Background. The widespread increase in allergic diseases incidence is crucial issue of modern pediatrics. Objective. The aim of the study is to analyze the clinical and epidemiological features of bronchial asthma (BA) in schoolchildren of Chechen Republic.

Methods. The study included two stages. 3398 children were surveyed via ISAAC questionnaire at the first stage. All participants were represented by 2 age groups: group 1 — 7–8 years old (n=1331), group 2 — 13–14 years old (n=2067). The second study phase covered clinical and diagnostic examination of children with asthma-like symptoms, enrolled by questionnaire (n=52) — 34 first-graders and 18 eighth-graders.

Results. BA symptoms were recorded in 18.4% (625) of children (mostly in the older age group) according to the first stage results. Comparative analysis of the BA symptoms has revealed their prevalence in urban residents (p<0.05). BA was diagnosed in only 46.3% (37) of children during the clinical diagnostic stage. There were no statistically significant differences in age groups at the second stage of the study. No gender differences were revealed at both stages. The highest prevalence of verified BA was recorded in urban residents. Sensitization spectrum analysis in children with isolated BA in Chechen Republic has revealed predominance of domestic allergens sensitivity (house dust mites — D. pteronyssinus, D. farinae) and allergic rhinitis to pollen (ragwort, herd grass).

Conclusion. Thus, our study results (according to the ISAAC program) have shown high prevalence of BA symptoms in schoolchildren of Chechen Republic at the first stage, however, the second stage indicated that allergy diagnosis cannot be based only on the questionnaire data and requires clinical and diagnostic verification. The identified regional features of the sensitization spectrum will allow physicians to perform economically optimal diagnosis of BA in children living in Chechen Republic.

Background. The main component of the treatment of bronchial asthma is to achieve complete control over the disease. The aim of the study is to examine the role of educational programs in the treatment of bronchial asthma in schoolchildren of the Chechen Republic.

Methods. The educational programs included group and individual classes, which were conducted at the allergy school of the specialized Department of Allergology and Immunology of the E.P. Glinka Republican Children’s Clinical Hospital by an allergologist-immunologist. Educational meetings were held once a week for 2 months, their duration was 1–1.5 hours. Initially and every 3 months for one-year, bronchial asthma control was assessed based on the results of the Asthma Control Test (ACT), the number of emergency room visits, hospitalizations, attacks of shortness of breath stopped at home, missed days at school, the use of systemic glucocorticoids, indicators of pulmonary function test (PFT), the level of nitric oxide in exhaled air. The subjects were divided into two groups: group A —trained, group B — did not participate in educational programs. The subjects were represented by two age subgroups: group IA — 7–8 years old (n = 24), group IIA — 13–14 years old (n = 13). The control group consisted of 37 children who did not undergo allergy school training, who were observed on an outpatient basis by an allergist-immunologist: group IB — 7–8 years old (n = 23), group IIB — 13–14 years old (n = 14).

Results. 3 months after the educational activities, the lack of control over bronchial asthma, according to the results of the ACT, was noted only in 10.8% (4) of patients, whereas in the comparison group — in 59.5% (22). The PFT study recorded an increase in the volume of forced exhalation in 1 second in children who attended allergy school (p < 0.05). A comparative analysis of the frequency of emergency room visits and hospitalizations revealed a decrease in the studied indicators in groups IA and IIA (p < 0.05). The number of missed days at school due to bronchial asthma was significantly lower in children after educational activities — 16.1% (6) and amounted to less than 14 days. Attacks of shortness of breath for 12 months occurred only in 18.9% (7) of patients and were stopped independently, their frequency ranged from 1 to 3, and the use of systemic glucocorticoids in arresting an attack was not recorded among children who attended allergy school.

Conclusion. Thus, our study confirmed the high importance of educational programs in the treatment of bronchial asthma, which are an additional tool for achieving disease control and allow timely prevention of disease progression.

Background. Food allergy (FA) is a common chronic disease. There are no official data on the prevalence of FA in Russia. The results of only a few Russian studies of FA and anaphylaxis in children have been published.

The aim of the study is to study the prevalence of sensitization to food allergens from the group of “big eight” in children with atopic phenotype living in the Moscow agglomeration.

Methods. The cross-sectional study included children aged 0 to 17 years with complaints of seasonal manifestations of allergies / diagnosed with seasonal allergic rhinitis (pollinosis); with complaints of allergic reactions when eating any food; with complaints of atopic dermatitis. The determination of sensitization to allergens was carried out using ImmunoCAP technology, ImmunoCAP ISAC / ALEX2 allergy chips.

Results. 240 children were included in the study. Sensitization to extracts of food allergens of the “big eight”, detected by the ImmunoCAP monoplex method, was determined in 1.5 (for fish) — 5 (for wheat) several times more often than with multiplex allergodiagnostics. In molecular allergodiagnosis, sensitization to hazelnut allergens was found in 57%, peanuts — in 47%, soy — in 39%, walnut — in 24%, chicken egg — in 18%, cow’s milk — in 12%, fish — in 9.7%, cashews — in 7.6%, shrimp — in 6.3%, wheat — in 4.6% of children. The frequency of food allergy symptoms, based on the assessment of the patients’ parents, was up to 7 times higher than the detected frequency of sensitization, accompanied by complaints of symptoms when eating the appropriate foods. Among the products causing symptoms in such patients, hazelnuts, cow’s milk, chicken egg and peanuts were in the lead.

Conclusion. More than half of Russian children are sensitized to the allergens of the “big eight”, while clinically significant sensitization was noted 2 times less often. Sensitization to the allergen components of the PR-10 group of hazelnuts, peanuts and soybeans was most often detected. The frequency of FA diagnosed by a doctor is significantly lower than the frequency of the disease detected by the results of a survey of patients’ parents.

