Study aim: analyzing the results of pneumococcal infection vaccination conducted to reduce infantile morbidity and mortality in 2011-2012 at the expenses of the Irkutsk municipal budget. Patients and methods. Vaccination using the 7- and 13-valent pneumococcal conjugated vaccine was conducted for more than 700 risk group children: premature infants, children with congenital heart diseases or bronchopulmonary dysplasia from 2 months to 2 years of age. 193 vaccinated children had been observed for 1.5 years. 30% of premature infants and 46% of children with congenital heart diseases were vaccinated using the PCV7/PCV13 vaccine at the age of 2-6 months, 52 and 40% - at the age of 7-11 months, accordingly. The PCV7/PCV13 vaccine was administered together with other vaccines of the national preventive vaccination calendar in 65% of cases. Results. Rate of general post-vaccinal reactions (body temperature increase from 37.6 to 38.0^oC) – 4%; no local reactions were registered. No other unfavorable phenomena were noted in the post-vaccinal period. No cases of pneumonia, meningitis, acute otitis media and bronchoobstructive syndrome were registered within the observation period. Conclusions: pneumococcal infection vaccination of premature infants with congenital heart diseases and bronchopulmonary dysplasia conducted in Irkutsk proved high efficacy and safety of the used vaccine – PCV7/PCV13.

 A considerable number of biopharmaceuticals have recently been introduced into clinical practice. Their role is becoming more and more important in managing various diseases, including incapacitating and life-threatening diseases. The authors systematically reviewed literary data from 1990 to 2013 dedicated to studying adverse side reactions to medicinal proteins. The authors used international databases to search for publications dedicated to this issue. As a result, this analysis involves studies describing adverse reactions of such biopharmaceuticals as immunosuppressants and antineoplastic agents. Differences between biopharmaceuticals and small molecules in the rate of adverse phenomena, structure and severity of their manifestations are shown. Classification of adverse reactions and possibility of its use in terms of biopharmaceuticals, recommendations and conclusions for the Russian pharmacovigilance system are given.

The article presents a case of a rare post-vaccinal complication, which appeared after BCG revaccination in the setting of insignificant catarrhal phenomena in a girl of 7 years 6 months of age. An ulcerous defect started to form on the 2^nd-3^rd day on the vaccine administration site. Similar ulcerous lesions started to form on facial skin on sites of cat scratches within the first week. Later, the ulceration spread on all cutaneous coverings. Multiple deep drawn-in cicatrical defects remained on the girl’s skin after long-term treatment at various inpatient hospitals. The developed generalization of the infectious process may have resulted not only from violating the vaccination technique, but also from untimely diagnostics and incorrect disease treatment tactics. The article throws light upon clinical forms and differential diagnostics of various skin tuberculosis forms and presents modern tuberculosis vaccinal prevention issues, classification and causes of post-vaccinal complications.

The article is dedicated to parenteral feeding – infusion therapy aimed at introducing water, macro- and micronutrients in concordance with body needs. Different parenteral feeding types are described: complete, partial and additional. It shows that balanced parenteral feeding allows providing the child’s body with the sufficient amount of amino acids, carbohydrates, fats and energy required to maintain a baseline energy level and correct a preceding nutritive insufficiency. Protein-energy homeostasis is the basis for vital activity of the body; it determines the inflammatory response activity, immune status adequacy, disease duration and severity and disease prognosis (to a considerable degree). Long-term parenteral feeding is associated with complications of varying severity: from transitory and mild to severe, requiring operative intervention and liver transplantation. The command of modern recommendations allows a practicing doctor to successfully overcome issues associated with long-term parenteral feeding. The article presents modern data on diagnostics, prevention and treatment of parenteral feeding complications.

The increase in arterial hypertension is one of the most sensitive markers of the renal affection grade, including patients without chronic renal diseases; its rate is in inverse proportion to renal functions. Left ventricular hypertrophy development at chronic renal disease results from the development of increased left ventricular afterload and end diastolic pressure influence; it is a compensatory mechanism, which is closely interconnected with mortality from cardiovascular diseases. Echocardiography is the most widely used method of evaluating the condition of central hemodynamics both in adults and children with arterial hypertension. However, echocardiography does not give the researcher any complete presentation of the cardiovascular system’s affection and the consequences of it in the setting of a progressing arterial hypertension. Detection of changes in the arterial wall (intimal medial thickness) and endothelial dysfunction is used to estimate the risk of developing such complications. Ultrasonic diagnostics allow to assess the wall’s structure, vascular lumen and determining the intimal medial thickness. Data from a range of foreign and domestic studies allows to suggest that the level of endothelin-1 in the blood serum and its excretion with urine may reflect the renovascular damage severity. The article presents a literary review on the given issue.

