Background:  High mortality rates of cardiovascular disease request research revealing risk factors and early markers of cardiovascular dysfunction in children with chronic pathology.

Objective:  to reveal the risk factors and early markers of night hemodynamic disorders for the development of personalized cardiovascular disease prevention in children based on the results of the combined daily monitoring of arterial pressure, ECG examination, and analysis of night sleep. Patients and methods:  Parents filled screeningquestionnaire of night sleep before the study onset. Combined monitoring and examination was performed  in 232  children aged 6–17 with different blood pressure disorders using Astrocard НS E2bp (Russia) equipment in the outpatient setting.

Results: 24-hour BP monitoring identified arterial hypotension 3.8 times more often than routine ambulance method. 21% of children or every fifth child with hypotension  had night hypertension  associated  with maximum (93%) pathology  of ENT organs  with nasal obstruction. Differentiation of investigated groups by night PP and DBP show these marks of hemodynamics to be really important at the early period of pathology development in children. 62% of children had QT interval with bad adaptation to RR-interval at night. In the group with high BMI we found 1.6 times more often children with height more than 85th percentile of the norm. These children had night diastolic hypotension  5 times more often, children with obesity didn’t have normal 24-hour  BP dynamics, children with high BMI had longer QT-interval at night.

Conclusions: We demonstrate the necessity of night sleep hemodynamics investigation in children for personalized cardiovascular disorder prevention. Children of early school age suffering from chronic ENT-pathology with nasal obstruction and/or high BMI, with high BMI, and with height ≥85th percentile of gender-age norm have risk of development of cardiovascular diseases.

Background: Long-term corticosteroid therapy in children leads to plenty of adverse effects with negative influence on health. Objective: analysis of adverse effects of corticosteroids in children with steroid-sensitive  nephrotic syndrome and development of recommendations of their early detection.

Methods: A retrospective study is conducted on children with this syndrome aged 3–18 who applied to Voronezh Regional Children’s Clinical Hospital № 1 in 2011–2014.  Complications  of corticosteroid  therapy revealed during clinical examination of children were taken into account. Data on 118 healthy children examined in 2012–2014 were used to calculate integral index.

Results: The study analyses treatment results of 18 children who received glucocorticosteroids  during 6 months before hospitalization and 13 children who were withdrawn from glucocorticosteroids  for 6 months or more before hospitalization. Among adverse reactions in group 1 there prevailed overweight/obesity  (78%), reactive pancreatitis (72%), leukemoid reactions (67%), liver damage (61%), Cushingoid syndrome (44%), chronic gastroduodenitis  (33%). Hyperglycemia (11%), hypertension (6%) and infection (6%) were less common. In group 2 only 2 (15%) patients had chronic gastroduodenitis,  other complications were not documented. Indices that change in children with nephrotic syndrome during corticosteroid treatment (body mass index, blood serum glucose and amylase) were measured by a single scale using modifications coefficients. Average value of the coefficients is suggested to be a new diagnostic criterion (metabolic reaction index) which allows to reveal corticosteroid adverse effects before any clinical manifestations.

Conclusion: Most adverse reactions of glucocorticosteroids are short-term and continue after 6 months in a small number of patients.

Background:  Recent research shows that the growth and development of the gastrointestinal  tract of children fed by breast milk is more intense than that of the formula fed, since the human lactoferrin contained in the breast milk is a factor that stimulates cell growth. Therefore, the possibility of using exogenous lactoferrin will be of great importance in the nutrition of infants.

Objektive: To study the bifidogenic properties of the biotechnological analogue of human lactoferrin. Methods: Kinetics of growth and CFU titer of bifidobacterial culture in the presence of a biotechnological analogue of human lactoferrin (0,05–5 mg /ml) was determined.

Results: It has been shown that different concentrations of the protein can have both a stimulating (for B. bifidum and B. infantis) and inhibitory (for B. longum) effect on the growth of bifidobacteria, which is due to the affinity of lactoferrin binding to them. It seems important to further study the stimulating effect of this protein on the growth of lactobacilli in the intestine of the child.

