The article is dedicated to one of the most important issues of modern neonatology – prevention of respiratory-syncytial virus infection, which is a frequent cause of bronchiolites and pneumoniae in infants and neonates, especially premature infants. The latter belong to the high-risk group for the development of this infection with unfavorable outcome. The authors present detailed data on epidemiology and world spread of respiratory-syncytial virus infection, its consequences (short-term and long-term) and prevention possibilities. The authors demonstrate efficacy of passive palivizumab (humanized monoclonal antibody) immune prevention on the basis of multiple studies conducted in different countries. The authors show the process of formation of national recommendations for immune prevention of development of this infection. Apart from the main risk groups for the development of respiratory-syncytial virus infection, acknowledged by the scientists, the authors also present additional groups – children with mucoviscidosis, Down’s syndrome, neuromuscular diseases and immune compromised patients due to the primary immune deficiency or in the setting of immune suppressive therapy.

The article is dedicated to vaccination of premature/low-birth-weight children. This is an extremely topical issue as these children are the most susceptible to infectious diseases, including controlled diseases; however, specialists are reluctant to vaccinate them due to possible unfavorable responses of premature bodies to the introduction of an immunotropic agent. The authors present peculiarities of immune response of premature infants, of the T-cell level in particular, which are to be taken into account during vaccination. Special attention is given to the safety of vaccines – risk of development of apneic episodes with/without bradycardia, their influence on the frequency of obstructive episodes and effect of simultaneous introduction of several vaccines on body. Moreover, the article sets forward issues of immunogenicity and reactogenicity of various vaccines when administered to low-birth-weight children.

The article presents data on the peculiarities of the rotavirus infection spreading in the Russian Federation and other certain countries. It is shown that morbidity levels depend on both objective (population size and territory density, transmission paths activity) and subjective (detectability levels) factors. It has been established that children 0-3 years of age are the most susceptible to rotavirus infection. The epidemic process development intensity is higher in bigger cities. Considerable regional and seasonal changeability of circulating rotavirus strains is noted.

Primary prevention of allergy is an attractive aim due to high social, economic burden and increasing prevalence of allergic diseases. The up-to-date data strongly support the use of partially hydrolyzed whey formula for primary prevention of atopic dermatitis. This approach is effective and cost-saving both from societal and governmental health service perspectives. Pediatricians as well as parents of high risk children should be strictly aware of these data. Because of cost-saving effect of partially hydrolyzed whey formula governmental health service administrations should develop programs for primary prevention of atopic dermatitis with free supply of high risk children with this nutrition for first months of life.

Parenteral nutrition allows adequately providing children’s bodies with amino acids, carbohydrates, fats and energy required to maintain the baseline energy level and correct the preceding nutritive deficiency. Long-term parenteral nutrition is associated with hepatobiliary complications of varying severity – from transitory complications to lethal ones, caused by cholestasis. The article presents modern data on diagnostics, prevention and treatment of hepatobiliary complications of parenteral nutrition in children.

The article is dedicated to the issue of bronchial asthma in children. Immaturity of respiratory and immune systems, peculiarities of the disease course, difficulty in establishing diagnosis and selecting delivery devices for drugs and a limited amount of evidence-based recommendations determine the current situation: only few guides touch upon the subject of infant asthma management. Although asthma is the most widespread disease of lower respiratory tract in children, a significant number of patients do not receive adequate treatment, which is why they cannot control asthma. The authors of this article analyzed the most up-to-date documents (ICON, GINA, PRACTALL, NAEPP, SIGN) that touch upon this subject and briefly stated the key principles of attaining control over this nosology in order to increase availability, spread and introduction of standard therapy of infant asthma.

The article is dedicated to modern treatment of mucoviscidosis. The article covers issues of pathogenesis and emphasizes importance of mucociliary clearance and anatomic-physiological peculiarities of respiratory tract’s structure in childhood in the development of the disease. The article shows that efficient treatment of this disease requires an early beginning of pathogenetic treatment in combination with kinesitherapy. The article shows that the currently used drug – dornase alfa – has 3 key clinical effects – mucolytic, anti-inflammatory and antibacterial. Complex action of dornase alfa should be remembered; the treatment should be continued to prevent development of infectious complications typical for mucoviscidosis. The article also lists general rules of conducting inhalations and using dornase alfa in combination with kinesitherapy.

