Deviant behavior of adolescents is a serious social problem in today's society because of the significant prevalence of this phenomenon. Authors present the results of the study of adolescents with behavioral problems. Aim: optimization of medical and social care for adolescents with behavioral problems. Patients and methods: the authors studied the incidence of this condition among children aged from 15 to 17 years using the software package «SOC/PEDIATRIA-2». The features of the personality structure of adolescents with deviant behavior were revealed using the adopted Russian short version of MMPI-MINI-MULT. Demographic and social characteristics of the families of adolescents were assessed. SF-36 questionnaire was applied for the quality of life assessment of the studied category. Results: increasing morbidity among adolescents was revealed due to various reasons: economic, medical and social. The study allowed to develop personal characteristics of the criteria in order to timely identify adolescents with accentuated and psychopathological features. The characteristics of quality of life were used as criteria of health care for adolescents with behavioral problems. The measures for the prevention and correction of deviant behavior among adolescents were proposed, including intersectoral integration and active participation of family in the process of rehabilitation. Conclusions: it is necessary to identify adolescents with deviant behavior timely, followed by a set of measures to provide them with health and social care to protect their health.

Celiac disease is characterized by intolerance to gluten, which is a protein composite of grain species. The prevalence of this condition in Europe and USA is 1:100–1:500. Gluten can indirectly initiate immune response through the molecules of major histocompatibility complex I and II. Changes in gluten tolerance are likely to be a key factor of celiac disease development, with increase of epithelial barrier permeability having the primary role in gluten intrusion into the mucous membrane and immune response initiation. Treatment of celiac disease at present is based on strict lifelong gluten free diet with exception of grain species containing gluten (wheat, rye, barley) and certain products of their processing. Safe threshold of gluten contain in food is considered to be 20 ppm (parts per million). The optimal management decision is intake of manufactured gluten free products, which are totally safe, variously represented and have good organoleptic characteristics. Appropriate diet in combination with correction of secondary metabolic disturbances and treatment of associated disorders can provide high life quality in patients with celiac disease.

Ulcerative colitis is recurrent inflammatory disorder of the large intestine characterized by continuous expansion of bowel involvement, from the rectum to the proximal parts. Despite certain similar sign with adults, ulcerative colitis in children has a number of special features and distinctions to disease course and therapy response, therefore such peculiarities should be considered while choosing the management strategy. In 2012 European Crohn’s and Colitis Organisation and European Society for Pediatric Gastroenterology, Hepatology and Nutrition developed collaborated recommendations on diagnostics and treatment of ulcerative colitis in children based on the evidence-based medicine. On the base of European recommendations and with regard to Russian peculiarities and experience of management of children with ulcerative colitis the Russian Consensus on Ulcerative Colitis in children was developed by the group of the chief pediatric gastroenterologists specializing in inflammatory bowel diseases in children. This Consensus was approved on the 15^th of February 2013 at the Expert Counsel on Development of the Russian Consensus, which took place during the XVII Summit of Pediatricians of Russia. These recommendations contain standardized protocols, which allow to provide timely and efficient diagnostics, treatment and follow-up of children with ulcerative colitis. It is necessary to mention, that this Consensus is not a doctrine and individual features of each patient and modern scientifically based data must be taken into account.

The article contains modern views on indications and contraindications to skin tests as a part of allergological evaluation of patients. The literature review includes data, materials and conclusions of the international expert group, which have been recently developed. These data contribute to correct selection of such a wide-spread method of allergological evaluation, as skin tests.

Physical health of a child is inseparable from his emotional state. At present time it is defined that stress and negative life situations (for example, sudden changes in environment and order of day, beginning and ending of school year, examinations and preparation to them, parents’ divorce or dismissal, parting with close friends, interviews etc.) are responsible for increase of distress symptoms in children and adolescents and decrease their ability to self-control. Moreover psychological processes interfere in life activity and can lead to negative consequences in future. The state that emotional and other types of stress can prevent normal psychological and social development in many children is proved in this article. Such disturbances can lead to severe long-term consequences and increase the demand in medical resources, which requires measures aimed to improvement of resistance to stress in childhood and adolescence. During this millennium methods of therapeutic and preventative measures, based on molecular and cellular magnesium-dependent pathogenetic mechanisms of stress formation and consequences of magnesium insufficiency, gain more and more popularity. Recommendations on following certain motional regimen and appropriate for stress condition nutrition do not lose their urgency.

