Results of numerous international epidemiological studies currently suggest a growing prevalence of many infectious diseases and, hence, an increased number of complications and fatal outcomes. The global medical community has come to a conclusion about the need to use all available efficient and safe vaccines in order to fight the spread of infections that cannot be tolerated in modern society (pertussis, poliomyelitis, measles, rubella, etc.) The article provides the latest data on these infections, their prevalence, and international recommendations on immunisation against influenza, which is especially critical in the light of recent H1N1 influenza pandemic and its likely propagation going forward as the virus continues to mutate.
Key words: controlled infectious diseases, epidemiology, vaccination, children. 

(Pediatric Pharmacology. – 2010; 7(6):6-9)

Active use of probiotic medications in children with acute enteric infections (AEI) does not always result in noticeable improvement of therapy results, which triggers the need for a study of pharmacoeconomic efficacy of using probiotics. The results of complex therapy for AEI in infants using lactobacillus-based prebiotics and conventional therapy were compared. Key clinical criteria of therapy for AEI were: reduction in inflammatory intestine modifications, elimination of Klebsiella pneumoniae, restoration of indigenous microflora. The results of the conducted study helped identify antagonism of Vitaflora against K. pneumoniae, a positive influence on colitis syndrome progress, as well as identify Biobacton’s impact on the restoration of intestine microbiocenosis.
Key words: Acute enteric infections, children, infancy, therapy, prebiotics, pharmacoeconomic efficacy.

(Pediatric Pharmacology. – 2010; 7(6):10-15)

An annual growth in the number of children with chronic pathologies is registered in the Russian Federation, as in the rest of the world. The disease universe is dominated by visceral, metabolic and motor function disorders. Despite the efforts to enhance healthcare services to children with severe pathologies, the issue of immunization against infections remains unresolved. There is currently an especially strong need to create robust individual immunity against managed infections for patients with chronic pathology, most of whom continue to be socially active. The key principle of the WHO’s Expanded Programme of Immunization for such patients is priority immunization. Children with severe chronic pathologies are vaccinated by an individual algorithm in several stages.
Key words: vaccinal prevention, severe chronic pathologies, immunization.

(Pediatric Pharmacology. – 2010; 7(6):16-21)

In March 2010, the International Symposium on Pneumococci and Pneumococcal Diseases was held in Tel-Aviv. Experts from 70 countries across the world gathered to discuss the latest scientific advances related to epidemiology and diagnostics, treatment and prevention of the pneumococcal infection. The latest achievements in microbiology and genetics helped discover the «genetic» portrait of S. pneumoniae and assess its phenotypic properties. Pneumococcal infection, which is a leading cause of death throughout the world, is vaccine-controlled. Multiple scientific studies conducted in different parts of the world reliably confirmed the safety, immunogenicity and efficacy of currently available pneumococcal vaccines and related vaccination schedules. An ongoing exchange of knowledge about pneumococcus is required to optimize the clinical and economic efficacy of pneumococcal vaccination. Developing new vaccines capable of expanding the coverage of pneumococcus immunotypes, as well as support more sustainable immune defense in high-risk patients (children, elderly people and patients with chronic pathologies).
Key words: vaccinal prevention, pneumococcal infection, advances, safety, efficacy, children.

(Pediatric Pharmacology. – 2010; 7(6):22-25)

The article focuses on modern approaches to pathophysiology, diagnostics and treatment of disseminated intravascular coagulation. Consumptive coagulopathy is a serious complication and associated with significantly increased mortality in children. The causes of developing disseminated intravascular coagulation (DIC) may be a systemic inflammatory response and/or an entry of procoagulant material into bloodstream. Chronic DIC may run with no symptoms whilst the acute DIC may be accompanied with bleeding, thrombosis, and multiorgan failure. The laboratory diagnostics should be serial and determine the combination of blood coagulation indicators. DIC is a secondary clinical manifestation of the core pathology, hence the key objective of an integrated therapy is to treat the core disease.
Key words: Disseminated Intravascular Coagulation, causes, pathogenesis, diagnostics, treatment, children.

