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Hematohidrosis (bloody sweat) is a symptom of trophic damage to the vascular wall, in which sweat mixes with blood and seeps onto undamaged areas of the skin in the form of red or pink liquid (depending on the ratio of sweat to blood). In our study we have analyzed 25 case reports of hematohidrosis in children, reported throughout the world using PubMed, ResearchGate with detailed description and opened access. We took into consideration: age of the patient, sex, location of bloody excretion, cause or trigger, treatment and its effectiveness. Our clinical case present a 9-year-old girl complained of a periodic bleeding from the intact skin of the face, neck, thighs (without visible damage to the skin) manifested by red or pink liquid, nosebleeds, and bloody discharge from the mucous membrane of the eyes. The secretions were of varying intensity and lasted up to several hours. Most of all episodes are associated with a strong emotional exertion. One of the theories of hematohidrosis pathogenesis is evident vasoconstriction of the blood vessels surrounding the sweat glands, provoked by hyperactivation of the sympathetic nervous system, which is followed by their excessive vasodilation up to rupture and blood entering the sweat gland ducts. Capillary endothelial cells are known to contain β2-adrenoceptors, which, through the modulation of nitric oxide release, cause endothelium-dependent vasodilation. Blocking β-adrenoceptors (for example, propranolol) prevents excessive vasodilation of blood vessels and, accordingly, their rupture and blood flow to the sweat gland. We managed to find out that the patient's bloody sweat was a manifestation of a separate pathological phenomenon, and not one of the symptoms of another disease. A properly formed treatment complex and the great trust of the parents enabled to stabilize the child's condition, and later to cure her. Currently, hematohidrosis is recognized as an independent disease that requires in-depth study of the triggering mechanisms of development, pathogenetic and clinical features., (Copyright © 2024 Oksana Matsyura, Lesya Besh, Svitlana Jefimova, Khrystyna Slivinska-Kurchak, Sergiy Gerasymov. Published by Vilnius University Press.)

It is observed a correlation between the administration of artificial ventilation in the neonatal period and the subsequent formation of bronchopulmonary pathology. Aim - to study the frequency and the features of the course of broncho-pulmonary pathology in young children who were on artificial ventilation of the lungs in the neonatal period. The directions of the selection of medical histories were conducted, which was carried out by artificial ventilation of the lungs for pulmonary causes. The article presents the literature data and own experience of authors, which proves that there is a correlation between the conducted artificial ventilation of the lungs in the neonatal period and the subsequent formation of bronchopulmonary pathology. The results of a retrospective analysis of 475 children who received respiratory therapy are shown. It is a positive correlation is observed between the duration of artificial ventilation and the incidence of bronchitis (p<0.005) and pneumonia (p<0.005). There is a close correlation between the early introduction of artificial feeding and the development of allergies. We found a positive correlation between the presence of allergic pathology and hereditary predisposition to the development of atopy, gestational age and the development of bronchopulmonary dysplasia. In 27% of children who stayed on artificial ventilation during the neonatal period, there was a recurrent broncho-obstructive syndrome in early childhood. Premature children who have undergone acute pulmonary disorder and hereditary hereditary burdens should be considered as a high-risk group for developing bronchial asthma. Repeated episodes of broncho-obstructive syndrome in young children, who during the neonatal period were on artificial ventilation of the lungs, were most often due to bronchial asthma, which was characterized by a severe course.

Objective: The aim: 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., Patients and Methods: Materials and methods: 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)., Results: Results: 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), could not be obtained., Conclusion: 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.

The global spread of SARS-CoV-2 points to unrivaled mutational variation of the virus, contributing to a variety of post-COVID sequelae in immunocompromised subjects and high mortality. Numerous studies have reported the reactivation of "sluggish" herpes virus infections in COVID-19, which exaggerate the course of the disease and complicate with lasting post-COVID manifestations CMV, EBV, HHV6). This study aimed to describe clinical and laboratory features of post-COVID manifestations accompanied by the reactivation of herpes virus infections (CMV, EBV, HHV6). 88 patients were recruited for this study, including subjects with reactivation of herpes viruses, 68 (72.3%) (main group) and 20 (27.7%) subjects without detectable DNA of herpesviruses (control group): 46 (52.3%) female and 42 (47.7%) male; median age was 41.4 ± 6.7 years. Patients with post-COVID manifestations presented with reactivation of EBV in 42.6%, HHV6 in 25.0%, and EBV plus HHV6 in 32.4%. Compared with controls, patients with herpes virus infections presented with more frequent slight fever temperature, headache, psycho-neurological disorders, pulmonary abnormalities and myalgia (p < 0.01), activation of liver enzymes, elevated CRP and D-dimer, and suppressed cellular immune response (p ≤ 0.05). Preliminary results indicate a likely involvement of reactivated herpes virus infections, primarily EBV infections in severe COVID-19 and the formation of the post-COVID syndrome. Patients with the post-COVID syndrome and reactivation of EBV and HHV6 infections are at high risk of developing various pathologies, including rheumatologic diseases., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Gestation and the neonatal period are crucial periods in infant development. Many components of breast milk, including fatty acids, play an important role in strengthening the immune system. The aim of our research was to evaluate the fatty acid profiles of milk from 69 mothers, including subjects having a normal weight, obesity, or gestational diabetes. For the analyses, we used gas chromatography (GC) with flame ionization detection (FID) and GC coupled with mass spectrometry (GC/MS). The main fatty acids found in breast milk were palmitic acid (C16:0; 26-28%), linoleic acid (C18:2; 23-28%), and α-linolenic acid linoleic acid (C18:3; 15-17%), followed by myristic acid (C14:0; 5-8%), lauric acid (C12:0; 4-6%) and stearic acid (C18:0; 4-5%). The average breakdown of fatty acids was 50% saturated, 44% polyunsaturated, and 6% monounsaturated. Breast milk samples were classified using principal component analysis and linear discriminant analysis. Results showed that milk from the two major groups of obese and normal body mass index (BMI) could be distinguished with an accuracy of 89.66%. Breast milk samples of Hungarian and Ukrainian mothers showed significant differences based on the fatty acid composition, which variations are attributable to the mothers' dietary habits.

