Clinical investigations in children must meet all the requirements, making to such kinds of investigations in adults. To the present time a number of international instructions and documents, regulating the holding of clinical investigations of medications in children is developed. The basic ethical problems, arising up during preparation and holding of clinical investigations are described in the article in details: informed consent for participating in investigation, estimation of the degree of the risk for the child-participant, decreasing of this risk, and also minimization of fear and pain, which arising up in the process of investigation. Following of the ethical principles gives not only the opportunity of improvement of pharmacotherapy in children, but also allows to observe the inseparable rights of the most vulnerable category of patients.
Key words: clinical investigations, ethical principles, consent, risk, children.

(Pediatric Pharmacology. – 2010; 7(3):6-11)

The article provides an analysis of using medications in children’s oncohematological department in Tomsk in 2008. Over that period 52 children aged from 6 months to 18 years were treated (with an acute lymphatic leukaemia, lymphogranulomatosis, non Hodgkin lymphom, acute and chronic myeloblastic leukemia, etc.). According to АВС/VEN analysis, 79,9% of funds was spent on acquisition of 11 group A medications, 15,1% — on group B medications, 5% — on group C medications. Vital medications (V) accounted for 79,4%, essential medications (Е) — 14,7%, non-essential medications (N) — 5,9%. The authors examined the toxicity of vincristine depending on manufacturers.
Key words: children, malignant blood diseases, ABC/VEN analysis, vincristine, neurotoxicity.

(Pediatric Pharmacology. – 2010; 7(3):14-16)

The article illustrates results from a follow-up study of children vaccinated against Haemophilus influenzae type b. It demonstrates that one year after vaccination children’s health condition remains stable. It proves that there is a substantial reduction in acute respiratory infection episodes in the group of children suffered recurrent respiratory infections VS the prior year. It demonstrates that in a follow-up period the protective antibody level remains the same in most children.
Key words: Haemophilus influenzae type b, vaccination, children.

(Pediatric Pharmacology. – 2010; 7(3):18-21)

Children suffering from oncological diseases fall into the group of immunocompromised patients. They are more at risk of severe children’s banal infections. Development of safe and efficient methods for immunological prevention of preventable infections diseases in this group of children is one of priorities for modern medicine. It is also important to properly organise the process of vaccinating the persons surrounding the patient to eliminate the risk of postvaccinal complications in the sick (non-vaccinated) child. The article provides a detailed overview of the global experience in vaccinating children with malignant neoplasms. It describes modern principles of immunological prevention in children both being administered the standard anticancer therapy and those have undergone transplantation of hemopoietic stem cells.
Key words: children, malignancy, vaccination.

(Pediatric Pharmacology. – 2010; 7(3):28-34)

Enteral nutrition is a method best adjusted to human physiology for correcting disorders of homeostasis in the postoperative period. Untimely and inadequate correction of these disorders may fatally affect a child’s health and rates of the child’s further development. Understanding the laws of stress response generation is important in selecting an optimal nutritive support in the postoperative period. It is necessary to take account of neuro-endocrine-immune response, changing metabolism and an impaired function of the gastrointestinal tract. Modern methods of diagnostics and treatment make it possible to resolve most of the arising issues, but it requires physicians to take a comprehensive approach and have knowledge in many areas of theoretical and practical medicine.
Key words: stress, metabolism, children, enteral nutrition.

(Pediatric Pharmacology. – 2010; 7(3):36-45)

The World Health Organization classifies pregnant and nursing women, as well as children under 2 years, as the group at increased risk of developing diseases related to iodine deficiency. Russia’s population experiences a chronic deficiency of iodine due to lack of mass iodine preventive care. Under these conditions, it is absolutely necessary to have individual iodine prevention using iodine-based drugs among the above risk groups. The article provides data from epidemiological research into iodine-deficiency diseases in Russia, discusses issues of pathogenesis of brain damages caused by iodine deficiency in children, and outlines modern principles of prevention in accordance with the WHO’s latest recommendations.
Key words: iodine-deficient conditions, risk groups, prevention, children.

