Introduction. Vitamin deficiency states are found in 50–80% of pregnant women. Vitamin D deficiency is hazardous because it significantly increases the risk of complications during pregnancy, childbirth, as well as its effect on the child’s condition.
Aim. To analyse the relationships between vitamin D status and levels of pro-inflammatory cytokines (IL-1β, IL-6) in children born to mothers with endocrine pathology.
Materials and methods. Clinical-anthropometric and laboratory examination included 218 newborns: 98 (45.0%) infants of obese mothers, 32 (14.7%) infants of gestational diabetic mothers with underlying obesity, 22 (10.1%) infants of gestational diabetic mothers, 31 (14.2%) infants of mothers with type I diabetes mellitus and 35 (16.0%) infants of mothers without obesity and signs of impaired glucose tolerance.
Results. Severe calcidiol deficiency is more often recorded in infants born to mothers with obesity, gestational diabetes mellitus and type I diabetes mellitus than in infants born to mothers without endocrine pathology. Serum IL-1β level was 2.6 times higher in newborns born to mothers with obesity than in the newborns from the control group — 14.6 (4.7; 36.5) and 5.6 (1.5; 13. 8) pg/ml, respectively (p = 0.04), 2.8 times higher in those born to women with gestational diabetes mellitus with underlying obesity —15.7 (6.5; 54.3) pg/ml (p = 0.02), 4.5 times higher in those born to mothers with gestational diabetes — 25.4 (5.0; 40.5) pg/ml (p = 0.035), and 6.1 times higher in those born to mothers with type I diabetes — 34.3 (3.8; 61.3) pg/ml (p = 0.01). Newborns born to mothers with type 1 diabetes mellitus had a higher serum IL-6 level as compared to the control group — 48.2 (21.3; 75.6) and 20.2 (5.1; 53.2) pg/ml (p = 0.006).
Conclusion. Overweight and impaired glucose tolerance in the mother negatively affect the vitamin D sufficiency status, and if a fetus experiences vitamin D deficiency, provoke excessive production of pro-inflammatory cytokines in newborns.

Introduction. Intrauterine hypoxia and asphyxia during childbirth are the leading causes of infant mortality in the structure of certain conditions arising in the perinatal period.
Purpose. To study the involvement of negative events for the fetus in the ante- and intranatal periods in the occurrence of perinatal asphyxia in newborns and identify the main modifiable risk factors that will allow formulating preventive strategies in the development of child hypoxia.
Materials and methods. A retrospective assessment of the course of the ante- and intranatal period was carried out according to 50 case histories. Nominal data are presented with indication of absolute and relative values. Sets of quantitative indicators are described by the values of the median (Me) and the lower and upper quartiles (Q1–Q3). The χ2 test was used to compare unrelated samples. Differences were considered statistically significant at p < 0.05. Statistical data processing was carried out using the Microsoft Office 2021 software package.
Results: In the group of children with moderate and severe asphyxia at birth, the median gestational age was 36 and 33 weeks. The main ante- and intranatal risk factors for asphyxia of newborns were established in the following percentage: fetoplacental insufficiency – 32%; premature rupture of membranes and medical abortions in history, 30% each; first pregnancy, anemia, obesity, hypertension, smoking, maternal age > 35 years, 18% each; isthmic-cervical insufficiency – 16%; history of antenatal death, threatened miscarriage, vaginitis, 14% each; acute respiratory infections during pregnancy, assisted reproductive technologies (IVF), uterine fibroids – 12% each; oligohydramnios – 8%; polyhydramnios – 6%.
Conclusion. The structure of factors that can contribute to the development of asphyxia in newborns is diverse. Understanding the involvement of modifiable risk factors determines the need to build a strategy and tactics to reduce their impact on the development of the pathology under consideration.

