The issue of long-term breast feeding maintenance is relevant for medical communities of many countries of the world. Long-term breast feeding is especially important in premature children and children born with a perinatal pathology. According to scientific literature, the main reasons of breast feeding termination/reduction and early transfer of children to milk formula feeding include impossibility of breast feeding due to condition severity, prematurity, mother’s milk supply failure and, therefore, various functional digestive disorders (aerophagias, regurgitations, flatulence, colics). It is important to ensure proper latching of the baby to the breast, as it is conductive of effective sucking, and recover complete breast feeding in the event of temporary supplementary and mixed feeding. The article presents results of a trial conducted at the FSBI Scientific Center of Children’s Health. Use of special medical products (nipples, phials) developed on the basis of thorough study of maternal breast sucking physiology in the breast feeding termination risk group children (n = 33) allows maintaining children’s need in breast feeding and promotes effective breast feeding recovery.

Key words: breast feeding, aerophagia, neonates, premature children, causes of weaning, special medical products (phials, nipples).

The article is dedicated to allergic rhinitis (AR) in children. AR is widespread among children and adolescents; it negatively affects physical and psychological condition, social life and school performance and reduces life quality of both patients and members of their families. The authors consider the most modern approaches to diagnostics and control over the disease and present evidence-based recommendations. The authors offer the relevant classification; describe classic and additional disease symptoms and list the key nosological forms of differential diagnostic search. The complex of therapeutic measures to be taken at AR is aimed at relieving devastating symptoms of the disease and involves limitation of contacts with pathogenetically significant allergens, drug therapy, specific immunotherapy and education. Preventive measures are aimed at preventing development of sensitization/manifestation/aggravation of the AR course. The information given in the article is aimed at spreading the main principles of AR therapy and increasing accessibility of the modern methods of control over allergic diseases.

Key words: allergic rhinitis; children; control; therapy

Clinical task.

Parents of a 3.5-year-old girl consulted a doctor due to the girl’s unusual urine color.

The day before the girl had been complaining of pains in the lower abdomen. The girl urinated at night; in the morning the father discovered that the urine was bright crimson.

The review is dedicated to the issues of body magnesium deficit. The authors used data of the evidence-based trials. The authors consider pathologic conditions predisposed by magnesium deficit, i.e. excess weight and obesity, attention deficit and hyperactivity disorder, impaired glucose intolerance, arterial hypertension, gallstone disease and other conditions in detail. The authors dwell upon ways of magnesium deficit correction. The article shows that the most effective method is application of organic magnesium salts (lactate, pidolate, citrate).

The article is dedicated to acute respiratory infections — the most frequent cause of visits to doctors all around the world, especially among children under 5 years of age. The authors cite data on clinical ARI course variants in small children, present data of virologic analysis and immune status peculiarities, list the main methods of ARI prevention in children and assess efficacy of using bacterial lysates in children with acute and recurrent acute respiratory diseases.

Examination of 73 children of 8–12 years of age was conducted in order to study morphological characteristics of erythrocytes at undifferentiated connective tissue dysplasia (UCTD). Scanning electron microscopy revealed significant alterations of surface architectonics of red blood cells, characterized by reduction in the number of discocytes and increase in the number of transformed and degenerative cell forms in the group of children with UCTD without development of anemic syndrome. The most intensive morphological presentation disorders of red blood cells were registered in children with UCTD and anemic syndrome. The article shows that structural inferiority of erythrocyte membranes is a pathogenetic anemia development factor in children with connective tissue dysplasia

The article presents advantages of use of diffusion-weighted magnetic resonance imaging (DW MRI) for revealing hypoxic-ischemic brain lesions in neonates. The trial included 97 neonates with perinatal brain lesion who had been undergoing treatment at a resuscitation department or neonatal pathology department in the first month of life. The article shows high information value of diffusion-weighted images (DWI) for diagnostics of hypoxic-ischemic lesions in comparison with regular standard modes. In the event of no structural brain lesions of neonates, pronounced increase in signal characteristics revealed by DWI indicated considerable pathophysiological alterations. Subsequently, children developed structural alterations in the form of cystic encephalomalacia with expansion of cerebrospinal fluid spaces manifested with pronounced neurological deficit. DW MRI has been offered as a method of prognosticating further neurological development of children on early stages.

