Osteogenesis imperfecta is a group of rare hereditary diseases of connective tissue, which are based on a defective collagen formation. The main focus of the osteogenesis imperfecta drug therapy is a cyclical use of bisphosphonates (pamidronic acid). The article presents the procedure of health care and drug supply organization for children with that disease, including the development of the regulatory framework.

In children with chronic pathologies, co-occurring frequent respiratory infections of a prolonged course obstructs and reduce the effectiveness of rehabilitation measures, and adversely affect the adaptation reserves. Hydrotherapeutic factors are widely used for the prevention of colds in children from the first days of life. Addition to the water of medicinal and phytoaromatic preparations increases their efficiency. For patients with chronic pathology, when prescribing balneotherapeutic factors for treatment and prophylaxis of respiratory infections, it is important to take into account the potential risk of adverse effects on the symptoms of the underlying disease. Researches in patients with orthopedic, chronic gastroenterological diseases, spastic forms of cerebral palsy, with co-occurring frequent respiratory infections of a prolonged course in history revealed that addition of medicinal baths based on phytoaromatic preparation, containing eucalyptus oil, to the rehabilitation complex is an effective method of preventing and stopping initial symptoms of respiratory infections. It also contributes to the adaptation reserves of the organism, without adversely affecting the course of the underlying disease.

Phytotherapy is one of the oldest treatment methods. Studies and conclusions of the World Health Organization (WHO) Expert evidence of the trend towards greater demand for alternative treatments, including herbal medicine. The article presents such actual data on the issue under review as herbal preparations use at the present stage, frequency of and reasons for the use of medicinal plants in the world pediatric practice. There is a review of the WHO documents on quality assessment, harvesting, preparation and use of vegetable raw materials in the article. It also highlights the key provisions of the WHO strategy for ethnoscience in 2014–2023. There also is data on the properties of one of the plant-based drugs components and results of clinical trials of its effectiveness in children.

Background: Amoxicillin is the drug of choice for treating the majority of community-acquired respiratory tract infections in children, including pneumonia and acute otitis media according to both international and national guidelines. Nevertheless, the practice of not following these guidelines is widespread.

Objective: Our aim was to study a range of antibiotics prescribed prior to hospitalization to children with community-acquired pneumonia (CAP) and acute otitis media (AOM), and to evaluate their effectiveness.

Methods. Observational study of children with hospital-verified diagnosis CAP or AOM.

Results. Amoxicillin was prescribed to only 4.5% of children with CAP and 1% of patients with AOM; along with parenteral cephalosporines and amoxicillin/clavulanate in adequate doses therapy was started in 34 and 25% respectively. Other children received 3d generation oral cephalosporines or macrolides, which rendered a very low effectiveness (19 and 10% respectively). In view of a flagrant inconformity of the prescribed antibiotics and their doses to the guidelines, non-effective prescriptions were made for 72% of children with CAP and 69% — with AOM. For children with atypical pneumonia macrolides were prescribed in only 19%.

Conclusion. Since amoxicillin remains the main drug for treating infections caused by an ever increasing number of resistant strains of S. pneumonia and S. pyogenes, it should be prescribed to children with CAP and AOM: its doses (as well as doses of amoxicillin/clavulanate) should be not less than 45 mg/kg/d, and in risk group patients — 80–100 mg/kg/d. The pediatricians’ skills of differentiating atypical pneumonia should be improved.

Background: There are few data on co-occurring with bronchopulmonary dysplasia diseases but there is no single point of view on their mutual effect.

Objective: Our aim was to learn the structure and frequency of extrapulmonary disease, concomitant of bronchopulmonary dysplasia, in children aged up to 3 years.

Methods. A retrospective analysis of histories of 93 children with bronchopulmonary dysplasia with an analysis of the consequences of perinatal pathology structure was carried out.

Results. On average, each patient with bronchopulmonary dysplasia accounted for 5 comorbidities. The most common (89; 96%) were perinatal lesions of the nervous system and their consequences. In children with bronchopulmonary dysplasia at the age of 3 years there was a relatively low incidence of hydrocephalus and, on the contrary, high — of infantile cerebral palsy. Violations of the organs of vision were found in 58 (62%) children, malnutrition and other violations of physical development — in 58 (62%) and 27 (29%), respectively, and the cardiovascular system pathology — in 59 (63%).

Conclusion. The most commonly, extrapulmonary pathology, co-occuring with bronchopulmonary dysplasia, includes neurological deficit with psychomotor retardation, violations of organs of vision, pathology of the cardiovascular system, malnutrition/delay in physical development.

Background: The allergen-specific immunotherapy (ASIT) is the only method of etiopathogenetic treatment of allergic diseases. Noninvasive method of ASIT is the most popular for children population. Given the features of salivary glands’ anatomy, authors suggested the possibility of using ultrasound diagnosis in salivary glands’ study to determine the effectiveness forecast of ASIT.

Objective: Our aim was to evaluate a possibility of using Doppler study of sublingual salivary glands as an accessible method of evaluation of future ASIT efficacy.

