bluuebunny/crossref_metadata_2025 huggingface dataset:
Peculiarities of pregnancy and childbirth course in women with inflammatory bowel diseases
Authors:   Bogomolets National Medical University, Kyiv, Ukraine, Kupchik L.M. , Tsapenko T.V. ,   Bogomolets National Medical University, Kyiv, Ukraine, Narytnyk T.T. ,   Bogomolets National Medical University, Kyiv, Ukraine,
Published: April 2024

The problem of pregnancy management in women with inflammatory bowel diseases is becoming more urgent, due to the prevalence of such pathologies as Crohn's disease and ulcerative colitis in the age group of women 20-40 years old, during which reproductive function is mainly being realized. Purpose - to investigate the course of pregnancy and labour in women whose pregnancy occurred on the background of the existing Crohn’s disease and ulcerative colitis. Materials and methods. The main group (the Group I) included women with chronic inflammatory bowel diseases - Crohn’s disease (the Group I-A; n=27) and ulcerative colitis (the Group I-B; n=52); the control group (n=20) consisted of women without severe somatic pathology. Retrospective clinical and statistical analysis was performed using data from medical documentation. Obtained results were statistically processed in specialized programs. Results. A statistically higher frequency of pregnancy complications was found in women with inflammatory bowel diseases, such as anemia (59.3% in the Group I-A and 69.2% in the Group I-B versus 30% in the control group); threatening abortion (40.7% in the Group I-A and 53.8% in the Group I-B against 15% in the control group); hyperemesis gravidarum (44.4% in the Group I-A and 67.3% in the Group I-B against 25% in the control group); preeclampsia (37% in the Group I-A and 44.2% in the Group I-B against 10% in the control group); premature rupture of fetal membranes (37% in the Group I-A and 21.1% in the Group I-B against 10% in the control group). At the same time, women of the main group had an earlier development of spontaneous labor and a slightly smaller mass of newborns. Conclusions. Received results indicate presence of Crohn's disease and ulcerative colitis influence on the course of pregnancy in women, which requires joint management of such women with gastroenterologists. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
The effect of an elimination diet on the functional state of the gastrointestinal tract and liver of childbearing age women having symptomatic adenomyosis
Authors:   Shupyk National Healthcare University of Ukraine, Kyiv, Lonshakova M.S. ,   Clinic of reproductive technologies Ukrainian State Institute of Reproductology of the Shupyk National Healthcare University of Ukraine, Kyiv
Published: April 2024

The existence of food intolerances disrupts the work of the gastrointestinal tract and the liver, the symptoms of which are largely similar to those of adenomyosis. Purpose - to investigate the effect of the elimination diet on indicators of the functional state of the gastrointestinal tract and liver of women having symptomatic adenomyosis. Materials and methods. 120 women with symptomatic adenomyosis were divided into 4 groups: the Group I - 30 women who were treated with dienogest; the Groups ІІ, ІІІ and IV - 30 women each, who were prescribed an elimination diet taking into account the identified type of food intolerance. A comprehensive clinical examination, coprological examination, and ultrasound steatometry of the liver were performed. Statistical data was processed by the SPSS 21 program. Results. Compared with women of the Group I, patients of the Groups II, III, and IV showed a decrease in the pain symptoms of adenomyosis, the frequency of complaints from the digestive tract, amylorrhea, steatorrhea in feces, and markers of the inflammatory process in the intestine, as well as the frequency and severity of liver steatosis. Conclusions. The elimination diet, taking into account the identified type of food intolerance, has a positive effect on well-being, the functional state of the gastrointestinal tract and reduces the symptoms of the disease of childbearing age women with adenomyosis. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.
Clinical aspects of preeclampsia: a retrospective analysis
Authors:   Bogomolets National Medical University, Kyiv, Ukraine, Govsieiev D.O. , Spichak K.O. ,   Bogomolets National Medical University, Kyiv, Ukraine
Published: April 2024

Preeclampsia (PE) is a serious cause of maternal and perinatal mortality. Every year, more than 2 million cases of PE and about 76,000 deaths among women from this pathology are registered in the world. Preeclampsia can cause premature birth and increase the risk of complications. Clinical manifestations of the disease are diverse. Therefore, studying the clinical features of PE is necessary to improve its prevention, diagnosis and treatment. Purpose - to study the frequency and clinical aspects of the course of PE in pregnant women to improve prevention, diagnosis and treatment of this pathology of pregnancy. Materials and methods. 21,950 cases of childbirth from 2016 to 2022 were analyzed. The clinical characteristics of 1,209 patients with preeclampsia were analyzed. The obstetric history of women with PE was studied, their somatic status was assessed, and laboratory data were analysed. The results were statistically analysed using the methods of variation and alternative statistics. Results. In 2016-2020, the frequency of PE was 5.5% of the total number of births. The increase in PE during the observation period was 51.5%, its severe degree was 70.5%. In women with PE, I-III pregnancies prevailed (79.5%) and I or II births in the anamnesis (97.4%). The severity of the disease was correlated with the body mass index, which varied from 22 to 43 kg/m2. Pathological changes in the objective status were revealed, including edema (53.8%) and neurological disorders (71.7%). Almost all pregnant women with PE had proteinuria. Thrombocytopenia was detected in 15.4%, hemoglobin decrease was in 25.6%. The majority of pregnant women had an increase in the prothrombin index (73.6%) and a decrease in fibrinogen (52.7%). Conclusions. The study of clinical aspects of PE reveals a high frequency of this pathology, a wide range of clinical symptoms, hemostasis disorders and organ dysfunction, which indicates the need to develop effective strategies for its diagnosis and treatment. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Algorithm of differentiated treatment of patients with ovarian endometrioma and infertility
Authors:   Dnipro State Medical University, Ukraine, Sadullayev A.S. , Medvedev M.V. ,   Dnipro State Medical University, Ukraine
Published: April 2024

