The article presents historical data on the feeding, care and education of children of the Northern peoples of the Tyumen region.

Early diagnosis and timely correction of pathological changes in the newborns’ heart can be a major factor in reducing the frequency and severity of cardiovascular pathology in older children and adults. Given the important role of secondary carnitine deficiency in developing disadaptant cardiopathies in newborns (especially premature and immature), the study of the efficacy of exogenous levocarnitine (L-carnitine) in neonatal cardiology offers the greatest promise. The study was aimed at evaluating the efficacy of L-carnitine solution in the post-hypoxic syndrome of cardiovascular deconditioning in newborns, including premature infants. After the treatment course, the newborns showed the effective reduction of signs of electrical instability and myocardial ischemia, restoration of heart rate and resetting of systolic and diastolic function of the heart, the size of the heart cavities, a decrease in the diameter and hemodynamic significance of functioning fetal communications, the restoration of the circadian heart rhythm profile, as well as a reduction in the duration of pauses in rhythm and arrhythmias. The study results showed the efficacy and safety of the L-carnitine solution in correcting cardiac disorders in newborns with hypoxic myocardial damage.

According to the literature, hypogalactia is the main reason for premature termination of breastfeeding. The prevention and treatment of hypogalactia can significantly prolong breastfeeding. The article describes the hypogalactia preventing practice by delivering the lecturing courses for pregnant women during antenatal classes and preparation for childbirth, which led to significant differences in the duration of breastfeeding: 62% of women who attended the lectures and only 37% of women who did not attend courses on their own initiative (p <0.001) were breastfeeding up to 1.5 years. Thus, antenatal prevention of hypogalactia, informing pregnant women about WHO guidelines (frequent breastfeeds, skin-to-skin contact, night feeding and expression of breast milk) can significantly prolong breastfeeding. In addition, the use of lactogenic agents can be useful. The article gives an overview of modern information on the efficacy and administration of lactogenic agents, both herbal and pharmacological in different countries. Special attention is paid to herbs: fennel, anise, nettle and cumin, which form a part of Lactaphytol® herbal tea that is widely used in Russia.

Medical examination of 360 children from four regions of Russia (Moscow, Astrakhan, Stavropol, Kazan) showed significant regional differences in the sufficiency and compensation of vitamin D deficiency at the baseline (Day 0) and established factors associated with vitamin D sufficiency on Day 0. The established interregional differences in vitamin D levels were not due to insolation, but primarily to adequate vitamin D supplementation received at the baseline. Vitamin D supplementation (an average of 894 ± 632.6 IU/day) significantly reduced the risk of vitamin D deficiency (RR 0.15, 95% CI 0.09–0.26, P = 5.7 x 10^–14). The study included the analysis of factors associated with the increase in 25(OH)D levels during the administration of Aquadetrim, identification of predictors of patient’s response and the analysis of identified predictors. The most important factor determining the patient’s response was the dose of vitamin D taken by the patient: 25(OH)D levels increased by 1 ng/ml with an increase in the dose of vitamin D by 90 IU per day. As can be seen from the above, the study results indicate that the vitamin D deficiency requires a long-term preventive therapy (for at least several months) with adequate doses of vitamin D (1000–2000 IU/day).

The article presents modern data on the ontogenesis of the skin, the formation of all its elements and structures during prenatal development and postnatal period. The modern ideas about the features of the structure of the skin in the newborn and infant are highlighted in detail. Particular attention is paid to the protective mechanisms of the skin, providing a mechanical barrier, and factors of innate immunity, lipids, as well as skin microbiome. Much attention is paid to the importance of the dampening for the skin of the fetus and newborn, as well as the processes of adaptation of the skin of the newborn to the extrauterine environment. The modern recommendations for skin care, based on data of the features of the development, structure and functioning of the skin of the newborn and infant are presented.

The subnormal vitamin deficiency form poses a threat to the normal growth and development of the child. Reduced supply of vitamins A, PP, B6, B12, E is associated with decreased immunity, and increases the risk of physical development delay and the formation of functional diseases. According to 2015--2017 data, the vitamin provision pattern for preschool and school children is almost the same regardless of the place of their residence: only one in four or five children are provided by all vitamins. Up to 50% of children suffer from polyhypovitaminosis, (i.e., a deficiency of 3 or more vitamins). In the settings of insufficient production of food products enriched with vitamins, the main way to eliminate vitamin deficiency is the use of vitamin mineral complexes. The inter-vitamin interactions and the high incidence of polyhypovitaminosis conditions among the children give occasion to use the vitamin mineral complexes (VMCs). The intake of VMCs is more efficient in comparison with the use of monovitamins. When choosing an VMC for children, one should give preference to complexes containing a full set of vitamins to be taken in an amount comparable with the age recommended intake, and mineral substances, which deficit is most often found in the population of Russia. The systematic consumption of food products enriched with vitamins and/or VMCs results in increased levels of vitamins in blood plasma, a decreased frequency of polyhypovitaminosis, increased number of children adequately provided with all the vitamins.

