Aim. The research aims at analyzing the kinetics of IgA, IgM, and IgG to SARS-CoV-2 in children based on the severity of COVID-19 and age.
 Materials and Methods. The conducted prospective study involved 88 children (mean age 9.4 years) with COVID-19, admitted to the "Lviv Regional Pediatric Clinical Hospital "OKHMATDYT" from 2020 to 2021. The participants included 36 males (40.90%), and 52 females (59.10%) in the observation group. Diagnosis verification relied on clinical manifestations of the disease, with the detection of SARS-CoV-2 RNA from nasal mucus using the PCR method. The values of IgA, IgM, and IgG to S and N proteins of SARS-CoV-2, determined by the ELISA method at different times of the infectious process in 380 blood serum samples, were analyzed.
 Results and Discussion.The research findings of IgM to SARS-CoV-2 in the first week of illness revealed a median value of 0.24 [0.14; 1.39], increasing to 0.49 [0.30; 2.87] in the second week. The highest median value of IgA to SARS-CoV-2 is 0.33 [0.24; 1.00] was found from 15 to 30 days, after 30 days it was 0.24 [0.20; 0.28].
 The increase in the median value of IgG-N to SARS-CoV-2 was observed from the second week of the illness, reaching 1.13 [0.52; 3.17], with its maximum value at 5.68 [2.39; 8.86] within the period up to three months. Severe COVID-19 was diagnosed in 27 children (30.68%), comprising 15 females (55.56%) and 12 males (44.44%). In the majority of hospitalized children, IgM values at different degrees of disease severity were positive from the first to the seventh day of illness. In children with a severe course of SARS-CoV-2, the median value of IgM in blood serum during this period was 1.39 [1.36; 4.07]. There was a statistically significant difference between the IgG levels for moderate and severe forms on days 15-30 of the illness: 0.54 [0.21; 1.89] compared to 5.55 [4.99; 5.80], respectively (p<0.05). In patients with both moderate and severe forms of the disease, median values of IgG to N SARS-CoV-2 were positive throughout the study period. A significant increase in the median value of IgG to N SARS-CoV-2 was observed in females from day 31 to day 90. In severe cases of the disease, the median value of IgG to SARS-CoV-2 from three to six months was 9.40 [7.80; 10.60], which was higher than in patients with a moderate form of the disease - 8.72 [8.64; 8.97] (p<0.05).
 Conclusions. Serological studies enable the investigation of the immune response to SARS-CoV-2, determination of seroconversion, and characterization of the course of COVID-19, being crucial for epidemiological research. The levels of IgM, IgA, and IgG to SARS-CoV-2 depend on the disease's severity and the patient's age.

Biological age (BA), as a criterion for assessing health, can also be viewed as a marker of material aging resulting from occupational exposure to factors in the industrial environment. Aim. To determine the biological age and aging rates of workers in the footwear industry. Materials and Methods. The research group included 200 workers from footwear enterprises (119 males and 81 females) aged 25-62. They were distributed based on their primary workshops and occupational hazards as follows: isolated exposure to occupational noise (Group 1): 61 males and 35 females, combined exposure to occupational noise and chemicals (Group 2): 57 males and 47 females. The control group - 54 workers: 26 males and 28 females who were not exposed to these production factors during their work activities. Additionally, the workers were divided into groups based on their work experience in the profession: up to 5 years, 6-14 years, and 15-21 years. BA and aging rates were determined using the methodology developed by the Institute of Gerontology of the Academy of Medical Sciences of Ukraine. Results and Discussion. The presence of unfavourable occupational factors in constant workplaces, particularly in isolated (occupational noise) and combined (occupational noise and chemical substances) conditions, is a significant contributing factor to premature aging among workers engaged in footwear production. In Group 1 of male workers, the BA-NBA (normative biological age) index exceeded 5.22 [4.81; 6.11], in Group 2 - 7.79 [6.29; 9.11], compared with the control - 3.96 [3.21; 4.2]. For female workers, this difference is 4.81 [4.29; 5.22] and 5.84 [5.26; 6,44]. The maximum aging rates were observed in work experience groups up to 5 years, regardless of the combination of occupational factors and young workers (age group up to 30 years) in both gender groups were for Group 1 - 8.11 [7.55; 8.29] (male) and 6.37 [6.15; 7.01] (female); Group 2 - 11.68 [11.18; 12.49] (male) and 8.81 [8.39; 9.54] respectively. Aging rates drop down with age and job experience, which can be attributed to workers' improved capacity to adapt to challenging working conditions. Conclusions. The determination of BA in workers can be utilized at the preliminary and periodic medical examinations to determine occupational risk groups and profession selection, as well as to evaluate the effect of elements in the production environment and labour process on the functional state of the body.