Purpose - to improve fertility in women with ovarian endometrioma (ОЕ) and infertility using the proposed algorithm and treatment methods. Materials and methods. The prospective study was conducted in 2 stages. In the first stage, 93 women with infertility were included in the study, who were divided into the following groups depending on the surgery performed: the Group 1 - with ОЕ sclerotherapy followed by platelet-rich plasma (PRP) injection into the ovarian tissue; the Group 2 - laparoscopic cystectomy followed by PRP injection into the ovarian tissue; the Control (C) group - with classical laparoscopic cystectomy. After dynamic observation, assessment of ovarian reserve and control of pregnancy for 12 months, an algorithm for differentiated treatment of ОЕ in women with infertility was developed. At the 2nd stage, 20 women (the Group 3) were treated with the proposed methods of treatment, such as sclerotherapy with ОЕ + PRP (the Subgroup 3a) and laparoscopic excision of the ОЕ + PRP capsule (the Subgroup 3b), based on the algorithm, and analyzed. Statistical processing of the results was performed using Microsoft Excel. Results. The mean level of anti-mullerian hormone (AMH) in the Subgroup 3a increased from 1.76 (CI: 1.47-1.71) ng/ml to 1.87 (CI: 1.63-1.86) ng/ml (p=0.036). In the Subgroup 3b, AMH changed from 2.15 (CI: 1.89-2.48) ng/ml to 2.22 (CI: 1.91-2.53) ng/ml (p>0.05). The number of antral follicles (AF) in the Subgroup 3a increased from 8.88 (CI: 7.90-9.90) to 11.10 (CI: 10.40-11.80) (p<0.001). In the Subgroup 3b, from 10.60 (CI: 9.90-11.20) to 11.00 (CI: 10.50-11.50) (p>0.05). Spontaneous pregnancy within 6 months occurred in 6 (60%) patients from the Subgroup 3a, and in 4 (40%) women from the Subgroup 3b (p>0.05). After 6 months of follow-up, 2 underwent assisted reproductive technology. The remaining women from the Subgroup 3a (3 (30%)) and the Subgroup 3b (5 (50%)) also had spontaneous pregnancies by 1 year of follow-up (p>0.05). Conclusions. The proposed methods of treatment of ОЕ, sclerotherapy + PRP and laparoscopy + PRP, showed a significant positive effect on the preservation of ovarian reserve. A differential approach to the treatment of ОЕ based on the proposed algorithm increases the occurrence of spontaneous pregnancy. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Modern understanding of the impact of stress on the immune system of pregnant women
Authors:   Bogomolets National Medical University, Kyiv, Ukraine, Poladych I.V. , Kostenko O.Yu. ,   Bogomolets National Medical University, Kyiv, Ukraine
Published: April 2024

Today, there is increasing attention being paid to mental health, especially in pregnant women who are vulnerable to the risk of mental disorders such as depression, anxiety, and post-traumatic stress disorder. Despite scientific progress, research on the impact of stress on mental health during pregnancy is insufficient. Purpose - to analyze the impact of stress on the immune system of pregnant women. A search and analysis of 78 original studies investigating the impact of stress on the course of pregnancy were conducted. Keywords and article selection criteria were applied. The systematic review included the most relevant studies that met the established criteria. The findings indicate that the immune system plays a significant role in the development of stress-related mental disorders during pregnancy. However, most studies do not establish a clear link between stress, inflammation, and mental disorders in pregnant women. Conclusions. The review highlights the need for further research aimed at understanding the relationship between stress, the immune system, and mental health in pregnant women. This will help develop effective methods for the prevention and treatment of mental disorders in this population, promoting healthy pregnancy outcomes and the birth of healthy children. No conflict of interests was declared by the authors.
Maternal and fetal arrhythmia as a sign of hemodynamic deterioration: a case report
Authors:   Kharkiv National Medical University, Ukraine, Lakhno I.V. , Sykal I.M. ,   Kharkiv National Medical University, Ukraine, Korovai S.M. ,   Kharkiv Municipal Perinatal Center, Ukraine, Korotych V.M. ,   Kharkiv Municipal Perinatal Center, Ukraine, Tkachov A.E. ,   Kharkiv Municipal Perinatal Center, Ukraine
Published: April 2024

