The article details the pattern of a home nursing visit of a newborn. The authors advise when after birth the visit should take place and by whom, its purpose, the components of the newborn examination after discharge from maternity hospital, and recommendations for young parents.

Purpose of the study: compare perinatal factors, clinical-anamnestic data and the levels of anti-inflammatory IL-10 and indirect marker of fibrosis - metalloproteinase 3 (MMP3) in preterm infants with and without respiratory distress syndrome (RDS) to clarify their role in the pathogenesis of lung injury during the period from 3 to 6 weeks of life.

Patients and methods: 15 premature infants with RDS (group 1) and 10 premature infants without RDS (group 2) were examined in the same period of life.

Results: The proportion of children with reduced IL-10 was 60% in group 1 compared to 20% in group 2 (p = 0.048). The proportions of children with reduced MMP3 were 47 and 27%, respectively (p = 0.17). The proportions of elevated IL-10 and MMP3 values were comparable in the two groups (27 and 20% for IL-10 and 13 and 10% for MMP3), the data was unreliable. Children with elevated IL-10 in combination with decreased MMP3 had a history of frequent ARVI complicated by obstructive bronchitis and pneumonia in the first year of life.

Conclusion: Premature infants with RDS are characterized by reduced levels of IL-10 and MMP3 compared with the same biomarkers for premature infants without RDS.

Breast milk contains representatives of the microbiota which affect not only the health of child but also the condition of mammary glands in breastfeeding women both in the short and long term. In fact, dysbiosis of the breast milk microbiota caused by the mother’s body dysfunction as well as exposure to microbial and health factors, often contributes to the development of acute, subacute or subclinical mastitis. The pathology frequently results in the cessation of breastfeeding. Antibiotic resistance, ability to form biofilms, iron binding capacity, as well as the impact on the host’s immune response, are the common features of today’s bacterial pathogens (mainly staphylococci, streptococci and corynebacteria) which may also cause mastitis. This explains why people may become immune to antibiotic therapy, and why the development of new approaches in mastitis treatment using probiotics is becoming very attractive. Some strains of lactobacilli isolated from milk have already demonstrated high efficacy in the prevention and treatment of mastitis in lactating women.

Atopic dermatitis (AtD) is the most common inflammatory skin disease in childhood. In practical healthcare, the basic mechanism for the development of AtD in children is food allergy. However, recent studies demonstrate that disruptions of the skin barrier structure play a relevant role in the pathogenesis of AtD, contributing to xeroderma and increased skin permeability to allergens. Accordingly, AtD therapy should be targeted not only at relief of allergic reactions but also at restoration and maintenance of the skin barrier integrity. The key role here belongs to agents that restore epidermal lipid content – emollients. Among representatives of the group of treatments, the effectiveness of Stelatopia moisturizing emulsion for the treatment of atopic dermatitis in children was confirmed by clinical trials. 

The modern society places before the specialists in various fields of knowledge all the new challenges. A pediatrician is not an exception, who in his/her daily practice has to solve problems of children’s health, guided by modern knowledge of medical science and using a personalized approach to patient care. This article is intended to help practicing pediatricians to find the answers to some of the complex issues related to breastfeeding and questions that lactating women currently have.

Systems biology analysis of over 700 magnesium-dependent proteins in human proteome shown that these proteins affect (1) the embryonic development, (2) energy metabolism, (3) signal transduction processes from receptors, (4) neurological function, (5) support of connective tissue structure, (6) cardiovascular and (7) immunological roles. Magnesium deficiency during pregnancy will stimulate development of congential malformations (skeletal defects, rickets, hernia of the diaphragm, facial defects, craniosynostosis, structural disorders of the retina and vision, brachydactyly). Magnesium deficiency at an early age is associated with sudden death syndrome in preschool and adolescence leads to impaired function of skeletal muscles and myocardium. Magnesium deficiency is also characterized by mitochondrial disorders, hyperinsulinemia, disorders of the skin structure and its appendages, tumors and diseases associated with impaired energy metabolism (including hypoparathyroidism and anemia). Effects of magnesium deficiency in children significantly heavier on the background of lack of vitamin B6 (pyridoxine). The results of proteomic analysis enable to point out the relevant molecular and physiological mechanisms of synergy between magnesium and pyridoxine. Overall, the results of the analysis indicate a very extensive area for the correction of magnesium and pyridoxine deficiency for the prevention and treatment of a wide range of diseases, from the period of fetal development and early childhood through adolescence.

