SINGLE NUCLEOTIDE POLYMORPHISM RS4696480 OF TLR2 GENE ASSOCIATES WITH SEVERITY OF ATOPIC DERMATITIS IN CHILDREN, BUT NOT WITH IGE SENSITIZATION TO MALASSEZIA.

OBJECTIVE: The aim: Malassezia has been linked to atopic dermatitis, and TLRs are suggested to mediate influence of Malassezia spp on human cells. The aim of the study was to examine if TLR2 rs4696480 polymorphism predisposes to atopic dermatitis, IgE sensitization to Malassezia or to severe phenotype of atopic dermatitis. PATIENTS AND METHODS: Materials and methods: The study included 103 patients with eczema and 84 healthy children. Specific IgE against Malassezia mix (m227) was analyzed in 47 patients using immunochemiluminescent method on the ImmunoCAP 100 (Thermo Fisher Scientific Inc., Phadia, Sweden). Genotyping for TLR2 rs4696480 was performed by using Real-time PCR. RESULTS: Results: Increased IgE to Malassezia spp. was observed in 34,3 % of children with eczema. Higher Malassezia spp.-specific IgE titre positively correlated with duration of atopic dermatitis and a higher total IgE. There were no difference in allele distribution among patients and control group (OR=1.096 (0.549- 2.191) for AT, OR=0.946 (0.430- 2.078) for TT, р > 0,05). TLR2 polymorphism rs4696480 was not associated with Malassezia spp.-sIgE. AA-genotype was significantly more frequent among patients with severe and moderate-to-severe AD (OR=6.395 (1.240-32.991). CONCLUSION: Conclusions: AA variant of TLR2 rs4696480 polymorphism predisposes to severe phenotype of AD.

CURRENT CHALLENGES FOR THE HEALTH CARE SYSTEM DUE TO THE LACK OF MEDICAL STAFF AND THE CONTINUOUS PROFESSIONAL DEVELOPMENT OF DOCTORS.

OBJECTIVE: The aim: Research of the ways of adequate solving of problems with understuffed healthcare system and problems with continuous professional development of doctors. PATIENTS AND METHODS: Materials and methods: We have used a official statistical data for the period from 2009-2020 years. This data was analyzed with usage of systemic approach and statistical epidemiological analysis. RESULTS: Results: According to the data from Ministry of Health of Ukraine during the first year of the pandemic (2020) the quantity of our doctors has diminished by 6.9 thousands, and quantity of nurses - by 22,5 thousands which is much bigger deficit then in period of 2018-2019 years. The insufficiency of pediatric doctors in Ukraine has reached 1000 vacancies, general physicians - 1700, family doctors - more than 3000 vacancies, surgeons - more than 950 vacancies. It is also important to involve medical experts and medical associations and unions in the process of accreditation and licensing of providers of continuous medical education. CONCLUSION: Conclusions: Existing deficit of medical personnel should be replenished by increasing of medical education of students in medical universities and colleges funded by government. Existing system of continuous professional development of doctors requires a lot of changes (additional activities, new technologies) which must be implied with the help of professional medical associations and unions.

EPIDEMIOLOGY OF RESPIRATORY PATHOGENS IN CHILDREN WITH ACUTE RESPIRATORY TRACT INFECTION IN UKRAINE DURING 2018-2020 YEARS.

OBJECTIVE: The aim: Is to provide data on the presence of potential pathogens of ARTIs in children in Ukraine. PATIENTS AND METHODS: Materials and methods: The etiology of ARTIs was investigated in 487 children in MC 'Eurolab', Kyiv, Ukraine during 2018-2020 years. Seven respiratory viruses - Respiratory Syncytial virus (RSV), Parainfluenza virus (PIV), Adenovirus (AdV), human Metapneumovirus (MPV), Rhinovirus (RV), human Bocavirus (BoV), Coronavirus (CoV), were identified by PCR. Qualitative detection of Influenza type A, type B, Group A Streptococcal was performed by chromatographic immunoassay. Pathogens profiles, clinical characteristics and seasonality were analyzed. RESULTS: Results: 487 nasal and throat swabs from children with ARVI were collected. 400 (82,1%) samples were found to be positive: 319 swabs were positive at least for one respiratory virus, 43 children had positive rapid influenza test, 38 - positive strep test. A total of 403 viruses were identified. RV (27,1%), ADV (13,4%), RSV (13,2 %), IVA (10,7 %) were the most commonly identified viruses. CONCLUSION: Conclusions: Detection of viral seasonality in Ukraine and estimating of clinical features in case of infection allows predicting probable clinical course of disease, to provide, optimize the therapy and to develop preventive measures, vaccination, in particular.

