The article presents data on unique worldwide experience of biologic agents use in pediatric rheumatology. 433 children with different types of juvenile arthritis (JA) were treated with biologic drugs in Rheumatological Department of Scientific Center of Children’s Health, Russian Academy of Medical Sciences from November 2002 to September 2010: 270 patients received infliximab, 74 — adalimumab, 55 — rituximab, 34 — tocilizumab. Results of a study showed that differentiated biological therapy unlike classic immunosuppressive agents (methotrexate, cyclosporine, leflunomide, etc.) results in clinical and laboratory remission in 70% patients with JA and decrease of disease’s activity in 20% of children in one year. Treatment with genetically engineered biologic drugs increase quality of life of children with JA and their families, provides normal growth and development of patients, and changes a prognosis of this previously incurable autoimmune disease.

The study estimated outcomes of 22–27 weeks of pregnancy according to the analysis of new statistic forms. The official statistic data on births and deaths of children with extremely low body weight in Russian Federation, federal Districts and Subjects in 2009 were used in this work. Mortality decreased in children 750–999 g and in a less degree in children 500–749 g. Dynamics of results showed the necessity of development and delivery to health care institutions of Russian Federation the new forms of statistic reports for monitoring, analysis and improvement of health care quality in delivery and management of extremely premature infants.

The basic ingredient of normal nutrition in infants is breast milk. If breast feeding is impossible the choice of artificial feeding formula should be made taking into account the qualities of formula which must be extremely close to that ones of breast milk. Objectives: to evaluate of state of health of infants having breast and artificial feeding. Methods: effectiveness and tolerance to adopted formula «Nutrilon Comfort» compared to standard milk formula and breast milk were analyzed. Dynamics of physical and neuro-psychical development of children was observed during 12 months. The cases of infectious diseases and tolerance to artificial feeding formulas were estimated. Results: prolonged observation of children from the group of adopted formula with immunomodulatory factors (long-chain polyunsaturated fatty acids and prebiotics) showed its complex action (influence on physical, neuro-psychical development and infectious morbidity) is similar to that one of breast feeding. Acute respiratory infections and atopic dermatitis in children having breast feeding and adopted formula developed rarely than in children from group of standard formula (p < 0.05). Conclusion: nutrition with «Nutrilon Comfort» formula in cases when breast feeding is impossible allows child’s development similar to children with breast feeding.

Evaluation of prolonged storage of breast milk safety for nutrition of newborns remains actual problem of modern nutritiology. Objectives: to evaluate an influence of freezing and prolonged storage of expressed breast milk on its nutritive, biological values and microbiological safety. Methods: samples of expressed breast milk (native samples and after 1 and 3 months of storage in containers Philips AVENT in t -18°С) were analyzed; levels of secretory IgA, lysozyme, transforming growth factor (TGF) β1, potassium, calcium, magnesium, pH, buffer capacity and bacterial cells were detected. Results: there is no statistically significant influence of low temperature and prolonged storage of expressed breast milk on levels of secretory IgA, lysozyme, TGF β1 and bacterial cells. Potassium and calcium levels significantly decreased (on about 10% and 20% accordingly), pH increased, and buffer capacity of milk lowered after freezing during 3 months. Conclusion: children’s feeding with native and expressed breast milk defrosted after 3 months of storage is equal in nutritive and biological values and microbiological safety.

Respiratory infections are frequent in children; consequently evaluation of prophylactic effectiveness of immunomodulators is needed. Objective: to evaluate of clinical, immunological efficacy and safety of pidotimod in complex treatment of children with acute respiratory infections (ARI) and obstructive syndrome. Methods: patients 3–10 years old hospitalized with ARI and obstructive syndrome participated the study. Children from first group (n = 30) were treated with pidotimod 400 mg 2 times daily during 14 days, children from control group (n = 30) received standard treatment without immunomodulatory agent. Dynamics of clinical course of a disease, immunological indices of blood (IL 2, 4 and 8, interferon α  and γ, IgA, M, G and total IgЕ) and swabs from mucous tunica of nasopharynx (sIgA) was estimated. The cases of recurrent ARIs during 12 months after the beginning of a study were controlled. Results: treatment with pidotimod induced statistically significant decrease of cytokines levels (IL 2, IL 8, and interferon γ) and increase of sIgA. The rate of recurrent ARIs during 12 months after the beginning of a study was lower than in control group. Recurrent episodes of bronchial obstruction occurred rarely. Conclusion: pidotimod has high clinical and immunological effectiveness and safety in treatment of children with ARI and concomitant obstructive syndrome.

The article presents the literature review of recent publications on efficacy and safety of methotrexate in treatment of juvenile rheumatoid arthritis. Administration of methotrexate 15 mg/m² of body surface weekly results in significant decrease of inflammatory activity of rheumatoid process and in several cases in induction of clinical and laboratory remission of the disease. Maximal effect can be achieved via subcutaneous or intramuscular injection.

