Political and socio-economical destabilization, military conflicts, lack of infrastructure and massive migratory movements formed a current medico-demographic situation in the Republics of Chechnya and Ingushetia: the fertility and birth rates here are very high and exceeds twice the same figures all over the Russian Federation. At the same time the infant mortality and feto-infantile losses rates are also very high. The high fertility leads to overpopulation, low per capita income, worsening of somatic and reproductive women’s and children’s health and consistent increase of reproductive losses. The aging of fertility (in the Republic of Ingushetia) and the low level of education (which is typical of the Republic of Chechnya due to the “children of war” achievement of childbearing age) and inobservance of optimal intergenetic interval contribute to the aforesaid phenomena. The analysis of pregnant women, women in labour and newborn children state of health shows that according to many characteristics it is worse than at the average in Russia. Feto-infantile losses in the Republics of Chechnya and Ingushetia are more than twice as high as in all over the Russian Federation. One of the most important conditions for the improvement of child-bearing age women and their children is increase of the efficacy of obstetrics and pediatric services in both Republics and family planning.

Craniopharyngioma is a rare embryonic tumor of the chiasm-sellar region with low malignancy rate but high frequency of recurrence. In spite of the favorable outcome and satisfactory results of treatment the patients quality of life worsens due to complications associated with anatomic localization of craniopharyngioma close to the optic nerve, optic chiasm, hypophysis and hypothalamus. The development of hypothalamic obesity is observed in 25–60% of children and adolescents after surgical treatment of craniopharyngioma, which is usually accompanied with significant disturbances of circadian rhythm and has the most important influence on patients quality of life.

During this study the influence on the clinical and immunological characteristics of frequently ill children at the age of 3–6 years of a complex drug containing β-carotene and vitamins E and C was investigated. It was found that the frequency and duration of respiratory tract diseases decreased in children received the vitamin complex. The improvement of phagocytic parameters and contain of circulating immune complexes was established in such patients.

During the last decade the amount of children with lingering hyperbilirubinemia has significantly increased. The cause of this phenomenon is unclear, as well as there are no uniform criteria for the choosing of appropriate management of children with lingering jaundice. The authors offer the option for the follow-up of such children.

Chronic anterior uveitis is the most common extra-articular complication of juvenile idiopathic arthritis. It is more frequent in the early onset forms with a higher prevalence in the oligoarticular (40%) than in other juvenile idiopathic arthritis subtypes (5–14%). The risk for severe visual impairment is still high due to the development of sight-threatening complications (synechiae, band keratopathy, cataract, glaucoma, cystoid macular oedema. Treatment is not standardized and requires a complex decision-making process, involving a close collaboration between paediatric ophthalmologist and rheumatologist. Topical therapy alone is often inadequate to control ocular inflammation and bulbar injections are too invasive to perform in children therefore immunosuppressive treatment is often advocated. Low dose methotrexate is the second-line agent mostly used although no controlled studies comparing effects of early to late methotrexate treatment have been reported. Mycophenolate mofetil is effective in controlling inflammation in methotrexate -refractory patients. Its efficacy, however, seems to be more relevant in intermediate or posterior uveitis, than in juvenile idiopathic arthritis uveitis and scleritis. Anti-TNFα agents, namely infliximab and adalimimab showed effectiveness in open-label studies but no wide controlled trials have been reported so far. Adalimimab is as effective as infliximab but has an easier way of administration and a better drug tolerance. Abatacept should be used in anti-TNF refractory patients with juvenile idiopathic arthritis uveitis.

The important part in the group of biological compounds, participating in the regulation of the functions of the gastro-intestinal tract, is assigned to endothelial factors because of their impact on the majority of physiological and pathophysiological processes of the digestive system. The article provides information about physiological role of nitric oxide and endothelin-1 and presents a review of scientific data on the participation of nitric oxide and endothelin-1 in the pathogenesis of many digestive system diseases, emphasizing chronic inflammatory disorders of the upper gastrointestinal tract. The authors accentuate the importance of endothelium endocrine function research in children with esophagogastroduodenal disorders at the beginning of puberty, which is the critical period of ontogenesis.