Influenza is an acute respiratory infection, mainly affecting the respiratory tract (often the trachea), with a tendency to develop symptoms rapidly and in most cases not requiring hospitalization. All acute respiratory infections are non-specific, with symptoms of intoxication, catarrhal symptoms (nasal congestion, rhinorrhoea, sore throat or pharyngeal discomfort), fever and cough. Improvement and widespread implementation of molecular methods to identify respiratory pathogens has led to the establishment of a higher frequency of co-infections. A literature review of the frequency of influenza co-infections is presented. Clinical cases of monoinfluenza and co-infections of influenza and respiratory syncytial infection are described, demonstrating the antagonistic effect of the two viruses on the course of the disease. In the first case, the patient, 1 year 1 month old, was hospitalised with a fever of 39 ºC in a moderate condition. A nasopharyngeal swab showed RNA of influenza A virus by PCR and was diagnosed with influenza. In the second case, the patient, 2 years old, at the beginning of the disease complained of an increase in body temperature to 38.7 ºC, cough, and difficulty in nasal breathing. On admission, the patient was in moderate condition with a body temperature of 36.6 ºC, clear consciousness and well-being. On auscultation, breathing in the lungs was rigid, single moist rales, scattered on both sides. A nasopharyngeal swab showed RNA of influenza A virus and respiratory syncytial virus by PCR. A viral acute respiratory infection of combined etiology and acute bronchitis was diagnosed. In the third case, a 14-year-old patient presented with complaints of fever up to 39 ºC, headache, weakness, muscle pain, dry cough. The condition was of moderate severity. The diagnosis of influenza A was confirmed by a rapid test for influenza A/B/C. In the treatment and prevention of both monoinfection and co-infections of influenza and other viruses, these clinical examples demonstrate the effectiveness of oseltamivir. These clinical examples highlight some key parameters: respiratory co-infections change the typical clinical picture of the disease, making it difficult to clinically diagnose the infection, highlighting laboratory diagnosis, which in turn facilitates rapid verification of the diagnosis and timely prescription of adequate therapy.

This work summarizes the current understanding of the mechanisms providing mucociliary clearance and their disorders in respiratory diseases. It is noted that currently the understanding of the drainage function of the respiratory tract and cough formation in bronchopulmonary pathology has significantly expanded, and therefore much attention is paid to the search for opportunities to correct these parts of pathogenesis. The use of drugs improving sputum rheology and decreasing inflammatory mucosal edema are of great importance in this aspect. The article summarizes the data on the possibilities of pathogenetic correction of respiratory disorders with the emphasis on the use of expectorants and mucolytic drugs made from herbal raw materials. For many of them a sufficiently rich clinical experience has been accumulated, and modern manufacturing techniques have significantly increased their quality and safety. The mucolytic and expectorant properties of modern herbal remedies are in many cases as good as those of synthetic drugs. An important feature of herbal remedies is that they contain a combination of many components with a complex therapeutic effect, whereby the quality of herbal remedies is ensured by the most modern manufacturing control mechanisms. The paper reflects the main therapeutic effects of herbal remedies, which depend on the plant species and are determined by their content of biologically active substances: alkaloids, glycosides (including anthraglycosides, cardiac glycosides, saponins, flavonoids), phytoncides, essential oils, coumarins, tannins, resins, etc. The results of own observations on the use of herbal remedies in routine clinical practice are presented. The high adherence of patients to the use of herbal syrups and drops based on ivy extract in the therapy of cough syndrome in adults and children is shown.

Introduction. Acute respiratory viral infection (ARVI) is the most common reason for visits to the physician by both children and adults.
The aim of the study was to analyse the features of the course of ARVIs in patients with different immune status, to evaluate the effectiveness of standard therapy for these groups of patients, as well as the use of silver-based medicines in the combination therapy of patients.
Materials and methods. For the period from July to September 2022, 26 children (Group 1) without immunodeficiency conditions and 26 immunocompromised children (Group 2) were identified, all of them had symptoms of acute respiratory viral infections. In Group 1, 69.2% of children (n = 18) were classified as frequently ill children with ARVI rate of more than 8 times per year, 38.4% (n = 10) had allergic rhinitis, 7.7% (n = 2) had a concomitant bronchial asthma. In Group 2, the distribution of underlying immunocompromised disease was as follows: primary immunodeficiency – 7.7% (n = 2), Hurler syndrome after bone marrow transplantation – 11.5% (n = 3), acute lymphoblastic leukemia during specific therapy – 26.9% (n = 7), with graft versus host disease – 30.7% (n = 8) and currently in remission – 23% (n = 6). Among patients in this Group, only 7.7% of children (n = 2) had a history of allergic rhinitis.
Results. The criterion for recovery in Group 1 was reversal of all clinical symptoms, in Group 2 – clinical improvement, normalization or significant decrease in C-reactive protein levels, improvement of paranasal sinuses pneumatization.
Conclusion. During ARVI, post-viral rhinosinusitis often occurs, the ability of the mucosa to regenerate becomes disturbed, which makes it more vulnerable to adhesion of viruses, bacteria, and fungi. In this case, especially effective is the intranasal use of a silver-based medicine to form a protective protein film on the injured mucosa. The use of silver-based medicines in the combination therapy of patients with inflammatory pathologies of the nose, nasopharynx and paranasal sinuses can greatly increase the effectiveness of treatment, while shortening the duration of therapy and being safe.

