Introduction. Currently, there are more than 200 methods of surgical treatment of a megaureter, but none of the methods has achieved universal acceptance. Until now, the issues of differential diagnosis of organic and functional causes of ureteral dilatation in children under 3 years of age have not been sufficiently illuminated, there is no generally accepted algorithm for the management of patients with this pathology.Relevance. The relevance of obstructive uropathies is evidenced by the fact that they occupy the third position in the list of the most common causes of chronic kidney disease in children, and account for 15% of cases. The prognosis of the outcome of obstructive uropathy is determined by the nature of the lesion and the degree of involvement in the pathological process of the kidneys, one of the main homeostatic and endocrine organs in humans. The degree of involvement of various markers in the development and progression of kidney damage in children is still insufficiently understood. All this prompts the search for screening, highly sensitive and specific methods for the diagnosis and prediction of nephrosclerotic changes in children against the background of urinary tract obstruction. Objective:The study of the clinical and laboratory diagnostic methods, allowing to differentiate functional or organic urodynamic disorders, to determine the tactics of managing patients with obstructive uropathy.12 Materials and methods. Since 2016, a study has been conducted of 174 children aged 0 to 18 years. 3 groups of children were identified: 1) with endoscopic treatment (main group);2) treated with an open surgical method (control group); and 3) a group of children without urinary tract obstruction (reference group). Results.In the course of the study, it was found that the most optimal values of serum cystatin C, close to the reference group (0.048-0.831 mg/ml) were obtained in children treated with endoscopic correction of the intramural ureter (0.217-0.798 mg/ml). Conclusions. The tactics of endoscopic treatment of obstructive uropathies in children has advantages in terms of open surgical methods in technical simplicity, minimally invasiveness, maximum physiology, and a decrease in the frequency of postoperative complications. These theses are confirmed by the obtained results of the study of serum cystatin C as a marker of the state of renal filtration. It should be remembered that the effectiveness of endoscopic stenting of the lower ureter depends on the age of the child.

Tuberculosis in children is a chronic inflammatory process in which immunological mechanisms occupy one of the leading positions in pathogenesis. Therefore, the immune status indicators study among children makes it possible to determine the disease activity, predict its course for the purpose of revealed violations early correction and determine the effectiveness of the treatment. One of the immunological indicators of tuberculosis is immunoglobulins level.The aim of the work -to investigate IgE, A, M, G levels in children's blood serum with newly diagnosed tuberculosis at the beginning of antimycobacterial therapy for further development of rationally directed immunocorrective therapy.Materials and methods. The study of IgE, A, M, G levels in blood serum was performed in 28 children with newly diagnosed tuberculosis aged 1 to 16 years (average age was 9.2 ± 1.1 years old). The levels of IgE, IgA, IgM and IgG in the blood serum were studied using the method of solid phase enzyme-linked immunosorbent assay on the equipment of the Sirio S immunoenzyme reader with the use of reagent kits "Granum" LLC (Kharkiv, Ukraine). The results of the study were processed by modern methods of analysis on a personal computer using statistical software package Statistica ® for Windows 6.0 (StatSoft Inc., AXXR712 D833214FAN5).Results. Children with newly diagnosed tuberculosis at the beginning of the intensive phase of antimycobacterial therapy had a significant increase in IgE and A levels in 2.1 and 1.2 times respectively. With an increase in the prevalence of a specific process and the appearance of destruction, there is a significant increase in the IgG level in 1.2 times. Direct correlations between IgE and IgA, IgA and IgM, IgM and IgG in the disseminated process, and IgA, IgM levels in the local process have been found. A reliable correlation between the decrease in the BCG post-vaccination sign size and the increase in IgE content has been revealed, that may be a prognostic factor in the post-vaccination immunity evaluation. Cellular component of immune system activation is determined in the children, as evidenced by a significant increase in albumins level in 1.5 times against the background of the specific inflammatory process low activity (α 1 -and α 2 -globulins levels were within the age norm). There is a significant worsening of dysproteinemia (a decrease in albumin levels by 9 % and an increase in β-and γ-globulins levels in 1.3 times) and specific inflammatory process activity (an increase in α 1 -globulin level in 1.3 times) with the increase in the specific process prevalence and destruction development. It has been established that the decrease in the albumin level is associated with growth in the IgE, A and G levels; growth in the β-globulin level is associated with growth in the IgA and G levels, and with IgE, M, and G -in γ-globulins. It has been found that IgA, M and G, and the protein fractions parametersalbumins, β-and γ-globulins are significant and highly informative for the immune changes diagnosis in ...