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.

Introduction: Over the years, heart failure remains one of the most common and prognostically unfavorable conditions. The aim of our study was to determine the frequency of complications in patients with CHF depending on the body weight and intoxication syndrome of varying degrees of severity. Materials and methods: A complete clinical examination was performed in 58 patients (41 (70.6%) men and 17 (29.4%) women) with CHF. In addition to the standard examination in accordance with the protocol, the level of endogenous intoxication was determined by the level of medium-weight molecules (MWM254) and leptin. The patients were randomized into 4 groups depending on their body mass index and the degree of endogenous intoxication. Statistical processing of the results was carried out using the methods of variation statistics “Statistica 6.0”. Results: It was revealed that the worst survival rate is observed in patients with normal body mass against the background of the expressed endogenous intoxication syndrome, the best survival rate is observed provided that there are a normal body mass and endogenous intoxication of a minimum degree. An inverse correlation between the body mass index and the endogenous intoxication indicator (blood MWM) was detected. Patients with CHF should have their leptin level evaluated. An increase in its level was associated with arterial hypertension, an increase in blood glucose levels and lipid metabolism disorders. Conclusions: Increased level of blood MWM worsens the forecast of CHF. The unfavorable outcome was observed in patients with the combination of hypoleptinemia with severe endogenous intoxication.

Проблема алергічних захворювань у світовій педіатричній практиці залишається пріоритетною впродовж багатьох років [5]. З 2010 року, згідно з даними ВООЗ, поширеність алергічної патології набула рис епідемії та характеризується погіршенням її клінічної структури [6]. В Україні спостерігається тенденція до пізньої діагностики алергічних захворювань, зокрема атопічного дерматиту. Слід відзначити, що така ситуація зустрічається навіть у сім'ях, де реєструється обтяжена атопією спадковість [1]. Аналіз основних причин алергічної епідемії показав, що основними тригерними чинниками є вплив мегаполісів, погіршення стану довкілля, нераціональне харчування, стресові навантаження, безконтрольне застосування медикаментів, пасивне та активне тютюнопаління [3, 6]. Атопічний дерматит характеризується поліморфними змінами на шкірі, що зумовлює серйозні труднощі диференцііальної діагностики. Під час діагностичного пошуку клінічна практика потребує проведення диференціації не лише з іншими захворюваннями алергічного характеру (харчова алергія,

The article presents the data from recent literature and personal, practical experience of differential diagnosis of skin allergies in children. The difficulties detected at various stages of the disease diagnosis with the need for differentiation of allergic diseases (food allergy, atopic dermatitis, urticaria, insect allergy) and non-allergic genesis are: viral infections with skin lesions (herpes, chicken pox, measles, infectious erythema, hand foot mouth disease), bacterial infections of the skin (strep-and staphylodermia), and a group of other diseases (ichthyosis, scabies, psoriasis). It also should be mentioned that special emphasis on diagnosis belongs to food hypersensitivity, which combines immunological and nonimmunologic reactions. An example of the observation of 60 children with skin allergies shows the approach to the investigation of the diagnosis and the difficulties that arose during this. All children were ill for more than 3 months, and at the time of inclusion in the research, there were no identified causes of the disease. The diagnostic algorithm included three stages: clinical (detailed collection of complaints and anamnestic data), laboratory (general blood test, biochemical and coprological examination, determination of total IgE and specific IgE to gluten and different milk fractions, serological biomarkers of celiac disease) and instrumental. For 14 days before blood collection patients underwent an elimination test. 2 L. Besh et al. The results of the study showed that in the study group of children aged 1-5 years the main diagnosis was atopic dermatitis (36.84%), food allergy (24.56%), lactase deficiency (7.02%), helminthiasis (7.02%), streptodermia (5.25%), celiac disease (3.51%). The need for an individual approach to the laboratory-instrumental algorithm of skin allergies was described, and the results of our personal approach to the diagnosis were shown.

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The aim: To investigate long-term effects of primary percutaneous coronary interventions (pPCI) in patients with STEMI basing on the prevalence of clinically relevant endpoints. Materials and methods: Totally 200 patients with STEMI hospitalized within a period of “therapeutic window” for revascularization were included into the study. 100 patients who additionally to pPCI underwent manual thromboaspiration entered the main group. The comparison group consisted of 100 patients who underwent standard pPCI. Results: Six months after the pPCI, the incidence of either major adverse cardiac events and the combined endpoint did not differ in the main and comparative groups (11.8% vs. 12.5%, p = 0.888 and 18.2% vs. 20.8%, p = 0.658, respectively). There were no significant differences in these endpoints taken separately. In twelve months after procedure, also there were no significant differences between the groups. However, a tendency toward lower incidence of chest pain was observed in the main group (p = 0.08) during this period that was lost in 24 months after pPCI. None of these techniques demonstrated significant advantages during the whole duration of the follow-up period. Conclusions: The addition of manual thromboaspiration to the standard pPCI in patients with STEMI and severe thrombosis of the culprit artery did not significantly influence the prognosis.

Neurohumoral theory of chronic heart failure (CHF) development, approved by most scientists, does not completely explain mechanisms of its decompensation. Standard treatment is not always effective, thus, search for pathogenetic and prognostic factors, which influence the course of CHF, remains a current issue. However, individual prognosis of CHF course in clinical practice is not performed at present, since its distinct criteria have not been specified. Thus, it became the expediency and rationale of our research, the aim of which was to assess individual risk of occurrence of complications in patients with CHF, considering a combined influence of several factors. A complete clinical examination of 110 patients (74.5 % males, 25.5 % females) with CHF has been performed. The method of logistic regression was used for determination of combined influence of analyzed factors on CHF prognosis; adequacy and reliability of the difference of the obtained model were investigated by Wald’s criteria and chi-square test. On elaboration of the prognosis method of individual risk of the development of cardiac insufficiency, among other factors that, according to literature data, influence the development of the disease, we have singled out three factors, which have a reliable (P < 0.05) association with CHF: BMI, total cholesterol and amount of lymphocytes. Elaborated computer program, which can calculate the prognosis of CHF complications. This file opens in the program “Microsoft Excel” calculates individual risk and graphically demonstrates the degree of risk. Conducted correlation analysis of individual risk of CHF complications showed that its likelihood is accompanied by development of systolic dysfunction, hypertrophy of the left ventricle with dilatation, anemic and detoxification syndromes, impairment of liver and kidney functions with the reduction of leptin in the blood, which has important regulative functions. Thus, based on conducted logistic, correlation and prognostic analyses, individual risk of the development of CHF complications increases under conditions of combined factors, such as weight loss, decrease in total cholesterol level and reduction of the content of peripheral blood lymphocytes. Application of elaborated computer program allows a doctor to calculate individual risk and visualize it.

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.