(Pediatric Pharmacology. – 2010; 7(6):27-31)

Despite years of investigations an approach to urinary tract infections in children remains controversial. A new data from clinical, microbiology studies together with a progress in diagnostic methods has brought a basis for a reevaluation of main principles. The lecture contains a review of up to date information upon that issue.
Key words: urinary tract infections, etiology, pathogenesis, diagnostics, treatment.

(Pediatric Pharmacology. – 2010; 7(6):39-43)

The article is devoted to specific disorders of the respiratory system in cystic fibrosis. 64 patients with cystic fibrosis (CF) aged 2 months to 32 years and residing in the Udmurtian Republic were studied. Epidemiological and genetic specifics of this disease in the mentioned region of the RF were examined. Clinical, X-ray, functional and microbiological studies of the CF patients’ respiratory system were conducted. It was found that genotype delF508 and chronic infection Pseudomonas aeruginosa, Staphylococcus aureus cause severe structural changes to the bronchopulmonary system more often. The obtained data suggest the advisability of identifying the groups of CF patients at the highest risk of severe respiratory system disorders in order to optimise therapeutic efforts. The article provides indicators of clinical efficacy of a dornase alfa therapy in CF children.
Key words: cystic fibrosis, genotype, delF508 mutation, respiratory organs, pseudomonas aeruginosa infection, staphylococcal infection, respiratory function, mucolytic function, dornase alfa.

(Pediatric Pharmacology. – 2010; 7(6):44-48)

The article demonstrates the treatment results on the protocol the treatment of children with acute lymphoblastic leukemia (ALL) (COALL-92–Saint-Petersburg) after 10 years of follow-up. Between January, 1999 and August, 2008, a total of 272 children and adolescents 0–18 yr of age, from Saint-Petersburg and its area were eligible for the protocol. All the patients have met diagnostic criteria for ALL. Those with a mature B-cell phenotype and FAB-L3 morphology were excluded. The diagnosis was based on morphological evaluation of the peripheral blood and bone marrow smears, immunophenotyping and cytogenetic analysis. All patients were classified as being at lower (LR, 47%) or higher (HR, 53%) risk of relapse. The intensive phase of treatment lasted 5, 5 months in low risk group and 8 months in high risk group and consisted of 4 parts (induction, consolidation, CNS-treatment and reinduction). It was followed by maintenance treatment until 2 years from date of diagnosis. After an observation time of 11 years, the estimate for EFS of all 272 evaluable patients was 67,7 ± 3,1%, the estimate of probability of RFS was 74,1 ± 3,3%, and probability of overall survival was 75,6 ± 3,0%.
Key words: acute lymphoblastic leukemia, intensive chemotherapy, children.

(Pediatric Pharmacology. – 2010; 7(6):50-56)

The article illustrates the results of a study whose purpose was to determine the antimycotic action of activated zinc pyrithione (AZP) against Malassezia in patients with atopic dermatitis (AD). 30 patients diagnosed with AD and aged 3 to 18 years were studied. A mycological study that aimed to identify Malassezia was done by the scraping method and skin surface collection using a cotton ball on a 1 cm2 area, with further yeast maintenance procedure in a selective environment. The activated zinc pyrithione in the form of cream was applied on children’s skin of the left shoulder and forearm twice a day. Nothing but a moisturizing cream was applied to the skin on the right shoulder and forearm. The samples for mycobiota were taken on both sides three times: before AZP treatment, 1 and 2 weeks after treatment. As a result of treatment, a two-fold reduction in skin colonization with Malassezia just in a week’s time (up to 102–105 КОЕ/cm2). The significant dynamics was observed in the modification of species diversity which got more sparse in skin areas where activated zinc pyrithione cream was applied. The follow-up results confirm that AZP has a moderate antimycotic effect.
Key words: atopic dermatitis, treatment, activated zinc pyrithione, antimycotic action, children.

