The purpose of this study is to substantiate the choice and evaluate the efectiveness of therapeutic tactics aimed at suppressing collagen formation and improving metabolic processes in the kidney parenchyma in young children with pyelonephritis against the background of vesicoureteral refux associated with undiferentiated tissue dysfunction. 67 children from 2 weeks to 3 years old with pyelonephritis and vesicoureteral refux were examined. All children during the period of remission of the infammatory process were examined for the content of oxyproline in the urine. Urine crystallinity and urinary excretion were determined, and markers of the morphofunctional state of the cytomembranes of the renal epithelium were determined: calcifcation test—the presence of polar lipids in the urine and test for the presence of lipid peroxidation products in the urine.
Children with high urinary hydroxyproline excretion prior to protocol treatment of pyelonephritis during the remission of the infammatory process at the stage of maintenance therapy were recommended to receive metabolic preparations that can inhibit collagen formation and improve parenchyma metabolic processes during the month—vitamin E 10% and l-carnitine in age-related doses. After 6 months, a study was made on the functional state of the renal parenchyma in the dynamics of treatment. After metabolic antihypoxic and membrane-protective therapy, there was a signifcant positive dynamic of all markers of tissue hypoxia and membrane destruction in the kidney parenchyma, which confrms the inhibition of collagen formation processes and a decrease in tissue hypoxia with vitamin E and l-carnitine in age-related doses.

The high incidence of children with recurrent episodes of acute obstructive bronchitis is a widespread problem. Correct identification of chil-
dren at risk of developing bronchial asthma at school age may improve treatment and prevention approaches to this pathology, but the ability to identify these children remains limited. The purpose of the study was to determine the effectiveness of recombinant interferon alpha-2β in
children with recurrent episodes of acute obstructive bronchitis in the course of treatment based on the assessment of cytokine profile. The
study examined 59 children of the main group with recurrent episodes of acute obstructive bronchitis and 30 children of the comparison group
who suffered from acute bronchitis, aged 2–8 years, who were in the hospital. The results of laboratory studies were compared with the data of
30 healthy children. In children with recurrent episodes of acute obstructive bronchitis, the content of serum interferon-γ and interleukin-4 was
significantly reduced compared to healthy children, after treatment with recombinant human interferon alpha-2β, the content of interferon-γ and
interleukin-4 in children significantly increased. The content of interleukin-1β in children with recurrent episodes of acute obstructive bronchitis
was significantly higher than in healthy children, after immunomodulatory therapy with recombinant interferon alpha-2β, interleukin-4 normalized
to its level in healthy children. It was found that children with recurrent episodes of acute obstructive bronchitis have an imbalance of cytokines,
the effectiveness of recombinant human interferon alpha-2β therapy, which normalized the levels of the studied cytokines in the serum.

 616.61-053.2:575:576.5

The prevalence of dysmetabolic nephropathies in children is increasing from year to year, representing a significant problem in the overall structure of kidney diseases in pediatric age. Despite numerous studies dedicated to the issue of dysmetabolic nephropathies in children, the role of epigenetic factors in the pathogenesis of dysmetabolic nephropathy with calcium oxalate crystalluria remains insufficiently explored.
Aim — to identify the leading epigenetic factors in the pathogenesis of dysmetabolic nephropathy with calcium oxalate crystalluria in children.
Materials and methods. The data from the medical histories and outpatient records of 173 children were studied. Each child was additionally
examined by narrow specialists of different profiles. Three groups were formed from the examined children: Group I — children with a complicated course of dysmetabolic nephropathy and a history of inflammatory processes in the urinary system (52 children), Group II — children with dysmetabolic nephropathy with persistent crystalluria (56 children) and the Control group, which included 65 healthy children.
Results. The most significant prenatal epigenetic factors are the threat of early miscarriage, gestosis of the first and second halves of pregnancy, maternal anemia during pregnancy, parental alcohol and tobacco use, mother's work on computer during pregnancy, presence of maternal
chronic diseases, parental exposure to industrial dust and noise, and heavy physical work of mother leading to fetal hypoxia.
Conclusion. The most significant postnatal epigenetic factors influencing children's susceptibility to a more severe course of dysmetabolic
nephropathy included low birth weight, early artificial feeding, frequent acute respiratory infections, atopic diathesis, and physiological jaundice
in the first year of life, as well as the presence of concomitant diseases such as chronic tonsillitis, dental caries, frequent acute respiratory infections, chronic gastritis, atopy, and chronic cholecystitis later in life.
The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics
Committee of these institutions. The informed consent of the children's parents was obtained for the research.
No conflict of interests was declared by the authors. 