The co-existing maternal (MA) and fetal arrythmia (FA) are associated with maternal goiter disease, chorioamnionitis, or Ballantyne’s syndrome. The aim of the study - to determine the involvement of maternal arrhythmia and fetal arrhythmia in the pathogenic scenario of hemodynamic deterioration in Ballantyne’s syndrome. Clinical case. It is presented the case of sustained several weeks of MA and FA. A pregnant woman aged 36 years was admitted to the division of maternal and fetal medicine at 34 weeks of gestation. She was gravida 4 and para 3. She had complaints of rapid heartbeat, left-side chest discomfort, and lower extremities edema. The diagnosis of maternal sinus tachycardia was supported via electrocardiography. The indices of fetal, umbilical, and uteroplacental hemodynamics detected via Doppler ultrasound were appropriate. However, fetal heart rate was 209 beats/min. The transplacental attack of oral sotalol 80 mg thrice daily was prescribed. But maternal and fetal tachycardia persisted to stay. The tricuspid regurgitation was detected via Doppler ultrasound next day. The fetus was hydropic. The male baby of 2400 g, 46 cm length, 31 cm head circumference, and Apgar score 3→5 was delivered via caesarean. The newborn was discharged in 21 days. He was admitted again in one month for rehabilitation. Maternal heart rate reduced to 72 beats/min and edema regressed in three days after birth. Conclusions. MA and FA before fetal hydrops are supposed to be the early signs of mirror syndrome. This speculation needs further investigation. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
The frequency of anxiety-depressive syndrome in children with inflammatory bowel diseases
Authors:   Bukovinian State Medical University, Chernivtsi, Ukraine, Sorokman T.V. , Cherney N.Ya. ,   Bukovinian State Medical University, Chernivtsi, Ukraine, Makarova O.V. ,   Bukovinian State Medical University, Chernivtsi, Ukraine, Koliesnik D.I. ,   Bukovinian State Medical University, Chernivtsi, Ukraine
Published: April 2024

Inflammatory bowel diseases (IBD) have been spreading rapidly in industrialized countries since the beginning of the 21st century. Purpose - to determine the frequency of symptoms of anxiety and depression in children with IBD, in order to optimize treatment. Materials and methods. 18 patients aged 10-17 years were surveyed: 10 people with ulcerative colitis (UC) and 8 people with Crohn’s disease (CD), symptoms of anxiety and depression were studied using PHQ-2, PHQ-9 questionnaires (Patient Health Questionnaire) and GAD-7 (Generalized Anxiety Disorder). The obtained results were analyzed using SPSS 26.0 programs. The odds ratio (OR) was considered significant if the 95% confidence interval (CI) did not include 1. The difference in samples was considered significant at p<0.05. Results. Of the 18 patients who were surveyed using the PHQ-2 questionnaire, 13 (72.2%) were screened for further investigation using the PHQ-9 questionnaire. The prevalence of anxiety symptoms was 55.5% (95% CI: 38.3-66.5), depressive symptoms - 34.8% (95% CI: 21.4-45.8). Patients with CD had higher odds of anxiety symptoms (OR: 1.2, 95% CI: 1.1-3.6) and depressive symptoms (OR: 1.3, 95% CI: 1.1-1.7) than children with UC. There were differences in the severity of anxiety and depression in different pathological conditions (IBD: p<0.01; UC: p<0.05; CD: p=0.05). The frequency of symptoms of anxiety or depression was higher in patients with active IBD than in children with inactive disease (100% and 33.3% and 100% and 45.8%, respectively). Minimal (0-4 points) and mild (5-9) degrees of anxiety and depression prevailed. Conclusions. The frequency of detection of symptoms of anxiety and depression in children with CD and UC in the active stage of the disease is 55.5% and 34.8%, respectively, with a predominance of minimal (0-4 points) and mild (5-9) degrees. Patients with CD are higher odds of anxiety and depression symptoms than children with UC. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
The course of the post-vaccination period when using combined vaccines from different manufacturers during one vaccination cycle
Authors:   Shupyk National Healthcare University of Ukraine, Kyiv, Pugach A.M. ,   Medical Centre Dobrodiy, Kyiv, Ukraine, Bondarenko A.V. ,   Bogomolets National Medical University, Kyiv, Ukraine,   International European University, Kyiv, Ukraine, Lapiy F.I. ,   International European University, Kyiv, Ukraine
Published: April 2024