In the article the authors present to the reader to the concept of homeopathic constitution. On the example of the most common homeopathic types they show how to use the constitutional approach in treatment programs. In addition, the article analyzes the role of constitutional medicines in the prescription of complex homeopathic drugs.

In the article the authors consider the problem of treatment of the complicated course of acute respiratory infection (ARI) by natural origin drugs. The efficacy and adverse reactions of official medicine drugs and complex homeopathic medicines are discussed. The basic principles of homeopathic treatment are set forth. Data of international and Russian researchers are provided to prove the feasibility and effectiveness of treating symptoms of cough and rhinitis by natural origin drugs. Schemes of treatment by the example of some complex homeopathic preparations are proposed.

Adequate, balanced nutrition containing the required amount of micronutrients is essential for the normal growth of children at all stages of their development starting from the prenatal period. Prenatal nutrition and breastfeeding are entirely dependent on the mother’s diet and micronutrient sufficiency. Nutrition of pregnant and lactating women and children which is based on natural products, balanced with the energy intake and even excessive in calories cannot fully supply the body with certain vitamins. The high incidence of micronutrient deficiency among children and adults and the existence of vitamin interactions in the body are the reasons for the use of vitamin and mineral complexes (VMC) and/or specialized foods with vitamins for pregnant and lactating women, as well as special nutrition for children. VMC are more effective compared to intake of a single vitamin. Preventive doses, i.e. close to the age-specific physiological need in vitamins, provide for adequate vitamin sufficiency of the diet, reduce the risk of vitamin deficiency and its consequences. With regard to the choice of a VMC, it should contain a complete set of vitamins and mineral substances the deficiency of which is most common, in doses which satisfy the age-specific body needs.

The objectives of the study conducted at the Research Institute of Children’s Infections of the Federal Medical and Biological Agency was to analyze the changes in the severity of clinical syndromes and isolation of influenza/ARVI viruses during treatment with Kagocel®. The study group consisted of 80 children aged 3–11 years who were hospitalized with symptoms of influenza and ARVI, whose complex therapy included Kagocel®. The study showed a significant (p <0.001) reduction of fever on day 3 of therapy with normalization of body temperature from day 4. The intoxication syndrome was in most cases relieved by day 4 (p <0.001). Catarrhal syndrome significantly (p <0.01) decreased from day 3 to day 7 of therapy. The elimination of respiratory viruses based on PCR results by day 5–6 of therapy with Kagocel amounted to 57.1%. The most frequently observed reduction of isolated viruses was recorded for influenza B, A and RS-virus (86, 53.8, 71.4% respectively), and rhinovirus was eliminated less frequently (33.3%). Comparison of the results of the study with the literature data demonstrated correlation of the changes in clinical syndromes of influenza/ARVI if Kagocel was included in therapy, as well as its good tolerability in children from three years at hospitals and in outpatient settings.

Bronchial asthma (BA) in children is a difficult diagnosis, and that is especially true for patients in the first six years of life. According to the GINA experts, among the reasons for difficult asthma diagnosis are high prevalence of wheezing, especially under the age of 3 years; limited availability or absence of pulmonary function tests, wherefore asthma diagnosis is based on complaints, medical history and examination, and often on a third-party impression; the existence of different phenotypes of asthma. Both the medical community and parents mistakenly believe that up to 6 years of age the diagnosis can not be established. As a result, for many years patients are followed-up with alternative diagnoses and do not receive the necessary treatment. That means poor control of the disease, repeated exacerbations and hospitalizations. The review presents findings which dispel the afore-mentioned medical myths about the predictors, diagnostic criteria of asthma in children, under-diagnosis, treatment difficulties and errors. 

