The article presents the results of observation of uncared-for children in medical center during 10 years. Children and adolescents (n = 3,875, average age — 14,9 years old) were observed by pediatricians and doctors of particular specialities; an anonymous sociological survey was performed (n = 3,254). Doctors diagnosed infectious diseases (HIV, hepatitis B and C, syphilis) in 542 children and estimated the quality of life in 112 children. The study showed negative peculiarities of life and health mood of uncared-of children: deficiency of height and weight, nonobservance of personal hygiene, use of injection narcotics, polynarcotism. Sexual behavior of children is characterized by early debut of sexual contacts, low level of sexual competence, promiscuity, and inclusion into sex-business. There’s a high prevalence of infections and parasitic diseases, including HIV-infection. The rates of quality of life are significantly decreased compared to the schoolchildren from successful families. 

Key words: uncared-for and homeless children and adolescents, life mood, prophylactic pediatrics, quality of life.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):5-11)

The article presents the analysis of a dynamics of physical development and functional readiness of children 3–7 years old, studying in children’s educational institution with daily stay. Authors revealed statistically significant (р < 0,001) correlation connections between the age and the rates of functional readiness (except flexibility; р = 0,08). Sanitary and pedagogical measures, performed in children’s educational institution, favor to physical development of pre-school children and locomotive experiences and skills.

Key words: pre-school children, health, physical development, functional readiness.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):12-16)

The article presents results of a study of tolerability of recombinant human granulocyte colony-stimulating factor (G-CSF) Leukostim and its efficacy compared to Neupogen in patients with neutropenia, associated with chemotherapy of malignant tumors in children. At the 1^st stage (randomized double-blinded study of tolerability) 10 patients randomly received injections of Leukostim or Neupogen for treatment of neutropenia. Intensity of pain was estimated by visual analogue scale. Both medications were well-tolerated: an average pain intensity was 1,1 for Leukostim and 1,7 for Neupogen. At the 2nd stage of the study courses of different G-CSF drugs (5 mсg/kg daily) were administrated subsequently to 40 patients with malignant tumors treated with repeated identical blocks of chemotherapy. The time of neutropenia correction and absolute increase of neutrophil count were similar for both medications. Thus, Leukostim and Neupogen have identical tolerability and efficacy in patients with neutropenia associated with chemotherapy of malignant tumors.

Key words: children, neutropenia, chemotherapy of malignant tumors, granulocyte colony-stimulating factor, filgrastim, visual analogue scale of pain.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):18-25)

In 2008/2009, at the time of influenza epidemic, the study of ambulatory prophylactic treatment of fusafungine (Bioparox) in 50 children 7–15 years old with chronic tonsillitis was performed. All these children underwent regular ENT check-up. The control group included 50 schoolchildren the same age without chronic diseases of upper airways. After the treatment with intranasal fusafungine, the amount of patients with Streptococcus pyogenes was decreased 1,6 times low (and after 3 months of treatment it was decreased 3,5 times low). The sanation of palatine tonsils from Candida albicans was detected (eradication of microorganism was achieved in 58% of cases, and the amount of patients with pharyngomycosis was decreased 2,4 times low). Patient’s quality of life significantly increased, and ENT-specialists met less complaints (in 4,5–15 times low). The morbidity with respiratory infections in 3 months after the treatment with fusafungine was 7,5 times low than in control group.

Key words: schoolchildren, chronic tonsillitis, acute respiratory infection, fusafungine.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):26-31)

Key words: children, β-carotene, interferon.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):32-36)

The article presents a study of prophylactic effectiveness of hypoallergenic compound «Nutrilon Hypoallergenic 1», fortified with prebiotics «IMMUNOFORTIS», in children from group of risk of development of atopic dermatitis. Anthropometric rates of children after 8 weeks of observation corresponded with average age rates; their physical development was estimated as harmonious. The compound was well-tolerated. Its use resulted in increase of bifido- and lactobacteria of intestinal micro flora and decrease of acute respiratory infections in infants.

Key words: infants, alimentary allergy, atopic dermatitis, artificial feeding, prebiotics, hypoallergenic compound.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):37-43)

The study of effectiveness of prebiotic dose of lactulose in 200–400 ml of milk formula «Bifidus» in nutrition of infants, hospitalized with infectious enterocolitis, was performed. Microbiological effectiveness of «Bifidus» was estimated in 1–1,5 months according to the results of gas-fluid chromatography with evaluation of short-chain fatty acids (SCFA). Statistically significant increase of initially low level of SCFA testified to the restoration of quantity and activity of microbe populations in colon. The dynamics of SCFA in some rates was similar to that ones in children, receiving breast feeding and with data on quality-quantity bacteriological analysis. The study showed the key role of butyric acid level that influences on several microbiological features of intestinal flora in acute stage of infectious enterocolitis. 

