Background. Recurrent upper respiratory diseases in children are an urgent and common issue in pediatrics. Comorbidities often lead to prolonged, complicated, or chronic course of the inflammatory process in the upper airways.

Objective. The aim of the study — scientific evidence and complex technology development for the management of children with recurrent upper respiratory diseases according to implemented multidisciplinary personalized approach, complex of modern methods for diagnosing and health monitoring to achieve long-term remission.

Materials and methods. The study included 115 children aged from 2 years 6 months to 17 years 11 months with recurrent upper respiratory diseases. Examination included: nasal cavity, nasopharynx and larynx endoscopy, abdomen ultrasound with aqueous-siphon test, tympanometry, and laboratory tests (total and specific IgE levels, antistreptolysin-O, microbiological study of nasopharynx and oropharynx discharge, enzyme-linked immunosorbent assay of feces on Helicobacter pylori.

Results. The study has revealed high prevalence of associated allergic pathology in children with recurrent upper respiratory diseases. Allergic rhinitis was the most common (55 (48%) children). There was also a high prevalence of gastroesophageal reflux disease (GERD) (37 (32%) children). Clinical signs of GERD were revealed in patients with chronic diseases significantly more often than in children with acute ENT pathology (27 (38%) and 10 (23%) children, respectively). It confirms the role of this comorbid condition in the development and course of chronic inflammatory process of the upper airways. Obtained data analysis has shown high prevalence of allergic and gastrointestinal pathology in children with recurrent upper respiratory diseases. Diagnostic and management algorithm for patients with recurrent upper respiratory diseases as well as practical guidelines were prepared based on the study data. This algorithm will allow to implement the personalized multidisciplinary approach for the management of prior and comorbid diseases via modern informative diagnostic methods. The complex approach to timely physical examination and pathogenetic treatment will ensure control of the patient’s condition and prevent the development of chronic ENT organ pathology in children.

Background. The usage of new psychoactive substances (NPAS) is increasing every year among various social groups around the world. According to various authors, the use of abused drugs during pregnancy remains at a high level — from 2.8 to 7% of pregnant women. The usage of NPAS, as well as other groups of abused drugs, during pregnancy is fraught with intrauterine multi-organ damage, however, any organ and tissue specificity for NPAS has not been described. In intervention trials conducted on laboratory animals, negative pathophysiological mechanisms triggered by synthetic cathinones have been demonstrated in the form of increased proapoptotic activity, the formation of autophagolysosomes and reactive oxygen intermediates in cells of nervous tissue, and the pro-inflammatory orientation of cells of the immune system.

Case report describes a predominant lesion of the nervous system (developmental brain malformations, damage to the inspiratory center) and the musculoskeletal system (pronounced miotonical syndrome, congenital pathological fractures of the femurs), leading to multiorgan dysfunction, uncontrolled inflammatory response and, as a result, to the development of severe disablement of such children and an increase in the cohort of palliative pediatric patients. In the article, the authors focus on the pathophysiological mechanisms of NPAS for a deeper and more holistic understanding of the pathological process occurring in the body, in order to form and improve the medical judgment of specialist doctors and cite their own clinical observation as an illustration of the consequences of using NPAS during pregnancy. The authors believe that this review describing the case report is valuable from the point of view of practical applicability both for clinicians of various fields and for researchers.

Conclusion. In addition, it is necessary to pay attention to the fact that the use of NPAS is of great social and economic significance, the description of such clinical observations, as well as in vitro studies, is relevant, and the expansion of ideas about the short-term and long-term negative consequences of the use of NPAS should serve as an initiating stage for the development of rehabilitation strategies for these patients

Hematooncological diseases head the list in the structure of malignant neoplasms of childhood. Somatic mutations in tumor clone cells have been well studied, included in modern classifications, and are used to stratify patients into prognostic risk groups and select a therapy program. At the same time, more than 50 hereditary syndromes associated with the development of hemoblastoses have been described. Some of them (Down’s syndrome, Klinefelter’s syndrome, microdeletion syndromes et al.) are caused by chromosomal pathology, while others describe alterations of one or more genes with different types of inheritance and age of manifestation of hematooncological diseases. Genes of predisposition to hematooncological diseases are involved in the processes of DNA repair, regulation of the cell cycle, immune response and bone marrow function. This article presents current data on genetic syndromes associated with the development of hemoblastosis with a description of their own clinical observations.

This article describes the onset of arrhythmogenic cardiomyopathy, left-dominant form, in a pediatric patient that was initially regarded as dilated cardiomyopathy. This clinical case shows issues of the disease differential diagnosis and the need of complex approach to the patient’s examination including heart magnetic resonance imaging and molecular and genetic testing.

The obesity prevalence in children has increased dramatically over the past four decades and has epidemic nature. Lifestyle correction in majority of obese children and adolescents leads only to slight success in reducing body weight (that usually restores to initial level). The increasing availability of pharmacotherapeutic agents approved by Food and Drug Administration (FDA) for body weight reduction in children provides physicians with new and effective tools for obesity management. Phentermine/ topiramate is a combination medication (with once-a-day administration, controlled release) that has been recently approved by the FDA for pediatric obesity therapy. Its efficacy is significantly higher compared to orlistat and phentermine (in monotherapy), two other FDA-approved drugs for this age group. The aim of this review is to analyze the literature on the topic of phentermine and topiramate mechanism, as well as these drugs safety and efficacy as monotherapy and in combination in children and adolescents with obesity.

Rehabilitation of children with motor disorders is a continuous, staged and dynamic process carried out on the basis of individualization of the program, the effectiveness of which depends on many important factors, starting from the consciousness and motivation of the patient, his rehabilitation potential and ending with the methods of medical rehabilitation used. In recent years, global changes have been taking place in rehabilitation related to the introduction of robotic technology. One of the modern methods is robotic mechanotherapy, with the advantages of the wide possibilities of changing training parameters, continuous computer analysis of motor functions, the possibility of training with simulated movements close to physiological ones. The modern introduction of the possibilities and limitations of the use of robotic complexes in the rehabilitation of children with cerebral palsy will eliminate errors and complications during complex medical rehabilitation and optimally use all the advantages of this method.

Dyslexia (disturbance of reading) and dysgraphia (disturbance of writing) are a common problem of teaching children in secondary schools. Information on the prevalence of these conditions is ambiguous, the data presented in the Russian speech therapy literature differ from the results of a few foreign works, and therefore population studies are becoming particularly relevant. The review of the domestic methodological base with the prospect of application in population research and international approaches to population screening are presented.