Prophylactic and therapeutic administration of prebiotics in treatment of different disorders is used very often nowadays. However, this kind of a treatment confirmed its efficacy in only several diseases. The review presents the data on efficacy of two probiotic microorganisms (L. rhamnosus GG and B. lactis Вb-12) in pediatric practice. Author summarizes and analyzes existing evidence-based data on efficacy of probiotics in treatment of acute diarrhea, prophylaxis of antibiotic-associated diarrhea and nosocomial infections. L. rhamnosus GG and B. lactis Вb-12 have their own place in prophylaxis of infections of airways and gastrointestinal tract. Administration of probiotics for treatment and prophylaxis of allergic and other diseases is reviewed. Safety of probiotics is described as well.

Literature review discusses the problem of open arterial duct (OAD) in premature newborns — one of frequent complications of neonatal period in newborns with very low and extremely low body weight. The article analyzes modern data on pathogenesis and approaches to the diagnostics of the disorder, and on therapy of premature children with OAD. Authors present the characteristics of homodynamic markers of OAD; the role of OAD’s function in formation of several disorders typical in premature newborns is described as well. Studies of different strategies of conservative and surgical treatment of children with OAD are analyzed.

Omega-3 polyunsaturated fatty acids (PUFA) are important nutrient for proper support of normal living. Omega-3 PUFA play significant role in neurogenesis, neurotransmission, neuroprotection, they are necessary for development of human’s brain. Present study discusses results of fundamental and clinical studies on role of omega-3 PUFA in ontogenesis. Authors performed systematic analysis of physiological effects of omega-3 PUFA on molecular level. Deficiency of omega-3 PUFA results in decrease of intellect and increase of hyperactivity in children. The necessity of proper administration of omega-3 PUFA in early pre-school period and in younger schoolchildren is confirmed by results of clinical studies.

Clinical effectiveness and safety of topical immunomodulator IRS 19 in treatment and prophylaxis of infectious diseases of airways in adults and children was studied in numerous Russian clinical studies. The article reviews the most interesting results of these studies. Administration of bacterial lysates mixture lowers the rate of acute respiratory infections (ARI) and exacerbations of chronic ENT diseases in patients including frequently ailing children. Treatment with the drug results in much smoother disease’s course. Action of a drug shortens terms of a disease, induces significant decrease of ARI complications rate, normalization of nasopharinx biocenose, and lowers the need in antibacterial drugs.

The article presents data on nutritive value of soya as a material for children’s nutrition production. Peculiarities of children’s mixtures based on soy protein isolates for infants’ nutrition and indication for its use are described.

The lecture describes modern data on disorders of acid-base state (ABS): their types, etiology, key stages of pathogenesis, main symptoms, and principles of treatment. The first part of the lecture in present journal characterizes main conception, parameters of ABS in normal state, buffer systems, common mechanisms of BS shifts elimination, etiology and pathogenesis of gas-induced (respiratory) disorders of ABS. The second part of the lecture in following journal will describe not gas-induced (metabolic, excretory and exogenous) disorders of ABS and principles of their treatment.

Anemia in children is one of the most frequent somatic diseases. Criteria of anemia diagnosis are strictly regulated as decrease of hemoglobin/erythrocytes level accompanies majority of infectious, inflammatory, autoimmune, hereditary diseases and, in several cases, it is estimated as transitory disease in some periods of children’s growth and development. The article presents main classification and differential diagnostic schemes of anemia. Diagnostics makes accent on laboratory analysis; they are the basis of differential diagnosis and differential therapy of anemia in children.

The article discusses questions of etiology, pathogenesis and morphological signs of myocardiodystrophy in different periods of childhood. Functional disorders of cardiogenesis and hypoxic cardiopathy could be main causes of a disease. Author mark the necessity of systemic pathomorphological study of a heart with total analysis of contractile, conductive, microcirculation and neurovegetative structures in observation of cardiovascular pathology.

World Health Organization and European Center of Prophylaxis and Control over Morbidity recommend inclusion of systematic vaccination against human papilloma virus in girls-adolescents in national immunization programs. The article makes a review of vaccination reasonability as in countries with developed programs of neck of uterus cancer, as in societies with absence of adequate screening. Author discusses the age of vaccination and presents a foreign experience of vaccine against human papilloma virus inclusion into National Immunization Programs.

60 children 7–15 years old with year-round allergic rhinitis (AR) and colonization of mucous tunic with Candida and Staphylococcus aureus were observed. At the first stage main group (35 children) was treated with antibiotic fusafungine — Bioparox which is active against Candida and Staphylococcus aureus in dosage 4 inhalations 4 times daily during 7–10 days combined with antihistamine drugs. At the second stage patients received anti-allergic treatment of year-round AR with cromones, topical corticosteroids and antihistamine drugs according to the severity of a disease. The second group (25 children) was treated according to the traditional anti-allergicь scheme of therapy. Complex treatment with fusafungine resulted in beneficial therapeutic effect in 77 % patients. Exacerbation period decreased 1.8 times lower and remission was 2.7 times longer. Cultural mycological and bacteriological analyses were negative in most patients with AR.

