The article describes a clinical case of the development of a severe, life-threatening methemoglobinemia in a patient with a dystrophic form of congenital epidermolysis bullosa while receiving a drug containing benzocaine. The current data on classification, pathogenesis, clinical course and methods for treating this state has been presented. Many substances and drugs that are methemoglobin formers are widespread and can cause chronic methemoglobinemia. Acute severe methemoglobinemia is accompanied by life-threatening organ disorders. In some cases, it may be difficult to diagnose methemoglobinemia due to the polymorphism of the clinical picture, the need for laboratory confirmation of the diagnosis, which may be underperformed in the absence of adequate alertness. The presented clinical case will be useful for doctors of various specialties.

Rhythm and conduction disorders of the heart occupy one of the leading places in the structure of cardiovascular pathology in children. Atrioventricular block is the slowing down or loss of impulses from the atria to the ventricles. The team of authors presents clinical guidelines based on the principles of evidence-based medicine, including all stages of diagnosis and treatment of children with atrioventricular block. The use of guidelines in clinical practice will allow to choose the best strategy for the diagnosis and treatment of atrioventricular block for each individual patient.

Premature infants are especially in need of timely and effective specific immunoprophylaxis due to their vulnerability to infectious diseases. The article describes the basic principles for vaccination of premature infants used in healthcare by the leading countries of the world. Based on the results of clinical trials, the peculiarities of the vaccination schedule for certain infections have been determined, the specific features of the course of the post-vaccinal period have been described. The operating procedures for active immunoprophylaxis of various types of infections have been explained in detail depending on the pathology and the therapy being performed. The article uses the key points of the recommended practices for prevention of the main controlled types of infections developed by the professional association of pediatricians ‘Union of Pediatricians of Russia’ and approved by the Ministry of Healthcare of the Russian Federation.

The review discusses experimental and clinical trials on applying noble gas Xenon to treat therapeutic conditions in adults, as well as the prospects for its applying in children. Xenon therapeutic effects on the body are based on the healing properties of a noble gas. Xenon is close to the ‘ideal anesthetic’ by its anesthetic properties; but in addition, it possesses organoand neuroprotective as well as anti-stress properties which have been proved in experiment and clinically. Xenon in pediatric practice is an attractive agent because it is non-toxic, effective for the treatment of posthypoxic and traumatic impairments of the central nervous system, pain syndromes and stress conditions at its therapeutic concentration up to 30%.

Background. Introduction of new methods of diagnosing functional disorders of the upper gastrointestinal tract into children’s practice will reveal the true cause of changes in esophageal motility in its various pathologies, which will significantly change the treatment tactics, since the selection of therapy will be based on the pathogenetic mechanisms of disease development.

Our aim was to highlight the capabilities and benefits of high-resolution mano-impedancemetry in comparison with esophagogastroduodenoscopy, which has been studied and used in pediatric practice for a long time, and to prove that only due to a new method for diagnosing esophageal motility disorders, it is possible to determine the cause of dyspeptic complaints in children.

Patients and Methods. The results of our own examination of children aged from 7 to 17 years 11 months (n = 23) with clinical manifestations of functional disorders of the upper gastrointestinal tract have been presented.

Results. According to the mano-impedancemetry data, it has been found that the time of the substrate in the esophagus (p<0.02) and the speed of its passage through the esophagus depend on the pressure in the distal esophagus: the lower the pressure in the distal esophagus, the lower the fluid flow rate and the higher the degree of its reflux (р<0.001). Decreased speed indicates hypotonia of the lower esophagus and lower esophageal sphincter, which provides only a correction by physiotherapeutic treatment methods since surgical intervention in such conditions is ineffective.

Conclusion. The method of mano-impedancemetry allows to determine the indications for surgical treatment and to predict the efficacy of the conducted anti-reflux surgical correction.

Background. Taking into account the variability in the incidence of skin and subcutaneous tissue diseases among children aged 15–17 years by constituents of Russia is an important condition for optimizing pediatric dermatological care. According to modern literature, this issue has been underinvestigated.

Our aim was to study the nature of the variability in the incidence of skin and subcutaneous tissue diseases among children aged 15–17 years by constituents of the Russian Federation.

Patients and Methods. State medical statistics for 83 constituents of the Russian Federation for 2009–2015 were used. The risk aggregation method was used in the study. The degree of morbidity variability by region was assessed by the range of variation and coefficient of variation. Subjects were ranked according to the annual incidence rate. To assess the sustainability of the subjects’ belonging to a certain rank place, the Spearman's rank correlation coefficient was used.

Results. In 2009, the incidence of skin and subcutaneous tissue diseases among children aged 15–17 years in Russia had significant variability: the range of variation was 8.3 times, the coefficient of variation was 29%. Subjects were ranked by year. In 2010–2015, annual variability indicators remained high. Ranked places of subjects had rank correlation coefficients of 0.53–0.83 as compared to 2009. Groups of subjects with different levels of pediatric dermatological morbidity have been identified.

Conclusion. The incidence of skin and subcutaneous tissue diseases among children aged 15–17 years by constituents of the Russian Federation during 2009-2015 was characterized by significant variability. Subjects had a stable belonging to a certain rank place. The constituents of the Russian Federation have been divided into groups according to the incidence rates for skin and subcutaneous tissue diseases.

Background. Vitamins and minerals are significant components of the diet of a person of any age. Nowadays, when there is a focus on the ‘Western’ type of food, it is impossible to get the necessary amount of all vitamins and minerals with a normal diet, which explains the high prevalence of hypovitaminosis in children. It is known that children with allergic diseases have a lower provision of vitamins as compared to apparently healthy children, which is the rationale for the relevance of this study.

Our aim was to evaluate the efficacy and tolerability of vitamin complexes in children, including children with allergic reactions.

Patients and Methods. The work was performed at the Federal State Autonomous Institution ‘NMRC for Children’s Health’ of the Ministry of Healthcare of Russia from February to August 2017. We examined 90 apparently healthy children without severe somatic pathology at the age of 4–14 years, including 17 children with a history of allergic reactions. The children were divided into 2 groups. Group 1 received marmalade pastilles with vitamins C (16–27% of the recommended dietary allowance, RDA), E (29–40% of the RDA), A (24–34% of the RDA), B5 (40–80% of the RDA) , B9 (18–35% of the RDA), and D3 (4–9% of the RDA). Group 2 received marmalade pastilles with vitamins C (57–80% of the RDA), E (50–86% of the RDA), A (40–80% of the RDA), B5 (143–167% of the RDA), B3 (44 –73% of the RDA), D3 (10% of the RDA), B6 (82–117% of the RDA), and B12 (83–167% of the RDA). The tolerance of the vitamin complex was evaluated by the questionnaire method. The provision of vitamins C and B6 was evaluated in 39 children by an hourly urinary excretion of vitamins at the beginning of the study before taking the vitamin complex and 1 month after the start of intake.

Results. The studied vitamin complexes showed good clinical tolerance in all children, including those with a history of allergic reactions to vitamin-mineral complexes. Evaluation of the efficacy of the vitamin complex in the 2nd group showed an improved provision, especially in children who had a deep deficiency of vitamins C (10%) and B6 (22%). At the same time, the excretion of vitamin B6 metabolite increased by 42.2%.