The article presents the results of clinical, allergological and immunological examination of 399 children with bronchial asthma, who live in the iodine deficient southern part of Moscow region. The results of dynamic follow up have revealed a prevalence of moderate asthma (47.2%) and a high frequency of severe asthma (11.5%). RELATIVELY SEVERE ASTHMA WAS NOTED IN A Group of children with long term and recurrent respiratory infections and in a group of children with thyroid changes, where the average remission period lasted for 2.3±0.6 and 2.4±0.8 months, respectively (p<0.05). The allergological examination has demonstrated prevalence of household and pollen sensitization. The immunological examination has shown prevailing Th2-immune response. Higher levels of total IgE have been observed in children with more severe asthma when compared to mild moderate (Р<0.05). Higher levels of total IgE and IgG4 have been registered in the group of children with recurrent respiratory infections and in children with thyroid changes.

Key words: bronchial asthma, allegrodiagnostics, immunological features, iodine deficiency.

 

The article outlines etiology, pathogenesis, clinical course, diagnostic, therapeutic and surgical treatment of recurrent respiratory papillomatosis (RRP) in childhood. Basic issues of adjuvant therapy iincluding recombinant interferons interferon inducers, indol:3:carbinol, thymic extracts (tactivin) and cytostatic agents (prospidine) are scrutinized in detail.
Key words: recurrent respiratory papillomatosis, children, larynx, recombinant interferon, interferon inducers, indol 3 carbinol, prospidine.

Amblyopia is a frequent disorder in pediatric ophthalmology. The term of amblyopia refers to reduced vision caused by limited visual sensory stimulation (visual deprivation) at a time of visual system development, so the vision can not be improved by proper sunglasses. Apparatus treatment of amblyopia have limited effect in rehabilitation of children with moderate (lens corrected visual acuity between 0.2 and 0.3) and severe (lens corrected visual acuity below 0.2) amblyopia. Novel data concerning the use therapeutic agents affecting neural impulse transmission in patients with amblyopia have emerged over the recent years. The union of centers for vision care in children and adolescents «serene vision» has investigated the influence of agents containing choline alfoscerate on vision of children with refraction amblyopia. We have observed that complex therapy including choline alfoscerate agents has significantly improved the lens corrected visual acuity and visually induced potentials and has provided better results lasting through all the period of follow up (1 year).
Key words: refraction amblyopia, choline alfoscerate, children

The purpose of the study was to evaluate the prevalence of innate urinary tract malformations and minor abnormalities and to develop regional norms for ultrasound examination of urinary tract. The study included 8501 children aged from 1 day to 18 years who underwent visceral ultrasound examination. The prevalence of urinary tract malformations and minor abnormalities has been registered at a level of 4.8% and 12.7% in all children, respectively. The structure and distribution correlated with biogeochemical zones where the patients lived. Statistical correlation analysis has established that the renal size is mostly dependent on patient’s height.
Key words: urinary tract abnormalities, screening, ultrasound morphometry, children.

Thrombophilia in children with diffuse connective tissue disorders as systemic lupus erythematosus (SLE) and juvenile dermatomyositis (JDM) could arise from various causes including peripherial blood circulation of antiphospholipid antibodies (APH) and genetic mutations in the system of hemostasis. Thrombosis is a serious and prognostically unfavorable complication that has negative impact on the underlying disease course. The study included 96 children, 65 of them had diagnosed SLE and the other 31 had JDM. The Elisa method was used to detect antiphospholipid antibodies, coagulation method was used to detect lupus anticoagulant (LAC) and antibodies to cardiolipins (anticl), ?2:glycoprotein 1 (anti ? 2 gp 1) and prothrombin (APT). The PCR method (DNA diagnostics) was used to detect DNA mutations as factor resistance to of activated protein c (Leiden) 5,10 methylen tetrahydrofolate reductase (MTHFR) gene polymorphism. The incidence of APL antibodies was registered in 61.5% patients with SLE and in 32.2% of patients with JDM. Ac ligg, anti ?2 gp 1 Igg were clinically significant in thrombotic events in patients with SLE and JDM, and so was LAC in patients with SLE. The prevalence of the hemostasis system mutations is concordant with reported data. Conclusion thrombophilia is frequently associated with APH antibodies or combination of APH antibodies with genetic abnormalities. Sole genetic mutations are salient in patients with JDM.
Key words: thrombophilia, systemic lupus erythematosus, juvenile dermatomyositis, antiphospholipid antibodies, lupus anticoagulant, leiden, prothrombin, methylentet rahydrofolate reductase.