By results of the studies performed by the World Health Organization recurrent respiratory infection (RRI) children experience more than 6 episodes of SARS per year. In the Russian Federation every 4th-5th child can be included in this group, which represents more than 60% of all diseases of childhood [1]. The most common pathologies in these children are acute respiratory viral infection followed by the addition of infectious and endocrine diseases. It must be remembered that recurrent respiratory infection children are characterized by a high incidence not only in the autumn-winter period but throughout the year, a prolonged duration of the inflammatory process, a tendency to recurrence or transition to a chronic form, resulting in special interest of practitioners to the treatment of such children and the disease prevention. 

Cough is an indispensable companion of a majority of acute and chronic bronchopulmonary diseases. There are also many extrapulmonary diseases with cough often being the only symptom, so the multifactorial nature of cough complicates the diagnostic search. The article is a detailed review of current literature on the causes of cough and antitussive therapies. There are guidelines for the rational use of antitussives in acute and chronic respiratory diseases in children.

The article discusses the current prospects for herbal medicines in treatment practice, specifically, in the therapy of acute respiratory infections (ARI). The authors highlight the properties, characteristic features, principles and objectives of the phytotherapeutic method. Based on their own experience and analysis of a number of experimental and clinical reports, the use of Umckalor, the Pelargonium sidoides extract (Pelargonium sidoides EPs 7630), is substantiated in the treatment of ARI and its complications in children.

Sore throat is one of the most common complaints with which patients seek the aid of pediatricians. Acute tonsillopharyngitis is a frequent cause of sore throat in children. In a majority of cases, the disease has viral etiology, and less frequently bacterial. Acute tonsillopharyngitis in children is often associated with irrational prescribing of antibacterial agents. Antibiotics are only indicated for tonsillopharyngitis caused by group A beta-hemolytic streptococcal infection. In order to choose rational therapy for acute tonsillopharyngitis, pediatrician should perform differential diagnosis, guess the etiology of the disease based on the clinical pattern using the McIsaac score, and, if possible, quick tests for identification of group A beta-hemolytic streptococcus. In the treatment of acute tonsillopharyngitis in children, regardless of the etiology, the doctor should be guided by a comprehensive approach including the use of drugs with a local antimicrobial effect.

This article presents an overview of the clinical studies investigating the role of pathogenic bacterial flora in etiology of chronic adenoiditis in children. According to the literature, the main reason for the development of chronic diseases of the nasopharynx in children is viral and bacterial infection. The main bacterial pathogens isolated from the nasopharynx in children with chronic adenoiditis are Staphylococcus aureus, Haemophilus influenzae and Streptococcus pneumonia. However, on the basis of research it is evident that opinions of scholars differ. Significant role in formation of persistence of these pathogens in the nasopharynx in chronic adenoiditis is the ability of bacteria to biofilm formation. Bacterial biofilms as well as the identification of a large number of bacteria within the tissues of the pharyngeal tonsil determine numerous issues about the need for both systemic and topical antimicrobial therapy. 

More than half a century ago, clinicians first encountered real difficulties in the treatment of infectious diseases due to the development and subsequent spread of pathogens with antimicrobial resistance (AMP). Since then, medical science has been constantly searching for a solution to the problem of ineffective antibacterial therapy (ABT) against a background of rapidly changing sensitivity of microorganisms to antibiotics. One of the medications which could compromise the most common mechanisms of pathogenic resistance is amoxicillin in combination with clavulanic acid. Despite its long-term use, the drug is becoming increasingly relevant for ABT of respiratory bacterial infections today, justifying the trust of doctors and patients with its long history of effective and safe use. The review tells about indications for amoxicillin/clavulanic acid with regard to the most widespread pediatric infections of the upper and lower respiratory tract and the ENT organs in outpatient settings.

Cough is one of the most common reasons for seeking medical care and may be one of the manifestations of the respiratory tract pathology and various extrapulmonary diseases. Given the diversity of causes of cough, the individualized approach to differential diagnosis and rational purpose of antitussive therapy is required. Agents of plant origin used in the treatment of cough, differ in composition, mechanism of action, forms of production; their modern production must be accompanied by strict control of collection, storage and processing of raw materials. The syrup Eucabal has an expectorant, anti-inflammatory, antioxidant and bactericidal activity by increasing the activity of ciliated epithelium of the mucous membranes of the respiratory tract, reducing hypersecretion, liquefying the phlegm and accelerating its evacuation.