Acute tonsillopharyngitis in children is one of the most common reasons for medical consultations. The majority of acute pharyngeal inflammatory diseases are viral. The frequency of bacterial tonsillopharyngitis in children (the main causative agent is group A Streptococcus, GAS) is about 20–30%. In spite of it antibiotics are prescribed for 95% of patients, thus it is inappropriate. On the other hand misdiagnosis of acute streptococcal tonsillopharyngitis and antibiotics refusal can lead to suppurative and nonsuppurative rheumatic complications. Some prominent trials have shown a poor ability of signs and inflammatory biomarkers to identify tonsillopharyngitis streptococcal vs. viral. So it is impossible to use them as indication for antibiotic. The experience of clinical score use (McIsaac etc.) have also demonstrated a poor prognostic value. As a result the throat swab culture is the «gold standard» of acute streptococcal tonsillopharyngitis. It has such limitations as rare microbiology labs, method technology, the price and the delay in obtaining result. An alternative technique is GAS rapid antigen detecting test (RADT) for the identification of GAS directly from throat swabs. The world data shows a high sensitivity and specificity of modern RADTs.

The results of the analysis of modern views on etiology, pathogenesis, classification and clinical manifestation of psoriasis are discussed in this article. The authors described the algorithm of assessment of severity of psoriasis by the means of PASI calculation. The data on different approaches to systematic and topical treatment of psoriasis according to the PASI values, as well as peculiarities of complications and disease course in patients with psoriasis of the scalp are shown. Assessment of efficacy of modern emollients as drugs of choice for the basic care of the skin of patients with psoriasis of the scalp is given.

Characteristics of medicinal mineral waters as well as the role of magnesium in human organism activity and normal functioning of the gastrointestinal tract are discussed in this article. Aim: to study the influence of mineral water enriched with magnesium on stool of children suffering from constipations, to determine the appropriate dosage and tolerance to such water and to research the effect of the combination of mineral and artesian drinking water on the functioning of the intestines of children with constipations. Patients and methods: 60 patients with chronic constipations (30 — in the study group and 30 — in control group) were included into the first study. Children from the study group were administered mineral water at the dosage of 3–5 ml/kg of the body weight 3 times per day, the treatment course was 10 days at hospital and after that — for 3 weeks in outpatient conditions. The second study included 45 children at the age of 3–15 years old, suffered from chronic constipations, who received sanatorium-and-spa treatment. Patients were divided into 2 groups: 25 were included into the main group, they were administered simultaneously medicinal mineral and artesian water. Mineral water was given at the dosage of 3–5 ml/kg of the body weight 3 times per day before eating. Artesian drinking water was given at the dosage of 6 ml/kg of body weight after eating. The duration of combination treatment was 21 days. Comparison group consisted of 20 children, receiving moderate mineral water. During the first study clinical examination of children was performed, the number of defecation was assessed and the blood samples were performed. During the second study clinical effect of mineral water in the form of regular formed stool was assessed. Results: data from the first study allow to recommend mineral water in treatment of children with chronic constipations as laxative agent at the dosage of 3–5 ml/kg of the body weight.  It should be received 15–20 minutes before eating at the full dosage 3 times per day. The course of treatment of chronic functional constipations in children must be at least 4 weeks. According to the results of the second study, combination administration of mineral and artesian water led both to normalization of the stool frequency and consistence and arresting of dyspeptic symptoms and abdominal syndrome, which often accompanied functional chronic constipations, as well as appetite improvement. Conclusions: including of mineral water into the scheme of treatment of chronic constipations and its combination with artesian water significantly increase the efficacy of therapy.

Key words: children, mineral water, artesian water, gastrointestinal tract, chronic constipation, magnesium, mineralization, spa Rogashka Slatina, efficacy of treatment.

Hypertrophic cardiomyopathy (HCMP) is a genetically determined myocardial disease, characterized by massive hypertrophy of the myocardium of the left and/or (rarely) the right ventricle, often associated with obstruction of the left ventricular outflow tract and diastolic dysfunction. The course of disease can be complicated by development of various cardiac arrhythmias.  It was reported that severity of HCMP course depends at certain degree on polymorphism of candidate genes, including genes of the renin angiotensin system (RAS). Influence of RAS genes polymorphism on the frequency and character of cardiac arrhythmias in childhood is almost not studied. Aim: to determine the influence of RAS genes polymorphism on the prevalence and structure of cardiac arrhythmias in children with HCMP. Patients and methods: analysis of influence of RAS genes polymorphism on the prevalence and structure of cardiac arrhythmias was performed in 32 children with HCMP. All the patients were carried out ECG, cardiac ultrasound and ECG Holter monitoring. Polymorphism of the RAS genes (renin gene (REN) G83A, angiotensinogen gene (AGT) M235T, angiotensin-converting enzyme gene (ACE) I/D, angiotensin II receptor type 1 gene (AGTR1) A1166C). Results: in patients with HCMP was established a higher frequency of TT-genotype and T-alleles of angiotensinogen gene than in comparison group. In homozygous patients with T-allele of angiotensinogen gene ventricular arrhythmia was found reliably more often than in patients with MT- and MM-genotypes, which suggested that M235T polymorphism of angiotensinogen gene influenced on intensity of ventricular arrhythmias in children with HCMP. Conclusions: in children with HCMP and cardiac arrhythmias analysis of M235T polymorphism of angiotensinogen gene can be used as an additional criterion for revealing of patients with high risk of arrhythmic complications and for development of preventative measures.

