In recent decades there has been substantial progress in the technology of premature infants nursing, especially with extremely low birth weight. Adequate feeding is one of the fundamental factors of premature babies nursing. To ensure a premature baby with all necessary components for power saving in breast milk intake, breast milk fortifiers — specifically developed additives that adjust the composition of food for premature babies, are used for more than 20 years (for premature babies receiving breast milk). On the one hand, to preserve all benefits of breastfeeding, on the other — to prevent the deficit development of necessary elements for adequate growth and development of nutrients.

Today the tendency towards reducing the invasive techniques in pediatric patients is of current importance. This also applies to vaccination. Creating a modern multi-vaccine reduces the number of painful injections to infants, because most of the vaccines are introduced in the first year of the life. The article presents the convincing data concerning the combined vaccines efficiency and safety. There is shown the possibility of their effective combination with other monovaccines, the absence of adverse reactions summation and even their reduction by reducing the multiplicity of the vaccine introduced (in the case of monovaccines).

The results of studies of the safety of a combined five-component pediatric vaccine to prevent diphtheria, pertussis, tetanus, polio, Haemophilus influenzae type b (DTaP-IPV//Hib) in children in the primary vaccination and for the first boosterisation are shown. On the introduction of 208 doses of 264 (75.8%) there were no any local or general reactions registered. The registered local or general reactions occurred usually on the 1st day after vaccination and lasted for 1–2 days. Local reactions with a diameter ≥ 2 cm were reported in 2 cases (0.8%) and did not exceed the diameter of 2 cm. Increased body temperature ≥ 38,5°C was recorded in 3 cases (1.1%) and was not higher than 39,0°C. There have been fixed no cases of anaphylactic reactions, seizures, encephalitic reactions. Due to the high-profile security vaccine DTaP-IPV//Hib is suitable for wide application in outpatient conditions for the standard routine and catch-up vaccination of healthy children and children with underlying medical conditions.

Pain in neonates is often ignored by medical staff, it remains undetected and without adequate treatment. The increased interest in recent years to the problem of pain control in the neonates period is determined by early and long-term adverse effects on the child. The article highlights the features of the perception of pain in newborns including premature infants, examines the pain epidemiology, methods of diagnosis, its prevention and treatment. Considering the difficulty in determining the pain in this age group, the attention is emphasized on the leading role of medical staff in the pain control in newborns.

The article presents a case of early onset and severe systemic form of juvenile idiopathic arthritis refractory to classical immunosuppressive therapy, including pulse therapy with methotrexate and combined therapy with methotrexate and cyclosporine. There is described the successful use of chimeric antibodies to CD20 on B lymphocytes — Rituximab — a dose of 375 mg/m2 of body surface in the form of intravenous infusions of 1 time per week for 4 weeks. The child has got one course of treatment with rituximab. By the 12th week of treatment the extraarticular disease manifestations and acute inflammatory changes in the joints stopped, the range of motion in affected joints significantly increased. 22 weeks later the drug induced the development of clinical and laboratory remission, the duration of which is 2.5 years.

Celiac disease has traditionally been associated with severe malabsorption syndrome. Recent years it was shown that among children of preschool and school-age mild cases with atypical clinical picture were dominated that leads to diagnostic difficulties. Here we are citing an example of an atypical clinical/latent celiac disease course in a child aged 4.5 years.

The issue presents current views on the changes in the nervous system in children and adolescents with acne — shows the pathogenetic relationship of physical and psycho-emotional disorders. As part of a multidisciplinary approach the relationship between the onset and progression of acne and impaired emotional status were revealed. The levels of involvement in the psycho-emotional sphere of somatic pathology, as well as the basic methodology of the assessment and results of key studies of emotional status in patients with acne are presented.

