Diaper dermatitis is a disease belonging to the group of contact dermatitis. Clinical manifestations include skin inflammation in the area of contact with the diaper due to barrier epidermal dysfunction. The paper analyses the pathogenesis of the disease and presents data on a local clinical study on the safety and efficacy of the medication with a regenerative potential.

Inguinal hernia in children is one of the most common diseases requiring surgical treatment. There are two methods of surgical interventions for inguinal hernia in children: open and laparoscopic. In international clinical practice, open hernia repair is widely used due to the simplicity of the technique which does not require special tools. However, the percentage of complications and relapse frequency remain high when open hernia repair is performed. The article presents the analysis of the treatment results in 209 children with strangulated inguinal hernia who underwent open and laparoscopic surgery in the period from 2003 to 2014. The open hernia repair (Krasnobaev or Martynov technique) was performed in 89 children. The following complications were registered: edema of the spermatic cord — in 34 patients, non-viable loop of the intestine — in 2; one child had a vermicular appendix with signs of striation in the hernial sac, 4 patients — a vermiform appendix with signs of inflammation. In 6 cases the contents of the hernial sac included the strand of the greater omentum, in 1 — the strand of the greater omentum with signs of acute ischemia. In 12 children, the hernial protrusion was absorbed to the abdominal, and therefore no revision was required. In 1 patient, the early postoperative period was complicated by peritonitis due to bowel wall necrosis. Laparoscopic hernioplasty was performed in 120 pediatric patients. The contents of the hernial sac in 86 cases included a loop of the small intestine, in 7 — an appendix and a site of the caecum, in 15 — the ovary and fallopian tubes, in 5 — the strand of the greater omentum. In 14 children, unobliterated internal inguinal rings previously not diagnosed were detected when examining the abdomen. Simultaneous appendectomy was performed when the cecum and the appendix were strangulated. Laparoscopic techniques omitting the disadvantages of an open repair method make it possible to remove a restrained organ from the abdominal sac, to assess its viability, to visualize the neck of the hernial sac avoiding mobilization of the elements of the spermatic cord, and to perform hernioplasty. The endosurgical technique allows diagnosing the obliteration of the peritoneum (processus vaginalis) from the contralateral side and performs interventions simultaneously from both sides.

Infectious diseases in newborns are commonly intrauterine infections which affect greatly on the morbidity and mortality rates in neonates.

Background: The purpose of this study was to analyse the neurological status, taking into account the neuroimmunological indicators (neuron-specific enolase (NSE), interleukin-1β (IL1β), Interleukin-6 (IL6) in the serum of neonates with perinatal infections.

Metods: We conducted a complex clinical, laboratory, and instrumental examination of 433 infants with perinatal infections with a gestation period of 27–37 weeks. Determination of the level of NSE, IL1β, IL6 was performed with the standard method of the immune-enzyme analysis.

Results. Hypoxic ischemic, hemorrhagic, infectious lesion of the central nervous system (CNS) were more common in newborns with mixed infection and sepsis. High levels of NSE, IL6, IL1β in the serum of the examined newborns reflect a combined, deeper character of the CNS damage.

Conclusion: Significant diagnostic value of neuroimmunological indicators in the blood serum of newborns with perinatal infections makes it possible to use them as a markers for assessing the severity of the CNS lesions.

Vaccination is concidered worldwide as the most effective preventive measure for many pediatric infectious diseases (vaccine-controlled).

Objective. The goal of the study was to assess the current state of immunization and parent awareness on the vaccination of children under the age of five.

Methods: Analysis of data reported by the National Reporting System on the state of vaccination of children under age of five as well as analysis of two representative multi-indicator cluster and medico-demographic studies were used in the study. Cluster study of mothers’ general awareness and their attitude towards vaccination of children under the age of five was conducted. Total of 30 clusters from 93 villages in the region were selected by random sampling.

Results: In the Kyrgyz Republic, the coverage rates of children with a full range of vaccinations in accordance with the National Vaccination Schedule based on reported official statistics and two representative household-level studies are contradictory and range from 72.5% to 97.5%. In the last 15 years, the proportion of children aged 18–29 months who received all main vaccines recommended by WHO decreased by 10% points. The status of vaccinating children was influenced by the level of mothers’ awareness on the importance of vaccination: 34.4% of respondents denied vaccinations due to disbelief of the possibility of preventing infectious diseases by vaccination, versus 4.2% of mothers who doubted the effectiveness of vaccinations. Meanwhile, the quality of counseling to mothers performed by health professionals does not contribute to a better understanding of the importance of vaccination for children’s health and survival.