The authors present modern data on the issue of rational nutrition of children in different periods of childhood. The most frequent types of disorders are listed; insufficient consumption of long-chain polyunsaturated fatty acids is among them. The authors show that this issue is topical not only in Russia, but also in a range of the developed countries. The authors give special attention to classification and biological role of polyunsaturated fatty acids, especially in the development of nervous and immune systems. The authors demonstrated importance of sufficient consumption of long-chain polyunsaturated fatty acids in the period of fetal development for antenatal prevention of atopic disease. The authors list methods of recovery from deficiency of polyunsaturated fatty acids in antenatal and neonatal periods and after the first year of life.

Glycogen storage disease (glycogenosis) is a common name for a group of hereditary diseases characterized by excessive accumulation of glycogen with normal or altered structure in various organs and tissues, most often – in liver and muscles. This pathology is still diagnosed late and not completely; this considerably aggravates the disease’s prognosis. The modern stage of glycogenoses’ study is characterized by many unsolved issues; in particular, there are no clear examination and complex rehabilitation algorithms for such patients. Moreover, the authors have not revealed any literary data on the study of life quality of children with glycogen storage disease. The article presents results of the authors’ studies of life quality and its connection with clinical-paraclinic parameters in patients with this pathology.

Critical periods of atopic status formation in children of 0-1 years of age dictate the need in search and introduction to practice of effective allergy prevention methods. The aim of this study is to substantiate efficacy of using hypoallergenic beikost products on the basis of turkey or rabbit meat for prevention of atopic disease and polyvalent allergy development. The study participants are children over 6 months of age with compromised family allergology anamnesis and mild skin manifestation of allergy. The results have confirmed low sensitizing potential of the studied beikost products, good tolerability and efficacy of use for the prevention of atopic process development. The obtained results allow recommending the studied turkey or rabbit meat purees to the risk group children and children with allergy as primary/secondary allergy preventive means and within therapeutic diets.

The purpose of this work was to study the levels of neurotrophic factor nerve growth of the brain, the levels of vascular endothelial growth factor, the levels of neurospecific enolase and the activity of endothelin-1 in the serum of blood in preterm infants with extremely low birth weight in association with the state of the cerebral circulation, and morphologic changes in the brain. We examined 60 preterm infants, which were divided into two groups depending on weight at birth. In neonates with extremely low birth weight the dysfunction of mechanism of autoregulation in cerebral blood flow was characterized by a decrease in blood flow velocities in the anterior cerebral and in the basilar arteries, in association with low levels of trophic factors in serum to month of life and the developments of degenerative changes in the brain. In neonates with very low birth weight infants in the early neonatal period the vasospasm of cerebral vessels with the activity of neurotrophic factors to month of life gave way to the stabilization of the cerebral hemodynamics.

The article describes modern views on etiology and pathogenesis of various variants of hypophosphatemic rickets and main approaches to diagnostics and treatment of this disease; it also presents a range of clinical cases from the authors’ practice.

The article is dedicated to the problem of modern society of not only sociocultural, but also medical-psychological type – child abuse. Various stages of treatment of children by society in different periods of social development are given. The author considers this issue in the historical aspect and shows that only creation of the state service of children’s interests’ protection will efficiently protect rights of children. The author also emphasizes the need in interdisciplinary approach to helping the children, who have been abused and/or have found themselves in a difficult life situation.

Cough is one of the most widespread causes of outpatient pediatrician’s visits. There has been a notable increase in the use of phytogenic drugs recently, including treatment of respiratory infections in children. The article examines physiological and pathological effects of cough. Issues of phytotherapy efficiency and safety are covered. Data on the use of phytogenic drugs in the treatment of respiratory diseases are presented.