The article describes the modern concepts of breastfeeding in neonatal jaundice with elevated indirect bilirubin levels: hemolytic disease of newborns, jaundice because of variations in the composition of the breast milk and exclusively-breastfed jaundice. According to the guidelines of the Russian Neonatal Society (RON), the Russian Association of Perinatal Medicine Specialists (RASPM) and the National Neonatology Guidelines, there are no contraindications to breastfeeding or receiving milk by children with hemolytic disease of newborns despite the presence of antibody titres during pregnancy. In the event of jaundice because of variations in the composition of the breast milk, breastfeeding may be dropped at 24th – 48th hour and in exceptional cases after the 5th day of life against the background of phototherapy used for its indications specified in the clinical guidelines. It is required to comply with WHO guidelines for BF management from the first hours of life to prevent jaundice caused by breastfeeding. It is a pathological loss of body weight which may be an indication for supplementary feeding with the mixture, but not the jaundice itself associated with breastfeeding.

Symposium “Recurrent respiratory syndrome: a common cold or real threat?” was held as part of the XVI Russian Congress with international participation “Innovative technologies in pediatrics and pediatric surgery. Resolved and unresolved issues”. The head of the Otorhinolaryngology Department of Pirogov Russian National Research Medical University, Corresponding Member, Professor M.R. Bogomilsky and the head of Paediatrics Department of Russian Medical Academy of Continuing Vocational Education GBOU DPO Professor I.N. Zakharova, who ran the symposium, stressed that considerable interest of pediatricians and otolaryngologists in the symposium was understandable, because the routine practice of these particular specialists was closely related to the treatment of respiratory diseases in children. After the symposium was over, we turned to the experts, who took part in it, and questioned them closely about the optimal therapeutic choice for respiratory diseases in children.

The article presents the results of an in-house study aimed at assessing the safety, tolerability and therapeutic efficacy of Dishi plaster inhaler for the treatment of acute respiratory diseases in children. Our study showed that the administration of Dishi plaster inhaler since the first hours of ARD helps provide faster relief of catarrh symptoms, primarily nasal symptoms, reliably reduces the need for prescribing vasoconstrictors, thus reducing the drug load on the patient. The good tolerability and high efficacy of Dishi plaster inhaler enable us to recommend it as a remedy for symptomatic therapy of ARD in children over 2 years old.

Body temperature rise with and without other clinical symptoms, including respiratory ones is one of the most frequent causes for contacting an outpatient clinic or for emergency and urgent medical care in paediatric practice. In most acute respiratory diseases, an increase in body temperature (up to 3 months – above 38°C; in initially healthy children older than 3 months. – above 39–39.5°C) will not cause persistent health problems, and a fever at body temperature of 37.7–38°C shall be mainly reduced in the presence of pathological symptoms (impaired appetite, state of health, discomfort, myalgia, headache, toxicosis, etc.) in children at risk with febrile convulsions. The article reviews present-day knowledge on etiopathogenesis, clinical features of fever, provides practical recommendations on the prudent use of antifebrile therapy in children, which should be administered in a short course and using a differentiated approach. Paracetamol is currently considered as the first-line drug among anti febrile drugs.

Coughing is a common symptom that accompanies many pathological conditions and leads a child to a pediatrician. Determining the tactics of a doctor depends on the general condition of the child, the mechanisms of origin and nature of the cough. With dry non-productive cough after viral diseases, with whooping cough, preparation for diagnostic and therapeutic manipulations shows controlled use of the drug of the central action of the sinecode (butamirate).

Strange as it may sound, children get sick - most often with acute respiratory diseases, which is very frustrating for parents. And for doctors. Speransky Department of Paediatrics with Outpatient Pediatrics Module of Russian Medical Academy of Continuing Vocational Education GBOU DPO of the Ministry of Health of Russia held a seminar with international participation, which task was to comprehensively address the issue of frequent respiratory diseases in children.

