The aim: To investigate the parameters change of the general immune responds and endocrine metabolism in the children with Acute Respiratory Pathology and their correlational relationship. Materials and methods: The study group included: school-age children (10-14 years old) with a diagnosis of acute respiratory disease (ARI) as a general group of respiratory tract inflammatory diseases, of viral and bacterial origin (n=40), which included local inflammatory lesions of the respiratory tract and presented with acute pharyngitis (60.0%), acute bronchitis (20%), acute tonsillitis (22%) and a control group (n=25), identical in age and sex. The research was conducted at the clinical base of the CNE «UCChH» of the Uzhhorod City Council. General clinical, immunological studies, inflammatory response of the child’s body were conducted. Statistical analysis of the results of the examination of patients was carried out using the Statistics for Windows v.10.0 computer program (StatSoft Inc, USA). The evaluation of the obtained results was carried out using parametric and non-parametric methods Results: The inflammatory response parameters of the child’s organism present indicative increases in the levels of cytokines with a significant predominance in comparison with the data of the children control group: the level of IL-1 increased in 2 times, IL-4 – in10 times, IL-6 – in 1.5 times, γ-IFN – in 3 times, TNF-α – in 25 times, Neopterin – in 9 times. The data of the general immune response indicate a 2-times increasing in the level of IgM (3.85 ± 1.89 g/l, p<0.01) and IgG level increased in 10 times (147, 35 ± 56.12 g/l, p< 0.01). The, according to the obtained data but, in comparison with the data of the control group. There are significant differences in the levels of Leptin (р< 0.01), C-peptide (р< 0.01), Thyroid stimulating hormone ( p<0.01), Free thyroxine (p=0.002). The Leptin level, which is at the upper limit of the reference, the level of Thyroid stimulating hormone at the lower limit of the reference, and the slight predomi¬nance of the C-peptide level are noteworthy. Predominance of reliable correlations of pro-inflammatory cytokines IL 1, 4, 6 of varying degrees (r=0.34-0.45) are observed. Only IgG with Free triiodothyronine (r=0.45,p=0.004), IgE with Thyroid peroxidase antibody (r=-0.45,p=0.004) were identified as statistically significant correlations with high reliability. Conclusions: The obtained date presents the increasing of the levels Cytocines (Il -1,4,6) in 2-10 times. The IgG level increased in 10 times and IgM – in 2 times. The indicators of endocrine metabolism are within the reference values. Reliable correlations of pro-inflammatory cytokines IL 1, 4, 6 of varying degrees (r=0.34-0.45) are observed. IgG with Free triiodothyronine (r=0.45,p=0.004) have significant reasonableness.

The article presents clinical observation of a patient with cryptogenic cirrhosis of the liver, a chronic diffuse progressive liver disease, which is manifested by structural rearrange¬ment of its parenchyma. Cryptogenic cirrhosis is cirrhosis of uncertain etiology that lacks definitive clinical and histological criteria for a specific disease. Cryptogenic cirrhosis accounts for nearly 5% to 30% of cases of cirrhosis and nearly 10% of liver transplants. The problem of cirrhosis of the liver is extremely relevant, because this pathology is observed mainly in young and able-bodied people. In addition, it takes the first place among the causes of mortality from diseases of the digestive system. To clarify the diagnosis, laboratory and instrumental diagnostic methods of investigation were performed. Due to severe thrombocytopenia and minor leukopenia, myelodysplastic syndrome was suspected. Metabolic disorders that can be considered as probable in the occurrence of the above-mentioned changes in the liver parenchyma had been ruled out.

