According to the statistics of the recent 5 years, the share of rotavirus gastroenterites is 44-47% of all acute intestinal infections in children under 5 years of age in the Russian Federation. Up to 5% of mortality rate in children under 5 years of age is connected with rotavirus gastroenteritis. Rotavirus gastroenteritis takes an especially severe course in children of 6-24 months of age. The only reliable method of preventing this infection is vaccination. The authors present information on the rotavirus strains dominant in Russia and abroad, efficacy and safety of immunization with a pentavalent vaccine and the recommended schemes of its administration. This vaccine is registered in the Russian Federation; it is to be first used in the nearest future.

The article is dedicated to cough treatment in children as one of the most frequent causes of references to pediatricians. The authors explain mechanisms and causes of this symptom – both frequent and rare. The latter often lead to underestimation of the situation, incorrect diagnostics and, therefore, to ineffective treatment. Primarily, such conditions involve cough at gastroduodenal reflux disease. The article presents a detailed review of drugs for cough treatment. It examines a phytogenic drug with one of the best efficacy and safety profiles in detail.

The article presents a case of successful use of therapeutic monoclonal antibodies to interleukin 1 (canakinumab) at severe systemic juvenile idiopathic arthritis. Canakinumab treatment promptly provided reduction in clinical and laboratory disease activity indicators, increase in life quality, development of inactive disease stage and allowed avoiding prescription of glucocorticoids.

The article is dedicated to one of the relevant issues of childhood and adolescence – acne. It describes modern approaches to acne treatment, including local, systemic and combined therapy and physiotherapeutic treatment methods. The article also presents foreign and Russian data on the use of different groups of drugs for acne therapy and peculiarities of acne treatment in pediatric practice.

Botulinum toxin therapy is an effective and safe method of treatment of local spasticity in patients with cerebral palsy (CP). Calculation of botulinum toxin A (BTA) dosage based on the spasticity patterns and functional capabilities of the patient proved effective for the hypertonic lower limb muscle spasm treatment and is being applied to BTA injections in hand muscles more often. The article presents contemporary scientific data and results of the original study of BTA injections efficacy for pathologic tension reduction in hand muscles of 52 patients with CP. The authors give detailed description of the upper limb spasticity patterns, their frequency and role in the pathological movement pattern formation. The authors propose BTA dosage calculation for the functional segments of upper limbs, which allows minimizing the total amount of the administered drug and avoiding excessive weakness. The authors have also conducted a follow-up analysis of changes in hand muscle tone for the period of 6 months after the first BTA injection, compared results of botulinum toxin therapy at various clinical forms of CP and given recommendations on the optimum duration of the follow-up period.

Study of sensitization spread is crucial to the understanding of formation mechanisms of allergic diseases symptoms and development of prevention programs. However, this parameter has been studied very insufficiently in Russia. The aim of this trial is to study spread of sensitization to allergens and skin sensitivity to histamine in the populations of urban and rural schoolchildren using the method of skin prick test. Methods: the authors examined 2,290 urban and rural schoolchildren (1-11 grades). Mixed allergens of house dust mites, cockroach, fish, birch pollen, mixed weeds and cat hair were used for the allergy test. Results: the authors revealed spread of sensitization to various allergens in various age-sex groups of urban and rural schoolchildren in Tomsk Region. Conclusion: the trial revealed that sensitization spread and skin sensitivity to histamine was higher in urban schoolchildren than in their rural peers (p<0.001). Lower sensitization spread index in rural schoolchildren may be caused the skin reactivity reduction.

Juvenile idiopathic arthritis (JIA) is a multifactorial disease: its pathogenesis includes immunological and genetic factors. Gene MDR1 is responsible for resistance to various cytotoxic drugs. Product of gene MDR1 - P-glycoprotein (P-gp) acts as a transmembrane pump, thus affecting action of drugs. The research objective was to determine connection of C3435T polymorphism of gene MDR1 with P-protein’s expression level in children with JIA. P-protein was revealed in all the patents involved in our trial: the protein was revealed on peripheral blood lymphocytes before and after stimulation of interleukin 2. The authors also picked out genome DNA using phenol-chloroform extraction and detected C3435T polymorphism of the gene MDR1 using polymerase chain reaction. Methotrexate concentration in blood serum was determined using a standard method of fluorescent polarization (FPIA) using the Abbott apparatus TDxFLx. Statistical manipulation of the data obtained in the course of the trial was conducted using software Statistica 6.0. C3435T polymorphism of gene MDR1 affects therapy efficacy. Determination of both basal and stimulated (in vitro) P-glycoprotein may be used as additional criterion in the evaluation of disease activity.

The article presents the analysis of laboratory tests, which indicate the response of the body to systemic inflammation. The revealed interconnection of these parameters with peripheral hematosis alterations at chronic inflammatory diseases will allow objectively approaching the diagnostics of functional disorders at non-specific ulcerative colitis in children. The authors attempted to develop new approaches to the analysis of laboratory indicators, which will help to evaluate individual dynamics of processes at the systemic inflammatory response of the body and select adequate therapy of the primary disease.

Confocal laser endomicroscopy (CLE) is a method of optic biopsy, which allows obtaining histologic presentation of mucous tunic in real time and quickly differentiating between unaltered and inflamed, metaplastic and dysplastic tissue structures, thus developing a new and safe method of early diagnostics of diseases. Intravenous administration of 10% sodium fluorescein is necessary in order to obtain high-contrast images of the structure of digestive tract’s mucous tunic, although there have been no direct indications to that in the world pediatric practice. The authors examined 124 children of 3-18 years of age who received intravenous fluorescein of 5 mg/kg. No severe side effects were revealed at intravenous administration. The authors revealed temporary yellowing of skin and bright coloration of urine. In terms of mild side effects, the authors observed insignificant nausea and emesis in 2 children (1.6%). Strict observation of the selection protocol allows not only avoiding severe complications caused by administration of the drug, but also recommending its use at CLE of digestive tract’s mucous tunic in children.