Purpose - to evaluate the postvaccination period when using 6-valent vaccines against pertussis, diphtheria, tetanus, poliomyelitis, hepatitis B and infections caused by Haemophilus influenzae type b from different manufacturers within the same vaccine cycle. Materials and methods. The study was conducted on the basis of a private health care facility that provides outpatient admission, management, monitoring, and vaccination of children and adults. For the period from January 2020 to October 2023, we analyzed the records in the preventive vaccination registers, which were recorded the next day during routine monitoring of the child's condition after immunization. For the analysis, 343 children were selected and divided into 5 groups depending on the combination of doses of different hexavalent vaccines during the vaccine cycle (3 doses at 28-day intervals) and the first revaccination (one dose at 12-month intervals from the third dose). Results. In all groups of subjects, most children had no complaints during the postvaccination period. The combination of 6-valent vaccines from different manufacturers was not accompanied by an increase in postvaccination reactions, on the contrary, a tendency to their decrease was noted. Some differences were observed when comparing post-vaccination reactions when using all 4 doses of the 3-component pertussis vaccine and the 2-component pertussis vaccine. Thus, vaccination with a 3-component pertussis component, in 32% was accompanied by a fever up to 38.5C, and in only 15.38% in vaccine with a 2-component pertussis component, differences were not significant (p>0.05). Conclusions. In heterologous immunization against pertussis, diphtheria, tetanus, poliomyelitis, hepatitis B and infections caused by Haemophilus influenzae type b with vaccines from different manufacturers with a 2- and 3-component pertussis component, the spectrum and percentage of post-vaccination reactions practically do not differ. Thus, the use of combinations of doses of different 6-valent vaccines is justified, which is especially relevant in the conditions of interruptions in the supply of vaccines and vaccination of children in various medical institutions during migration in war conditions, when there is a risk of delay in the introduction of the next dose of the vaccine and violation of the intervals between vaccinations. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Difficulty in diagnosing refractory Kawasaki disease under the «mask» of hemoblastosis: a clinical case from the experience of a hematologist
Authors:   СNCE of LRC «Western Ukrainian Specialized Pediatric Medical Centre», Lviv, Ukraine, Dorosh O.I. ,   Danylo Halytsky Lviv National Medical University, Ukraine, Sheremet M.R. ,   СNCE of LRC «Western Ukrainian Specialized Pediatric Medical Centre», Lviv, Ukraine, Yevtukh V.P. ,   Center for Medical Innovations NOVO, Lviv, Ukraine, Ocheretna O.M. ,   СNCE of LRC «Western Ukrainian Specialized Pediatric Medical Centre», Lviv, Ukraine, Dubey L.Ya. ,   Danylo Halytsky Lviv National Medical University, Ukraine, Burak T.V. ,   СNCE of LRC «Western Ukrainian Specialized Pediatric Medical Centre», Lviv, Ukraine
Published: April 2024

Kawasaki disease (KD) is an acute systemic vasculitis that is the most common cause of acquired heart disease in children under 5 years of age with hyperthermia. Diagnosis of KD is a clinical challenge, given the wide range of clinical manifestations and similarities with many viral and bacterial diseases. Purpose - to describe a clinical case of refractory КD in a three-month-old girl with an emphasis on the importance of echocardiography and coronary angiography for the final verification of the disease, urgent initiation of treatment with minimal suspicion of КD. Clinical case. The article reports on a three-month-old patient with a difficult diagnosis of refractory form of КD. The disease debuted with hyperthermia, enterocolitis, obstructive bronchitis, and hepatoliver syndrome. The manifestations of skin exanthema were initially considered as an allergic dermatitis to the use of a cephalosporin antibiotic. Multisystemic inflammatory syndrome associated with SARS-CoV-2 infection was suspected. After the use of immunosuppressive therapy with mega-doses of dexamethasone and intravenous human immunoglobulin 2 g/kg/day for 3 days, clinical improvement was achieved. Subsequently, the haemogram showed an increase in neutrophilic hyperleukocytosis to the appearance of blast cells, hyperthrombocytosis and severe anaemia. A differentiation was made between a leukemic reaction, the debut of myeloproliferative disease, juvenile myelomonocytic leukaemia. Against the background of a rapid decrease in the number of leukocytes, the girl developed hyperthermia, migratory intermittent maculopapular rash, and foots edema. Laboratory findings included thrombocytosis and an increase in acute-phase parameters. Echocardiography revealed left ventricular dilation, a small amount of excess fluid in the pericardium, dilatation of the left coronary artery evenly to the bifurcation. Computed tomography revealed giant coronary artery aneurysms, which gave grounds to diagnose KD. The study was performed in accordance with the principles of the Declaration of Helsinki. Informed consent of the parents of child was obtained for the study. No conflict of interests was declared by the authors.
Chronic colitis in children. Problems of differential diagnosis
Authors:   SI Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine, Kyiv, Shadrin O.G. , Horіanska M.H. ,   SI Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine, Kyiv, Archakova T.M. ,   SI Institute of Pediatrics of Obstetrics and Gynecology named after academician O.М. Lukyanova of the NAMS of Ukraine, Kyiv, Mostovenko R.V. ,   National Children’s Specialized Hospital OKHMATDYT, Kyiv, Ukraine, Zayets V.V. ,   SI Institute of Pediatrics of Obstetrics and Gynecology named after academician O.М. Lukyanova of the NAMS of Ukraine, Kyiv
Published: April 2024