The aim: To optimize the treatment of children with Essential Arterial Hypertension (EAH) in assotiation with Endotelial Dysfunction (ED) by studying the clinical and morphofunctional characteristics of the cardiovascular system disorders and correction of endothelial dysfunction with the using of essential phospholipids. Materials and methods: The study group consisted of 80 children and 30 – a control group. The next stage included the division of 80 children into 2 subgroups. Patients in the first subgroup received basic treatment (angiotensin-converting enzyme inhibitor of the third generation), the second – optimized treatment (basic treatment was with addition of certified drug lecithin). Doses were determined according to the instructions and age for 2 months. In the study were used: ECG, Echocardiography, Ultrasonography, Morphofunctional studies of the endothelium. Results: There is a dynamic decreasing in the level of left ventricular myocardial mass index (LV MMI), reduction of end-diastolic volume (EDV) and increase in the absolute values of shock volume (SV), ejection fraction( EF) under the influence of optimized treatment due to the inclusion of lecithin in the treatment of children with EAH with ED. The Ve/Va ratio had a tendency to increase. Vasoconstriction of vessels after the reactive hyperemia test was significantly reduced, but the degree of vasodilation varied depending on the method of therapy. The intima-media thickness (IMT) decreased in 1.12 times in the cases of children with an optimized treatment, accompanied by a decreasing of DEC by 2-times. Levels of the aortic stiffness index had a tendency of decreasing (from 0.88 ± 0.02 to 0.71 ± 0.01 and to 0.63 ± 0.01, respectively, by groups and in comparison with the control group – 0.55 ± 0 , 01), which reflects the improvement of hemodynamic parameters. The dynamic parameters obtained in the cases of patients with EAH in association with ED, taking into account the impact of the optimized treatment had positive correction on the total risk of cardiovascular complications, changes in the profile of LV diastolic filling, dysfunction of arterial endothelium. Conclusions: The inclusion of essential phospholipids in the treatment of children with EAH and ED helps to optimize the profile of LV diastolic filling and exclude vascular endothelial dysfunction and indicate a positive effect of optimized treatment on the overall risk of cardiovascular complications.

Хронічний панкреатит (ХП) відноситься до нозологій, показники захворюваності яких мають тенденцію до загальносвітового зростання. Визначено ряд причин, які сприяють появі та прогресуванню хронічного запального процесу на рівні підшлункової залози (ПЗ). Одними із таких є дисліпопротеїнемії. Мета дослідження: проаналізувати особливості ліпідного метаболізму у пацієнтів, які страждають на ХП із екзокринною недостатністю. Матеріали та методи: нами обстежено 79 пацієнтів з ознаками ХП, які знаходилися на стаціонарному лікуванні у Хустській РЛ протягом 2017-2018 років. Відповідно до отриманих результатів було сформовано три досліджувані групи. Першу складали пацієнти на ХП із легкою зовнішньосекреторною недостатністю ПЗ (ЗНПЗ) (n = 50), другу ‒ із помірною ЗНПЗ (n = 29), до третьої включили практично здорових людей (n = 23). Для оцінки екзокринної функції ПЗ визначали рівень еластази-1 у калі. Ліпідний гомеостаз оцінювали за наступними показниками: загальний холестерол (ЗХС), тригліцерол (ТГ), холестерол ліпопротеїнів низької щільності (ХС ЛПНЩ), холестерол ліпопротеїнів дуже низької щільності (ХС ЛПДНЩ), холестерол ліпопротеїнів високої щільності (ХС ЛПВЩ) та індекс атерогенності (ІА). Крім того, провели кореляційний аналіз впливу дисліпідемічних розладів на виразність ЗНПЗ. Результати досліджень вказують на наявність у хворих на ХП “ліпідного дистрес-синдрому”, що проявлявся у вигляді гіперхолестеролемії, гіпертригліцеролемії, підвищення концентрації ХС ЛПНЩ, ХС ЛПДНЩ та зниження вмісту ХС ЛПВЩ. Встановлено залежність екзокринної недостатності від вираженості дисліпідемічних розладів. Висновки: у хворих на ХП виявлено ознаки порушень ліпідного метаболізму та доведено вплив останніх на екзокринну функцію ПЗ. Тому вважаємо необхідним ретельне дослідження ліпідограми у всіх пацієнтів із ознаками хронічного ураження ПЗ.

recommended to use the definition of FE-1 as a specific marker of the exocrine function of the pancreas.