Cough is one of the most common reasons for seeking medical treatment, and there are many reasons for its occurrence. Conventional expectorants are the most widely used medications in paediatric practice to this day, among which one may identify a large group of drugs with reflexive action that usually contain plant-derived substances. The article reviews present-day knowledge on the mechanisms of action and clinical efficacy of these drugs, provides practical recommendations on the rational use of expectorant therapy for bronchopulmonary diseases in children. It is known that the efficacy of treatment with medicinal plants is caused by their complex multicomponent composition. The use of combination drugs that have a simultaneous effect on various pathogenetic mechanisms of inflammation and coughing is becoming a promising area of mucoactive therapy. Due to relative safety, affordability and efficacy, the modern official herbal medicine is increasingly becoming the subject of informed choice in paediatric practice.

The article focuses on the treatment of respiratory viral infections of the ENT organs in order to prevent complications and chronicity of the process. It provides the data on the efficacy of the use of polidexa with phenylephrine in paediatric patient with acute post-viral rhinosinusitis. The microbiological tests and changes observed in imprint smears from the mucous membrane of the nasal cavity showed that the drug reduces the clinical manifestations of the disease quickly and significantly, has a sanative effect and positively affects the quality of life of patients.

Acute obstructive laryngitis is a life-threatening upper respiratory tract disease of various aetiologies that is characterized by laryngostenosis and manifests itself by barking cough, dysphonia and inspiratory dyspnoea [8]. A child showing these clinical symptoms needs urgent medical care. Delay in emergency treatment of a child with acute obstructive laryngitis may lead to serious complications and even to an unfavourable outcome [1–15].

Nasal forms of vasoconstrictor agents (decongestants) are one of the most frequently prescribed groups of drugs in the therapy of inflammatory diseases of the nasal cavity. The article provides an overview of the mechanisms of action of decongestants, safety and the evidence base for the efficacy of decongestants in various upper respiratory tract diseases. It is concluded that when choosing a nasal agent, the preference should be given to decongestants with a higher level of safety – modern imidazolines (primarily xylometazoline) over the “first generation” decongestants (naphazoline).

The diagnostics and treatment of acute rhinitis in children remains a live issue today. Polymorphy of reasons for acute rhinitis requires the search for new algorithms for the treatment of this disease, which is reflected in the consensus papers of both domestic and foreign authors. The article summarizes the principles of management of patients with various forms of rhinitis and its possible complications from the views of the European and national guidelines.

Acute tonsillitis, as one of the most frequent reasons for seeking medical care, especially in paediatrics, is almost the leading nosology that is misinterpreted and improperly treated. It is a fact of life that only pharyngoscopic data are the course for the prescription of a system antibiotic drug, sometimes more than one, for an average of 5 to 7 days, whereas most tonsillitis cases require only symptomatic therapy. But even in case of the right choice and streptococcal aetiology of the disease, this treatment regimen is not sufficient to eradicate the infection and prevent possible serious complications. Therefore, this approach to managing patients with acute tonsillitis does not fit the category “if an antibiotic drug is prescribed, the patient either will recover himself or the antibiotic drug will help.” Acute tonsillitis requires mandatory aetiological diagnosis and the right choice of therapy treatment of clearly defined duration. The article presents the main principles of diagnostics and treatment of acute tonsillitis, and the difficulties that paediatricians have to encounter in everyday practice.

Diagnosis of acute otitis media in infants is complicated due to few symptoms of clinical and laboratory manifestations dictating the need to find possible predictors of the disease.

Material and methods. Peculiarities of maternal history, pregnancy course, delivery and the child anamnesis of 116 infants with acute otitis media in the first 4 months of life and 36 children without a history of otitis media in the same age period. Risk factors for acute otitis media were detected and stratified.

Results. In the pregravid health status of the mother the most significant in terms of the risk of developing of otitis media in children in the first months of life are the presence of respiratory allergy (OR = 7,74; P = 0,014) and chronic infections of ENT organs (OR = 1,15; P = 0,022). In the prenatal period the risk of early manifestations of the first episode of otitis media in a child increases obesity during pregnancy (OR = 11,78, p<0,000), waterless period of more than 8 hours (OR = 8,60, p<0,000), TORCH and urogenital infections in the mother (OR = 7,29, P = 0,028). Formula (OR = 4,20, p = 0,004) and mixed (P = 0,008) feeding in the postnatal period and the male sex (58,6%) of the child are also associated with an increased risk of developing otitis media. For this age group otitis media was characterized by a high association with ARI (99,1%).