Pauciarticular juvenile arthritis associated with antinuclear factor and uveitis with onset at an early age has a special place in the structure of juvenile arthrites. This variant of arthritis is characterized by unpredictability of nosological outcomes and the prognosis is often associated with unfavorable uveitis course. Joint syndrome is characterized by frequent dactylites, which are usually associated with psoriatic arthritis. The article presents clinical observation of a family case (mother and daughter) of juvenile arthritis with onset at an early age, eye lesion, homogenous clinical manifestations in the onset and manifestation of severe ankylosing spondylitis in the mother 25 years into the disease. Both patients started undergoing adalimumab therapy at the same time and very effectively. Clinical observation illustrates the need in timely prescription of a pathogenetically substantiated genetically engineered biological therapy in order to prevent incapacitation of patients with juvenile arthritis regarding condition of joints and organ of vision.

Propionic aciduria is a rare hereditary metabolic disease with autosomal-recessive inheritance mode associated with organic acid metabolic disorder. Early diagnostics is difficult as clinical symptoms caused by metabolic defects are often observed at hypoxicischemic central nervous system lesion, brain malformations and intrauterine infections. Laboratory examination reveals increased concentration of organic acids in blood and urine. The article presents observation of propionic aciduria in a 5-month-old child.

The article is dedicated to optimization of psychological help rendering to children with mucoviscidosis. The authors emphasize the need in multidisciplinary approach to rehabilitation of such children and present results of a study of psychological peculiarities of children of 7–18 years of age with mucoviscidosis and formulate the main areas of psychological-pedagogical help in the process of rehabilitation. The children were divided into 2 groups according to physical and psychological condition: group 1 — stable condition, mild disease course and relatively good psychological condition (47.1%); group 2 — progressive aggravation of health, frequent exacerbations, low mood background and personality distortion (52.9%). The authors disclose content of psychological work with families and methods of optimizing social conditions at inpatient hospitals.

The article lists results of a complex examination of adolescents and conscripts of 15–23 years of age with enuresis performed according to the Ulyanovsk Region military commissariat’s referral in 2003–2012. The main methods of diagnostics were pelvic ultrasound, Doppler sonography of renal arteries, electric encephalography, uroflowmetry and sexual hormones level determination. Increase in size and volume of prostate gland, reduction in total testosterone and luteinizing hormone blood levels, high spread of vesicoptosis (prolapse of urinary bladder) and nephroptosis were revealed in 67.3 % of conscripts with nocturnal enuresis in comparison with healthy conscripts.

The article presents results of demographic status assessment of the Kyrgyz Republic, discusses trends of the main medicaldemographic parameters characterizing the nation and shows that the socioeconomic changes that have been taking place in the recent decades continue having considerably effect on population health formation and change of demographic processes.

The article presents results of back pain syndrome screening in a population of children according to the poll of 600 students of classes 1–11. The spread of dorsalgiae is 19%. According to the examination, nosological and clinical structure of dorsalgiae was determined in 35 children of 3–18 years of age hospitalized due to back pain. Lumbalgia was revealed in 55 (52%) patients; cervicalgia — in 31 (30%) patients; thoracalgia — in 19 (18%) patients. Juvenile osteochondrosis of lumbosacral spine is the cause of lumbosacral pain syndrome in most patients. The authors analyzed complex treatment efficacy and demonstrated that affective disorders are a prognostically significant factor of back pain onset.

The article is dedicated to vaccination against pneumococcal infection. The authors present vaccination results in 4 pilot districts of the Sverdlovsk Region. If necessary, lectures and classes were conducted in order to increase vaccination coverage of the target cohort of children and improve awareness of medical personnel and parents. 18,307 children were vaccinated 2 and 3 times in May-September 2013. Analysis of the post-vaccination children’s condition and undesirable phenomena demonstrated low reactogenicity and good vaccine tolerance.