The article is dedicated to the issue of acute respiratory infections in children. Acute respiratory infections (ARI) are the most common infectious diseases among both adults and children. The article presents data on the 2020/2021 ARVI and influenza epidemic season in the Russian Federation, which was characterized by an earlier beginning of the rise in the incidence of ARVI and influenza, a wide geographic spread, the highest rates of respiratory infections in children aged 1–2 and 3–6 years, high intensity of the epidemic process, the predominant circulation of influenza A (H3N2) viruses, and the low incidence, absence of severe disease and low mortality among vaccinated against the flu. Modern options for specific prevention of ARI (vaccination against influenza and other infections as part of the national and regional schedules) and non-specific prevention (implementation of the healthy lifestyle principles, including a day regimen, age-adequate nutrition, environmental control, cold exposure training and therapeutic exercise, avoidance of second-hand smoking, vitamin therapy, reduction of potential exposure to sources of infection, use of anti-epidemic measures in the site of infection, regular ventilation and moist mopping, hand washing, elimination therapy, barrier protective devices, use of systemic bacterial lysates, synthetic molecules) are discussed. The principles of rational ARI therapy are provided. The use of essential oil combinations with a composition of oils at certain proportions is one of the promising directions for therapy and prevention of acute respiratory infections. The results of numerous studies assessing the efficacy and safety of the inhalation administration of natural essential oil compositions as part of the combination therapy and prevention of acute respiratory infections in children are provided, good tolerance and high efficacy of essential oil inhalations are observed.

In world pediatric practice, protracted bacterial bronchitis is the leading cause of chronic cough in preschool-age children. However, in Russia this nosology is not often diagnosed, and in real clinical practice children are observed for doubtful and ambiguous diagnoses. In 2021, the Russian Ministry of Health updated the clinical guidelines “Bronchitis” for pediatric age category with inclusion of protracted bacterial bronchitis in the list of bronchitis variants with designation of disease criteria: wet cough lasting at least 4 weeks, auscultatory symptoms of bronchitis in the absence of signs of chronic lung and bronchial pathology, cough relief after 2 weeks of therapy with an antibacterial drug active against H. influenzae, S. pneumoniae, M. catarrhalis. The article presents a review of the literature on protracted bacterial bronchitis in the historical aspect, and also reflects the criteria of the disease, epidemiology, etiology, pathogenesis, clinical presentation, methods of examination. Particular attention is paid to the treatment and debatable scientific and practical issues in the study of protracted bacterial bronchitis in the light of the clinical guidelines of the Ministry of Health of the Russian Federation. It is emphasized that the etiotropic treatment of protracted bacterial bronchitis is antibacterial therapy. The effectiveness of antibiotics for this disease has been proven in systematic reviews. Therapy is prescribed empirically. The first-line drugs of choice is oral amoxicillin/clavulanic acid. Preference is given to drugs in the form of dispersible tablets. The duration of therapy remains a subject of scientific debate. According to the clinical guidelines of the Russian Federation Ministry of Health, the course of treatment should not exceed 2 weeks, in case of ineffectiveness and/or relapse of protracted bacterial bronchitis, the course of antibiotic therapy may be prolonged to 4–6 weeks.