Conclusion. We have identified risk factors of otitis media in infants and children during the first months of life allow us to form a high-risk group for development of this disease.

The strategy and tactics of antibacterial therapy for acute respiratory tract diseases in children in the practice of neighbourhood paediatricians are discussed on the basis of the current Russian clinical guidelines. The article presents the diagnostic criteria and the choice of antibacterial drugs for acute bacterial rhinosinusitis, acute streptococcal tonsillitis, acute otitis media.

The article is devoted to one of the most serious and unsolved issues in current gastroenterology: the issue of inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn’s disease (CD). IBD is a chronic, relapsing inflammatory condition of the gastrointestinal tract (GIT) (often the intestine), resulting in irreversible disruption of its structure and functions, which disables the patient. At an early age, patients have a greater lesion site, but at the same time, less specific, inapparent clinical signs, the effect of the disease on the physical and sexual development of the child. This review presents current knowledge on the epidemiology, aetiology and key points of current concepts of pathogenesis, symptomatology and therapy. The prescription of drugs for the correction of microbiocenosis in the combination therapy of IBD positively affects the clinical and endoscopic course of the disease, effectively relieving exacerbations and maintaining remission. It also improves the safety of treatment and enhances the quality of life of patients. S. boulardii-based drugs showed high efficacy and safety in several studies, which is associated with their probiotic activity against opportunistic microorganisms and clostridia, and with immunomodulating action.

50 subjects with functional bowel disturbance and 20 subjects with irritable bowel syndrome were examined. The control group consisted of 30 patients who had no clinical or laboratory signs of the gastrointestinal tract disorders. Ultrasonic investigation of bowel was performed without contrasting. 20 patients with functional bowel disturbance underwent pre-medication to reduce gaseous distention. It was revealed that the parameters of the thickness and structure of the intestinal wall in patients from the pathology groups are similar to those from the control group in 100% of cases. Comparison of the parameters for vascularization, presence of ascites, lymph nodes sizes, changes in gaustration revealed no significant differences either.

The article gives a modern definition of functional disorders of the digestive organs, presents diagnostic criteria and a possible mechanism for their development in newborns and infants in accordance with the Roman criteria for revision IV (2016). Much of the information is devoted to the positive effects of probiotic strain Bifidobacterium animalis subsp. lactis (ВВ-12).

How eating gluten may be associated with various disorders of human health including neurological diseases remains a topic of discussion in the academic and civil circles. Application of gluten-free diet is of particular interest for the complex management of diseases such as autism, schizophrenia, and borderline neurological disorders including chronic fatigue syndrome, various cognitive impairments, depression, etc. The article presents a review of the studies of efficacy of gluten-free diet in patients with various neurological diseases and psychiatric disorders; the potential mechanisms of the neurotropic action of gluten are also examined.

Modern molecular genetic methods of research, which emerged in the 21st century, completely unfixed all established notions not only about the microcosm, but also about its influence on the life and health of the macroorganism. The identification of intestinal bacteria and particularities of their various strains is increasingly expanding our understanding of the mechanisms of their action on the somatic and mental health of a human being. The various lactobacilli strains have been the most studied probiotic at the present time. The genus Lactobacillus is known to include about 90 species with a wide range of biochemical and physiological properties. Lactobacillus reuteri, which has strains with different mechanisms of action, is one of the unique microorganisms of the family Lactobacillaceae. The range of possibilities for using various Lactobacillus reuteri strains is currently very wide. This article deals with clinical effects associated with the strain-specificity of Lactobacillus reuteri.

In recent years, there has been an increasing incidence of atopic dermatitis in children. This paper provides a literature review on the skin microbiome in atopic dermatitis, and the pharmacological features of various background skin care products.

The allergic diseases and diseases of the gastrointestinal tract are rapidly changing the allergy trends upwards. 66 children with diseases of gastrointestinal tract (GIT) were examined. Of which, 23 children had atopic dermatitis and 43 had skin and intestinal forms of food allergies. The article describes the clinical manifestations of skin syndrome and presents allergological and immunological examination results. The skin syndrome was treated along with the treatment of the underlying disease. Treatment with topical medications was an obligatory and important part of the combination treatment. Skin-cap 0,2% cream was used as the basic therapy of skin syndrome. Skin-cap 0,2% cream is also supposed to be used for other forms of dermatoses.