Background. Timely verification of the clinical diagnosis of connective tissue diseases in children based on the onset of the earliest symptoms, including skin manifestations, and timely initiation of treatment can prevent the development of irreversible complications, increase the life expectancy of patients and its quality.

The aim of the study. To analyze the nature of skin manifestations as a marker of the onset connective tissue disorders, such as systemic lupus erythematosus (SLE), localized scleroderma (morphea), juvenile dermatomyositis (JDM), juvenile polyarteritis nodosa (PAN), systemic juvenile idiopathic arthritis (SJIA), and the timing of the main clinical diagnosis from the moment of manifestation of connective tissue disorders. To clearly demonstrate the importance of skin syndrome in the timeliness of clinical diagnosis, a clinical case is presented.

Methods. Analysis of medical records and prospective observation of 47 patients aged up to 17 years 11 months with an established diagnosis of connective tissue diseases and the presence of skin syndrome at the onset of the disease.

Results. Among patients with SLE, only 20.0% of children had skin syndrome only in the form of butterfly rash, and other skin manifestations were noted in 80.0% of patients. The period from the onset of skin syndrome to diagnosis was 8.0 ± 2.1 months. In 57.2% of patients with morphea, skin syndrome was detected exclusively in the form of single or multiple elements, and in 42.8% there was a combination of a pathognomonic morphological element with alopecia and scleroderma. The average time to make a clinical diagnosis of morphea from the onset of the skin syndrome was 11.0 ± 1.9 months. In all patients with JDM, skin manifestations were characterized by polymorphism (papules and Gottron’s sign, heliotrope rash, palmar capillaritis, livedo reticularis, cheilitis). The diagnosis was made 14.0 ± 3.2 months from the onset of skin syndrome. In patients with documented PAN, skin manifestations debuted in the form of erythema, areas of necrosis, palmar capillaritis, livedo reticularis, and cheilitis. The period from the onset of skin syndrome to clinical diagnosis was 6.0 ± 2.4 months. Among patients with SJIA, skin syndrome was represented by a maculopapular rash associated with fever and its regression when body temperature normalized. The period until clinical diagnosis was made from the onset of the skin syndrome was 2.0 ± 1.1 months.

Conclusion. In most cases, the skin syndrome in patients at the onset of the disease was characterized by polymorphism and diversity of elements with the involvement of the vascular component. At the same time, the time from the debut of connective tissue disease in the form of the appearance of skin syndrome to the clinical diagnosis varied in the range from 2 to 14 months.

Proper nutrition of the mother and baby is the most important condition for the development and health of the child. It is the first 1000 days of a child’s life that are critical for neuroontogenesis, the formation of further abilities to acquire and improve various skills, and to learn successfully. It is the first 1000 days of a child’s life that are critical for neuroontogenesis, the formation of further abilities to acquire and improve various skills, and to learn successfully. Breast milk is the “gold standard” of nutrition for all newborns, including children with functional digestive disorders and food allergies. Supporting and promoting adherence to breastfeeding in the first 6 months of a child’s life are the most important tasks for all medical professionals providing medical care to children. The most common pathological conditions among children of the first year of life are functional digestive disorders and manifestations of food allergies, in which diet therapy is the main type of treatment. In situations where breast milk is not available to such an infant, it is important to make the right choice of formula. Modern formulas for artificial feeding of newborns and infants have a number of useful properties due to the features of the composition, which bring them as close as possible to breast milk, specially designed to provide adequate nutrition and simultaneously perform therapeutic tasks.

The development of highly effective protocols for the treatment of acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphomas (NHL) followed the path of escalation of doses of cytostatic agents and improvement of supportive care. Methotrexate (MTX), used in high doses (1000–5000 mg/m²), radically changed the results of treatment of ALL and NHL in children, increasing patient survival rates. The downside of the anti-tumor effect of MTX is its organ toxicity, and therefore the development of methods for predicting the development of toxic effects of MTX is an important scientific and practical task. In recent years, the genetic factors of the patient’s organism have been considered as one of the reasons for the individual variability of pharmacokinetic and pharmacodynamic parameters of MTX. Abnormal function of folate cycle enzymes, methotrexate transporter proteins, due to gene polymorphism, may affect the effectiveness and toxicity of the drug. This review summarizes and analyzes the known genetic polymorphisms involved in MTX metabolism. The possibilities of predicting toxicity, as well as the prospects for individualizing therapy, taking into account the results of pharmacogenetic testing, are presented.

At the moment, in most countries of Europe and North America, there has been a steady increase in the prevalence of inflammatory bowel diseases (IBD). There is little data on the correlation between dairy consumption and the development of IBD, despite the likely biological mechanisms linking these products with the etiopathogenesis of the disease. The exclusion of dairy products from the diet is usually associated with the occurrence of dyspeptic symptoms when they are consumed, which may indicate an exacerbation of the inflammatory process in the intestine or the presence of lactase deficiency. Patients with IBD are characterized by a high prevalence of osteoporosis, and limiting the consumption of dairy products has an even greater negative effect on the state of bone mineral density. In turn, correction of diet therapy in patients with IBD in the presence of intolerance to dairy products should be an important part of the treatment and prevention of complications of the disease.

Dried fruits contain a large number of biologically active compounds, including phenolic compounds, flavonoids, carotenoids, phytoestrogens, etc. These compounds have an antioxidant effect, which has great health benefits. Dried fruits also have a high fiber content. Evaluation of the bioavailability and biological properties of biologically active compounds can contribute to understanding the health effects of dried fruits. A number of studies indicate the beneficial effect of eating dried fruits on the state of the intestinal microbiota. Further research is needed to better understand the health effects of dried fruits and their underlying biological mechanisms.