Key words: infants, infectious enterocolitis, intestinal flora, short-chain fatty acids, lactulose.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):44-51)

The article observes the data on the role of interleukin (IL) 6 in pathogenesis of rheumatoid arthritis and treatment of rheumatoid arthritis and different types of juvenile arthritis with blocker IL 6 receptor (tocilizumab). The data on multicenter open-labeled and double-blinded randomized studies on effectiveness and safety of tocilizumab are reviewed. The results of studies showed high effectiveness and safety of tocilizumab in treatment of rheumatoid arthritis and juvenile arthritis. 

Key words: children, rheumatoid arthritis, juvenile arthritis, interleukin 6, treatment, tocilizumab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):52-61)

This review analyzes the data on prevalence and microbe picture of pneumococcal infections in the world and in Russia, based on the results of the proper studies and the literature data. The perspectives of introduction of mass vaccinoprophylaxis of pneumococcal infections in children starting from the age of 2 months old and prognosis of its effectiveness depending on serotype spectrum, included in conjugated vaccines, are estimated.

Key words: children, pneumococcal infection, vaccination, prophylaxis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):62-69)

The literature review is dedicated to the characteristics of methods of diagnostics with tuberculin and the problems of contamination with mycobacterium tuberculosis in conditions of mass vaccinations of children with BCG.

Key words: children, tuberculin, Mantoux test, contamination, mycobacterium tuberculosis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):70-74)

Bronchial asthma remains disease with wide prevalence in children different age. Inhalation corticosteroids are medications of first line of therapy in children. The article describes the ways of treatment with budesonide (Pulmicort) in children preschool age. The data from different studies prove the effectiveness and safety of treatment with as turbuhaler, as nebulizer form of this drug. 

Key words: children, bronchial asthma, inhalational corticosteroids, budesonide.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):76-80)

The article presents the review of a safety of TNF blockers in treatment of rheumatologic diseases in adults and children. Authors give a data on separate, open-labeled, and multicenter double-blinded placebo-controlled studies of tolerance to infliximab, etanercept and adalimumab. The results of studies show high effectiveness and good safety of TNF blockers in adult’s and children’s rheumatologic practice. 

Key words: children, rheumatoid arthritis, juvenile arthritis, TNF blockers, treatment, safety, infliximab, adalimumab, etanercept.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):82-94)

Author analyzes an etiology, key components of pathogenesis and symptoms of hyperthermic states: hyperthermia, hyperthermic reactions, heat stroke, and sunstroke, adaptive and pathogenic effects, developing in these conditions, and principles of their etiotropic, pathogenetic and symptomatic therapy.

Key words: hyperthermic states, disconnectors of oxidative phosphorylation, hypoxia, toxemia.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):96-102)

The lecture presents a modern data on Kawasaki disease — an acute vasculitis with unknown etiology, among children younger than 5 years old. The algorithms of diagnostics and risk stratification are described. Authors review modern recommendation on treatment of children with Kawasaki disease and on peculiarities of their management after convalescence. 

Key words: children, Kawasaki disease, diagnostics, treatment, complications.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):104-115)

This article presents the results of a study of effectiveness and safety of ibandronic acid in 21 children with rheumatologic diseases and severe systemic osteoporosis. The treatment with ibandronic acid during 48 weeks provided statistically significant increase of mineral density of bones, decrease of pain intensity, lessening of serum concentration of bone resorption marker — C-terminal telopeptide. The development of repeated compressive fractures of vertebrae and bones of peripheral skeleton at the time of treatment with this medication was not detected. 

Key words: children, rheumatological diseases, osteoporosis, treatment, bifosfonates, ibandronic acid.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):116-121)

The clinical effectiveness of osmotic laxative drugs based on lactulose in restoration of gastrointestinal tract function in early postoperative period after transanal interventions and laparoscopic operations in 53 children 2–17 years old was studied. All patients had non-functional (cologenic and proctogenic) constipation. Patients underwent full-thickness laparoscopic or transanal biopsy due to suspicion of gastrointestinal malformation presence. Children from base group (n = 28) used lactulose (Duphalac) from the second day of postoperative period (dose complied with the age) once daily, in the morning. The control group (n = 25) received subcutaneous or intramuscular proserinum for the stimulation of peristalsis. Blood tests with serum potassium control were performed on 2nd and 4^th day. The study showed clinical effectiveness of lactulose in treatment of postoperational hypotonic constipation in children with colon malformations. 

Key words: children, gastrointestinal malformations, postoperative period, chronic constipation, lactulose.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):122-125)

One of actual modern problems of prophylactic pediatrics is provision of schoolchildren with vitamins and minerals. The years of school education are the years of rapid growth and pubescence. Adaptation in group, mental and physical loads increase the need of growing organism in main nutritive materials and energy. The article presents the results of a study of effectiveness of vitamins and minerals complex «ALFAVIT Schoolchild» in younger schoolchildren.

Key words: vitamins, schoolchildren, prophylaxis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):126-130)

The use of cystatin С as a probable marker of renal toxicity of cyclosporine A in children with nephritic syndrome, treated with this medication for a long time, is the subject of an interest. The present study included 29 children treated with cyclosporine A, divided into 3 groups depending on the duration of treatment (< 1 year, 1–2 years and > 2 years). The increase of cystatin С level in these groups compared with cystatin С level in control group (10 children without diseases of kidney) was marked. The highest level of cystatin С was detected in children treated with therapeutic doses of cyclosporine A (3–5 mg/kg daily) over 1 year. Authors showed positive correlation between cystatin С level in serum and medication’s dose.

