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Background. There is currently a debate about the diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescent girls. The role of vitamin D in the pathogenesis of PCOS remains unclear. The purpose: to study the serum level of 25(OH)D in adolescent girls and to analyze its connection with PCOS. Materials and methods. Twenty-three patients aged 14-18 years with PCOS were examined on the basis of the Chernivtsi Regional Clinical Hospital. The control group consisted of 25 girls of a similar age without disorders of gynecological status. Body mass index, degree of hirsutism, hormonal, lipid profile, HOMA index, calcium concentration were determined according to generally accepted methods. Levels of serum 25(OH)D were measured using the electrochemiluminescence method. Sonography of the ovaries was performed. Statistical data were processed using the Microsoft Excel 2020 program on a personal computer and the package of application programs Statistica for Windows v. 7.0 (StatSoft Inc.). Ethical principles are observed in the work, taking into account the main provisions of the ICH GCP and the Declaration of Helsinki. Results. The premorbid background of the examined adolescent girls included allergic reactions, infectious, respiratory, digestive, and urinary diseases. The level of 25(OH)D was inversely proportional to body mass index (r = -0.23, p < 0.05), hirsutism (r = -0.22, p < 0.05), HOMA-IR (r = -0.198, p < 0.05). Deficiency of 25(OH)D in adolescent girls with excess body weight was associated with dyslipidemia (r = -0.33, p < 0.01). Indicators of the serum level of calcium varied within the reference values. The odds ratios for the development of PCOS in adolescent girls were: 25(OH)D [2.35, 95% CI: 1.84-5.06, p < 0.05]; excess body weight [2.09, 95% CI: 1.94-4.56, p < 0.05], clinical hyperandrogenism (hirsutism) [2.98, 95% CI: 2.12-4.19, p < 0.01]; HOMA-IR [2.30, 95% CI: 1.02-5.15, p = 0.04]; high-density lipoproteins [2.56, 95% CI: 1.92-5.87]. Conclusions. PCOS occurs on the background of 25(OH)D insufficiency or deficiency. 25(OH)D deficiency, excess body weight, clinical hyperandrogenism, HOMA-IR, and high-density lipoproteins increase the risk of PCOS in adolescent girls. [ABSTRACT FROM AUTHOR]

Aim. The aim of the work is to draw attention to the symptoms associated with Tourette syndrome and to examine the association with comorbid diseases. Materials and methods. A review of the scientific literature on Tourette syndrome (TS) was conducted using the following keywords: "tics", "Tourette syndrome", "Tourette obsessive-compulsive disorder, TOCD", "obsessive-compulsive disorder, OCD", "attention deficit hyperactivity disorder, ADHD" using PubMed, MEDLINE, EMBASE as search engines. Taking into account studies conducted in the last 10 years, the abstracts of 275 articles were analyzed. Articles were selected for the study based on the criterion of their close relevance to the topic. The study results covered in 49 articles were examined in more detail. A description of a TOCD clinical case was prepared from primary medical documentation with parental informed consent. Results. The prevalence of TS is quite variable, depends on epidemiological research methods and ranges from 0.3 % to 1.0 % worldwide. Given the methodological limitations of most studies, the actual prevalence may be 10 times higher. TS is a progressive disease and is characterized by regular stages. Tourette syndrome-plus is distinguished, including autoaggressive actions besides the basic symptoms of OCD and ADHD. The etiology of TS is still being studied. In particular, the impact of environmental factors is considered: infection or inflammation, perinatal complications and chronic psychosocial stress in childhood. In 70-80 % of cases, TS is a hereditary disorder, making it one of the most heritable childhood-onset neuropsychiatric diseases. Various approaches have been applied to assess the genetic architecture of TS, including candidate gene studies, segregation analysis, linkage analysis, cytogenetics, copy number variants (CNV), rare variation studies, genome-wide association studies (GWAS), and whole exome sequencing (WES). Currently, there is no specific laboratory or genetic test for TS diagnosis. Pharmacological treatments are available but often ineffective; behavioral and surgical treatments are under development. The clinical case of TS in a 10-year-old boy is described with an onset at the age of 7 years following frequent infections, manifested as cephalocaudal motor tics and several vocal tics (coprolalia, echolalia) with a progression to obsessive-compulsive behavior (mysophobia, compulsive skin picking, self-hitting, self-biting, repetitive compulsions). The presented clinical case is of great interest from the viewpoint of somewhat belated diagnosis of TOCD syndrome, as well as indicates the need to continue the search for effective methods of diagnosis and treatment. Conclusions. The case of comorbid OCD and tic disorder is a unique endophenotype combining externalized disinhibited TS movements in parallel with internalized distress reminiscent of OCD. Clinicians should consider these features when choosing treatment methods. [ABSTRACT FROM AUTHOR]