The article summarizes data on methods and opportunities of frequently ailing children rehabilitation. Authors mark a leading role of vaccination against pneumotropic infections. Questions of successful interaction between doctor and frequently ailing child’s parents are highlighted. The observation of 94 children 3 months — 3 years old (patients had different types of initial immune insuffiiency, neurological pathology, recurrent obstructive bronchitis, or were included in group of frequently ailing children) vaccinated with Pentaxim was performed. 94% of children showed asymptomatic postvaccinal period. Fever up to 39°C occurred in 2.3% of patients. Local reactions (diameter was not over 3–5 cm) developed in 1.7% of children. There was no any case of postvaccinal complication. Evaluation of vaccine’s reactogenity proves its safety and reasonability in immunization against pertussis, diphtheria, tetanus, poliomyelitis, Haemophilis influenzae type b in children of different health state including those with concomitant diseases.

Main questions of meat inclusion into complementary food in infants’ diet are described. Author analyzes the role of several components of meat complementary food (protein, iron) which is necessary to growing and development organism. Inclusion of meat complementary food should be combined with products favoring to better meat uptake, particularly with vegetables and cereals rich with iron.

Treatment and prophylaxis of acute respiratory infections remain serious social and economical problem. Modern medicine estimates immunomodulators as one of promising methods of treatment and preventing of acute respiratory infections (ARI) especially in frequently and long ailing children. Prophylactic administration of immunomodulators allows decreasing the risk of recurrent ARI, and treatment with these drugs in acute phase shortens terms of a disease and compensates immunosuppression.

The article discusses possible violations of function of nutrition, in particular, food tolerance, due to inadequate tactics complementary food.

The article presents main principles of premature infants’ nutrition taking into account immature gastrointestinal system. The approaches are differentiated accordingly to gestational age and body weight. Parenteral and enteral nutrition of children with very low and extremely low body weight in early and late post-natal period is highlighted. Needs of patients in main nutritive ingredients are grounded; physiological role of several nutrients in premature infants (minerals, vitamins, essential fatty acids, nucleotides, etc.) is presented. Ready liquid nutritive mixtures are optimal for nutrition of premature patients. Two-stage system of nutrition (special mixtures for hospital management and following months of life) in extremely premature infants is described in details.

The article analyzes methods of enterosorption and its role and place in clinical practice; classification and mechanism of action of enterosorbates, pathogenetical and clinical aspects of enterosorption in treatment of acute intestinal infections (AII) and other gastroenterological pathology. Authors give brief characteristics, indications and dosing regimen of enterosorbents. The results of clinical efficacy studies of Russian enterosorbates based on hydrolyzed lignin — «Filtrum-STI» and «Filtrum-Safari» in complex treatment of AII in children are described.

The need of vitamin and mineral correction of diet in adults and children in Russian Federation is obvious for physicians and pediatricians. The main problem in the present times is not only necessity of vitamins and minerals complexes (VMCs) administration but compliance of the products with proper standards. Optimal compound of VMCs, content of several ingredients, possibility of selection of drug for specific problem by a doctor or a pharmacist (as VMCs are the out-of-prescription drugs), convenient dosage form and organoleptic characteristics making the drug easy-to use are significant. Clearness of proposed material is confirmed by description of VMC Pikovit as popular drugs among patients and specialists.

Authors consider direct mucolytic action of N-acetylcysteine and all its drug forms (ACC) with antioxidant and antitoxic effects. The drug is effective for treatment of different inflammatory diseases of respiratory tract in children with increase of bronchial secretion vi scosity including infected one. The article describes indications, contraindications and peculiarities of treatment with acetylcysteine in children.

The article presents a case report of a patient with juvenile rheumatoid arthritis refractory to the treatment with metothrexate. Combined therapy with metothrexate and leflunomide induced development of unfavorable effects resulted in cancellation of leflunomide. Successful administration of biological agent inhibitor of T-lymphocytes co-stimulation abatacept is described. Treatment with abatacept resulted in remission of a disease; it increased patient and her family’s quality of life.

The article describes the problems of hemorrhagic disease of newborns with late debut. Prophylaxis of hemorrhagic disease in maternity hospital is performed for not all newborns. The clinical analysis of 9 cases of disease is performed. Dangerous feature of late debut of hemorrhagic disease (after 1st month of living) is the development of massive intracranial hemorrhage on the basis of hemorrhagic diathesis. Late debut of hemorrhage as a result of vitamin K deficiency is characterized with three factors: absence of hemorrhagic disease prophylaxis, breast feeding of a child and transitory cholestasis.