(Pediatric Pharmacology. – 2010; 7(6):58-62)

Metabolic syndrome that represents a totality of interrelated carbohydrate metabolism and lipid disorders, as well as a mechanism regulating arterial tension and endothelium function is one of the critical issues in pediatrics. In recent years, children with metabolic syndrome are increasingly diagnosed with liver injuries symptoms that are associated with a fatty transformation of the liver [1–3]. In this case, non-alcoholic fatty liver disease (NAFLD), a liver manifestation of metabolic syndrome is diagnosed. The diagnosis is confirmed in the absence of alcohol abuse in the past medical history, virus and autoimmune liver disease markers, elimination of toxic and drug influence, as wells as disorders of copper and iron exchange in the patient’s system. One of the key risk factors for developing NAFLD in children is overeating and reduced physical activities. It was believed in the past that NAFLD is relatively benign, however, there is evidence in current literature that this is a pathological condition that may develop and result in extreme fibrotic alterations in the liver parenchymatous tissue all the way to cirrhosis and hepatocellular carcinoma [4]. Early-stage identification and timely launch of therapy for NAFLD in children represents one of the most important objectives in modern healthcare.
Key words: metabolic syndrome, non-alcoholic fatty liver disease, children, steatohepatosis.

(Pediatric Pharmacology. – 2010; 7(6):68-72)

The work contains the follow-up results obtained by the author himself. 51 children with chronic constipation were studied. A complex assessment of microecological and functional abnormalities of intestines in this pathology revealed a reduced level of short-chain fatty acids and anaerobic index, degree I and II dysbiosis, digestion disorder in small intestines. Changes in metabolic activity of intestinal microflora were in line with the functional state of GIT. One of therapy methods for chronic constipation is restoration of normal microflora of large intestines. Absorbents need to be used to influence the pathogenic microflora.
Kew words: chronic constipation, treatment, enterosorbents, dioctahedral smectite, children.

(Pediatric Pharmacology. – 2010; 7(6):74-76)

Coughing is the most frequent symptom that accompanies diseases of the bronchopulmonary system. However, it may develop in a number of diseases that vary in its pathogenesis and location. Despite the variety of potential causes, in most cases acute respiratory infections (ARIs) play the key role in the etyology of coughing. Key methods of therapy for coughing in ARIs include efforts to improve the bronchial drainage function, restore mucociliary clearance, antiinflammation and, if necessary, broncholytic therapy. However, if coughing disrupts the well-being and condition of a patient (non-productive, short, compulsive, vomitory, chest pain causing, sleep and appetite disturbing), cough suppressive medications are administered. To this end, combined preparations containing codeine are successfully used in pediatric practice. 

Key words: coughing, combined antitussive preparations, children.

(Pediatric Pharmacology. – 2010; 7(6):78-80)

Adequate nutritional support of children in critical conditions is undoubtedly a recognised, efficient and evident method of preventing and correcting many complications at the intensive treatment stage. Unhealthy eating habits of patients in critical conditions facilitate the development of nutrition deficit, results in an increased risk of infectious complications and multiorgan failure, slows down the tissue repair processes and restoration of spontaneous breathing. The work describes the results of dietary studies in children in a critical situation. The authors demonstrate that age-adapted infant formulas for enteral feeding are highly efficient in correcting metabolic disorders related to wound processes and help improve the tolerance to a long-term chemotherapy.
Key words: nutritional support, critical conditions, enteral nutrition, age-adapted formulas.

(Pediatric Pharmacology. – 2010; 7(6):82-85)

The article provides information on healthy eating and discusses the issues in reducing the consumption by the population of essential and functional food components, insufficient adaption of humans to aggressive environmental factors and the need to enrich the diet with micronutrients, omega-3 and omega-6 polyunsaturated fatty acids, and prebiotics that have a control impact on the body. The article contains information on the biological role of polyunsaturated fatty acids and prebiotics, their ability to enrich children’s diets.
Key words: healthy eating, child, micronutrients, omega-3 and omega-6 polyunsaturated fatty acids, prebiotics, diet enrichment.

(Pediatric Pharmacology. – 2010; 7(6):86-92)