Aim: to assess efficacy and safety of interferon therapy in children with chronic viral hepatitis C. Patients and methods: 93 children
aged from 3 to 17 (10,0±0,8 years) years old with chronic viral hepatitis C were included into the study. Among them 65 patients
had hepatitis C viral genotype 1 and 28 — genotype 2/3. All the patients before the beginning of antiviral treatment were performed a routine laboratory and instrumental examination. According to the scheme of antiviral therapy 3 different groups of children were distinguished. Analysis of clinical manifestations, assessment of changes in blood markers and control of body weight and height were carried out. Results: received data showed high prevalence of side effects of recombinant interferon α and even higher — of pegylated interferon α in combination with ribavirin. In a number of cases this required correction of drug dosages. It was also shown that usage of recombinant interleukin 2 with recombinant interferon in treatment of chronic hepatitis C in children significantly decreases prevalence and severity of side effects. This can be explained by the ability of interleukin 2 to levelling of antiproliferative effect of interferon therapy. Conclusions: usage of recombinant interleukin 2 in combination with recombinant interferon α in treatment of chronic hepatitis C significantly decrease prevalence and severity of side effects.

Children personality is actively formed at the preschool period, as they enter wider circle of social relationships and everyday tasks become more complicated. The most common emotional problem among preschool children is anxiety as a possible precursor of neurosis. Aim: to study the character of anxiety and the main causes of its development in preschool children in order to determine the structure of psychological care. Patients and methods: 68 children, 68 mothers and 22 fathers were included into the study. We used the following methods: observation, interview, projective and test methods. Results: each third child was diagnosed increased level of anxiety. Anxiety-inducing situations were mainly associated with disturbances of safety feeling in family. Correlation between ineffective types of parental relationship and high level of children anxiety was established. Conclusions: decrease in children anxiety is impossible without harmonization of parental aims in accordance to age and special features of children development. Structure and duration of rehabilitation should be based on analysis of somatic and neuro-psychic state of children, as well as social situation of development.

A history case of a patient with psoriatic arthritis, characterized by severe disease course, systemic symptoms, significantly increased laboratory markers, polyarticular syndrome, typical skin and nails changes, rapid development of patient’s disability and low quality of his and his family life is presented in this article. The authors showed high efficacy of treatment with biological agent — etanercept. In 3 months of treatment non-active stage of disease was achieved, in 9 months — clinical and laboratory remission, not only of the articular syndrome, but also of the extra-articular and dermatological manifestations and laboratory markers of the activity.

Breast milk is a perfect nutrition for infants during their first year of life. Despite the enormous significance of breast feeding for the formation of children health, its prevalence is still very low. Careful doctors’ attention to every woman, consulting on the issues of breast feeding will help to overcome its inadequate prevalence and prolong its duration to the maximum. Advantages of the breast feeding, including situations when a child requires supplementary bottle feeding, are described in this article. Selection of appropriate nipples and bottles, for one thing, will help to reduce children’s anxiety, associated with colic, and, in the second place, will contribute to maintaining of the breast feeding, if the process of suction from bottles is analogous to the process of feeding from mother’s breast.

Sophie Marie Dorothea Auguste Louise descended from German House of Württemberg and was the eldest daughter of the prince Friedrich II Eugen, Duke of Württemberg. She turned into Orthodoxy under the name of Maria Feodorovna. In September 1776 she married the future emperor — Paul I. One of the most significant pages in the history of Russia is associated with the name of Maria Feodorovna — formation of the charity as a system, including three main directions: public education, social support and health care. With her direct assistance 30 charity institutions (founding hospitals, a number of women institutes and other teaching and educational organizations, alms-houses, hospitals etc.) were founded, most of them — for children.