(Pediatric Pharmacology. – 2010; 7(3):46-50)

The inherited burdened is studied on diseases, associated with an overload iron in 41 children with frequent mutations of the inherited hemochromatosis (IG) of a 1 type (C282y, H63d, S65c). Control group was made by 27 children with undiscovered frequent mutations of NG. Frequencies of iron-associated diseases are compared for 560 members of families which have children with mutations of IG and 390 members of families which have children without IG mutations. Some features of medical-genealogical anamnesis, which can be conditioned of siderosis, are exposed, and indirectly specify in the presence of mutations in the gene of HFE. So, the high frequency of oncologic diseases, diabetes mellitus, hepatocirrhosis and deaths of relatives under the age of 50 years are the foundation for research of exchange of iron and holding of molecular-genetic research of the inherited hemochromatosis.
Key words: inherited hemochromatosis, heredity, children.

(Pediatric Pharmacology. – 2010; 7(3):52-56)

The article summarizes a two-year experience of treating children and adolescents with severe uncontrolled atopic asthma using Omalizumab. This treatment facilitated to achieve full asthma control in 70% of patients and partial control in 30% of patients. Anti-Ig Etherapy contributes to reduce the frequency of asthma relapses 77%, and the number of those seeking emergency medical treatment, particularly no need for in-patient asthma care. Thanks to treatment, lung function parameters improve, particularly in children with low bronchial patency parameters even after administration of broncholytics. Thanks to treatment with omalizumab, the dosage of inhalant glucocorticosteroids is reduced 1.5 to 2.5 times in 75% patients. Treatment tolerance in all children is satisfactory, no serious adverse events associated with the medication or any system side effects are registered in patients. Anti-IgE therapy is a good alternative to use of high and ultra-high doses of inhalant glucocorticosteroids in children with severe atopic asthma.
Key words: omalizumab, anti-IgE-antibodies, treatment-resistant asthma, atopic asthma, treatment, children, adolescents, asthma control.
(Pediatric Pharmacology. – 2010; 7(3):57-65)

Neurospecific enolase is an endoenzyme of the central nervous system (CNS) present in neurons of the brain and peripheral neuraltissue. This is currently the only known general marker of all differentiated neurons. The article illustrates the results of determining this enzyme in premature infants with fetal infections and assessment of their importance as a marker of damage to CNS in this group of children. A high level of neurospecific enolase in children with infectious and inflammatory diseases is not only the marker of damage to blood-brain barrier, but also reflects the nature of damage (hypoxia, intoxication, inflammation). This parameter in premature infants with various pathologies may serve as a degree of perinatal damage severity, and along with other parameters, determine the performed therapy tactics.
Key words: neurospecific enolase, marker of CNS damage, perinatal damage, children.

(Pediatric Pharmacology. – 2010; 7(3):66-70)

The article illustrates current views on the balanced diet concept and the healthy diet notion. It discusses the issues related to the shortage of nutrients in children and adults, its causes, symptoms, possibility of preventive measures and correction using specialized enriched foodstuffs, vitamin and mineral supplements, dietary supplements, provides information about key food sources of vitamins and minerals, new age norms for children’s consumption of micronutrients.
Key words: balanced and healthy diet, vitamins and minerals, norms for consumption of micronutrients, vitamin and mineral supplements, dietary supplements, enriched foodstuffs, children.

(Pediatric Pharmacology. – 2010; 7(3):82-87)

The frequency of acute respiratory infections remains high in childhood. It is impossible to identify etiology most accurately in each particular case. However, according to multiple studies, viruses, their associations with each other and bacteria prevail as causative agents. In addition, it is quite often that a respiratory infection, especially in minor children, is combined with a condition of the gastrointestinal tract. Apart from symptomatic and antiviral therapies in these cases, as the authors of this article demonstrated, it is advisable to use enterosorbents. This tactics results in a decreased level of intoxication, lower intensity and duration of diarrheal syndrome, i.e. more speedy recovery.
Key words: acute respiratory infections, condition of gastro tract, intoxication, diarrheal syndrome, treatment, enterosorbents, children.

(Pediatric Pharmacology. – 2010; 7(3):88-90)

The first demyelinating episode in the structure of multiple sclerosis is called clinically isolated syndrome, that is the clinical debut of the disease requiring an extensive differential diagnostic search and identification of long-term therapeutic tactics. It is well-known that experience of prescribing interferon β to adult patients at this earliest stage in the disease results in a substantially improved long-term disability prognosis. At the same time, promising techniques for an early launch of the biologic response modifier therapy have not yet found sufficient application in children and adolescents with multiple sclerosis.
Key words: multiple sclerosis, clinically isolated syndrome, children, adolescents, interferon β. 