Study aim: evaluation of efficacy of a range of bacteriophages in children with urinary tract infection caused by a urologic pathology. Study participants and methods. The study involved 331 children with a urologic pathology manifesting itself with disturbed urodynamics and secondary urinary tract infection. 159 children received operative treatment; the other 172 children were subjected to conservative treatment methods. The patients were divided into 4 groups: (I) operative treatment + antibiotic therapy, (II) operative treatment + antibiotic therapy + bacteriophage therapy, (III) only antibiotic therapy, (IV) antibiotic therapy + bacteriophage therapy. Bacteriological urine culture was conducted. The revealed microbes were differentiated using 27 biochemical tests with subsequent determination of microbial sensitivity to antibacterial drugs. The trials were conducted at admission to inpatient hospital, 7-14 days after and 6-12 months after. Results. Enterobacteriaceae family pathogens (Escherichia coli) were prevalent at admission – 63.7%; Klebsiella spp. was the second – 15.2%; Pseudamonas aeruginosae – 9.2%, Enterococcus spp. and Enterobacter spp. – 6.0% each. Bacteriuria rate in the group I children was 38.5% at admission, 62.6% 7-14 days after and 32.5% 6-12 months after. There were no differences in preoperative and early postoperative periods in the group II children, but there was a tendency to bacteriuria rate reduction. The combined use of an antibiotic and a bacteriophage in children subjected to operative treatment resulted in an almost double bacteriuria rate reduction in comparison with a group of children who received only antibacterial therapy without an operation (5.8 and 13.7%, respectively). Differences in urine microfloral species composition in the children of groups III and IV indicate the reduction in hospital flora pathogens, especially in case of the combined use of an antibiotic and a bacteriophage: normalization of urine analyses within the first month in 81.3% of cases, remission duration longer than 6 months in 92.0% of cases. Conclusions: the use of bacteriophages appears to be prospective as antibiotic resistance of causative agents of various infections and of their complications increases.

The article is dedicated to the most relevant issue of childhood – febricities, the causes of which and, subsequently, correct patient management tactics are difficult to determine. The authors present not only their own experience of clinical and laboratory differential diagnostics of viral and bacterial infections, but also the world literature data. Low bacterial infection risk criteria, which allow avoiding the prescription of antibacterial drugs, are listed. Special attention is given to the most important inflammation markers at various febrile diseases and signs of a severe bacterial infection and fever without an apparent infection’s nidus. The authors recommend using express tests to confirm the presence of a bacterial infection. Indications to antibacterial therapy prescription are analyzed.

Pathogenetically, prescription of local action drugs containing a wide spectrum antiseptic is reasonable for the upper respiratory tract diseases accompanied by throat irritation and pain. It should be noted that such drugs are very popular among parents; however, most of these drugs may have a range of side effects, which considerably complicate their use in children. That is why the right choice of local action drugs for the acute inflammatory diseases accompanied by throat irritation and pain is a guarantee of treatment efficacy and high compliance. This article examines pharmacological qualities of an antiseptic-containing local action drug permitted to use in children over 4 years of age.

The article offers successful application of a preparation of human monoclonal antibodies to tumor necrosis factor (TNF) α – adalimumab – in the setting of a severe course of juvenile idiopathic arthritis characterized by inefficiency of the standard antirheumatic therapy and secondary resistance to chimeric antibodies to TNF α. Adalimumab treatment secured overcoming of the secondary infliximab inefficiency, rapid disease activity decrease, peripheral joints’ function recovery and the patient’s functional activity increase in a short space of time. The drug averted the patient’s steadily progressing incapacitation and induced the clinical-laboratory disease remission development.

The article presents a case of successful application of a monoclonal antibodies drug to interleukin 6 receptors (tocilizumab) at severe systemic juvenile idiopathic arthritis with the development of secondary hemophagocytic syndrome. Tocilizumab treatment secured a decrease in clinical and laboratory parameters of the disease activity, life quality improvement, systemic juvenile idiopathic arthritis and hemophagocytic syndrome remission and allowed avoiding the per os prescription of glucocorticoids.