Due to improvement of genetic and molecular methods of study of both micro-organisms and individual human cell structures, the interest of scientists in the finest mechanisms of interaction between macro- and microorganisms has sprung up in recent years. The study of the microbiota and the diversity of microorganisms in all parts of the human body gave rise to a new understanding of the development of many diseases and, accordingly, to the possibility of creating new therapeutic approaches. The microbiota of the bladder is no exception either. The mechanisms of the formation of asymptomatic bacteriuria (AB) and urinary tract infection (UTI) are of interest to many scientists. The presented article is devoted to the review of recent studies focused on the genetic, immune and molecular mechanisms of interaction between macro- and microorganisms in the development of UTI.

In the article the case of parvovirus B19 infection in a child, which occurred in the form of carditis and myositis, was presented for the first time. There was the rapid progression of the symptoms of acute rhabdomyolysis with a sharp increase in blood levels of creatine phosphokinase, lactate dehydrogenase, myoglobin, ferritin and troponin 1. Ultrasound examination revealed diffuse inflammatory changes in the muscles of the upper and lower extremities with multiple foci of disorganization of the muscular tissue. A high level of PVB19 DNA was determined by the quantitative PCR method, which allowed verifying the parvoviral B19 infection. Rapid clinical and laboratory response in the observed patient was the result of adequate complex therapy, including due to the early use of drugs with antiviral and immunomodulating action.

The era of antibiotics began in the mid-twentieth century, which resulted in changing the basic views on the treatment of infectious diseases and significantly increased the life expectancy among individuals on average by 20 to 30 years. The widespread uncontrolled use of antibacterial drugs has led to development of resistance to antibiotics and a number of adverse events, one of which is diarrhoea. Diarrhoea is caused by the use of antibiotics in 6–7% of cases. Pre- and probiotics are used to prevent diarrhoea. A study of the efficacy and safety of Ecomed (a powder to prepare a suspension containing 100 mg/5 ml azithromycin manufactured by AVVA RUS JSC (Russia) in combination with prebiotics lactulose) in comparison with azithromycin without lactulose was conducted in children with acute bacterial rhinosinusitis. A total of 100 patients were included in the study (50 boys and 50 girls) aged 3 to 14 years, who were divided into 2 groups: the main group consisted of 50 children (mean age 6.16 ± 2.78 years) who received Ecomed for 3 days; the control group of 50 children (mean age 6.9 ± 3.24 years) who received azithromycin for 3 days. The observation period was 2 months. During the observation period, the gastrointestinal tract state was evaluated for such symptoms as flatulence, bloating, frequency of bowel movements and consistency of feces. Feces were collected from children of both groups for gene sequencing by the 16s rRNA method during 4 visits: visit 1: before therapy, visit 2: 3 days after start of the therapy (end of the therapy), visit 3: 17 days after start of the therapy, visit 4: 60 days after start of the therapy. The study showed a significant difference between the microbiota profiles against the background of therapy with azithromycin and Ecomed. It was established that the total share of micro-organisms exposed to the drugs accounted for approximately 20–25%. The use of azithromycin provoked the development of intestinal dysbiosis according to the criteria for the deviation of the microbiota families, genera and species profile from the initial state, and according to the diagnostic signs of clinical symptomatology. An important observation was the fact that even after 2 months the dysbiotic state did not return to normal. The use of Ecomed containing a combination of azithromycin and lactulose reduced dysbiosis of the intestinal microbiota exposed to azithromycin. The main advantages were that opportunistic microorganisms had been prevented from growing against the background of azithromycin therapy and useful and other microorganisms had been preserved.

The article presents present-day knowledge on the impact of microbiota on the health and development of infants, and considers the process of the microflora formation in newborns. It discusses the impact of the gut microbiota on the onset and course of such pathological conditions as infant intestinal colic and necrotizing enterocolitis, and the use of probiotic preparations for the prevention and correction of dysbiotic disorders.

Fever is one of the most common symptoms for sick children being brought by their parents to the doctor. In the vast majority of cases, fever is not a sign of a serious illness; nevertheless it increases parents’ concern for their child. The antipyretics are prescribed to a child with fever not only due to a rise in temperature, but also to improve the child’s well-being. When choosing antipyretics, the paediatrician takes into account the child’s age, route of administration, permissible doses, the frequency of intake, potential complications in children at risk. Apart from the monotherapy, antipyretics can be prescribed in the form of combined drugs that can not only keep the fever down, but also eliminate discomfort and relieve the condition of the child against the background of acute respiratory infection (ARI).