Introduction. The state of modern Russian adolescents health is characterized by negative trends such as high level of morbidity, largely due to recurrent acute respiratory diseases (ARI). Recurrent acute respiratory infections negatively affect the health of adolescents, contributing to the development of chronic infection foci, having a negative impact on their physical development and psychoemotional status. Many approaches have been proposed for the rehabilitation of adolescents with recurrent acute respiratory infections, but in recent years phytotherapy has attracted the attention of researchers.
Aim. The study is to analyze the experience of using phytotherapy in the rehabilitation of adolescents with recurrent respiratory diseases.
Materials and methods. 124 adolescents aged 13–18 years with recurrent acute respiratory infections were examined. The control group consisted of 50 conditionally healthy adolescents. The artificial colonization of buccal epithelial cells, anti-adhesive activity of saliva and level of psychic adaptation were determined. In addition to the generally accepted measures, the herbal medicine was included in the rehabilitation complex for 51 adolescents. Statistical processing of the obtained data was carried out using the SPSS 12.0 program.
Results. A decrease in oral mucosa adaptive stability in adolescents with recurrent respiratory diseases during the period of clinical well-being was found – such as decrease of anti-adhesive activity of saliva, increase artificial colonization of buccal epithelial cells index. The prevalence of persons with psychic desadaptation among adolescents with recurrent acute respiratory infections was revealed. The positive clinical effect of the herbal medicine in improving the health of adolescents with recurrent respiratory infections, manifested by the end of the course of therapy by an increase in the adaptive resistance of the oral mucosa in the most of patients, and at the follow-up period of 6 months – an increase in the immune resistance and psychic adaptation.
Conclusions. The use of herbal medicine effectively restores the reserves of oral cavity mucosal protection, psychic adaptation and reduces the number of acute respiratory infections. The drug has good tolerability and can be recommended for use in a complex of recreational activities for adolescents with recurrent respiratory diseases.

Bronchopulmonary diseases are an urgent problem for practical health care, as they are a frequent complication of acute respiratory viral infections (ARVI), which have a very high incidence in all age groups of the population, and especially among children. The novel coronavirus infection (COVID-19) pandemic, which the world faced in 2019, convincingly confirmed these facts. Therefore, effective pathophysiological treatment of patients with bronchopulmonary diseases is the most important task of modern pharmacotherapy. The 2 most important highly effective mechanisms for protecting the respiratory tract from pathogenic agents that provide the drainage function of the respiratory tract are described: mucociliary transport and cough. When pathological processes occur in the tracheobronchial tree (various bronchopulmonary diseases), the rheological properties of the bronchial secretion, structural and functional characteristics of the mucous membrane and submucosal layer of the airways change. This leads to mucostasis, a violation in the system of mucociliary transport – a key mechanism for protecting the respiratory tract from pathogenic agents, which significantly complicates the course and treatment of bronchopulmonary diseases, because mucostasis contributes to the violation of bronchial patency and the occurrence of atelectasis. Multfactorial is a distinctive feature of changes in mucociliary transport in bronchopulmonary diseases and requires a complex pharmacological action aimed at its normalization. Therefore, pathogenetic therapy aimed at restoring all the key factors of mucociliary transport is targeted in the treatment of various bronchopulmonary diseases. Mucoactive drugs that belong to different pharmacological groups, the use of which is aimed at restoring mucociliary transport, are considered. The necessity of using combined mucoactive drugs for the treatment of patients with bronchopulmonary diseases has been substantiated.

In the article, the authors provided the overview of the results of international clinical studies and recent papers, as well as their own experience with the use of an enzyme mucolytic – dornase alpha in the treatment of cystic fibrosis and other chronic bronchitis affected by mucostasis. The dornase alfa has been shown to have two more non-mucolytic effects, the most important of them is anti-inflammatory one. It is the anti-inflammatory effect that plays an important role in patients with cystic fibrosis, when chronic bacterial inflammation and destruction of lung tissue take place in the pathogenesis of the disease. Dornase alpha counteracts neutrophil elastase, reducing its concentration in sputum. The authors emphasize on the fact that the same inflammatory reactions occur in covid infection and that it is dornase alfa that acts with an anti-inflammatory effect in ordinary patients, as well as in cystic fibrosis. The authors share their own experience and bring three clinical examples that demonstrate not only good tolerability and safety, but also the clinical efficacy of dornase alfa (Tigerase): in a young child when a diagnosis was established, in a teenager with a successful transition to a biosimilar after a long-term administration, and in a teenager with mucoviscidosis, who successfully managed a covid infection during therapy with this drug. The authors emphasize that dornaza alfa is now the main component of the background therapy of patients with mucoviscidosis, and its representative Tigerase may be successfully used in variously-aged children.