The article presents information value of non-invasive arteriography, which reveals early signs of cardiovascular pathology formation in children, using a large number of trials in children. The authors examined predictors of cardiovascular catastrophes’ development, confirmed in adults: aortic wall’s stiffness, central aortic pressure and pulse pressure – that have not been sufficiently studied in children yet. The article shows that the high-technology method of non-invasive arteriography allows revealing changes of these parameters in children on the preclinical stage. It also shows their correlation with body mass index, fatty hepatosis, direct correlation of weight gain with connection of pulse wave velocity and central blood pressure and importance of follow-up evaluation of these parameters. Heterogeneity of the group of obese children in terms of these parameters is a premise for development of individual approach to control and prevention of cardiovascular complications’ development risk in childhood.

The article presents a case of early onset of systemic juvenile arthritis with active articular syndrome, severe systemic manifestations and high level of laboratory disease activity indicators. It describes successful use of methotrexate for intramuscular administration in the dose of 25 mg/m² of body surface per week. Systemic disease manifestations terminated in a child after 1 month of treatment, acute inflammatory articular alterations, arthralgiae and morning stiffness disappeared and laboratory disease activity indicators reduced after 6 months; range of motions completely recovered in 4 out of 6 affected joints after 12 months of treatment. Inactive disease state and remission were registered after 6 and 12 months of treatment, respectively. Remission has been present for 24 months.

In order to study self-attitude of younger adolescents with chronic diseases, we examined 86 children with chronic glomerulonephritis and 78 conditionally healthy peers. The average disease duration was 3.5 years. The authors revealed that the level of integral self-attitude, its components (self-esteem, autogenic sympathy, self-interest, expected positive attitude) and sets on internal actions towards one’s ego (self-confidence, attitude of other people, self-acceptance, self-interest) of younger adolescents with chronic diseases is significantly lower than in healthy peers. Special social situation arising in connection with the disease leads to distorted development of the personality. The adolescent’s personality becomes even more vulnerable to stressful situations, social and psychological deadaptation.

The article presents a clinical trial indicating efficacy and safety of a new cosmetic product – topical antiseptic – as monotherapy and in combination therapy with benzoyl peroxide and topical retinoid adapalene for acne treatment in children and adolescents of 8-18 years of age. The trial revealed high anti-inflammatory and antibacterial activity and an almost complete absence of systemic and local side effects; this makes use of this topical antiseptic preferable and advisable for pediatric practice.

The article is dedicated to one of the most difficult issues of world pediatrics – kidney transplantation. It displays the register of transplantations in children conducted at 2 leading Moscow clinics in this sphere of medicine. The article presents the authors’ experience of kidney transplantation, data on transplant survivability and discussion of the long-term results obtained in children from Moscow and other regions of the Russian Federation.

When prescribing mucolytic therapy for bronchopulmonary diseases to infants, it is necessary to consider not only peculiarities of a small child’s respiratory tract, but also action of mucolytic drugs. The authors exemplify their data on efficacy and safety of the use of mucolytics in children under 2 years of age with acetylcysteine.

It has been traditionally considered that primary immunodeficiency states (PID) are rare diseases. However, the incidence rate of PID in Europe is significantly higher than in Russia: our statistics on innate immunodeficiency morbidity is far from reality. Experience of establishing a register of PID patients in the Rostov Region proved that the combination of organizational and educational activities contributes to timely diagnostics, rational therapy and life quality improvement in patients with primary immunodeficiencies.

It is commonly known that acute tonsillites are in most cases caused by viral infections. Only ca. 20% of patients require antibacterial therapy, including cases of the group-A-β-hemolytic-streptococcus-caused tonsillites. Etiologic diagnostics of acute tonsillitis is extremely complicated in terms of both clinical symptoms and bacterial inflammation marker levels, which is why it is positive result of a cultural study of palatine tonsillar materials that should serve as an indication to prescription of systemic antibacterial therapy. Express test for detection of the group A β-hemolytic streptococcus, comparable to the cultural study method in terms of sensitivity and specificity, helps reasonable approach to the treatment of acute tonsillites.

Sore throat is a frequent complaint of children. Another aspect considered in this article is the issue of untimely and groundless prescription of antibacterial therapy to children, as it may result both in allergic reactions and toxic effect on the body in whole. Children of all age groups are rather sensitive to pain. In case of an acute complaint, there must be an effective drug, which may safely be used in children. The article examines various pharmaceutical forms of drugs for sore throat treatment and appraises their advantages, disadvantages and usability in children over 5 years of age in detail.

The article is dedicated to the issue of gastroesophageal reflux treatment in infants with neurological disorders, which remains insufficiently studied and unsettled. Bronchopulmonary complications in patients with gastroesophageal reflux are life-threatening, cause frequent aspiration pneumoniae and spontaneous apneas; therefore, operative correction is required in critical situations. The article presents results of operative treatment of 22 patients with different nervous system pathologies accompanied by gastroesophageal reflux disease. The authors have developed practical recommendations on the selection of surgical treatment tactics. The control group consisted of 10 infants and preschoolers with gastroesophageal reflux disease and central nervous system lesion, whose parents refused operative treatment for various reasons.