Cow’s milk allergy (CMA) is one of the most frequent types of food allergy. The aim of the study was to investigate whether IL-13 R130Q and IL-4 T589C polymorphisms are associated with the risk of CMA in young Ukrainian children. A total of 120 children (age range: 1−3 years) participated in the study and were divided into two groups: CMA (n = 60) and healthy controls (CNT, n = 60). The CMA group had two subgroups: specific oral tolerance induction (SOTI, n = 30) and milk elimination diet (MED, n = 30). The CNT group had two subgroups: positive family history of allergy (+FHA, n = 24) and negative family history of allergy (−FHA, n = 36). In the CMA group, molecular genetic testing of CC, CT, and TT genotypes of single nucleotide IL-4 T589C gene polymorphisms showed significantly higher rates of the CC genotype compared to healthy controls (92.2% vs. 58.8%; p < 0.01). In the CMA group, molecular genetic testing of GG, GA, and AA genotypes of single nucleotide IL-13 R130Q gene polymorphisms showed significantly higher rates of GA and AA polymorphic locus genotypes compared to healthy controls (43.5% vs. 22.4%, p < 0.05 and 8.7% vs. 0%, p < 0.05, respectively). In future studies, the genotypic and allelic distribution of these polymorphic variants will be determined in children with CMA and healthy children.

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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Matsyura, Besh, Borysiuk, Gutor, Malska, Kovalska, Besh, Sorokopud and Vari.)

Objective: The aim: To determine the significance of multidisciplinary approach to management of pediatric patients with skin symptoms of food allergy., Patients and Methods: 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: 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., Conclusion: 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.

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.

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.

The article presents analysis of causes of occurence and own diagnostic search for hypersensitivity to food additives in children. Food additives are substances of natural and artificial origin, purposefully added to food products for certain technological effects (color, resistance to spoiling, maintenance of the structure and appearance). It has been shown in the article that most frequently "harmful" food additives are present in meat, dairy and confectionery products, beverages, sauces, canned products, spices. The most threatening as to the development of allergic reactions in children (dermatitis, urticaria) are the following additives: E 102 - tartrazine, E 103 - alkaline, E 104 - yellow quinoline, E 105 - transparent yellow, E 110 - yellow "sunset", E 111 - orange alpha-naphthol, E 122 - carmoazine, E 123 - amaranth, E 124 - ponso 4R, E 126 - ponso 6R. Regarding the preservatives, the most commonly spread triggers of allergic reactions are benzoates (E 210-219) and sulfites (E 220-229), which can cause urticaria, dermatitis, bronchial asthma exacerbations, and anaphylaxis. Taking two clinical cases as the example, the observation of the development of severe allergic reactions associated with the harmful effects of certain nutritional additives (E 102 - tartrazine and E 110 - yellow "sunset") could be conducted. It is necessary to instruct patients to read and correctly interpret the information on the packaging of the products. Brightly colored foods, products with intense smell and long shelf life are often the source of "harmful" food additives. The longer is the list of the ingredients of the product on the packaging, the higher is the likelihood that it contains doubtful ingredients.

The aim of the study was to optimize the method of selecting patients with bronchial asthma for the use of allergen-specific immunotherapy with allergens of house dust mites and to evaluate its effectiveness. The research was carried out based on the Municipal Non-Commercial Enterprise «City Children's Clinical Hospital» in Lviv. The study included 120 school-age children (aged 6-17) with bronchial asthma and sensitization to house dust mites. 60 patients were the main group of patients who received ASIT along with the basic treatment (30 sublingual sprays, 30 subcutaneous ASIT). The other 60 patients were in the comparison group and received only basic therapy for bronchial asthma. The presence of sensitization to house dust mites was proved based on skin prick testing. Optimization of patient selection consisted of molecular allergy diagnostics using the Immuno CAP method with the determination of sIgE to components of allergens of house dust mites rDer p1, rDer p2, rDer p10 to accurately assess patient sensitization for further use of ASIT. To assess the effectiveness of ASIT, asthma control test (ACT) indicators were analyzed, patients' quality of life was assessed, spirometric indicators were evaluated (FEV1 and PEF), and IFNγ and IL13 levels were assessed in patients with ASIT. After one year of treatment, the average asthma control test among patients receiving sublingual ASIT increased the most - by 26.32% (p <0.01). Also in this group of patients, there was the largest increase in PEF - by 9.82% (p <0.01). Regarding the increase in FEV 1, it was the highest in the group of patients receiving subcutaneous ASIT - by 9.85% (p <0.01). The quality of life of patients in the assessment of symptoms increased the most in patients who received sublingual ASIT by 28.7%. Based on our results, we can draw the following conclusions: The application of molecular allergy diagnostics using the definition of sIgE to the components of allergens of house dust mites rDer p1, rDer p2, rDer p10 allows optimizing the selection of patients for allergen-specific immunotherapy. Treatment of bronchial asthma with the involvement of ASIT during the first year allows obtaining higher efficiency indicators, which are manifested by a significant improvement in asthma control test, external respiration function and quality of life. Monitoring of immunological parameters showed a significant increase in IFNγ, which can be regarded as the activation of the process of switching the immune response from Th-2 to Th-1 indirect, and thus illustrates the positive effect of ASIT.