Conclusion. The results of the study indicate the vaccination coverage reduction, unreliability of registered number of vaccinated children, and low level of informational awareness on the importance of vaccination for the prevention of a number of infectious diseases and improvement the survival rate in children under 5 years. This data should be considered when developing programs for the improvement of coverage levels for vaccinations in in the Kyrgyz Republic.

The article presents a literature review of pediatric abdominal surgical emergencies in the Russian Federation. The article considers the issues of the development of laparoscopic surgery in pediatrics, the current state of this problem in surgical hospitals, the difficulties associated with transition to minimally invasive surgical interventions, in providing emergency surgical care for children. The possible risks of laparoscopic access and methods for their reduction were analyzed. The advantages of this technique were specified in comparison with open surgical interventions. The reliable economic efficiency of the offered technique was demonstrated. The analysis of the literature sources showed that there was no consensus on laparoscopic treatment for complicated abdominal diseases after previous open repair; and there were also no clear algorithms in clinical practice for complete transition to laparoscopic surgery in children. The analysis revealed very few economic studies on the efficacy of laparoscopic interventions.

The article presents current approaches to medical care delivery in children with primary ciliary dyskinesia. The genetic heterogeneity of the disease causes the variability of pathological symptoms in clinical practice. The most common clinical manifestation in children is the frequent inflammatory diseases of the upper and lower respiratory tract which are registered in the majority of patients, especially in young children. However, the diagnosis is often untimely due to the low disease awareness among medical specialists. The article describes the algorithm for differential diagnostic search in detail, presents approaches to the treatment and management of pediatric patients with primary ciliary dyskinesia. The material is based on clinical recommendations developed and approved by the professional association «Union of Pediatricians of Russia»; recommendations were updated in 2018.

Background. Differential diagnosis of exacerbations of allergic diseases in children at pre-hospital and hospital stages of rendering emergency medical care (EMC) remains a relevant issue. One of the reasons is that medical care does not always comply with current clinical guidelines.

Objective. Our aim was to analyze the quality of emergency medical care for children with acute allergic pathology.

Methods. A retrospective study with a retrospective analysis and extraction of data from medical records (in 2 stages) was conducted.

Results. The study analyzed the data of 595 children with acute allergic pathology who applied for emergency medical care (girls — 215; 36.13%). The average age of patients was 43.12 ± 41.09 months, 455 (76.47%) were under 5 years of age. 513 (86.22%) children applied for medical care for the first time, 24 (4.03%) children — for the second time; in 58 (9.75%) emergency team call records, this column was not filled. Based on the complaints and diagnoses indicated in the medical documentation, the children were divided into 3 groups: Croup, Cutaneous Manifestations of Allergy, and Bronchopulmonary Manifestations. We analyzed the reliability and validity of final diagnoses made at pre-hospital and hospital stages and assessed the adequacy of the carried out pharmacotherapy.

Conclusion. According to our study, the quality of medical care at pre-hospital and hospital stages does not always correspond to current standards, algorithms, and available clinical guidelines.

Background. The primary serological status of children with bronchopulmonary dysplasia (BPD) with respect to respiratory significant pathogens remains unstudied. Wherein, the efficacy of vaccination of children with BPD against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) has been studied in a small number of studies which results are contradictory.

Objective. Our aim was to study the pre-vaccinal serological status with regard to S. pneumoniae and Hib and the immunological efficacy of vaccination against these infections in children with BPD.

Methods. The study included children with BPD without exacerbation. The immunological efficacy of conjugate vaccines — pneumococcal 13-valent and against Haemophilus influenza type b — was assessed by the level of IgG against S. pneumoniae and Hib using the ELISA method. The level of antibodies was determined before vaccination and 1 or 3–6 months afterwards.

Results. The study included 32 children with BPD, mean age at the time of determining primary serological status was 13.3±1.3 months, at the time of vaccination — 15.2±1.5 months. The mean gestational age was 28.7±0.8 weeks, the body weight at birth was 1225±180 g. Before vaccination, all children with BPD had no protective antibody titre against S. pneumoniae and Hib averaging 0.2±0.034 and 0.13±0.0106 mg/L, respectively. One month after vaccination, the level of antibodies to S. pneumoniae reached 12.9±2.34 mg/L to Hib — 3.34±0.769 mg/L.

