The aim: To evaluate the efficacy of the drug VitD children with H.pylori-associated duodenal ulcer. Materials and methods: Two treatment groups of children with DU were formed: I - 60 children with H. pylori-associated DU, who received the optimal scheme of anti- Helicobacter therapy (AHBT) for Chernivtsi region; II - 62 children with H. pylori-associated DU who received a modified treatment regimen: AGBT + VitD at a dose of 2000 IU / day for 1 month. The effectiveness of the treatment was evaluated taking into account the Relative Risk Reduction (RRR) of the adverse event and Number Needed to Treat (NNT). Results: All children with DU and a positive H. pylori infection test showed changes in serum VitD levels: 81.9% deficiency and 18.1% insufficiency. Successful eradication was achieved in 77.1% of children, in particular in the first group 73.3%, in the second - 82.2%. Predictors of successful eradication are the duration of infection, H. pylori CagA (+), VitD level. When using the VitD treatment regimen in children with DU associated with CagA (+) strain H.pylori, RRR was observed 2.29 times (χ2 = 6.34, pφ<0.05) with NNT 1.59. Conclusions: Due to the reduced level of serum VitD in children with H. pylori-associated DU, it is advisable to include in the treatment regimen the adjuvant component of AHBT in the form of VitD. Predictors of effective eradication of H. pylori are CagA (+) strain of H. pylori, duration of infection and VitD level.

Purpose - to investigate the clinical and paraclinical features of the course of chronic gastroduodenitis (CGD) in children against the background of selenium deficiency. Materials and methods. Clinical and laboratory examination of 63 children (main group) aged from 7 to 18 years old, patients with CGD and 20 healthy children (comparison group) of the appropriate age was carried out. Quantitative determination of selenium in blood plasma was carried out using inductively coupled plasma mass spectrometry (ICP-MS) on an Optima 2000 DV spectrometer (Perkin Elmer, USA). Results. The average level of selenium in the blood plasma of children with inflammation of the gastric mucosa and duodenum was 73.45±4.21 μg/l, in children of the comparison group - 85.42±5.44 μg/l (p<0.05). 14 children had a selenium concentration within the normal range, and 49 patients had a significantly reduced selenium level (p<0.05), while 9 had the lowest level and was 57.2±3.5 ng/ml. Moderate erythema was recorded 3 times less often and a pronounced degree of erythema was recorded 4.6 times more often, in 4 people (8.1%) atrophy of the mucous membrane of the stomach and/or duodenum was detected, subatrophy was more often recorded (16.3%), 36.7% were diagnosed with the second degree of granularity. Was typicalhad nocturnal and «hungry» pain (22.4%). Conclusions. In the vast majority of children (77.7%), CGD occurs against the background of selenium deficiency in blood plasma. A direct correlation between the concentration of selenium in the blood plasma of sick children and the stage and activity of gastroduodenitis was established. The longer the course of the disease, the lower the levels of selenium in children's blood plasma. There is a pathomorphosis of CGD in children against the background of selenium deficiency: night and «hungry» pain, diffuse damage to the mucous membrane with erosions and subatrophy, a long course with high inflammatory activity are more common. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Background. The formation of polycystic ovary syndrome (PCOS) and the manifestation of its clinical manifestations often begin in adolescence. In recent years, one of the new and modern areas in the study of reproductive dysfunction is the problem of melatonin on the gonadotropic function of the pituitary gland (ovariogenesis). The purpose of the study was to determine the level of melatonin in the saliva of adolescent girls with PCOS. Materials and methods. A single-center prospective simple randomi­zed study was conducted with 23 patients aged 14–18 years (inclusive) with PCOS. The control group consisted of 25 girls of the same age without gynecological status violations. Determination of melatonin levels in saliva was performed by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS). Before salivation during the day and throughout the saliva collection period, patients excluded caffeine, alcohol, and exercise, did not smoke for one hour before collection, did not brush their teeth, did not floss, rinsed their mouths, and did not chew gum. Results. There were no significant differences in the age of the girls in the main group and the comparison group (16.70 ± 0.11 years in the main group and 16.90 ± 0.14 years in the comparison group, p > 0.05). The most common symptoms of PCOS in girls were: hypomenstrual syndrome (86.9 %), dermopathy (82.6 %) and hirsutism (60.8 %). Girls with PCOS had significantly higher melatonin levels in saliva (03:00) (28.89 [18.17; 46.53] pg/ml) compared to girls in the comparison group (12.07 [11.56; 16.27] pg/ml, p < 0.01). A pro­bable difference in melatonin levels in saliva depending on age has not been established. Conclusions. The results of the study indicate a violation of hormonal balance in polycystic ovary syndrome, in particular an increase in melatonin levels, which indicates the need to determine it in the process of diagnosis and treatment.

Поширеність алергічних захворювань (АЗ) останніми роками набула розмірів епідемії й зростає в усьому світі [1]. До цих захворювань належать бронхіальна астма, алергічний риніт, алергічний кон'юнктивіт, атопічний дерматит (АД), кропив'янка, медикаментозна й харчова алергія, алергія на укуси комах, ана-філаксія, ангіоневротичний набряк. За прогнозами ВООЗ, до 2050 року від різноманітних алергозів буде страждати більша частина населення планети, при цьому алергеном може виступати будь-яка речовина, а ХХІ століття стане епохою алергії [2]. У структурі АЗ особливе місце посідає АД [3], оскільки він є одним із перших і найчастіших про-Êë³í³÷íà ïåä³àòð³ÿ / Clinical Pediatrics

Background. Most experts agree that duodenal ulcers are much more common in children. In recent years, the research interest in the relationship between the thyroid system and duo­denal ulcer processes has become evident. The purpose of the study is to investigate the thyroid functional state in children with duodenal ulcer. Materials and methods. The observation group consisted of 56 children aged 7 to 18 years with a verified duodenal ulcer and 15 healthy children. All pediatric patients underwent fibroesophagogastroduodenoscopy with a targeted thyroid biopsy and examination for the presence of the Helicobacter pylori bacterium, intragastric pH-metry, ultrasound examination of the abdominal cavity and thyroid gland; the concentration of thyroid hormones (thyroid-stimulating hormone, T3, T4) was also stu­died. Reliability was assessed using Student’s t-test. The diffe­rence was considered significant at p < 0.05. Results. The average age of children with duodenal ulcer was 13.1 ± 3.1 years. In all age categories, duodenal ulcer occurred more often in boys — 58.9 %. During an in-depth ultrasound examination, the structure of the thyroid gland in 52 (92.8 %) children was homogeneous, in 4 (7.1 %) individuals it was heterogeneous, but without nodular formations. Serum concentrations of thyroid-stimulating hormone and T3 in children with duodenal ulcer also did not differ from the average levels in children of the comparison group. At the same time, a decrease in the concentration of T4 was no­ted, which can be considered as a variant of euthyroid sick syndrome — the syndrome of reduced T4. The average serum level of T4 (32.67 ± 3.84 nmol/l) was significantly lower (p = 0.001) in children infected with Helicobacter pylori than in those wi­thout infection (39.45 ± 4.23 nmol/l) and healthy individuals (89.12 ± 5.91 nmol/l). Conclusions. Children with a duodenal ulcer have a violation of the thyroid status due to a decrease in the thyroxine concentration. A functional shift in the thyroid status in these patients can be considered as a prognostically unfavorable sign of possible deterioration of the ulcer course.