Background.  The placenta condition is the health marker of newborns  and it can be considered  in the early diagnosis  of the development of severe pathological conditions in a child. Objective:  Our aim was to study the relationship between the placenta characteristics and the risk of a birth-induced critical condition in a child and the risk of having children with the APGAR score of < 4 points.

Methods. The data of macro- and microscopic studies of the placenta of newborns who have experienced birth-induced critical conditions was retrospectively  analyzed. Birth-induced  critical conditions were the APGAR score at 1 min after birth < 4 points and/or the presence of severe perinatal hypoxia, cerebral ischemia requiring respiratory support and intensive care in the intensive care unit.

Results.  We examined 92 placentas of mothers who gave birth to children in a critical condition. Depending on the APGAR score at 1 min after birth, the main group (n = 56, < 4 points) and the comparison  group (n = 36, > 4 points) were singled out. In multivariate analysis, it was established  that the appearance  of a birth-induced  critical condition with the APGAR score < 4 points was associated with pathological attachment of the umbilical cord (odds ratio, OR, 2.8, 95% confidence interval, CI, 1.1–7.0),  placenta weight (OR 5.4, 95% CI 1.9–14.9),  signs of chronic fetoplacental  insufficiency (OR 7.3, 95% CI 2.9–18.8), impaired blood circulation in the placenta (OR 13.7, 95% CI 4.7–39.3), placental hypoplasia (OR 8.9, 95% CI 2.4–32.4), fetal-placental  ratio (OR 8.9, 95% CI 2.4–32.4)  as well as low birth weight of a newborn (OR 2.9, 95% CI 1.2–6.9). 

Conclusion. Morphological characteristics of the placenta are prognostic markers for the development of critical conditions with the APGAR score at birth < 4 points.

Space-occupying lesions in the heart refer to a rare congenital pathology with incidence of 0.32% in pediatric practice. In recent years, the detection  frequency  of this pathology  has increased  due to the achievements  of early diagnostics  (including prenatal diagnostics),  integration of high volume scanning and high-quality ultrasound images. The greatest number of tumors (72–77%) is detected in infants under 1 year of age, up to 26% of which — prenatally. Available international clinical data confirms the congenital nature of most heart tumors, approximately 50% are rhabdomyomas.  The presented clinical case demonstrates  the demand for a complex approach and the application of new 3D and 4D cardiac scanning in pediatric practice to assess the severity of cardiovascular damage and the prognosis of treatment in patients with rhabdomyomas of the heart.

For the first time, a clinical observation of a rare case of a mature teratoma of the kidney in a child aged 5 months is presented in domestic literature. A literature review is given on this topic. The clinical picture, characteristic signs of a tumor during ultrasound and X-ray computed tomography, the results of a surgical procedure receive full coverage. Special attention is paid to the morphological characteristics of a mature teratoma.

This article describes the peculiarities of the National immunization programs for adolescents in the WHO Euro region. A comparative analysis of the groups was conducted based on economic development. The best and the worst performing states were identified in every group. It was demonstrated that economic development is not the leading factor that determines a country’s vaccination policy. 

Improving the quality of medical care is a priority in countries with developed and developing health care system. There are various approaches to improve the quality and safety of patient’s care, as well as various strategies to encourage hospitals to achieve this goal. The purpose of the presented literature review was to analyze existing experience of the implementation of technology of supportive supervision in health care facilities to improve the quality of hospital care delivery. The data sources for publication were obtained from the following medical databases: PubMed, Cochrane Library, Medscape, e-library, and books on the topic of the review written by experts. The article discusses the results of the research studies demonstrating the successes and failures of supportive supervision technology application. Implementation of supportive supervision in medical facilities based on generalized experience of different countries is a promising direction in improving the quality of medical care delivery. This technology opens up opportunities to improve skills and work quality of the staff at pediatric hospitals in the Russian Federation.