616.61-053.2:575:576.5

It  should  be  noted  that  oxidative  stress,  as  a  universal  mechanism  of  tissue  hypoxia  at  the  cellular  level, accompanied by non-enzymatic free radical oxidation and accumulation of lipid peroxidation products (LPO) in the blood, has attracted particular interest among medical professionals in our time. Research in the last decade has shown that there are all reasons to consider the activation of free radical LPO as a nonspecifi c component of physiological and pathological reactions characterizing the stress of activation of homeostasis maintenance systems.The aim of stady to establish the relationship between the impact of LPO processes, antioxidant defense, and membrane destruction of renal epithelium in children with dysmetabolic nephropathy.Materials and methods. Two groups of examined children were formed from the examined group, including those  with  dysmetabolic  nephropathy  and  secondary  urinary  tract  infections:  Group  I  -  52  individuals  in  whom  dysmetabolic nephropathy was complicated by the superimposition of infl ammatory processes in the kidneys and urinary tract - complicated DN (I-UDN), and Group II - 56 children with uncomplicated course of DN (II-DN), (a total of 108 children). The control group consisted of 65 healthy children. In children of all groups, the indicator of LPO process activity and the indicator of catalase activity in blood and urine were determined as a mechanism for regulating the antioxidant system of the body.Results. Against the intensifi cation of lipid peroxidation and membrane destruction processes in the bodies of children  with  DN,  the  possibilities  of  antioxidant  protection  are  exhausted,  which,  in  turn,  leads  to  even  greater  intensity of the LPO process. The catalase activity indicator in urine is an informative, reliable, and sensitive marker not only for the result of the impact of epigenetic factors on a child’s body but also a prognostic marker for a more severe course of dysmetabolic nephropathy in children.Conclusions.The revealed facts allow us to assert that against the background of intensifi  cation of lipoperoxidation and  membrane  destruction  processes  in  the  body  of  children  with  DN,  the  possibilities  of  antioxidant  protection  are  depleted,  which  in  turn  leads  to  an  even  greater  intensity  of  the  process  of  lipid  peroxidation.  And  the  index  of  catalase  activity  in  urine  is  an  informative,  reliable  and  sensitive  marker  not  only  of  the  result  of  the  impact  of  epigenetic  factors  on  the  child’s  body,  but  also  a  prognostic  marker  of  a  more  severe  course  of  dysmetabolic  nephropathy in children.