Methods. A prospective randomized comparative controlled study was held. All children underwent an ultrasound procedure of sublingual salivary glands; children with pollinosis underwent it twice, with an assessment of intraparenchymal hemodynamics before and after ASIT.

Results. 160 children with pollinosis in remission period aged 5–17 and 40 children aged 5–17 without burdened allergic history were included in the study. When comparing bloodstream parameters in patients after ASIT with sublingual, parenteral and combined method with positive effect, it is established that the values of all indexes increased in sublingual glands. In children treated with sublingual method these values even exceeded the values of comparison group. In patients receiving ASIT sublingually, parenterally or with combined method without a positive effect in dynamics, all the sublingual salivary glands Doppler study parameters were comparable to those of comparison group. Endonasal method has not shown any significant results either befor or after the ASIT course.

Conclusion. The sublingual salivary glands Doppler study can be used as an additional efficacy criterion of future ASIT, which will be carried out sublingually, parenterally or with combination of those two methods.

Objective: Our aim was to study the clinical efficacy of pneumococcal conjugate 13-valent vaccine (PCV13) in children aged less than 3 years.

Methods: retrospective comparative study of the incidence of acute respiratory infections (ARI), otitis and pneumonia during the first three years of life in 184 children vaccinated with PKV13 and 186 unvaccinated peers.

Results: 91 of 184 children (49.4%) were vaccinated during the 1st year of life, 61 (33.2%) — during the 2nd year, and 32 (17.4%) — during the 3rd year. Number of ARI per 1 child among children vaccinated in the 1st year of life was 5.5 times less than among unvaccinated children (0.42 and 2.31 cases); frequency of otitis during the second year of life was 6.8 times less (7.6% and 52.1%, р < 0,01), and during the third — 34.7 times less (1.1% and 38.2%, р < 0,01). All children vaccinated before the age of 1 were 6.3 times less (1.1% and 6.9%) ill with pneumonias. Additionally it was noted that number of ARI per 1 person among children, vaccinated during the 1st year of life, during the third year of life was lower than among children vaccinated later (0.42; 1.02; 2.03 respectively). There also was a significant in otitis number between children vaccinated during the first and the third years of life (1.1 and 15.6% р < 0,01).

Conclusion: to reduce the incidence of ARI, otitis and pneumonia in children, it is necessary to vaccinate children with PCV13 in the age under 1 year. «Catching up» immunization of the second and third years of life is effective, but to a lesser extent.

Analysis of features of physical and neuro-psychological development of children with low, very low and extremely low birth weight in different age periods is carried out according to cohort studies of newborns with different gestational age and birth weight, presented in electronic databases PubMed and Medscape. It is revealed that the overwhelming number of children with low, very low and extremely low birth weight, gain physical and neuro- psychological development impairments, hearing and vision disorders of varying severity, violation of motor function, intelligence and cognitive skills infringement in an older age. In this regard, it is actual not only to develop new neonatal reanimation and intensive care technologies, but also to ensure adequate prevention of preterm birth in the group of women with a high degree of perinatal risk. All this will further allow preventing increase in children with disabling conditions number among premature infants.

Hypoxic-ischemic brain lesions in children are the main environmental (non-genetic) factor in forming severe neurological pathology with subsequent disability. Scientists see the improvement of therapeutic approaches in acute phase of the disease as a main way to reduce the severity of neurologic complications. Due to the achievements in neuroscience in the field of perinatal hypoxicischemic injury mechanisms, three energy phases of pathologic events deployment were identified: primary (up to 6 hours from the lesion), secondary (6 to 24–48 h after the lesion) and distal tertiary (during few weeks, months). At the same time, necrosis, apoptosis, glutamate excitotoxicity, oxidative stress, inflammation, angiogenesis and neurogenesis make up separate links of destruction process. On the basis of new data on the pathogenesis of the disease, scientists from different countries have already offered modern treatment methods for perinatal hypoxic-ischemic injury with erythropoietin, allopurinol, melatonin, N-acetylcysteine, magnesium sulphate, albumin, -interferon, as well as with the help of controlled hypothermia, xenon, the use of stem cells, etc. This article presents a review of new data on pathogenesis and promising treatment methods for perinatal hypoxic-ischemic injuries.

Adequate nutrition is the most important factor of children’s health, affecting not only his/her state of health, but also physical activity indicators. Children athletes, for compensating the energy cost, anabolic processes activation, and operability recovery, need an optimum diet with adequate protein, fats, carbohydrates, minerals and vitamins to cover the development and growth needs, as well as to recover from the physical and neuro-psychological stress. There are also certain requirements to food and drinking regime, especially during periods of intense training and competitions. Recommendations for the composition of diets for children athletes are developed and presented in a number of guidelines; however, studies show that the actual nutrition of almost half of the specialized children and youth Olympic reserve schools’ students does not meet the recommended standards. The article presents an overview of modern approaches to young athletes’ nutrition organization, and gives recommendations for personified diet correction and nutritive support depending on sports specialization, nature of physical activity, stage of training process, and individual features of a child.