Cow's milk protein allergy is an urgent problem in young children. Early diagnostics and formation of therapeutic tactics are the basic priorities in allergy treatment among young children. Oral provocation tests, which can be performed only in medical establishments, are a golden standard for diagnosing food allergy. Active search continues for optimal scheme of diagnosing cow's milk protein allergy in children in the first year of life. The aim of our research was to create the algorithm of diagnosing cow's milk protein allergy in children younger than one year of age, which will optimize obtaining reliable data on a patient's condition and decrease a load of laboratory examinations on young children using elimination and provocation food test. To complete the set goal, a record of allergological anamnesis, examination, assessment of physical condition and determination of specific IgE to cow's milk proteins were conducted to diagnose cow's milk protein allergy. Then, based on the obtained results, elimination and provocation food test was performed in two phases - elimination phase and provocation phase. Diagnostic in vitro is needed to choose the level of medical establishment for conduction of oral provocation tests: in case a specific IgE index is over 0.7 kU/L, testing is performed in an intensive care unit, if IgE is less than 0.7 kU/L - in a specialized inpatient department. Three clinical cases involving different methods have been presented for diagnosing cow's milk protein allergy - elimination and provocation test, oral provocation test and administration of individual diet based on the obtained results. A complex diagnostic approach, in particular, study of anamnesis, record of nutrition diary, elimination diet, enables to optimize diagnostics of food allergy, and diagnostic addition of a product - to assess tolerance clinically during extension of diet. An elaborated method of diagnosing cow's milk protein allergy in children younger than one year of age can be recommended for wide use in a clinical practice.

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.

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.

Early use of continuous positive airway pressure (CPAP) is equal to the prophylactic administration of a surfactant to prevent neonatal respiratory distress syndrome (nRDS) in high-risk infants. However, almost half of the smallest infants still require intubation and mechanical ventilation in the first 72 hours after birth. It is known that ineffective initial CPAP is associated with a poorer prognosis. Therefore, the search for reliable prognostic risk factors for ineffective CPAP in very preterm neonates whose respiratory support is started with CPAP is still relevant today. The results of a retrospective cohort study conducted at the Lviv Regional Clinical Hospital (Ukraine), which included 151 children with birth weight <1500 g and gestational age <32 weeks, showed that CPAP failure occurred at a median age of five hours in 31% of infants initially treated with CPAP and average (SD) FiO2, while the failure point was 0.48 (0.15). The prevalence of the main risk factors for severe nRDS did not differ significantly between two groups (CPAP success and CPAP failure). The risk of CPAP failure was significantly associated with surfactant treatment (OR – 7.46; 95% CI: 2.3–24.2), severe RDS (OR – 12.17; 95% CI: 3.8–39.3), requirement in resuscitation after birth (OR – 3.10; 95% CI: 1.2– 8.1), initial CPAP pressure (OR – 0.38; 95% CI: 0.15–0.99). Earlier administration of exogenous surfactant to children at high risk of developing severe RDS could prevent the need for mechanical ventilation.

Respiratory pathology in the recent years remains an urgent problem in clinical pediatrics. The aim of the research was to improve primary prophylactic measures associated with the development and progression of recurrent bronchial obstruction syndrome in young children, who had suffered respiratory disorders in neonatal period. Algorithm of primary prophylactic measures implied adequate balanced nutrition, sanation of living conditions, restriction of contact with infectious agents, sanation of chronic foci of infection, systematic training and general fitness. 

The investigation included 160 young children (1 day – 3 years of age). The basic group (n=80) involved children, who had experienced respiratory disorders in neonatal period and received appropriate respiratory therapy (artificial ventilation and / or spontaneous breathing with continuous positive airway pressure and supply of free oxygen), control group – children, who did not have respiratory disorders and respiratory therapy (n=80). 

Conducted investigation throughout 12-month monitoring enabled to record the development of recurrent bronchial obstruction syndrome in 43 children (respectively, 30 – 37.50% patients of the basic group versus 13 – 16.25% of control group; p<0.05). However, the results, which would confirm the efficacy of suggested primary rehabilitation measures (р>0.05), could not be obtained. 

Conclusions: comparative analysis within groups did not show a reliable difference in the development of recurrent bronchial obstruction syndrome in children (р>0.05), which can be explained by partial following of doctor’s recommendations. There is the need in further study of the issue involving more patients for a longer period of monitoring.