616-039:[616-008.6:578.834COV-19-053.2]-06

Коронавірусна хвороба 2019 (COVID-19) та її віддалені наслідки чинять значний негативний вплив на життя людей у всьому світі. Довготри-валими наслідками гострого респіраторного синдрому коронавірусу 2 (SARS-CoV-2) є пост-COVID-19 синдром, симптоми якого можутьзберігатися понад 12 тижнів від початку захворювання. Незважаючи на вже проведені заходи щодо контролю та боротьби із захворюван-ням, залишається актуальною проблема зі встановленням структури пост-COVID-19 синдрому, особливо в дітей, яка є важливою глобальноюпроблемою для суспільства. Мета— визначити структуру захворюваності дітей із пост-COVID-19 синдромом.Матеріали та методи.Обстежено 505 дітей віком до 18 років із пост-COVID-19 синдромом, які перебували на стаціонарному лікуванніпротягом січня — липня 2023 року. Джерелом інформації слугувала медична карта стаціонарного хворого (ф. 003/О). Дослідження прове-дено методом випадкової вибірки. Усім хворим дітям виконано комплексне клініко-лабораторне обстеження згідно зі стандартними,загальноприйнятими в педіатрії методами клінічного, лабораторного та інструментального обстеження. Статистичну обробку здійсне-но в пакеті програми EZR (R-statistics).Результати.Встановлено, що в дітей із пост-COVID-19 синдромом найменшу (12,87%) кількість становили діти віком до 3 років,а найбільшу (31,69%) — віком від 12 до 18 років. У дітей із пост-COVID-19 синдромом спостерігалося найчастіше ураження сенсорної(80,20%) і нервової (78,61%) систем.Висновки.Ураження нервової та сенсорної систем у дітей із пост-COVID-19 синдромом пояснюється коморбідністю тропності SARS-CoV-2 до цих систем і різким погіршенням соціально-економічного та психоемоційного стану дітей із пост-COVID-19 синдромом.Під час розподілу обстежуваних дітей за статтю і віком одночасно виявлено прогресивне збільшення частоти дітей із пост-COVID-19синдромом чоловічої статі зі збільшенням віку. Встановлення сукупності цих факторів у дітей має підвищити настороженість педіатрівщодо виникнення пост-COVID-19 синдрому в дітей і сприяє вчасному корегуванню та діагностуванню пост-COVID-19 синдрому.Дослідження виконано відповідно до принципів Гельсінської декларації. Протокол дослідження ухвалено Локальним етичним коміте-том усіх зазначених у роботі установ. На проведення досліджень отримано інформовану згоду батьків, дітей.Автори заявляють про відсутність конфлікту інтересів

Сoronavirus disease 2019 (COVID-19) and its long-term consequences have a significant negative impact on the lives of people around theworld. The long-term consequences of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are known as the post-COVID-19syndrome, the symptoms of which can persist for more than 12 weeks after the onset of the disease. Despite the measures already takento control and combat the disease, the problem of establishing the structure of post-COVID-19 syndrome, especially in children, remainsan important global problem for society.Aim — to determine the data on the structure of the incidence of children with post-COVID-19 syndrome.Materials and methods. We examined 505 children under 18 years of age with post-COVID-19 syndrome who were inpatients duringJanuary-July 2023. The source of information was the medical record of an inpatient (Form 003/O). The study was conducted by randomization.All sick children underwent a comprehensive clinical and laboratory examination in accordance with standard, generally accepted methods ofclinical, laboratory and instrumental examination in pediatrics. Statistical processing was performed in the EZR program package (R-statistics).Results. It was established that in children with post-COVID-19 syndrome, the smallest number were children under 3 years old (12.87%),and the largest number were children from 12 to 18 years old (31.69%). In children with post-COVID-19 syndrome, the most commonly affectedsensory (80.20%) and nervous (78.61%) systems were noted.Conclusions. The lesions of the nervous and sensory systems in children with post-COVID-19 syndrome are explained by the comorbidityof SARS-CoV-2 tropism to these systems and a sharp deterioration in the socioeconomic and psycho-emotional state of children withpost-COVID-19 syndrome. The distribution of the examined children by gender and age simultaneously revealed a progressive increasein the frequency of male children with post-COVID-19 syndrome with increasing age. Identification of a combination of these factors in childrenmay increase pediatricians' alertness to the occurrence of post-COVID-19 syndrome in children and will facilitate timely correction and diagnosisof post-COVID-19 syndrome.The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local EthicsCommittee of all the institutions mentioned in the work. Informed consent of parents and children was obtained for the study.The authors declare no conflict of interest.