Introduction. Diabetes mellitus type 1 (T1DM) in children and adolescents occupies a leading place in the structure of chronic diseases of childhood. Despite modern advances in the treatment and control of CT 1, adolescents have problems with glycemic control in comparison with other age groups.
Aim. Is to estimate the correlation between the degree of compensation for diabetes in adolescents and the features of the personality profile, emotional and behavioural characteristics and environmental factors.
Materials and methods. The study included 101 children aged 11 to 17 years, treated to pump insulin therapy or multiple injections of insulin. Adherence and compliance to therapy was assessed using the Medication Adherence Questionnaire (MAQ) and the Self Care Inventory-Revised Version (SCI-R). Emotional and behavioral problems were evaluated using the Youth self-report for ages 11-18. Characterization of personality profile was assessed using the The Sixteen Personality Factor Questionnaire».
Results. Diabetes was compensated in 25% of children (Hb_A1c < 7,0%). A statistically significant relationship was established between the degree of patient compliance and the level of Hb_A1c. The predictive role of individual psychological characteristics on compliance has been determined. Factors such as realism and acceptance of moral norms have a positive impact on compliance.
Conclusions. The therapy compliance indicator is the most significant indicator of better compensation for type 1 diabetes in adolescents. The personality traits of adolescents, such as acceptance of moral norms and realism — sensitivity have a predictive effect on the therapy compliance.

Constipation holds an important place among the functional gastrointestinal disorders. The following are among the main reasons for the development of functional constipation: alimentary factors, impaired nervous and endocrine regulation (functional immaturity of the colon, perinatal injury of the central nervous system, endocrine disease), psychosomatic factors, hypodynamia, previous intestinal infections, iatrogenic effects, food allergies and anorectal pathology, genetic predisposition. Treatment of constipation should be comprehensive and include lifestyle maneuvers, dietary recommendations, dietary fibres and water schedule, pharmacotherapy, biofeedback, and surgical methods. Stimulant laxatives (sodium picosulfate, bisacodyl) are effective drugs among the medications used to treat constipation. A sodium picosulfate drug is an effective stimulant laxative, which has a triple effect: stimulation of bowel movements, reduction of the evacuation time and softening stools. The efficacy and safety of the drug was studied in a multicenter, parallel, double-blind, randomized, placebo-controlled study in patients with chronic constipation. The article presents our own experience – a clinical observation – of the use of sodium picosulfate. 26 children with chronic constipation aged from 1 to 7 years, who had stool retention from 3 to 7 days, were observed. The inclusion of a stimulant sodium picosulfate laxative in the comprehensive functional chronic constipation therapy in children aged 1 to 7 years at age-specific dosage variances for 7 days showed high clinical efficacy, which resulted in the normalization of stool in 76.9% of children, facilitating bowel movements and improvement of children’s well-being. This drug can be recommended in the comprehensive therapy of functional constipation in children.

The prevalence of psoriasis reaches about 3% of the global adult population and is twice as lower in the paediatric population. In children, as well as in adults, psoriasis is associated with several different concomitant pathologies: metabolic syndrome, depression, anxiety, arthritis, etc. However, the diagnosis of psoriasis in children and subsequent treatment is quite a difficult task. The clinical presentation in a pediatric patient differs from the symptoms of the disease in an adult. Psoriatic patches are usually thinner and with less severe desquamation, which is often accompanied by itching, and children are also characterized with unusual regions of rash localization, such as the periaucular or umbilical region. Psoriatic diaper rash is often misdiagnosed as diaper dermatitis. However, diaper psoriasis is the most common manifestation, seen in about 45% of cases in children under two years of age. In children, the presence of psoriasis is associated with an increased risk of metabolic syndrome and its components, and with higher rates of hyperlipidemia, even after weight management, in addition to an observed increased risk of depression and anxiety and a possible increased risk of arthritis and Crohn’s disease. The clinical presentation of pediatric psoriasis is diverse, and the diagnosis is most often made clinically. Auspitz’s sign, Koebner’s phenomenon, and Voronov’s ring might be of some help in clinical diagnosis. The treatment of psoriasis in children is based primarily on the same principles as in adults. However, few of the existing treatment options are approved for use in children and adolescents.