The aim is the analysis of clinical and anamnestic, biochemical and hemostasiological parameters in thromboembolic complications in patients with acute calculous cholecystitis (ACC). Materials and Methods. A retrospective analysis of clinical information was performed regarding 206 patients with a diagnosis of acute calculous cholecystitis, who were hospitalized in the Emergency Medical Care Hospital of Lviv (current name: St. Panteleimon Hospital of the First Territorial Medical Association of the City of Lviv) in the period from 2014 to 2018. Results and Discussion. It was established that 2.91% of patients with ACC had thromboembolic complications, which were manifested in the form of deep vein thrombosis and PE of small branches and were more often diagnosed in patients with significantly older age (on average, 72.67±11.13 years of age). Thromboembolic complications in patients with ACC developed reliably more often in people who had concomitant pathology (hypertensive disease, IHD, COPD, liver cirrhosis, stroke). Patients with a complicated thrombotic diagnosis were also diagnosed with final non-thrombotic complications: local and general peritonitis, perivesical abscess, perforation, abdominal sepsis and subhepatic abscess. The average duration of laparoscopic cholecystectomy (LCE) in patients without complications was 60.00 [45.0-70.0] minutes, in patients with non-thrombotic complications - 62.50 [38.5-85.0] minutes, and in patients with thrombotic complications it was significantly longer - 95.0 [95.0-95.0] minutes (p<0.05). Conclusions. In patients with complicated acute cholecystitis, thromboembolic complications with local and general peritonitis, perivesical abscess were diagnosed more often (p<0.05). Patients with complicated acute calculous cholecystitis underwent cholecystectomy (83.33% [46.48-99.96]) reliably more often than patients with uncomplicated acute cholecystitis, whereas LCE was performed only in 16.67% [0.04-53.52] of cases. Therefore, cholecystectomy lasted for more than 1 hour in 80% [38,45-99,94] of cases.

Aim. To compare the hypotensive effect of non-penetrating deep sclerectomy (NPDS) as a standalone surgery and non-penetrating deep sclerectomy in combination with dosed endotrabeculectomy in patients with primary open-angle glaucoma. Materials and Methods. 27 patients (27 eyes) with primary open-angle glaucoma were under our follow-up. In the first group (15 patients) we performed a non-penetrating deep sclerectomy, in the second group (12 patients) - a combined surgery. Results and Discussion. When comparing values, we found that the difference between the preoperative and postoperative IOP, as well as the preoperative and postoperative amount of topical antihypertensives used, was significant up to the 12th month inclusive in both groups (p<0.05). No significant difference was found when comparing IOP values between two groups in the same follow-up periods. However, there was a difference in the amount of topical intraocular pressure-lowering agents used by two groups in the 12th month of follow-up. Conclusions. Non-penetrating deep sclerectomy, both standalone and in combination with endotrabeculectomy, has a significant hypotensive effect in patients with primary open-angle glaucoma during 12 months of follow-up, however, patients of the first group instilled a higher amount of topical antihypertensives in the 12th month of follow-up, which makes us consider the hypotensive effect of the combined surgery to be higher.

Aim. The paper aims at analyzing the state of monitoring of adverse reactions to penicillins based on spontaneous reports of the pharmacovigilance system of Ukraine, received from healthcare institutions of Kharkiv region and the city of Kharkiv during 2017-2019. Materials and Methods. The objects of the study included maps-reports of adverse reactions to the use of penicillins, which came from health care facilities of Kharkiv region and the city of Kharkiv to the pharmacovigilance system of Ukraine during 2017-2019. Information on adverse drug reactions was obtained using the method of collecting spontaneous messages in mixed form (paper and electronic versions). Results. The analysis revealed that among the 6 INNs of the penicillin group, the largest number of adverse reactions were registered for amoxicillin / clavulanic acid (in 2017 - 73% of message cards, in 2018 - 54% of message cards, in 2019 - 70% of message cards). In the number of reports amoxicillin drugs ranked second place (in 2017 - 22% of card-messages, in 2018 - 43% of card-messages, in 2019 - 27% of card-messages). Discussion. The recorded adverse reactions are not serious and most frequently manifested in the form of local reactions: itching, swelling and redness of the skin, as well as from the gastrointestinal tract: diarrhea and nausea. No serious adverse reactions with lethal outcome were reported. Conclusions. The conducted monitoring confirmed the literature data on typical adverse reactions to antibiotics of the penicillin group. It has been established that penicillin-type antibiotics, namely amoxicillin/clavulanic acid and amoxicillin, have a high risk of adverse reactions as they are prescribed more frequently.