During the last few decades, there has been observed a "rejuvenation" of the inflammatory bowel diseases (IBD) onset in childhood. Very often the problem is narrowed down to the differential diagnosis of Crohn's disease and ulcerative colitis, which are related to IBD, although in reality the spectrum of chronic IBD is much wider. A diagnosed case of microscopic (collagenous) colitis confirms the need for a wide diagnostic search in patients with IBD. Purpose - to describe differential diagnostic features of collagenous colitis and collagenous gastritis in young children. Clinical case. Observational data on a patient aged 1 year and 7 months with a special form of colitis (collagenous colitis in combination with collagenous gastritis) are presented. The peculiarities of this rare disease course in the examined patient, in whom the pathology debuted with gastric ulcers with hematemesis, anemia and diarrhea syndrome, were analyzed. The differential search complex stages are discussed in detail, the results of laboratory, instrumental and pathomorphological research methods are described. Information is provided on the treatment prospects of patients with a gastrointestinal tract collagenous pathological process. There is a justified need to take into account rare causes of digestive tract inflammation when observing young patients with a clinical picture similar to the IBD debut. The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the child's parents was obtained for conducting the studies. No conflict of interests was declared by the authors.
The case of Kinsburn’s Encephalopathy in a child with neuroblastoma of posterior mediastinum
Authors:   Shupyk National Healthcare University of Ukraine, Kyiv, Stetsenko T.I. , Fedushka H.M. ,   National Children’s Specialized Hospital OKHMATDYT, Kyiv, Ukraine, Rebenkov S.O. ,   National Children’s Specialized Hospital OKHMATDYT, Kyiv, Ukraine, Ivanova T.P. ,   National Children’s Specialized Hospital OKHMATDYT, Kyiv, Ukraine
Published: April 2024

Opsoclonus-myoclonus-ataxia syndrome (OMAS) is an autoimmune rare disease of the central nervous system with lesion of the cerebellum and its ligaments. Purpose - to present a case of the rare Kinsburn’s Encephalopathy - OMAS and to attract the attention to its timely diagnosis. Clinical case. A child at the age of 1 year and 9 months was observed in the neurological department of the National Children’s Specialized Hospital “OKHMATDYT”. Neurological status: eyes opsoclonus, truncal tremor, ataxia of the cerebellum. There were also changes in behavior and a sleep disorder. She became sick in 1 month after acute respiratory infection. True diagnosis was made: Kinsburn’s Encephalopathy - opsoclonus-myoclonus syndrome. A study of the child’s immune status was made and, most importantly, computerized tomography (CT) of the whole body. Mediastinal neuroblastoma was diagnosed. In addition to the diagnosis, the child receive adequate therapy - intravenous immunoglobulin at a dose of 2 g/kg for a 5-day course. On the background of the received therapy, the child was marked with positive dynamics, she began to walk by herself, the atactic syndrome diminished, opsoclonus remained unchanged. Consequently, the main cause of autoimmune defeat of the nervous system was detected and the child was directed to the further examination and treatment to the Cancer Institute of the National Academy of Medical Science of Ukraine. Radical removal of the left hemopleura neuroblastoma was made. According to the results of morphological and immunohistochemistry tests, the phenotype obtained in the material of the operation is characteristic of the neuroblastoma (ICD-O code 9500/3), pT1bpN0M0, negative form. In the future, the child continued to receive courses of immunosuppressive therapy. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Structure of sensitization to fish and seafood in children
Authors:   Bogomolets National Medical University, Kyiv, Ukraine, Marushko Yu.V. , Moskovenko O.D. ,   Bogomolets National Medical University, Kyiv, Ukraine, Chmil A.I. ,   Bogomolets National Medical University, Kyiv, Ukraine,
Published: April 2024

In recent years, about 4% of children and 1% of adults in the world have suffered from food allergies to fish and seafood. About 40% of children have a high level of threat of systemic reactions. Literature data on the prevalence of FA on fish and seafood in the world are summarized, the principles of modern diagnostics are defined, taking into account the possibilities of molecular component diagnostics of fish and seafood allergen molecules. Purpose – To analyze the prevalence of allergies to fish and seafood in children; determine the structure of sensitization to the main allergens of these products using molecular component diagnostics. Materials and methods. 29 children aged from 3 to 18 years with clinical signs of allergies to fish and seafood were examined, with confirmation of sensitization to them using the ALEX-2 molecular component diagnostic method (Macro Array Diagnostics GmbH, Austria). Levels of specific IgE were determined. Results. Among those examined, children with food allergies to fish and seafood aged 3-6 years predominated (41.4%). 18 (62.1%) children had a severe allergy history. 19 (65.5%) children had oral allergy syndrome; 18 (62.1%) children had a papular rash with itching. Difficulty breathing was observed in 16 (55.2%) children. About half of the subjects were sensitized to fish allergens, most often to β-parvalbumin. Only 4 (13.8%) children were sensitized to fish enolase and eldolase. Among seafood, sensitization to squid predominated in children - in 18 (62.1%) children, while sensitization to tropomyosin was low - 1 (3.4%) case. Conclusions. The problem of the appearance of fish and seafood is relevant today, especially among children aged 3-6 years (41.4%). In children with fish allergy, sensitization to β-parvalbumin of different fish species predominated, namely to salmon (51.7%), mackerel (51.7%), herring (48.3%), carp (48.3%), tuna (48.3%), cod (41.4%). As a result of sensitization to seafood, sIGE was more often recorded to extracts of squid (62.1%), oyster (27.6%), lobster (20.7%), mussels (20.7%), clam (17.2%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Attention deficit hyperactivity disorder in children aged 6-8 as a medical and social problem
Authors:   T.H. Shevchenko National University Chernihiv Colehium, Ukraine, Hryshchenko S.V.
Published: April 2024