Infective endocarditis (IE) is a heart disease of an infectious nature with a primary lesion of the endocardium, heart valves, ligaments, followed by dissemination of the process to various organs. Infective endocarditis still remains a disease that is difficult to diagnose and unpredictable in terms of outcomes; it is registered in all countries of the world. Despite all the advances in medicine, infective endocarditis remains an extremely dangerous disease, with a mortality rate of 10–30%. The most common causes of lethal outcome of IE are multiple complications: embolisms of various localization, including cerebral arteries, aneurysms, toxic lesions of the spleen, myocarditis and pericarditis, acute renal failure. Currently, in pediatric cardiology practice, the frequency of primary infective endocarditis, which occurs with a change in the clinical picture, its atypical variants, has increased. The awareness of doctors of all specialties about this problem, the correct and timely diagnosis of the disease allows prescribing adequate therapy earlier and thereby improves the prognosis. The aim of our work was to familiarize physicians with the clinical observation of a teenager with an atypical onset of primary infective endocarditis, occurring under the “mask” of acute cerebrovascular accident. Also, the peculiarity of this case was the primary diagnosis of hereditary thrombophilia in the patient and the possible debut of a demyelinating disease of the central nervous system during the examination, which certainly complicated the diagnostic search and affected the outcome of infective endocarditis. The significance of dental procedures preceding the disease in a child, unfortunately, was not properly appreciated by the parents, but it is the inflammatory process in the oral cavity that should be considered as a key etiological factor in the development of infective endocarditis in this case.

Foreign body aspiration (FB) is one of the leading causes of death from accidents among preschool children. Every year, up to 8% of children worldwide die as a result of foreign body aspiration. In developed countries, the mortality rate is lower, but the problem remains no less urgent due to the high attendance at emergency departments. Longstanding foreign bodies deserve special attention. The absence of an aspiration episode in the anamnesis of the disease, nonspecific respiratory symptoms, “X-ray negative” foreign bodies, as well as organic FB can complicate the diagnostic search. The article presents data from domestic and foreign literature on epidemiology, risk factors, clinical features, as well as modern approaches to the diagnosis and treatment of foreign body aspiration. The authors present their own clinical observation of a long-standing foreign body in the bronchus in a 7-year-old child. Prolonged cough and repeated episodes of bronchial obstruction for 4 years were regarded as the onset of bronchial asthma. The lack of effect from ongoing bronchodilator and anti-inflammatory therapy with high doses of inhaled glucocorticosteroids dictated the need to expand the diagnostic search, and therefore the child was sent for examination in a hospital to the pulmonology department of the Children’s Clinical Hospital I.M. Sechenov. During endoscopic examination, a metal spiral spring (7 mm in size) was found in the child and simultaneously removed, which was presumably within 4 years in the right bronchus. Over the next 6 months, bronchial obstruction did not recur, there were no complaints.

Urinary tract infection (UTI) is a common and important clinical problem in all age groups. Diagnosis of UTI without localization is not difficult, while the differential diagnosis of UTI is complicated by the lack of specific criteria for pyelonephritis and cystitis. The presence of certain clinical symptoms in combination with a positive bacteriological examination of urine does not allow us to reliably determine the localization of the inflammatory process in the urinary system, which is important due to the different approaches to the treatment of pyelonephritis and cystitis. The review considers in detail the data of studies demonstrating insufficient sensitivity and specificity of the accepted markers of urinary tract infection. Studies have found that ESR and CRP cannot act as specific markers for UTI, especially in children with fever. It has been shown that the procalcitonin test can be considered as such a marker, however, a limited number of studies and a noticeable heterogeneity between studies do not allow us to state this fact definitely. In this regard, it is necessary to search for modern, more accurate biomarkers, that allow differentiating pyelonephritis and cystitis at the earliest stages. The article presents data of modern studies, demonstrating the role of cytokines as biomarkers of UTI, showing their role in differentiating UTI of the lower and upper parts. In addition, the potential role of antimicrobial peptides as diagnostic markers of UTI is considered.