The article presents the main causes of the dysbiotic disorders of the intestinal microbiota in children, provides the characteristics of probiotics for its correction, and justifies the use of Narine dietary supplement through various types of dosage form in the combined therapy in order to eliminate dysbiosis of the intestinal microbiota.

The necrotizing enterocolitis remains the basic disease leading to a mortality of mainly prematurely born children with low and extremely low body weight. The percent of newborns with a necrotizing enterocolitis in recent years tends to increase that is connected with intensive development of a neonatology and resuscitation. The high prevalence of the necrotizing enterocolitis and the lethality accompanying it among prematurely born children remain at the high level, despite numerous researches on optimization of the principles of nursing and treatment, and in most cases meets at children at a stage of perforation of a wall of a gut and mekonialny peritonitis. Diagnostics at early stages of the begun pathological process in digestive tract at small children is extremely complicated. Recognition of precursory symptoms of a terrible disease is one of the first tasks of children’s surgeons and neonatolog. Radiodiagnosis serves as the most reliable diagnostic method at emergence of a clinical picture of a necrotizing enterocolitis. Definition of the most significant ultrasonic symptoms of a necrotizing enterocolitis remains an important task for ultrasonographers, neonatolog and children’s surgeons.

Vaccination is the most important tool for combating infectious diseases. There are a number of major vaccine-preventable diseases included in the national calendar of preventive vaccinations Russian Federation (latest revision is regulated by Decree of the Russian Ministry of Health No. 175n of April 13, 2017). As before, poliomyelitis is one of the 12 nosologies on its list [9]. A. Ya. Kozhevnikov first gave a classic description of this disease as an infectious disease, «which is localized in certain places of the spinal cord», affects mainly children, but also occurs in adults [5]. At this stage, poliomyelitis is described as a highly contagious, acute infectious disease, the clinical manifestations of which are diverse: from asymptomatic infection to severe irreversible paralysis.  The colossal dissamination, high mortality and increased incidence of poliomyelitis made poliomyelitis a significant public health problem, which required the creation of a drug that would meet all the safety requirements and would solve the problem of eliminating the disease on a global basis [1]. The creation of live oral vaccine was a particularly important achievement in the control of polio, but countries that had achieved the eradication of infection on their territory had completely switched to the use of inactivated poliomyelitis vaccine (IPV) [14]. Therefore, WHO intends to completely abandon the use of live oral poliomyelitis vaccine by 2019, in order to consolidate the progress made in the control of polio [26].

The article presents the results of research of influence of synbiotic containing Lactobacillus rhamnosus GG in controlling the symptoms of atopic dermatitis of moderate severity in children. The study included children (n = 20) with atoral dermatitis of moderate severity. The studied patients were divided into 2 groups: group 1 (n = 10) received synbiotic containing Lactobacillus rhamnosus GG in combination with topical anti-inflammatory therapy and the hypoallergenic diet group 2 (n = 10) received topical anti-inflammatory therapy and the hypoallergenic diet. When comparing the data obtained in the group of children treated with synbiotic containing Lactobacillus rhamnosus GG and the control group obtained a significant decrease of the SCORAD index by the end of 2 weeks (p1<0,01) in group 1. Reliable clinical positive dynamics in patients of the 2nd group was mentioned only at the end of the 3rd week.

The monosomy 18p-syndrome refers to an extremely rare disorder (1:50,000 live-born infants). Congenital hypopituitarism is one of the manifestations of this syndrome in 13% of cases. The rarity of this pathology causes difficulties in the early detection of congenital hypopituitarism due to lack of awareness among paediatricians and neonatologists. The article presents a clinical case of congenital hypopituitarism in a girl with monosomy 18p-syndrome, which manifested itself after birth in the form of cholestasis and hypoglycaemia.

Lysosomal acid lipase deficiency (LAL D) is an orphan disease connected with accumulation of cholesterol estersin different organs, interest to this disease increased due to the possibility of enzyme replacement therapy. The article presents a clinical case of verification of LAL D in a child 5 years of age.

The article considers the problem of diagnostics of precancerous larynx diseases, in particular, laryngeal papillomatosis. Separately attention is concentrated on juvenile respiratory papillomatosis, which, not being a precancerous condition in childhood, in some cases precedes adult papillomatosis. Modern methods of surgical treatment of papillomatosis with the use of new technologies are described.