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.
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.
Проблема алергічних захворювань у світовій педіатричній практиці залишається пріоритетною впродовж багатьох років [5]. З 2010 року, згідно з даними ВООЗ, поширеність алергічної патології набула рис епідемії та характеризується погіршенням її клінічної структури [6]. В Україні спостерігається тенденція до пізньої діагностики алергічних захворювань, зокрема атопічного дерматиту. Слід відзначити, що така ситуація зустрічається навіть у сім'ях, де реєструється обтяжена атопією спадковість [1]. Аналіз основних причин алергічної епідемії показав, що основними тригерними чинниками є вплив мегаполісів, погіршення стану довкілля, нераціональне харчування, стресові навантаження, безконтрольне застосування медикаментів, пасивне та активне тютюнопаління [3, 6]. Атопічний дерматит характеризується поліморфними змінами на шкірі, що зумовлює серйозні труднощі диференцііальної діагностики. Під час діагностичного пошуку клінічна практика потребує проведення диференціації не лише з іншими захворюваннями алергічного характеру (харчова алергія,
The article presents the data from recent literature and personal, practical experience of differential diagnosis of skin allergies in children. The difficulties detected at various stages of the disease diagnosis with the need for differentiation of allergic diseases (food allergy, atopic dermatitis, urticaria, insect allergy) and non-allergic genesis are: viral infections with skin lesions (herpes, chicken pox, measles, infectious erythema, hand foot mouth disease), bacterial infections of the skin (strep-and staphylodermia), and a group of other diseases (ichthyosis, scabies, psoriasis). It also should be mentioned that special emphasis on diagnosis belongs to food hypersensitivity, which combines immunological and nonimmunologic reactions. An example of the observation of 60 children with skin allergies shows the approach to the investigation of the diagnosis and the difficulties that arose during this. All children were ill for more than 3 months, and at the time of inclusion in the research, there were no identified causes of the disease. The diagnostic algorithm included three stages: clinical (detailed collection of complaints and anamnestic data), laboratory (general blood test, biochemical and coprological examination, determination of total IgE and specific IgE to gluten and different milk fractions, serological biomarkers of celiac disease) and instrumental. For 14 days before blood collection patients underwent an elimination test. 2 L. Besh et al. The results of the study showed that in the study group of children aged 1-5 years the main diagnosis was atopic dermatitis (36.84%), food allergy (24.56%), lactase deficiency (7.02%), helminthiasis (7.02%), streptodermia (5.25%), celiac disease (3.51%). The need for an individual approach to the laboratory-instrumental algorithm of skin allergies was described, and the results of our personal approach to the diagnosis were shown.
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