Probiotics are widely used drugs with the proven effect that improve the health of the host organism. They differ in composition, therefore their choice should be based on the results of past clinical trials. Mechanisms of action of probiotics are not limited to simple colonization of the intestine, they exert antagonistic action against pathogens, strengthen the barrier function of the intestine, stimulate the immune defense and form immunological tolerance. Indications for their purpose is very broad: it is an acute intestinal infection, antibiotic-associated diarrhea, functional gastrointestinal disorders, treatment of chronic infections and inflammatory bowel diseases, prevention of allergic diseases and infections in frequently ill children. A rational choice of a probiotic depends on the age, as the disease structure and the purpose of the probiotics in different age groups may vary. The probiotic Primadophilus for infants and older children provides these features.

The review presents information about the pathophysiological mechanisms underlying disorders of the processes of mineralization of bone tissue in patients with celiac disease. The attention is focused on the role of vitamin D and its active metabolite calcitriol, and also parathyroid hormone in regulating calcium-phosphorus metabolism, which is carried out in target organs  – small intestine, kidney, bone tissue. Atrophy of the intestinal mucosa in celiac disease is accompanied not only by malabsorption of calcium, and increased resorption of bone due to increased concentration of PTG. According to various studies on the background of developing the osteoporosis in celiac disease, the risk of bone fractures is significantly increased in patients. Strict adherence to a gluten-free diet allows to normalize both the absorption of calcium, and impaired hormonal mechanisms in bone remodeling in the acute phase, and can reduce the risks of osteoporosis and pathological fractures in patients with celiac disease.

The intestinal microbiome plays a significant role in the regulation of peristalsis, exerts some influence on the functioning of the immune system, course of metabolic processes and formation of some aspects of behavior. There is evidence that maternal microflora can exert an influence on the fetus by translocation of bacteria or bacterial particles through the placental barrier, although, of course, the main colonization of the intestine of the infant occurs in the process of natural childbirth under the influence of the vaginal and intestinal flora of the mother. In children born by cesarean section the normal colonization of the gut is disturbed, which can determine a higher risk of developing in the future of some immune-mediated diseases, Type 1 diabetes mellitus and obesity. Medical men often try to adjust dysbiosis or changes in the composition of the fecal microflora called dysbiosis by the use of probiotics. In addition to the well-known effects of probiotics in the treatment of acute diarrhea in children, these drugs currently are being increasingly used for prevention of necrotizing enterocolitis of the newborn, despite the fact that evidence of the effectiveness of their routine use is not sufficient. A number of studies have shown that some probiotics may be effective in the prevention of atopic diseases, prevention and treatment of antibiotic-associated diarrhea, reducing the frequency and severity of necrotizing enterocolitis, relief of infant colic, and therapy of constipation. Given the role of microbiota in the development of obesity, some probiotics have been used and showed their effectiveness in weight loss. The fecal microflora transplantation was introduced relatively recently to treat Clostridium difficile infection and inflammatory bowel disease. In this review we discuss current data on the intestinal microbiota, its formation, functions, disturbance of the composition and possible ways of their correction. 

Introduction. Diagnosis and treatment of allergy to cow’s milk is subject to dispute in the absence of specific symptoms and reliable diagnostic tests.

Method. Databases were used to search for original articles and reviews on the subject.

Results. As before, a «provocative test» is recommended as the most specific and sensitive diagnostic test, despite the fact that a positive provocative test does not prove involvement in the pathological process of the immune system. A provocative test is not only recommended in case of anaphylaxis, which is extremely rare.

To raise awareness among physicians in order to better recognize symptoms caused by the consumption of cow’s milk, a Scale of symptoms arising from the use of cow’s milk (CoMiSS) has been developed but not yet validated. Today the recommended diagnostic approach includes an elimination diet with the intake of a complete hydrolysate of cow’s milk, followed by provocative tests. In severe cases amino acid mixtures are used. The growing popularity of rice hydrolysates is due to the fact that they have proven effective, better tolerated and cheaper than a mixture on the basis of a complete hydrolysate of cow’s milk. An additional alternative could be soy-based baby formulas as in accordance with the data of the review about 10–15% of children with allergy to cow’s milk will have the same response to soy.

