The newly identified strain of the Coronaviridae family called severe acute respiratory syndrome (SARS-CoV-2) recently became the most significant health threat for adults and children. Some main predictors of severe clinical course in patients with SARS-CoV-2 infection are age and concomitant health conditions. Therefore, the proper evaluation of SARS-CoV-2-specific immunity is urgently required to understand and predict the spectrum of possible clinical phenotypes and recommend vaccination options and regimens in children. Furthermore, it is critical to characterize the nature of SARS-CoV-2-specific immune responses in children following asymptomatic infection and COVID-19 and other related conditions such as multisystem inflammatory syndrome (MIS-C), para-infectious and late postinfectious consequences. Recent studies involving children revealed a variety of cytokines, T cells and antibody responses in the pathogenesis of the disease. Moreover, different clinical scenarios in children were observed-asymptomatic seroprevalence, acute SARS-CoV-2 infection, and rarely severe COVID-19 with typical cytokine storm, MIS-C, long COVID-19, etc. Therefore, to gain a better clinical view, adequate diagnostic criteria and treatment algorithms, it is essential to create a realistic picture of the immunological puzzle of SARS-CoV-2 infection in different age groups. Finally, it was demonstrated that children may exert a potent and prolonged adaptive anti-SARS-CoV-2 immune response, with significant cross-reactions against other human Corona Viruses, that might contribute to disease sparing effect in this age range. However, the immunopathology of the virus has to be elucidated first.

SUMMARYBackground: Due to the widespread use of bottled water, it is important from a hygienic point of view to ensure that these products have good quality and meet the requirements set out in regulations.Methods and Results: In the period 2000-2013, a large-scale study (2,500 samples) was carried out on the quality of Bulgarian bottled water as per the microbiological parameters laid down in the European and Bulgarian legislation. Standard microbiological methods were applied. There is strong evidence that the most frequently isolated contaminant in these products was Pseudomonas aeruginosa. This agent was found in 274 samples out of a total of 2,500 analysed bottled waters. Because of the absolute prohibition of the presence of this microorganism in the finished product, the manufacturers should not allow their products with compromised quality to reach the market. They are obliged to check the quality of each batch by conducting an internal monitoring of production. When any inconsistencies are established in microbiological parameters, the producers must detect the critical point and apply more effective decontamination measures of the bottling lines. Given the importance of this fact for the health of consumers, the study also included determination of the antimicrobial resistance of P. aeruginosa strains isolated from Bulgarian bottled water. Ten strains of P. aeruginosa, isolated from bottled water and other water habitats in the environment, were tested for the effect of 13 antimicrobial agents by applying the Kirby-Bauer's method.Conclusions: The investigation found that Pseudomonas aeruginosa strains isolated from bottled water are sensitive to Ceftazidime, Amikacin, Ciprofloxacin, and Cefepime and one of them is resistant to Meropenem and Piperacillin. Another important conclusion is that there is no specific behaviour of P. aeruginosa strains originating from different sources to the test antimicrobials. The authors consider that drinking tap water is perhaps a more appropriate way for newborns, infants, elderly, and people with compromised immunity to satisfy thirst than using bottled water.