The article discusses modern principles of diagnostics and treatment of acute streptococcal pharyngitis and tonsillitis in different age groups. It gives recommendations on using an express test for quick and quality diagnostics of infections caused by group A β-hemolytic streptococcus (GABHS) in routine practice. The introduction of recommendations on diagnostic and therapeutic tactics in adult patients into this article allows to resolve issues of managing family cases of GABHS-infection. Adequate conduct of GABHS express tests and rational selection of therapeutic measures at acute pharyngitis and tonsillitis reduces the risk of prescribing ungrounded antimicrobial therapy.

Study aim: to study the peculiarities of parents' emotional responses to the stress caused by their child’s hospitalization and operation to distinguish risk factors of losing personality potential by family members. Study participants and methods. The empirical study involved 82 parents (15 fathers and 67 mothers) and 76 children of preschool, primary school and juvenile age. A package of techniques involving analysis of medical cards, observation, structured conversation, mental stress calculation questionnaire, the “Incomplete sentences” technique, systematization of results and mathematical data treatment methods was defined. Theoretical analysis of the issue of emotional response of parents to stressful situations connected with their child’s congenital malformations and the need in operative intervention was made. Results. It was shown that all members of a family as a single system are subject to stress. The reaction of parents to their child’s operation depends on their personal characteristics, system of beliefs and life attitudes. Conclusions. The emotional condition of parents influences their child’s psychological condition and the efficacy of treatment. Supporting the family psychologically during pre- and post-operative stages allows to reduce the level of emotional discomfort of children and their parents.

The article presents results of a theoretical methodological analysis of the problem of familial dysfunction as a factor influencing the mental health of children. It shows that peculiarities of family relationships may play a defining role in the formation of psychosomatic symptoms, change the character of a child’s socialization. It describes the influence of peculiarities of different parenting styles on the psychophysical development of children and adolescents.

Study aim: to study the dynamics of changes of higher mental functions in children and adolescents with partial epilepsy forms. Study participants and methods. The study involved patients 6-16 years of age (15 people). Complex neuropsychological examination of the higher mental functions was conducted in children and adolescents with localized (focal, partial) epilepsy forms. Repeated neuropsychological examination was conducted 1 year later to reveal changes in the preregistered symptoms. Results. The most frequent and pronounced disorders in the primary examination were spatial, kinesthetic and constructive praxis disorders, visual-spatial and acoustic-nonvoice gnosis disorders, increased inhibition of traces, audio-verbal and visual memory constriction, defective order of reproducing words (figures) in stimulus sequence (transient errors), spatial errors in visual-constructive thinking, paragraphia. Thus, higher intensity of symptoms of the functional cerebral block II was registered. Repeated examination 1 year later showed slight changes in symptoms characterizing cerebral block II disorders; more serious changes affected symptoms connected with disorders in cerebral blocks III and I. Conclusions: symptom complexes of the functional block II, directly connected to epileptic nidi, appeared to be more resistant and hardly amenable to involution.

Study aim: analysis of surgical treatment of congenital diaphragmatocele on the basis of еру multi-profile republican hospital #1 of the National center of medicine. Study participants and methods. The article gives analysis of treatment results for 8 newborns (6 girls and 2 boys) with false diaphragmatoceles. The average age at the moment of operation was 3 days. In 6 cases the malformation was revealed antenatally during ultrasound investigation within a prescribed period, in 3 cases – within the first antenatal hours. Results. All patients were operated thoratoscopically, average operation time – 60 minutes. No intraoperative complications, hemorrhage or conversion. Average time of post-operative artificial pulmonary ventilation – 5.6 days, of pleural draining – 4.7 days. Results were being evaluated from 6 months to 2 years after operation. An excellent direct and long-term functional and cosmetic result was achieved with all patients. Conclusions. Thoracoscopic plastic surgery of defects at false congenital diaphragmatocele introduced in clinical practice is a sufficiently safe procedure for newborns. Excellent visualization of all stages of intervention, lack of technical difficulties with bringing organs down and plastic surgery of the diaphragm itself and quick recovery in the nearest post-operative period are indubitable advantages of endosurgical intervention.

Attention to the issue of realizing and appreciating pain by children has been increasing within the last 20 years. Papillomavirus skin infection is a widespread dermatosis in younger children. The only treatment method is mechanical removal, which is accompanied by pain, while cosmetic defect caused by verruciform outgrowths on skin, especially in facial and hand areas, causes psychological problems leading to the child’s life quality reduction. The following study assessed efficacy of local analgesic when removing flat warts and papillomata. The obtained results indicate that the use of anesthetic plaster with 5% lidocaine reduces both pain intensity and psychological distress. Plaster therapeutic system is a highly effective analgesic for application anesthesia used to conduct course injections, venous blood sampling and vaccination. This remedy is also recommended for anaesthetization of skin when conducting dermatologic procedures. Convenience and simplicity of use allow using it not only in clinical conditions, but also domiciliary, in particular, by patients themselves.