Currently, the attention of the medical community to a non-invasive method of laboratory diagnostics - the study of oral fluid (oral, saliva, saliva test) in various fields of clinical medicine and mainly in adult patients has been updated. Saliva testing has shown good results, especially in the areas of genomics, microbiomics, proteomics, metabolomics, and transcriptomics. The review presents the possibilities of using a non-invasive method for infectious and non-infectious diseases in children. Saliva contains a wide range of protein DNA and RNA biomarkers that help detect many viral infections in children. Oral fluid tests for human immunodeficiency virus, hepatitis B virus have improved access to diagnostics for infants. Both serological and molecular analyzes of the oral fluid are suitable for routine examination and early detection of measles virus RNA, polyomaviruses. Angiotensin-converting enzyme-2 receptor expression was found in the saliva of children with COVID-19, which can be used to diagnose SARS-CoV-2. The saliva test is as effective as the standard test at identifying asymptomatic individuals in contact tracing. The possibilities of saliva diagnostics are positively assessed in transplantology. New biomarkers in saliva have been identified for the diagnosis of many somatic diseases in children. The role of oral fluid as an alternative to blood serum in patients with terminal renal failure, chronic kidney disease (determination of creatinine, urea) in both adults and children is shown. The data obtained may influence the recommendations for the treatment of patients. As a non-invasive method, the study of oral fluid is promising for the diagnosis, prognosis, monitoring of diseases, large-scale typing of children, and the search for new biomarkers.

Introduction. Improving the nutrition of schoolchildren and introducing a culture of nutrition with a national component is one of the priority strategic tasks of improving the health of the population.
Aim. Study the frequency of consumption of foods with high nutritional value by schoolchildren living in the Republic of Sakha (Yakutia).
Materials and methods. According to the developed questionnaire, a survey of 932 parents (legal representatives) of children aged 7–18 was conducted. Statistical processing of the obtained data was carried out using the Excel program using Student’s t-test and Pearson’s χ2 method.
Results and discussion. Children living in Yakutia are characterized by a higher frequency of meat consumption, but less consumption of milk and sour-milk drinks, cottage cheese, fish compared to children in the Arctic zone and the Russian Federation as a whole. At least once a week, 31% of local and 30% of alien children consume fish. Despite the presence of meat in the diet, especially of the local population, 40–60% of children consume sausages more than 3 times a week. 70–90% of children consume fruits several times a week and 65–80% vegetables. The number of children consuming sour-milk drinks has increased, and 60–70% of children use them in their diet, whereas previously only 50% consumed them. 10–15% of children of both ethnic groups do not consume milk and sour-milk drinks, cottage cheese – 50–60% of local and 40% of aliens. Both local and alien children began to use national products more often in their diet.
Conclusion. In recent years, thanks to complex measures, the food diversity of the diets of schoolchildren living in the Republic of Sakha (Yakutia) has significantly improved, characterized by the inclusion of local traditional products in the diet of both the local and the alien population.

Introduction. The pandemic of coronavirus infection, declared by WHO on March 11, 2020, in the first months practically did not affect the inhabitants of the Russian Federation, which gave the healthcare system an advantage in the form of a temporary lag to prepare for the mass admission of patients to infectious diseases hospitals.
Aim. To disclose the issues of organization and operation of a children’s covid and provisional hospital on the basis of a separate medical institution as a single whole entity, which functioned for 495 days from 04/08/2020 to 08/15/2021 on the basis of the City Children’s Hospital №1 of Kazan.
Materials and methods. Descriptive statistics of 1554 cases of coronavirus infection COVID-19 in childhood are given, topical aspects of epidemiology, the clinical course of the disease and the significance of comorbid pathology are discussed.
Results. In the process of work, we noted three rises in the incidence: in June 2020, December 2020 and July 2021. In 61.2% (n = 951) of cases, intrafamily infection was noted, in 11.9% (n = 185) – infection in children’s groups, in 26.9% (n = 418) of cases the source of infection was not identified. The course of the disease was moderate in 74.3% of patients (1154 children), severe in 4.1% (64 children) and mild in 21.6% (336 children), whose hospitalization was justified by social reasons or serious comorbid pathology. The incidence of pneumonia was 21.4% (333 children). COVID-19 was diagnosed in 47 newborns, which proceeded in a severe (2.1% of cases, n = 1), moderate (66% of cases, n = 31) and mild (31.9% of cases, n = 15) form.
Conclusions. City Children’s Hospital № 1 of Kazan, transformed into a temporary children’s covid and provisional hospital, provided medical care to 7831 children, including 1554 patients with COVID-19 in the period from 04/08/2020 to 08/15/2021. This organizational decision made it possible to provide those in need with the necessary medical care, organize the routing of patients, and create a reserve of beds.