Headache is one of the most common complaints of children and adolescents. The most often causes of cephalgia in children are primary headaches (mainly migraine and tension-type headache). Recently there has been a significant increase in prevalence of primary headaches, which can be due to the changes of children’s way of life. The lack of the strict recommendations on symptomatic and preventive treatment of primary headaches in children in Russia often leads to erroneous indications. Inappropriate treatment can result in migraine and tension-type headache course aggravation with the formation of chronic daily headache, development of medicine-induced headache and other undesirable side-effects. The literature review covers the questions of therapy of the main forms of primary headaches in children: migraines and tension-type headaches. In the first part of the article the issues of diagnostics, algorithm of treatment and non-medicinal methods of treatment of headaches are discussed.

The modern data on sex chromosomes anomalies, diseases with hereditary predisposition, congenital malformations and methods of diagnostics, treatment and prophylaxis of hereditary disorders are discussed in the second part of the lecture «Hereditary, variability and pathology». There are tests and situational tasks with the variants of answers for evaluation of received knowledge at the end of the article.

The article covers the problem of urinary tract infections, which are the most common infectious diseases in children. The authors analyze etiology, pathogenesis, classification and clinical and diagnostic approaches to such patients. The modern methods of treatment are described in the article.t.

The article deals with the problem of the intestinal microflora, which is one of the most urgent problems in pediatrics. Special attention is paid to the process of microbiocenosis formation during early postnatal period, as well as to the realization of the main microflora function, which consists in colonization resistance in close interaction with the components of the local immune system. The author throws light upon the mechanisms of the development of the tolerance to the indigenous microflora, as well as upon the methods of the microflora correction with the help of alimentary pharmacobiotic drugs.

The article contains the review of modern studies performed by the leading Russian and foreign researchers, dealing with different aspects of topical immunomodulators usage in prophylaxis and treatment of the most common viral and bacterial otorhinolaryngological diseases in children. The review covers the pathogenetic and etiological bases of usage of these drugs and peculiarities of child’s immune system, awareness of which explains the reasonability of including of topical immunomodulators into prophylaxis and treatment of such conditions. The author analyzed the typical mistakes in management of patients with aforesaid diseases and frequently ill children, consequences of these mistakes and possibilities of their avoidance with the help of immunomodulators usage.

This article contains information on digestive disorders developing in infants when introducing the additional food. Physiologic, age-dependent and nutritive preconditions for the development of such disorders, classification of the complications occurring on introducing of the new foodstuffs are represented in the article. The authors also describe clinical presentation and treatment management of the patients with nutritive dietary breach, resulting in digestive disorders and/or allergic reactions.

The efficacy of recombinant TB allergen in tuberculosis diagnostics in children and adolescents was estimated by the single-step full expansion method. The results were compared with the ones of routine Mantoux method. Seventy eight children admitted to the somatic clinics and 1377 healthy children from preschool and school educational institutions were examined. The reactions to recombinant TB allergen were registered less frequently, than to Mantoux test: 2,5 times less frequently among the hospital patients and 11 times less frequently among the healthy children. Tuberculosis was revealed in 3,8% of hospital patients and in 0,3% of all the examined patients with the new preparation. It is necessary to introduce the tuberculosis screening with recombinant TB allergen among the adolescent population.

A 5-year clinical observation of 40 children with frequent respiratory infections and otorhinolaryngologic disorders at the age of from 6 months to 5 years was performed in order to assess clinical and immunological efficacy of modern mucosal vaccine. The tested medicine was shown to significantly decrease the frequency of respiratory infections and necessity of antibacterial treatment and to raise the level of serum IgA. The after-effect of the drug lasted for 1–2 years.