An individual approach to prescribing the most effective therapy for bronchial asthma is one of the actual problems of pediatric. It necessitates the development of new diagnostic markers of disease activity. a method of nitric oxide (no) measurement in exhaled air has been widely promoted to satisfy the necessity. The purpose of this study was to evaluate the measurement of no levels in exhaled air as an instrument to assess the efficacy of basic therapy for bronchial asthma in children and compare the method with those traditionally used for patient evaluation in pediatric pulmonological clinic. We examined 200 children aged 6:17 with varying severity of asthma course. all children underwent an on:line measurement of nitric oxide level in exhaled air by means of hemiluminescent gas analyzer 280i (sievers, usa) and body plethysmography (“master screen”, jaeger, germany).A statistically significant increase in no levels has correlated with disease severity, clinical course and amount of administered treatment. The concentration of no has corresponded to asthma severity in concurrence with respiratory function changes and elevation of total sera Ige. In some patients the increase of no in exhales air has anticipated clinical and functional features of asthma exacerbation, thus providing basis for therapy review. Anti-inflamatory agents have produced dose:dependent decrease of no concentration in exhaled air. The study has proven that the measurement of no in exhaled air could help to optimize therapy individually and to stabilize patient’s condition in shorter periods than those obtained using standard therapy regimes.
Key words: children, bronchial asthma, nitric oxide, therapeutic efficacy monitoring.

Airways inflammation and immune activation are known to play an important part in asthma patogenesis. Glucocorticoids are commonly used as the most effective agents to treat asthma. frequency in alleles and b cligene polymorphism of clucorticoid receptor has been studied in children with mild to severe asthma and in controls. The alleles and b cligene polymorphism genotypes have been uniformly distributed in all groups regardless to asthma severity. Distribution corresponds with the data obtained in the western countries.
Key words: bronchial asthma, glucocorticoids, glucocoticoid receptor, glucocoticoid receptor gene, bcli polymorphism, children.

Blood lymphocyte membrane receptors to IFNγ, IL 2, IL 4, IL 5, IL 8 and IL 10 have been investigated to assess cytokine sensitivity variations in children with asthma. Thirty children aged 5–17 with remission of atopic bronchial asthma ranging from mild to moderate persistent formed the study group. Ten children without any atopic disorders formed the group of controls. The flow cytometry with direct reaction of monoclonal antibodies to the mentioned above cytokine receptors has been used. An increased expression of IL 2 (due to high affinity CD122 subunit) and IL 5 receptors has been registered in children with asthma, and so a numbers of cells bearing IL 4 and IL 8 receptors that has trended to be higher. At the same time, there has been a decrease of IFNγ receptor expression an a trend to lower expression of IL 10 receptor in these children.
Key words: bronchial asthma, children, interferon-γ, interleukins.

The article reviews the problem of gluten intolerance, that is associated with gluten sensitive entheropathy (gee heuner herter or celiac disease) and food (wheat) allergic reactions. Defilement treatment approaches demand proper nosological diagnostic – celiac disease requires strict life time gluten free diet while wheat allergy would stand for temporary gluten free diet. The article elucidates the importance of proper diagnostics in acute period with morphological verification of the diagnosis and reveals pros and cons of serologic methods.
Key words: gluten intolerance, gee heubner herter (celiac) disease, gluten sensitive entheropathy, food allergy, children.

Infantile cerebral palsy (ICP) is an important medical and social problem, associated with high prevalence and disability rates. The efficacy of rehabilitation was evaluated in 38 patients with ICP. The complex rehabilitation consisted of massage, physiotherapy, therapeutic physical training, the method of dynamic proprioceptive correction using gravistat and adely therapeutic devices, traditional and laser acupuncture and botulin toxin a injections, which were used in 10 patients with symmetric neck:righting reflex. botulin toxin a was injected in m. pectoralis major. The efficacy was based on dynamic evaluation of physical and motor development regarding age, disease severity and injection route of botulin a toxin.
Key words: infantile cerebral palsy, rehabilitation, botulintoxin a, physical and motor development

The development of diagnostic and treatment methods used for blood hypertension and its’ complications is a crucial concern of pediatrics. The study included 229 children, the study group consisted of 113 children (60 boys, 53 girls) with elevated blood pressure, the control group consisted of 116 children (60 boys, 56 girls). The age ranged between 6 and 17 years. The study investigated the following genetic markers of blood hypertension angiotensin converting enzyme gene(ace) I/D polymorphism, angiotensin G 6 A gene polymorphism, type I receptor to angiotensin II a 1166 C gene polymorphism, apolyprotein E (APOE) gene polymorphism, TRP 64 ARG β3-adrenoreceptor, C 677 T MTHFR gene polymorphism. Statistically significant increase of I allele of polymorhous i/d marker of ace gene and 677 T MTHFR gene has been observed in patients with primary blood hypertension when compared with the controls. Correlation between total cholesterol and LDLP cholesterol levels has been strong in patients with primary blood hypertension regardless to sex, age and familial history.
Key words: primary blood hypertension, genetic markers, correlation analysis.