Aim. The paper aims at analyzing the state of cancer epidemiology in Ukraine for the past decade specifying the age, gender, territorial and nosological peculiarities. Materials and Methods. The study was conducted on the basis of the data analysis of the National cancer register of Ukraine for the 10-year period: starting from 2010 till 2019 years. The research was directed at studying and analyzing morbidity and mortality levels caused by malignant neoplasms, as well as age, gender, territorial and nosological peculiarities and the prevalence of nosological forms. Applied statistical methods include the analysis of the average and relative values, the calculation of indices of time series: growth rate and absolute growth, structural-and-logical analysis and systemic approach. Results and Discussion. The study has found that during the analyzed period of 2010-2019 years, the morbidity from malignant neoplasm in Ukraine increased, while the mortality level caused by oncologic pathology decreased. The morbidity and mortality among male population was higher in comparison with the female individuals. Over 50% of patients with firstly diagnosed "Malignant neoplasm" were identified in the early stages, but the share of detected patients with neglected form of oncologic pathology was increasing every year. One-year survival among the general population of patients with malignant neoplasms accounted 66,4-72,9%. The highest rates of morbidity have been fixed among male and female population, aged 70-79 years, while the highest death rate - among older individuals, 75-84 years of age. It has been defined that the age of 30-64 years wass characterized by high levels of morbidity and mortality rates in every sequential five-year group in comparison with the previous one. The hematological oncologic diseases were dominant in the structure of morbidity and mortality in young children and teenagers under 17 years. For the age category of 30-74 years, in female population the most common was breast cancer, in males - the cancer of the trachea, bronchi, lungs. For the analyzed period, Kirovograd Region occupies a leading position by morbidity level, while the Zaporizhzhia, Kirovograd and Dnipro Regions - are leaders in the mortality rate from malignant neoplasms. Conclusions. The analytical study of the oncologic and epidemiologic situation is an integral part in the development of an optimized system of oncologic care for Ukrainian population as it allowed to determine the age-gender and territorial groups, which require priory administrative attention concerning diagnostic and therapeutic decisions in oncology.

Aim. To evaluate the features of pharynx tonsils mucous membrane colonization by pathogenic and opportunistic microorganisms using electron microscopic examination of pharynx palatine tonsils epithelium in patients with infectious mononucleosis and acute streptococcal tonsillitis. Materials and Methods. Two patients, i.e. a patient P. (12 years old) with a confirmed diagnosis of infectious mononucleosis, and patient A. (8 years old) with acute streptococcal tonsillitis diagnosis were examined. A bacteriological examination of mucus and epithelium scraping from the surface of the pharyngeal tonsils was conducted. Tissue samples were examined in the electron microscopy laboratory of the Lviv National University. Results and Discussion. 36 tonsils epithelial tissue micro preparations of patient A. and 41 micro preparations of patient P. were studied. Streptococcus pyogenes, Str. pneumoniae, Str. viridans, Сandida albicans, as well as non-pathogenic bacteria, Diphtheroides sp., Neisseria sp., and Corynebacterium spp. were identified as result of the bacteriological examination of mucus from the surface of the pharyngeal tonsils of the patient P.. Staph. aureus, Str. Viridans, and Str. pneumoniae were identified during a bacteriological examination of the patient A. Eosinophils with a two-segmented nucleus, specific granularity, phagocytosed spherical bacteria in the cytoplasm were detected during the histological examination of the materials taken from the surface of the patient with acute tonsillitis tonsils. Research shows that bacteria accumulate not only in the structure of extracellular detritus. Numerous bacteria accumulations were found in the cytoplasm of the epithelial cells in the patient with infectious mononucleosis also. The cell's shape resembles a bunch of grapes. Conclusions. The electron microscopic examination showed differences in the coccal flora localization. The extracellular localization of bacteria in the patient with acute bacterial tonsillitis, and intraepithelial presence of the bacteria in the patient with tonsillitis during infectious mononucleosis were found.