Background. Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in children and is associated with reduced quality of life and increased health care costs. Objective. To evaluate the cost effectiveness of the tumour necrosis factor inhibitor adalimumab (ADA) vs. non-biologic therapy for the treatment of JIA in Russian children and adolescents. Materials and Methods. A Markov model was developed on the basis of the DE038 clinical trial, which compared ADA plus methotrexate (MTX) vs. placebo plus MTX for the treatment of JIA in children aged 4–17 years. Cost-effectiveness analyses were performed from the standpoint of the Russian health care system and society as a whole. Base case analyses followed 11-year-old patients with JIA for a period of 7 years (until the age of 18 years) or over an expected lifetime. Additional analyses followed patients aged 7 years at treatment initiation for a period of 11 years or over a simulated lifetime. The cost of treating severe JIA was assumed to be the same as reported in a published investigation. The cost of ADA therapy was based on the expected cost assuming inclusion in the List of Vital and Essential Medicinal Products. This took into account the Value Added Tax and a 10% trade mark-up. Treatment outcomes were measured in quality-adjusted life years (QALYs). Results and Discussion. Over a 7-year time horizon, the incremental cost-utility ratio (ICUR) for ADA vs. conventional nonbiologic therapy in the treatment of JIA in 11-year-old patients was 1,571,500 roubles/QALY when using a health care system perspective and 1,515,000 roubles/QALY when using a societal perspective. Over a simulated patient lifetime, the corresponding ICURs were 286,300 roubles/QALY and 275,300 roubles/QALY, respectively. Over an 11-year time horizon, the ICUR for ADA vs. conventional non-biologic therapy in the treatment of JIA in patients aged 7 years at the start of therapy was 852,400 roubles/QALY when using a health system perspective and 802,900 roubles/QALY when using a societal perspective. The corresponding ICURs were 229,700 roubles/QALY and 215,500 roubles/QALY, respectively, when modeling cost effectiveness over a simulated patient lifetime. In each set of analyses, the ICUR for ADA over conventional therapy declined precipitously when taking the long-term consequences of JIA into account. Conclusions. Relative to conventional non-biologic therapy, ADA is cost effective when used to treat JIA patients whose disease severity is comparable to that of participants in DE038. ICURs estimated in the base case lifetime analyses did not exceed the per-capita gross domestic product (GDP) for the Russian Federation — i. e., approximately 380,000 roubles in 2011— which is regarded as the upper threshold for highly cost-effective interventions. These findings support the use of ADA in clinical practice.

The article presents data on the epidemiology of HIV infection and co-infection with HIV/TB in children in Ukraine. Along with the increasing number of HIV-infected women of reproductive age and their children, it is mentioned the growth of tuberculosis among HIV-infected children. The problems of adequate monitoring and management of these patients, in particular with regard to the prevention of tuberculosis among them are described. There are made conclusions about the need to improve the delivery system of TB care for children born by HIV-infected mothers.

Among pediatricians — nephrologists there is no unified point of view on the appropriateness of the use of the term «Chronic kidney disease» (CKD) and its classification worked out by an international group of experts’ of Kidney Disease Outcomes Quality Initiative (K/DOQI) based on studies in adults. The aim of the study is to determine the correlation between the frequency of important symptoms (arterial hypertension (AG), anemia) of CKD with its stages in children. The study involved 295 patients with CKD: 213 children with glomerulopathy, 82 children — with nonglomerular diseases. We found positive correlations between the frequency of AG and anemia with CKD stages. The most significant differences were found between early and late stages of CKD. The nature of the kidney damage produced less impact on the frequency of these symptoms. Given the need for continuity professionals and international harmonization of terminology, it is appropriate to continue the search for markers of cardiovascular disease in the early stages of CKD, as well as to set target values of blood pressure and hemoglobin, depending on the stage of CKD in children. 

The issue presents three main groups of factors that contribute to the support of a full lactation; some difficulties of breastfeeding, which are often the cause of its early termination are considered. Difficulties in the organization of breastfeeding are presented in the form of five groups: 1 — psychological and social; 2 — organizational; 3 — from health workers; 4 — from the mother; 5 — from the child. It is shown that the breastfeeding dominant (a part of the motherhood dominant) has a leading role in the establishment of lactation and its duration. Conscious attitude to the need for breastfeeding for at least the first year of life is formed only in those mothers who throughout their adulthood (girl — adolescent — woman) formed a mother dominant. There is demonstrated how to make a supplementary feeding with expressed breast milk using special devices.

For relief symptoms of pain and sore throat the prescription of combined topical preparations containing antiseptic and analgesic components is the most appropriate from the pathogenetic point of view. This article discusses the use of local therapy for the treatment of acute inflammatory diseases associated with pain, feeling a tickle in throat. The author introduces the local action drug, which has antiseptic and analgesic effects and is safe and effective in the symptomatic treatment of pharyngitis, tonsillitis and laryngitis in children older than 4 years.

The article analyzes the development of medical and organizational measures aimed improving the efficiency of nurses at the example of a day -care clinic. The paper analyzes the innovative approaches in children’s day-care nurses. New economic conditions call for new approaches to the organization and structure of health care, implementation of nursing innovations.