Prevention of vitamin D deficiency in children. The state of the problem in the world and in Ukraine.

The article presents current data on the prevalence of vitamin D deficiency and criteria for its deficiency in children in different countries. Vitamin D is recognized as one of the most important vitamins involved in many biochemical processes in the body. Its active metabolites play a key role in calcium absorption, bone mineralization and promote phosphate and magnesium metabolism. At the same time, in addition to affecting mineral metabolism, there is a wide range of conditions in which vitamin D also plays a preventive role. Vitamin D has been shown to play a vital role in innate immunity maintenance and is important in prevention of several diseases, including infections, autoimmune diseases, certain forms of cancer, type 1 and 2 diabetes, and cardiovascular diseases. Vitamin D is of particular importance for newborns and young children. This vitamin is involved in important physiological regulatory processes such as bone metabolism, lung development, maturation of the immune system and differentiation of the nervous system. Vitamin D deficiency increases risks of neonatal sepsis, necrotizing enterocolitis, respiratory distress syndrome, and bronchopulmonary dysplasia. Adequate intake of vitamin D and calcium during childhood can reduce the risk of osteoporosis and other diseases associated with vitamin D deficiency in adults. Recently, vitamin D deficiency has shown to be a potential risk factor for COVID-19 propensity. It has been established that to date most scientific pediatric societies have recognized the need to prevent vitamin D deficiency in healthy children of all ages, but data on the dosage of vitamin D in its prophylactic use differ. Most scientific societies recommend an average of 400-600 IU per day of vitamin D for prophylactic purposes. The analysis of published data shows the need to follow a strategy based on an individual approach, taking into account physiological characteristics, individual requirements and lifestyle.Copyright © 2021 University of Tartu Press. All rights reserved.

Efficacy and safety of inhalation 6% N-acetylcysteine in 3% NaCl solution in clinical practice (literature review)

The article summarizes the literature on the use of N-acetylcysteine and its combination with 3% NaCl solution (FLU-ACYL broncho) in clinical practice. Studies show that N-acetylcysteine is currently effective in the treatment of respiratory diseases due to its multicomponent effects on the respiratory system and the immune system. Hypertonic (3%) NaCl solution potentiates the action of N-acetylcysteine by inhalation and allows to achieve good results in the treatment of acute and chronic respiratory diseases in the optimal time. One of the well-known in Ukraine products for fast and effective evacuation of viscous sputum is FLU-ACIL broncho, sterile solution for nebulizer and instillation. One 5 ml ampoule contains 300 mg of NAC, which has a mucolytic effect in direct contact with mucus, and 150 mg of hypertonic NaCl solution, which draws water from the intracellular space into the extracellular space by osmosis and increases the proportion of water in the bronchial secretion, dilutes it and thus facilitates its removal. The combination of NAC with hypertonic NaCl solution creates synergy and allows to obtain optimal treatment results with minimal side effects. This combination has mucolytic, anti-film, antiviral, antioxidant, anti-inflammatory and immunomodulatory effects, making it promising in a pandemic SARS-CoV-2. © 2022 by the Author(s).

Tolerance to physical activity and its changes in children after COVID-19 (literature review, own data)

Purpose - to summarize data from the literature and own experience regarding the course of COVID-19 in children;to determine changes in tolerance to physical activity in children who have experienced COVID-19. The issue of long-term consequences of the transferred COVID-19 is increasingly being raise in connection with the pandemic of COVID-19. The problem of changes in the functional state of the body health and improving the quality of life of children who have infected COVID-19 is relevant. To analyze these parameters, it is advisable to use the assessment of tolerance to physical activity Tolerance to physical activity is a total indicator of the body's physiological capabilities, which allows you to assess the processes of oxygen consumption by the myocardium and myocardial reserves, which are important in the overall adaptation of the body. The «gold standard» of assessing tolerance to physical activity is the determination of the maximum VO2, and other indicators, the control of which in dynamics will allow the development of medical and rehabilitation measures aimed at the elimination of post-COVID symptoms. © 2022 by the Author(s).