One of the medical and social problems that are considered urgent today is the need to improve the health of children with disorders of mental development, including attention deficit hyperactivity disorder (ADHD). Purpose - to conduct a systematic analysis of scientific sources regarding the etiopathogenesis, clinical manifestations, and joint practical work of doctors, social workers, and teachers regarding ADHD in children 6-8 years old. Domestic and international studies prove that the treatment of ADHD in children should be comprehensive, include recommendations on regime and lifestyle, drug therapy, and practical recommendations from an educational component. A multidisciplinary approach to determine clinical-psychopathological and clinical-psychological regularities of the mental development of children with ADHD is relevant. A feature of such children is high activity, inability to focus on one thing, short-temperedness. But such a condition can be corrected if treatment is started as early as possible. The cause of the development of the disorder can be: complications during pregnancy (this includes early toxicosis, preeclampsia, intrauterine hypoxia of the fetus), complications during childbirth (premature, rapid); low body weight of the child at birth or suffered serious diseases during the first year of life; the presence of bad habits in a pregnant woman, hard work or work in harmful conditions during the period of bearing the fetus. The main signs of attention deficit hyperactivity disorder in children 6-8 years old are as follows: inattention; hyperactivity; impulsiveness. The main symptoms of ADHD can also be accompanied by accompanying symptoms: difficulties in learning, even despite high intellectual abilities; tics; quick fatigue; the presence of phobias, anxiety and depression; autism; sleep problems; speech or behavior disorders. Scientists consider the features of intellectual development of children with ADHD to be voluntary regulation of mental activity, cognitive functions, speech, voluntary motor activity, insufficient development of perceptual-gnostic and emotional spheres. No conflict of interests was declared by the author.
Rational antibiotic therapy for respiratory tract infections in children: modern recommendations
Authors:   SI National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine, Kyiv, Rechkina O.O.
Published: April 2024

Diseases of the respiratory tract remain relevant in pediatrics. Purpose - to provide modern recommendations for the prescription of rational antibiotic therapy for respiratory tract infections in children to improve clinical practice and preserve the effectiveness of antibacterial drugs. The principles of optimal use of antibacterial drugs in the treatment of respiratory diseases in pediatric practice are discussed. The data of the study of the pharmacological profile of azithromycin, its effectiveness and safety in the treatment of respiratory diseases are presented. A detailed analysis of the drug's spectrum of action, its pharmacokinetics, and the possibility of side effects is provided. The study includes the results of clinical trials and meta-analyses, emphasizing the importance of choosing the right dosage and duration of treatment. The presented results contribute to the understanding of optimal approaches to the use of azithromycin in the treatment of respiratory diseases in children, contributing to the improvement of clinical practice and maintaining the effectiveness of antibiotic therapy. No conflict of interests was declared by the author.
Evaluation of Knowledge, Attitudes, and Practices towards Vaccination among Patients with Spina Bifida in Ukraine
Authors:   I. Horbachevsky Ternopil National Medical University, Ukraine, Boyarchuk O.R. , Koshmaniuk M.V. ,   NGO Association of parents of children with spina bifida and hydrocephalus Lights of Spirit, Ternopil, Ukraine,   Ternopil Volodymyr Hnatiuk National Pedagogical University, Ukraine, Kovalenko R.O. ,   Kyiv School of Economics, Ukraine
Published: April 2024

Patients with spina bifida (SB) face an increased risk of infection due to frequent exposure to medical procedures and visits to healthcare centers, including rehabilitation centers. Infection can lead to complications in kidneys and urinary bladder, disrupt rehabilitation efforts, and reduce the quality of life. Purpose - to assess the knowledge, attitudes, and practices related to vaccination among patients with SB and identify the reasons for the low vaccination rates in this group of children. Materials and methods. An anonymous online survey was conducted among 56 parents of patients with SB. The questionnaire evaluates the knowledge (10 questions), attitudes and practices (4 questions) towards vaccination among parents of patients with SB in Ukraine. The results were analyzed using standard procedures with Statistica StatSoft 6.0 software package. Continuous variables were expressed as a mean and standard deviation (SD). The comparison of frequency parameters was performed using the Chi-square test. The differences between the parameters were statistically significant at p<0.05. Results. Overall, parents demonstrated good knowledge about the role of vaccines in preventing serious diseases (61.7% gave correct answers), and the percentage of correct answers did not significantly differ between vaccinated, partially vaccinated, or unvaccinated groups of children. However, only 12.5% of SB patients were fully vaccinated and 51.8% were completely unvaccinated. Among the unvaccinated, the majority (55.2%) indicated non-recommendation by specialist doctors (neurosurgeon, neurologist, etc.) as the main reason. Primary care physicians were less likely to not recommend vaccination. Delayed vaccination was primarily due to fear of adverse reactions (40%). Despite low vaccination rates, parents generally had a positive attitude towards vaccination (only 5.4% against). Doctors remained the most influential source of information (63.4%). Conclusions. A study suggests a need to enhance knowledge among healthcare professionals, increase public awareness, and provide education within patient groups to improve immunization coverage and protect SB children from preventable infectious diseases. No conflict of interests was declared by the authors.
The influence of smoking on the cytogenetic status of the oral mucosa in teenagers and young adults
Authors:   Ivano-Frankivsk National Medical University, Ukraine, Lisetska I.S.
Published: April 2024