(Pediatric Pharmacology. – 2010; 7(3):91-94)

Vesicoureteral reflux in children without diagnostics and correct treatment could result in chronic renal failure. This prognosis forces to look for new more informative methods of diagnostics. The authors of the article conducted research to assess the reliability of key methods — radionuclide and radiological methods. The results obtained indicate the need for a differentiated approach to each child and advisability of comprehensive examination of a child using various methods not only to identify the presence of reflux, but also its duration, intensity in order to select the right tactics of treating the patient.
Key words: vesicoureteral reflux, diagnostics, dynamic nephroscintigraphy, radionuclide cystography, voiding cystography, children.

(Pediatric Pharmacology. – 2010; 7(3):95-97)

The prevalence rate of atopic asthma in children remains high. One of the reasons for lack of control over asthma symptoms is repeated infection. The article describes results from the study of immunomodulating medication inosine pranobex used in treatment of acute respiratory infections in children with atopic asthma. The results obtained prove the efficacy and safety of this medication. The use of this immunomodifier with antiviral activity during the period of acute respiratory infection in children with atopic asthma contributes to shortening of intoxication and catarrhal signs duration, elimination of viral agents.
Key words: asthma, acute respiratory infections, immunomodifiers, inosine pranobex, children.

(Pediatric Pharmacology. – 2010; 7(3):98-105)

Establishment and maintenance of the contact is a major condition of the successful advising of parents on questions of feeding. An author is divided his own experience with parents not only after the birth of child, but also in the period of pregnancy, as it is particularly important in forming of correct relation of mother to the breast-feeding. The aims of consulting physician are not only a revival of culture of breast-feeding but also providing and control of the correct feeding and care of kid on the first year of life.
Key words: advising, breast-feeding, extra feed.

(Pediatric Pharmacology. – 2010; 7(3):106-112)

For the last decade a great successes were attained in the study of molecular bases of glomerular diseases. It was certain that the most frequent reasons of congenital and infantile nephrotic syndrome are mutations in the genes of NPHS1, NPHS2, and WT1. Nevertheless, until now, a number of patients, having combination of early nephrotic syndrome with inherent pathology of other organs, which etiology remains un known. These cases continue to be intensively probed. One of the most important recent achievements in understanding of molecular mechanisms of early nephrotic syndrome is the discovery of mutations of gene of LAMB2, encoding β2 laminin, as the cause of Pearson syndrome (OMIM#609049). In this article the author presents the basic genetic and clinical descriptions of this recently identified pathology.
Key words: Pearson syndrome, congenital nephrotic syndrome, β2 laminin, malformation of organ of vision.

(Pediatric Pharmacology. – 2010; 7(3):114-117)

Therapy of allergic and many other diseases using antihistamine medications is the pressing topic in modern medicine. Since the first antihistamine medications were created, knowledge of effects from these drugs have expanded and changed. The article discusses approaches to classification, pharmacological properties, side effects of antihistamine medications, and provides literature review of information about justification for administering and safety of using antihistamine drugs in pediatric practice from the standpoint of evidence-based medicine.
Key words: antihistamine medications, efficacy, safety, pharmacoepidemiology, children.

(Pediatric Pharmacology. – 2010; 7(3):71-77)

The article focuses on the issue of evaluating potential risk posed by medications to the fetus during pregnancy. For this purpose various countries use classifications of medications broken down into risk categories during pregnancy. The most popular classification is US FDA classification, which identifies five categories of medications (А, В, С, D and Х) depending on the degree of their embryotoxic and teratogenic side effect, which enables physicians to make informed choices in selecting pharmacotherapy during the entire gestational period. The article discusses possible specific fetal and neonatal disorders when administering medications in categories X and D. Medications in category D may be prescribed to pregnant women only in extreme situations. Administering medications in category X is absolutely inadvisable before and during pregnancy. Further research in this area makes it possible to improve the classification of medications by degree of their embryotoxic and teratogenic risk and address the issue of selecting safe medications during pregnancy.
Key words: medications, gestational period, embryo, fetus, embryotoxic and teratogenic action, fetal and neonatal disorders.

(Pediatric Pharmacology. – 2010; 7(3):78-81)