Thing. In recent years, the importance of sports in improving the health of the population by involving people in physical education has increased. However, sports of the highest achievements are associated with the risk of occupational diseases. Physical and emotional stress of athletes can lead to impaired health. Dental diseases are also common in people involved in sports. In domestic and foreign literature, athletes describe bruxism, occlusal disorders, periodontal disease, tooth abrasion. Of particular interest are injuries of hard tissues of the teeth of athletes in connection with their highest prevalence, ineffectiveness of treatment and prevention. The goal is on the basis of a clinical and laboratory study of the state of hard tooth tissues in athletes, to develop and justify the tactics of complex treatment, prevention of diseases of hard tooth tissues. Methodology. All participants underwent a comprehensive dental examination, which included the main research methods (determination of complaints, medical history, external examination, examination of the oral cavity, detection of diseases of hard tissues of the teeth, malocclusion) and additional (X-ray examination, “hamburg testing”, diagnosis of T-scan, assessment of oral fluid indices, cytological examination of buccal epithelium, electrometry of hard tissues of teeth, assessment of resistance of hard tissues of teeth). Results. Based on the results, we developed a new treatment-and-prophylactic toothpaste based on Silivatit organosilicon glycerogel hydrogel with the addition of nanostructured hydroxyapatite. Its biocompatibility, remineralizing and anti-inflammatory activity are proved, and clinical efficacy in athletes with diseases of hard tissues of the teeth is confirmed. The tactics of the complex treatment and prevention of diseases of hard tooth tissues in athletes based on the differentiated choice of filling materials have been substantiated. Conclusions. Thus, the optimized tactics of complex treatment and prevention of diseases of hard tissues of the teeth prevents the progression of diseases, the development of complications, and improves the quality of life of athletes.

Nowadays, the relevance of the diagnosis and treatment of facial bones, especially the midfacial region, is undoubted. According to scientific literature, the incidence of facial bone fractures is up to 16% in the total structure of fractures [5, 10, 13]. Such injuries can lead to aesthetic disorders in the form of various post-traumatic deformities, often disfiguring the face of patients, as well as lead to functional disorders of varying severity. According to variability of traumatic injuries of the facial bones, polymorphism of clinical manifestations, as well as the aesthetic and functional significance of the area under consideration, the need to individualize the medical and diagnostic process is formed [7–9, 11, 14, 15, 17]. The individualization of the approach to the diagnosis and treatment of patients is gaining more and more popularity and today is one of the more significant vectors for the development of practical medicine, opening new horizons for specialists in various fields of medical science. One of the most interest directions of this approach is the use of additive manufacturing technologies. Additive prototyping and virtual modeling open up wide possibilities for customizing diagnostics and treatment in accordance with a specific clinical situation. Modern computer modeling technologies enable representatives of various medical specialties, including maxillofacial surgeons, not only to be limited to preoperative planning using virtual prototypes of defective zones and also to model structures that replace various bone defects based on additive technologies by printing of high-precision physical models of the damaged zone. In turn, the presence of such means of visualization of injury areas already at the preoperative stage makes it possible to develop individualized augments of bony defects, taking into account all the features of the anatomical structures of a particular patient [1–4, 6, 16]. The article deals on the results of a comparative study of the effectiveness of surgical treatment of maxillary fractures in the orbital region using an algorithm based on the use of additive manufacturing technologies and traditional methods.

Background. Hemangiomas of the skin and mucous membranes, which belong to the group of vascular abnormalities, make up about 50% among other soft tissue tumors in children. Laser coagulation is one of the treatment methods that can provide both a radical removal of superficial hemangiomas and leaving an imperceptible trace. The goal is to increase the effectiveness of treatment of children with superficial infant hemangiomas of the head and neck by substantiating the differentiated selection of a high-energy laser. Methodology. A total of 512 children were included in the study. In accordance with the tasks of the study, the total body of material was divided into four parts: evaluation of the long-term results of the treatment of infant hemangiomas; a comparative study of the effectiveness of two laser systems in the treatment of infantile hemangiomas with varying degrees of elevation over the surrounding skin; assessment of the aesthetic efficiency of using laser technologies against the background of the modernization of the cooling method in the treatment of infantile hemangiomas of the face and neck in children; the study of the social effectiveness of the protocol for choosing a method of treatment of infantile hemangiomas of the head and neck in children. Results. The obtained statistically significant difference in changes on all scales between the two groups mathematically confirmed that the modernized approach makes it possible to obtain higher social effectiveness of the treatment, apparently due to the greater aesthetics of the remaining scars after treatment. Conclusions. A pronounced difference was found in the response of hemangiomas to various types of lasers, the combination of laser-coagulation with constant water cooling has a greater aesthetic effectiveness than the use of periodic ice applications, the social effectiveness of the approach using the protocol for choosing treatment tactics is higher than with standard approaches.