Use of probiotics could be an additional tool in the treatment of allergy to cow’s milk.

Conclusion. For most patients, complete hydrolysates of cow’s milk remains the first tool in the treatment of allergy to cow’s milk and amino acid mixtures used in the most severe cases. Rice hydrolysates and soy infant formula are considered the second choice means. 

Urinary incontinence is a common problem of childhood. Among voluntary urination disorders in children, isolated (monosymptomatic) nocturnal enuresis is the most widespread. The article presents the modern classification of monosymptomatic nocturnal enuresis and describes the potential pathogenetic mechanisms of its development. Diagnostic algorithms and challenges of non-pharmacological and drug therapy are considered in detail.

Urinary tract infection (UTI) is one of the most frequent problems in children, especially early age. A practicing pediatrician, pediatric urologist, nephrologist is frequently faced with the problem of diagnosis and treatment of UTI. Clinical manifestations of UTI in children are diverse and depend on the age and sex of child, severity of the inflammatory process, presence and nature of comorbidity. The experts dealing with the problem of UTI in children in different countries initiated the establishment of clinical guidelines that can assist clinicians in the diagnosis and treatment of UTI in children. The paper presents national European recommendations for the treatment and diagnosis of UTI in pediatrics. 

Chronic constipation is one of the biggest problems in pediatric gastroenterology. The reasons for these diseases are currently a number of conditions, described in the article.

The article tells about the most common bacterial infection in the world - pneumococcal disease, in particular, pneumococcal meningitis, which is the second most common purulent meningitis and the most common cause of mortality and severe neurological deficits in recovered patients. A clinical case of severe pneumococcal meningitis in infant is described in detail.

The review summarizes recent findings on the syndrome of small intestine bacterial overgrowth (SIBO) which is not a separate disease. The triggers of SIBO and the impact on gastrointestinal physiology are considered. Treatment approaches are described taking into account the mechanism of occurrence of digestive disorders. The article highlights the therapeutic effect of probiotic medicines and refers to the research profile of L. rhamnosus strain GG.

Metabolic syndrome (Mets), obesity and overweight are widely distributed worldwide [1–7]. According to experts of the world health organization (who), MS acquired the character of a «pandemic of the XXI century» and is currently regarded as one of the major public health problems [8]. Approximately 30–40% of the population of middle and old age has metabolic syndrome and has an increased risk of premature death from cardiovascular diseases and diabetes mellitus (DM) 2-type [9]. 

In the article the authors consider the problem of diagnostics of the causes, development mechanisms and algorithm for treatment of fevers in children. Indications for use of fever reducing medicines are discussed. Data of Russian researchers to prove the feasibility and effectiveness of treatment of fever symptoms by drug Ibuclin and Ibuclin Junior are provided.

The article tells about the problem of diabetes in childhood and provides detailed data on morbidity across the globe and in Russia. The stages and first signs of the disease are described; the prospects for laboratory diagnostics and guidelines for the prevention of diabetes early in life are highlighted.

Antibiotic-associated diarrhea (AAD) is a common and quite dangerous complication of antibiotic therapy. AAD treatment is associated with certain challenges; the disease can be recurrent, while hospitalized patients can pose an epidemiological risk. The article tells about the etiology and pathogenesis of AAD, the main approaches in the diagnosis and treatment. The use of modern probiotic drugs against a background of antibacterial therapy seems effective in preventing AAD. The article demonstrates that Linex® Forte is one of the most efficient drugs for the treatment and prevention of the disease.

The article examines the prevalence and incidence of acute otitis media (AOM) in children, the causes of the disease, the specific therapies, empirical approach to the prescription of antibacterial drugs, and the choice of antibiotics.

Myocarditis defined by the World Health Organization (WHO), International Society and Federation of Cardiology as an inflammatory disease of the heart muscle confirmed by histological, immunological and immunohistochemical criteria continues to challenge clinicians due to the significant heterogeneity of clinical presentations, specific problems in relation to diagnostic and therapeutic options [1, 2].