Introduction. Data on the increased susceptibility of patients with thalassemia to infections are of great interest to the study of various aspects of the immune status of patients.
Aim. The aim of the study was to study the parameters of the humoral immunity and their relationship with chelation therapy in patients with thalassemia.
Materials and methods. This study was carried out at the Republican Specialized Scientific and Practical Medical Center for Hematology from 2015 to 2020. The material of the study was the peripheral venous blood of patients with thalassemia. When determining the immunological status of patients with β-thalassemia, we examined 74 schoolchildren, aged 8–12 years. Statistical processing of clinical material was carried out using the statistical package of application programs STATISTICA 10.0.
Results and discussion. The results of the study of the content of serum immunoglobulins in the blood of sick children showed a reduced synthesis of IgA (p < 0.001). At the same time, the level of IgM was significantly increased in patients with β-thalassemia, compared with the control (p < 0.001), which indicates the presence of acute inflammation in the body. Also, the results of our studies showed that there is a certain tendency to increase the level of IgG (11.2 ± 0.41 pg/ml in control versus 16.13 ± 0.58 pg/ml), there was a significant increase in the synthesis of this immunoglobulin (p < 0.001), this allows us to state about the autoimmune process. In the group of children with β-thalassemia, the level of C-reactive protein (CRP) was 4 times higher than the values of the control group (3.8 ± 0.1 ng/mg in the control versus 15.33 ± 0.17 ng/mg, p < 0.001). The level of lactoferrin in sick children was reduced by 4.2 times compared with the data of the control group. There is a dysregulation of acute phase protein factors – C-reactive protein and lactoferrin. β-thalassemia is characterized by a sharp increase in the level of pro-inflammatory cytokines – the level of IL-6 is increased by 2.9 times, and the level of IL-18 – by 8.7 times.
Conclusion. The relationship between the indicators of the immune status and indicators of hemosiderosis was revealed, there is a significant difference in all the studied indicators, the use of chelation therapy contributes to positive dynamics.

Introduction. In recent years, there has been an increase in the number of schoolchildren with chronic diseases. Employees of the Astrakhan State Medical University, together with colleagues from Children’s City Polyclinic №4, worked to study the impact of nutrition on the growth of disease cases in educational institutions.
Aim. Study of the impact of nutrition in educational institutions on the state of health of modern schoolchildren in the city of Astrakhan, as well as the understanding of children and their parents of the principles of healthy nutrition of children.
Materials and methods. The health status of 9063 schoolchildren was monitored in general education institutions located in the service area of Children’s City Polyclinic No. 4. Data from preventive examinations 2018–2020 were used. Schoolchildren (579 people) in grades 8–11 and parents (591 people) were surveyed for the state of the child’s health and attitude to healthy nutrition in schools.
Results. According to the results of monitoring by the Office of Rospotrebnadzor in the Astrakhan region in the region, no educational institution has a balanced diet. Preventive examinations of schoolchildren showed that only 7% of children with health group I entered the first grades. In a significant part of schoolchildren, various functional violations were noted (57%). In the structure of such disorders, the first place is diseases of the musculoskeletal system, the second place is the pathology of the digestive organs, and the third place is the violation of neuropsychiatric health. There was a high level of allergopathology, eye diseases. 3% of children showed hearing loss. When examining the cardiovascular system (ECG screening), only 63% of schoolchildren had no significant abnormalities.
Conclusion. Unsustainable nutrition of schoolchildren is one of the reasons for the high level of incidence of schoolchildren, the prevalence of chronic diseases, and physical disorders. It is necessary to introduce healthy-saving technologies in schools and control the organization of nutrition for schoolchildren.