Cytogenetic monitoring provides information on both the health status of the population under study and the impact of genotoxic factors, i.e., the cytogenetic status of a person can serve as a biomarker of the level of exposure to genotoxicants, including various types of smoking. Purpose - to investigate the effect of different types of smoking on the cytogenetic status, namely, to analyse the cariological parameters of buccal epithelial cells of the oral mucosa in teenagers and young adults. Materials and methods. The cytogenetic status was studied by analysing the karyological parameters of buccal epithelial cells of the oral mucosa in 114 adolescents aged 15 to 24 years, who were divided into groups: the Group I included 26 people who smoke traditional cigarettes; the Group II - 22 people who smoke electronic cigarettes (vapes); the Group III - 23 people who smoke tobacco heating devices (IQOS); the Group IV - 43 people without smoking habits. Results. A significant increase in epithelial cells of buccal epithelium with nuclear disorders was found in smokers compared to the group of people without smoking habits. In addition, in individuals without smoking habits, no nuclear disorders such as protrusions, proliferation rates, early stage of nucleus destruction and completion of nucleus destruction were detected. Conclusions. The sensitivity of buccal epithelial cells to the effects of different types of smoking was established, which affects changes in cariological parameters. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.
Viral pneumonia in children: present and future
Authors:   Shupyk National Healthcare University of Ukraine, Kyiv, Chernyshova L.I. , Chernyshov A.V. ,   SI National Research Center for Radiation Medicine, Hematology and Oncology of the NAMS of Ukraine, Kyiv
Published: April 2024

Purpose - to attract attention and provide information about modern approaches to the diagnosis of viral pneumonia, which in the future will make it possible to make a more confident diagnosis of viral pneumonia and not to prescribe antibiotics to all patients. Pneumonia is the leading cause of morbidity and mortality among young children outside the neonatal period worldwide. Not always a detected microorganism or virus in the nasopharynx is proof that it is the causative agent of this particular pneumonia, since healthy carriers of both bacteria and viruses are found quite often. For example, during the examination of healthy children under the age of 5 years in Ukraine, pneumococcal carriers, which are recognized as the leading cause of community-acquired pneumonias (CAP), were found in 21.3% when bacterially examining swabs from the nasopharynx, and when using the PCR method - in 53.8%. However, on in practice, the diagnosis of viral pneumonias was almost never made, and when a diagnosis of pneumonia is made, the first thought about a bacterial infection traditionally arises. Following the emergence of severe acute respiratory syndrome (SARS), avian influenza A (H5N1) and pandemic influenza A (H1N1) viruses in 2009, the important role of respiratory viruses as causes of severe pneumonia has received special attention. Recently, the availability of multiplex PCR-based tests, which allow for the simultaneous identification of a large number of viruses, contributes to an increase in the number of diagnoses of viral pneumonia, increasing awareness of viruses as causative agents of respiratory lung diseases. Clinically, it is not easy to distinguish between viral and bacterial pneumonia. New protocols for the treatment of CAP in children are already being created, which include a set of clinical and laboratory signs that allow us to think about the viral etiology of pneumonia. However, today there is a dissonance: everyone recognizes the predominance of viral etiology of CAP, but at the same time, the main treatment for the most part remains antibiotics. With the expansion of universal vaccination against Hib and pneumococcus, an increase in the share of viral pneumonias among CAP is predicted, which will stimulate the development of drugs against respiratory viruses. We can hope that in the near future not all children will be prescribed antibiotics, which will contribute to reducing the development of resistance of microorganisms to antibacterial drugs. No conflict of interests was declared by the authors.
Clinical manifestations of Hirschsprung’s disease in children aged 1 to 3 years
Authors:   Ivano-Frankivsk National Medical University, Ukraine, Kurtash O.O. , Prytula V.P. ,   Bogomolets National Medical University, Kyiv, Ukraine,   National Children’s Specialized Hospital OKHMATDYT, Kyiv, Ukraine, Rybalchenko V.F. ,   Shupyk National Healthcare University of Ukraine, Kyiv, Hussaini S.F. ,   Bogomolets National Medical University, Kyiv, Ukraine,   National Children’s Specialized Hospital OKHMATDYT, Kyiv, Ukraine
Published: April 2024