Conclusion. After immunization with a pneumococcal 13-valent conjugate vaccine and a conjugate vaccine against Haemophilus influenzae type b, the concentration of IgG against S. pneumoniae exceeded the protective level in all examined patients (100%), the concentration to Hib — in 29 (90.6%).

Background. The development of premature infants is slower than that of term ones, often due to nutritional status disorders in preterm infants. Objective. Our aim was to study the nutritional status, physical, and psychomotor development of infants.

Methods. Nutritional status — the composition (the ratio of fat and fat-free tissues) and the value of lean body mass (LBM) — was assessed by plethysmography and densitometry; physical development — by measuring the mass and length of the body, the circumference of the head and chest, calculating the body mass index (BMI); psychomotor development — assessing compliance with the schedule of neuropsychological development of infants (GNOM). The examination was carried out at 12–14 and 16–18 weeks of the corrected age for preterm and actual age for full-term infants. Initially, the diet of infants was assessed by determining the amount, content of macronutrients and energy in the breast milk and/or milk formula and complementary food consumed. The diet was considered to be balanced if the diet parameters diverged not more than 10% of the norm.

Results. The study included 23 preterm infants with extremely low (ELBW), 20 — with very low (VLBW), 34 — with low body weight (LBW), and 33 full-term infants. At 12–14 weeks of the corrected age, the magnitude of LBM in infants with ELBW — 3,397 (3,096; 3,608) and with VLBW — 3,824 (3,797; 3,899) was lower than in infants with LBW — 4,497 (4,034; 4,651) and full-term infants — 4,511 (3,887; 4,647) (Kruskal–Wallis test, p = 0.048). Protein balanced diet was in 2 (9%) infants with ELBW, energy balanced diet — in 1 (4%) infant. Among infants with ELBW, 17/23 (74%) referred to the risk group, 6/23 (26%) — to the developmental disorder group. Compared with infants with ELBW and VLBW, infants with LBW and full-term infants had a higher LBM and, correspondingly, higher body weight and BMI. Improvement of the nutritional status after 4–6 weeks due to correction of protein and energy consumption in infants with ELBW was accompanied by some increase in lean body mass, while its proportion was much higher and the proportion of fat mass was lower, which was accompanied by an improvement in the psychomotor development in individual infants: 5/23 (22%) became age-appropriate, and in the risk group of developmental disorders, the proportion of infants decreased from 17 (74%) to 13/23 (57%). The obtained results testify to the influence of nutritional status on the physical and psychomotor development of infants.

Conclusion. The importance of dynamic assessment of the nutritional status of premature infants with individualized correction of their diet for improving the physical and psychomotor development of the child during the first year of life is shown.

The article presents the review aimed at summarizing the opinions on the epidemiology of pneumococcal infection and the most effective measures for its prevention. The review combines the results of the trials conducted by Russian and international groups who analysed vaccine prophylaxis of pneumococcal infection. In the previous review on the most important indicators of the effectiveness of vaccination against pneumococcal infection, the main approaches to the assessment of the effectiveness of vaccination against pneumococcal infection were identified, and the academic data on the global experience of pneumococcal conjugate vaccination was systematized. This review results in cumulation of evidence for the efficacy and impact of pneumococcal conjugate vaccines on the key «end points» of the epidemiological process of pneumococcal infection.

Acute cough is a common symptom and a common reason for seeking medical care. Patients with acute cough often practice selfmedication using over-the-counter (OTC) drugs. However, the efficacy and safety of OTC drugs are generally not tested in clinical settings. Moreover, a large number of side effects have been registered in children in response to OTC drugs. The article deals with the issues of the rationality of drug treatment in non-severe cases of acute respiratory infection accompanied by cough.

The article presents an overview of the current status of the vaccination against Human Papillomavirus (HPV) in the world. It describes different approaches to expanding the coverage with HPV vaccination at different national levels by inclusion of the vaccine in National Immunization Programmes. Moreover, the principal ways of project financing in different regions of the world are referred to. The results of the implemented vaccination against HPV in the pioneer countries provide the conclusions on the current situation of HPV vaccination in the world and strategies demonstrating its effectiveness.