with diverticulectomy with or without small bowel resection [15, 18]. With the advent of laparoscopic surgery, the intracorporeal diverticulectomy with the laparoscopic stappling devices or laparoscopic-assisted excision, is becoming increasingly popular [19, 20]. However, questions about what type of surgery should be chosen in children with the different types of MD still under debate. The aim of this study was summarized own experience in the management of MD in children.

Ушкодження діафрагмального нерва є нечастим, проте добре відомим ускладненням пологової травми, яке спричинюється травмуванням плечового сплетіння [14,16]. Найчастіше виявляють однобічний парез правого купола діафрагми [9], а білатеральні ушкодження трапляються рідше [1,4]. Діафрагмальний нерв  – єдиний, який забезпечує рухову активність діафрагми, а його ушкодження може зумовити розвиток паралічу або парезу діафрагми, що призводить до зниження вентиляційної здатності, дихальної недостатності, а також до необхідності в тривалій штучній вентиляції легень, особливо при білатеральному ушкодженні [1,11,12]. Лікування цих немовлят передбачає тривалу респіраторну підтримку, медикаментозне лікування та хірургічну плікацію діафрагми, найчастіше в разі однобічного ураження [14,15]. Слід зазначити, що можливе і спонтанне відновлення функції діафрагми [5,7,8], проте це потребує тривалої респіраторної підтримки. Наводимо клінічний випадок першого застосування в Україні трансторакальної імплантації стимулятора діафрагмального нерва в немовляти з білатеральним паралічем діафрагми. Метою роботи було представити нову можливість у лікуванні немовлят з білатеральним паралічем діафрагми.

Nowadays, newborns that required prolonged respiratory maintenance for different reasons are more often surviving. Increase in the number of complications is observed on the background of positive clinical effects of certain component of intensive therapy. Search for the factors, which provoke appearance of recurrent bronchial obstruction syndrome, is an important component and basis of prophylaxis.

The aim of our research was to conduct analysis of factors that provoke the development of recurrent bronchial obstruction syndrome.

To build mathematical model of bronchial obstruction development in young children with respiratory disorders in neonatal period,, the method of logistic regression was used

The results of conducted analysis enabled to detect that the presence of respiratory therapy significantly determines the risk of appearance of recurrent bronchial obstruction syndrome and suggest mathematical model of individual calculation of risk factors in this pathology. Data of conduction of mathematical analysis can be used for elaboration of a complex of rehabilitation measures concerning the development of recurrent bronchial obstruction syndrome in children, who suffered respiratory disorders in neonatal period. The highest risk of recurrent bronchial obstruction syndrome development in children born before 29 gestational week with simultaneous combination of prolonged (over 700 hours) total period of respiratory therapy.

Elaborated method of individual calculation of the risk of recurrent bronchial obstruction syndrome development in young children, who experienced respiratory disorders in neonatal period, has practical significance and can be applied in everyday clinical practice. 

The development of allergic rhinitis is considered to be caused by the complex interactions between genetic predisposition and environmental factors. Polymorphisms in the interleukin (IL)-13/4/4RA pathway have previously been shown to be associated with atopic diseases. The purpose of this study was to determine the association between IL-13 R130Q, IL-4 T589C, IL4 receptor alpha (IL-4RA) I50V, or IL-4RA Q576R polymorphisms and risk of allergic rhinitis in a hospital-based Malaysian population. A case-control pilot study was undertaken and genotyping of these polymorphisms was performed using polymerase chain reaction–restriction fragment length polymorphism on 54 allergic rhinitis patients and 45 healthy individuals. Polymorphism of IL-13 R130Q showed significant difference in genotype (p 0.048) and allele (p 0.002) frequencies in allergic rhinitis when compared with healthy controls. Individuals who were GA heterozygotes (adjusted odds ratio [ORadj] 3.567; 95% CI, 1.211–10.509), and carriers of A allele genotype (ORadj 3.686; 95% CI, 1.300 –10.451) and A allele (ORadj 3.071; 95% CI, 1.514 – 6.232) had an elevated risk of developing allergic rhinitis. The genotype and allele frequencies of IL-4 T589C, IL-4RA
I50V, and IL-4RA Q576R polymorphisms were not significantly different between the allergic rhinitis patients and normal healthy individuals and did not show an associated risk with allergic rhinitis. Our findings indicate that polymorphic variant of IL-13 R130Q appears to be associated with increased risk for development of allergic rhinitis in a hospital-based Malaysian population but not IL-4 T589C, IL-4RA I50V, and IL-4RA Q576 polymorphisms. Additional studies using larger sample size are required to confirm our findings and its exact role in allergic rhinitis.