Clinical manifestations of Hirschsprung's disease (HD) in children aged 1 to 3 years depend on many factors, namely the extent of colonic aganglionosis (CA), the age of patients, the presence of associated congenital malformations and severe complications. Purpose - to study the features of the clinical manifestations of HD in children aged 1 to 3 years for the early detection and verification of this pathology. Materials and methods. We conducted a retrospective analysis of the clinical manifestations of HD in 268 children aged 1 to 3 years: 74 (27.62%) children with the rectal form of HD, 187 (69.77%) with rectosigmoid form and 7 (2.61%) with subtotal form. Associated malformations were found in 50 (18.66%). To study the clinical course, we considered the anamnesis, physical examination, data of general clinical laboratory indicators of blood, urine and feces, electrocardiography, neurosonography, echocardiography, ultrasound and X-ray dianostics. Results. Hypotrophy was found in 54 (20.15%) children: the first degree in 9 (3.36%) children, the second degree in 34 (12.69%) and the third degree in 11 (4.1%) patients. Laboratory tests revealed mild anemia in 4 (1.49%), moderate anemia in 11 (4.1%), and severe anemia in 31 (11.57%) children. The HD course was complicated by enterocolitis in 25 (33.78%) of 74 patients with rectal, in 86 (46.52%) of 187 children with rectosigmoidal and in 7 (100%) of 7 children with subtotal CA. Toxic megacolon was diagnosed in 6 (3.21%) patients. Conclusions. Associated malformations and late diagnosis are the main causes of severe complications of HD in children aged 1 to 3 years: enterocolitis (44.03%), toxic megacolon (4.85%), hypotrophy (20.15%) and anemia (17.16%). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors.
Retrospective analysis of carious lesions of hard dental tissues in children from the territories of Ukraine contaminated by radiation as a result of the accident at the Chornobyl NPP
Authors:   Bogomolets National Medical University, Kyiv, Ukraine, Liubarets S.F. , Savychuk O.V. ,   Bogomolets National Medical University, Kyiv, Ukraine, Shapovalova G.I. ,   Bogomolets National Medical University, Kyiv, Ukraine,
Published: April 2024

The relevance of the study is due to the presence of significant carious lesions of the hard tissues of the teeth in children from radiation-contaminated territories as a result of the accident at the Chornobyl nuclear power plant (ChNPP). Purpose - to conduct a retrospective analysis of the intensity of dental caries in children of Ukraine, residents of radiation-contaminated territories, taking into account the general state of health at different times after the accident at the ChNPP (1993-1996, 2001-2003, 2016-2018) as a basis for the further development of a complex of therapeutic and preventive measures for this pathology. Materials and methods. The object of the study: 1852 children aged 7-15 - residents of territories contaminated with radionuclides. Assessment of caries intensity of permanent teeth in accordance with WHO recommendations (2013) included determination of caries prevalence and index assessment of caries intensity of permanent teeth (PT): «decayed, missing, filled permanent teeth» (DMFT) and «decayed, missing, filled permanent teeth surfaces» (DMFS). Statistical processing of data was carried out using methods of variational statistics (statistical package «IBM SPSS Statistics 20.0.0»). Results. In 1993-1996 irradiated children from the III zone had a very high intensity of dental caries (DMFT - 7.25±0.77, DMFS - 10.92±1.77), twice as high compared to residents of the IV zone. In children from III and IV zones in 2001-2003 the intensity of dental caries was higher in the presence of somatic pathology. In 2016-2018 compared to the period 2001-2003 there was a significant (p<0.05) decrease in both indices of carious lesions, probably due to a decrease in the degree of exposure of children to radionuclides. Conclusions. During the period 1993-1996 the highest rates of dental caries intensity were determined in 15-year-old children from zone III compared to residents of zone IV. The intensity of dental caries during the periods of 2001-2003 and 2016-2018 decreased, although it remained at a high level, which requires the further development of a complex of treatment and prevention measures for this pathology. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the children's parents was obtained for the research. The authors declare no conflict of interests.
Iterations and unions of star selection properties on topological spaces
Authors: Casas-de La Rosa Javier , Chen-mertens William , Garcia-balan Sergio A.
Published: April 2024

In this paper, we investigate what selection principles properties are possessed by small (with respect to the bounding and dominating numbers) unions of spaces with certain (star) selection principles.. Furthermore, we give several results about iterations of these properties and weaker properties than paracompactness. In addition, we study the behaviour of these iterated properties on $\Psi$-spaces. Finally, we show that, consistently, there is a normal star-Menger space that is not strongly star-Menger; this example answers a couple of questions posed in [J. Casas-de la Rosa, S. A. Garcia-Balan, P. J. Szeptycki, \emph{Some star and strongly star selection principles}, Topology Appl. 258 (2019) 572-587]
Warped product pointwise bi-slant submanifolds of locally product Riemannian manifolds.
Authors: Majeed Prınce , Lone Mehraj
Published: April 2024

In this paper we introduce the concept of pointwise bi-slant

submanifolds of locally product Riemannian manifolds and studied warped

product pointwise bi-slant submanifolds of locally product Riemannian

manifolds. We obtain some characterization results for warped products

pointwise bi-slant submanifolds. Also, we provide some non-trivial

examples of such warped product submanifolds.