Despite a sufficient number of scientific studies devoted to the study of myopia risk factors, the influence of obesity on the degree of myopia risk in childhood has not been sufficiently studied, which prompted us to study this issue using children as an example. The aim is to study the frequency and degree of myopia risk in overweight and obese children. Material and Methods. The sample of children for the study was formed step by step in the process of randomization. The first stage included a one-time epidemiological study of children aged 10-18 years during preventive examinations in schools of Chernivtsi and Chernivtsi region (1,035 persons). The primary screening included anthropometry and assessment of physical development. For detailed examination 205 persons were selected: with overweight (OW, 65 persons), with obesity (75 persons) and with normal body weight (65 persons, comparison group). The ophthalmologic examination included: visometry without and with correction, autorefractokeratometry before and after cycloplegia, biomicroscopy, ophthalmoscopy, optical biometry of the eye. To reveal the statistical difference between indicators in normally distributed groups, the Student's t criterion of reliability was used, the degree of significance - r. Comparison of groups on a qualitative basis was performed using Pearson's χ2 test. Differences were considered statistically significant at p <0.05. The research design and all methods used in this study were reviewed and approved by the Bioethics Committee of the Bukovinian State Medical University (Protocol No. 10, dated 18.05.2002). The study was conducted within the research work «Early diagnosis, treatment and prevention of combined pathology of gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022). Results. The frequency of myopia in children with OW and obesity was significantly higher than in children with average body weight (χ2 = 3.2, p < 0.05). Children with obesity and myopia were 2.7 times more likely to have diseases of the musculoskeletal system, 1.8 times more likely to have pathology of the autonomic nervous system, and 3.1 times more likely to have chronic diseases of the oropharynx than children in the control group. In all groups of children, the additional risk was greatest in children whose mother or father was myopic (49.6 and 41.3 %, respectively). Minimal additional risk was associated with a history of childhood infections (<1.6 %), helminthiasis (<3.9 %), nasal polyps (<3.4 %), adenoids (<2.4 %), and spinal cord injury at birth (<9.1 %). The odds ratio for the development of low myopia in the group with OW and obesity compared to the control group (normal weight) were 1.25 [95 % CI 0.56-2.82] and 0.88 [95 % CI 0.49-1. 58], for the development of moderate myopia - 1.22 [95 % CI 0.57-2.59] and 0.82 [95 % CI 0.46-1.49], respectively, and for the development of high myopia-1.37 [95 % CI 0.51-3.66] and 0.80 [95 % CI 0.49-2.09], respectively. Conclusion. The risk of myopia is higher in children with overweight and obesity, which emphasizes the importance and necessity of taking into account the somatic condition of the child. [ABSTRACT FROM AUTHOR]

Background. Obesity affects 27–34 % of children and is considered a major public health problem. As more and more children suffer from overweight, health professionals need to find effective methods of obesity prevention and treatment. The purpose was to evaluate the effectiveness of family behavioral therapy in the treatment of obese children. Materials and methods. For one year, 57 obese patients aged 7–12 years were under observation, they were randomly divided into 2 groups: a treatment group of 34 children (I) and a comparison group of 23 people (II). Group I children participated in the family behavioral treatment program, which included hypocaloric nutrition, control over the family environment, and dosed, controlled physical activity. The blood lipid spectrum was studied by the level of total cholesterol (TCh), triglycerides (TG), low-density lipoprotein cholesterol (LDL-Ch) and high-density lipoprotein cholesterol (HDL-Ch). Results. In obese children, both systolic (SBP) and diastolic blood pressure (DBP) were elevated (mean of 125.9 ± 0.9 mm Hg and 66.9 ± 1.2 mm Hg, respectively), an increase in the concentration of TCh, TG, and LDL-Ch was detected. One year after family behavioral therapy, body mass index in obese children decreased from 26.8 to 25.1 kg/m², changes in SBP and DBP were statistically significant between groups (group I: SBP before was 124.9 ± 0.8 mm Hg, after — 118.9 ± 0.9 mm Hg, p < 0.05; DBP was 65.7 ± 1.2 mm Hg and 62.1 ± 1.0 mm Hg, respectively, p < 0.05; group II: SBP before the program was 125.1 ± 0.7 mm Hg, after — 126.9 ± 0.8 mm Hg, p > 0.05, DBP was 66.6 ± 1.1 mm Hg and 67.7 ± 1.2 mm Hg, respectively, p > 0.05), and there were also significant changes in blood lipids: the level of cholesterol decreased by 0.87 times, TG — by 0.94 times, with a tendency to LDL-Ch decrease and HDL-Ch increase. Conclusions. Multicomponent family behavioral therapy is effective in reducing the body mass index of obese children. The obtained results indicate the need to apply the proposed treatment program in clinical practice. [ABSTRACT FROM AUTHOR]

Particular features were studied of immunogrammes in those children presenting with thyroid pathologies (hyperplasia of the thyroid gland, autoimmune thyroiditis, nodular goiter) who live in the territories affected by contamination with radionuclides. An analysis was carried out of particular characteristics of immunity in children depending on the level of contamination in the region where they reside. The results obtained suggest changes in the T and B links of immunity in children with thyropathy.