The maintenance of breast feeding when it is complicated due to mother and/or child health state is an important and difficult challenge. The application of bottles and nipples which contribute to imitation of the child’s suction process of mother’s breast is urgent to the lactation maintenance. The aim of the study was to perform comparative evaluation of different series bottles with nipples usage for artificial feeding of infants of the first months of life. The received results showed that the majority of children were more willingly to be fed with «Natural» series nipples, continuing to be breast-fed.

The issues of etiology, pathogenesis, clinical manifestations and development mechanisms of the most common forms of endocrinal
regulation of the sexual glands, impairments of the puberty in girls and boys and sexual dysfunction in women and men are analyzed in the article.

Acute rhinitis as a manifestation of acute respiratory infection is one of the most common complaints in pediatric practice. High prevalence of this condition, significant impact of the symptoms on the life quality of a child and frequent complications cause the necessity of the further search for the appropriate treatment of acute viral rhinitis in children.

The authors analyzed the issue of children with persistent conductive hearing impairment rehabilitation in cases when traditional prosthetics with parotid and entotic hearing aids is impossible or contra-indicated. The previous and modern methods of rehabilitation as well as the own authors’ experience of aural rehabilitation of children with external and middle ear malformations and bilateral chronic suppurative otitis media with the help of bone anchored hearing aids with covered implants are described in the article.

The problem of acute otitis media is discussed in this article. The authors describe the main concepts of antibacterial treatment with the culture and antibiotic susceptibility testing of tympanic exudate being the «gold standard» in medicine choosing. The choosing of antibacterial agent is a critical point and demands an increased care. The antibiotic must be broad-spectrum, have minimal side-effects and be of a convenient use form. The possibility of resistance development must be also minimized. The data on clinical efficacy and good tolerance of the macrolide antibiotic clarithromycin in treatment of acute otitis media in children are represented in the article. This medicine can be recommended as a drug of choice in treatment of acute otitis media.

A comparative trial including 80 patients at the age of 1–16 years old was performed in order to evaluate efficacy and safety of osmotic laxatives polyethylene glycol with molecular mass of 4000 kDa and lactulose (46 children received polyethylene glycol, 34 — lactulose) in children with chronic functional constipations. The observation period during the treatment lasted for 2 weeks, clinical and laboratory evaluation of the therapy efficacy and safety was carried out. The normalization of stool was achieved on the average in 3 days of treatment in both groups, pain and dyspepsia were arrested in the majority of the patients. Stool consistency was normalized. No side-effects were registered. However in the first days of lactulose treatment there were reliably more complaints on flatulence and rumbling, which passed spontaneously. Lactulose and polyethylene glycol were shown to be effective and safe in treatment of chronic functional constipations in children and can be recommended for usage even in infants.

Keywords: children, constipations, lactulose.

The results of pidotimod application in children with often respiratory infections are presented in the review and updated with the data collected by St. Petersburg Allergologic Society. The course application of pidotimod in children with allergic respiratory diseases (allergic rhinitis, bronchial asthma) is effective for often respiratory infections prophylaxis. Good medication tolerability and safety was noted in children with concomitant allergic diseases.

The issues of acute respiratory diseases treatment in children, including the most common mistakes in management of such patients, unreasonable from the etiopathogenic point of view treatment with systemic antibacterial drugs and advantages of the topical therapy in arresting of the inflammatory process (in particular, of certain medical agents with topical effect) are discussed in this article. The authors review the most common otorhinolaryngological lesions in acute respiratory diseases. The problems of appropriate anaesthetic therapy and differentiated approach to the evaluation of sore throat in children of different age groups are emphasized.

Antibacterial drugs are frequently used for the treatment of oropharyngeal infectious and inflammatory diseases despite the fact that in 80% of all the cases these diseases in childhood have viral etiology. Unjustified application of the antibiotics is one of the causes increasing in antibacterial resistance. The author considers the possibility of topical medicines usage in treatment of oropharyngeal inflammatory diseases. The recommendations on topical drug with antiseptic and anaesthetic effects are given in the article.