CONGENITAL ANOMALIES IN CHILDREN OF UKRAINE: 25-YEAR MONITORING OF MORBIDITY AND PREVALENCE.

OBJECTIVE: The aim: Of the work was to study 25-year trends in the incidence of congenital anomalies in the child population of Ukraine in order to determine the impact of ecotoxic environmental factors on their development, in particular radiation. PATIENTS AND METHODS: Materials and methods: Methods of statistical assessment, epidemiological analysis of materials at the Center for Medical Statistics of the MOH of Ukraine were used. RESULTS: Results: The rate of congenital anomalies growth for the recent 25 years has exceeded the growth rate of the total incidence in the child population of Ukraine by 1.6 times, occupying the leading place in Europe by the level of environment pollution. Over the last 25 years, the growth of the Ukrainian children's congenital anomalies incidence level by 59.5% is observed, mostly in children from large industrial regions of Ukraine, due to the significant ecotoxic effect of pollutants on the child's body. Children living permanently in the areas contaminated by the Chernobyl accident had significantly higher rates of congenital anomalies in 1986 than in the early 1990s, but over the recent 25 years the incidence in this contingent has decreased. CONCLUSION: Conclusions: The results of such long-term studies performed by a group of leading Ukrainian scientists from different regions of Ukraine indicate that in children experiencing negative effects of ecotoxic factors, including radiation, an increase in the detection and prevalence of congenital defects is observed, which requires complex international and intersectoral measures to prevent and reduce child mortality.

The impact of overweight and obesity on the quality of life in children with bronchial asthma.

OBJECTIVE: The aim is to investigate if the overweight (OW) and obesity (OB) impact on the quality of life (QOL) of children with bronchial asthma (BA). PATIENTS AND METHODS: Materials and methods: The study included 73 children aged 7 - 17, with moderate BA. Depending on the body mass index, patients were divided into the three clinical groups: normal body weight (NW) - 30 children, OW - 28 children and OB - 15 children. QOL was conducted by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). The statistical processing was carried out using the IBM SPSS Statistics Base (version 22) and EZR version 1.32. Results were considered statistically significant when p<0.05. RESULTS: Results: Children with BA and OB had statistically lower QOL than children with BA and NW in all PAQLQ domains. The Kruskal-Wallis H-test revealed a statistically significant difference between the different weight groups of children with BA both for the general QOL: H(2) = 37.51, p<0.001and for each rating scale separately. Pairwise comparisons using Steel-Dwass test indicated that scores of NW were observed to be significantly different from those of OW and OB for rating Activity and Symptoms scales (p<0.001). CONCLUSION: Conclusion: Comorbid OW and OB reduce the specific QOL of children with BA. In assessing the effectiveness of specific approaches to treating BA in children with OW and OB, an assessment of the QOL of children should be added to the traditional common clinical and laboratory assessment.

Changes in health status of child population of Ukraine after Chernobyl catastrophe

Introduction: The article is concerned with problems of morbidity of children and infant mortality during the latest 30th years after Chernobyl catastrophe. The 30th anniversary of the Chornobyl disaster is a stage that determines the analysis of its consequences, the assessment of the effects of radiation, the impact of the accident factors on the health of the population of the most affected countries and on global processes. The aim: To study the condition of child population of regions of Ukraine, which were contaminated by radionuclides in the result of Chernobyl catastrophe. Material and methods: Statistic assessment and epidemiological analysis were used to analyze materials of the investigations. Conclusions: Results of comparative analysis demonstrate the stabile increase of morbidity level as residents of regions of TRC. Abnormalities of respiratory system present the first group of the morbidity among children. The morbidity level of blood and blood forming diseases, tumors formation, diseases of endocrine system, digestive disorders, metabolism disorders significantly increases. The level of child population morbidity after Chernobyl catastrophe increases in 3.2 times. Respiratory diseases are involved in the first place in this structure.