Key words: children, nephritic syndrome, cystatin С, cyclosporine A.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):131-135)

Health-giving properties of fermented food are related to the fact, that acid medium improves assimilation of protein and fat, increases absorption of iron and zinc, improves digestion. But the kefir and other sour milk food based on the whole milk can’t be used in nutrition of infants as human milk substitute because of high content of protein, high osmolarity, deficiency of vitamins and microelements. The article describes the results of clinical approbation of new modern sour milk formula «NAN sour milk», containing proper amount of high-quality protein (OptiPro), enriched with lactalbumin and all sufficient vitamins and microelements. This mixture contains also probiotics (B. lactis), providing high functionality of this food. 

Key words: infants, sour milk formula, nutrition.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):136-141)

Inclusion to the clinical practice of genetically engineered biological medications opens new opportunities in treatment of juvenile arthritis. The article summarizes an experience of treatment of juvenile arthritis with infliximab in children’s department of Scientific Center of Rheumatology, Russian Academy of Medical Sciences. The analysis included 55 patients (16 children had systemic type, 23 — polyarticular type of juvenile arthritis, and 16 patients had juvenile spondylarthritis), treated with infliximab in 2002–2009 years. Infliximab was administrated in patients with high activity of the disease refractory to the modern basic therapy. Patients received intravenous infliximab 3–5 mg/kg daily according to the standard scheme (on 0, 2, 6 weeks and further every 8 weeks). Therapy with this drug was estimated as effective (improvement on 30% and more according ACRpedi) in 80% of patients: 16% achieved ACR30, 29% — ACR50, 26% — ACR70, and 9% — ACR90. Unfavorable effects (infusion reactions) were detected in 16% of cases. Infections, including one case of disseminated tuberculosis, developed in 20% of patients. Thus, treatment with infliximab is effective and has good «risk–benefit» ratio in treatment of patients with refractory juvenile arthritis. 

Key words: children, juvenile arthritis, infliximab, treatment.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):142-149)

Alimentary allergy in infants occurs because of intolerance to the cow’s milk protein. Infant formulas with hydrolyzed protein are widely used for the prophylaxis and treatment of alimentary allergy in children. The article describes main peculiarities and principles of administration of hypoallergenic infant formulas and formulas based on hydrolyzates of serum proteins or casein. Special attention is given to the nutrients’ role (nucleotides, long-chain polyunsaturated fatty acids), included into hypoallergenic formulas. The peculiarities and terms of supplementary feeding introduction in patients with alimentary allergy are discussed. 

Key words: children, alimentary allergy, hypoallergenic formulas, nucleotides, oligosaccharides.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):150-156)

At the present times there is a quickened interest in hereditary metabolic diseases that can be revealed by neonatal screening. The list of these diseases includes a phenylketonuria. The interest is conditioned by the opportunity of timely efficient correction of metabolic disorders, first of all by the diet. The article describes the questions of epidemiology, diagnostics, treatment dietotherapy and other methods of treatment of phenylketonuria in children. 

Key words: phenylketonuria, neonatal screening, dietotherapy, specialized food.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):157-160)

Authors analyze a problem of digestion disorders in children with cystic fibrosis (mucoviscidosis). The basis of these disorders is chronic pancreatic insufficiency, developed as malabsorption of fat and steatorrhea, and, to a lesser degree, as disorders of assimilation of protein and starch. A correction of such disorders in infants should be performed with the use of well-balances compound combined with effective pancreatic enzymes, according to the expert’s recommendations. These measures can compensate increased energy consumption in child with cystic fibrosis, provide patient’s normal growth and development, and decrease the rate of infectious complications.

Key words: infants, mucoviscidosis, nutrition.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):162-167)

Additional examination is needed for the purpose of detection of its etiology in some patients with abdominal pain, and it takes several days to prove a diagnosis. In most cases this pain is a result of muscle spasm in gastrointestinal tract. The administration of antispasmodic medication with directive effect, particularly, of hyoscine butylbromide (Buscopan), is well-grounded. Hyoscine butylbromide is M-cholinergic antagonist, it does not penetrates blood-brain barrier, does not induce common for cholinergic antagonists vascular reactions and decrease of blood pressure. This drug is used in pediatric practice for a long time, it can be used in patients 6 years old anв older, and it has good safety profile. 

Key words: abdominal pain, hyoscine butylbromide.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):168-170)

The deficiency of vitamins is one of the main reasons of health worsening. The lack or the absence of vitamins results in metabolic disorders, decrease of physical and intellectual development, and quick fatigability of organism. Besides the regular inclusion of food, fortified with vitamins, the reliable source of vitamins and minerals are multivitamin preparations and vitamins and minerals complexes for the prophylactic use. At the time of administration vitamins, the daily need, the presence of micronutrients deficiency, and compatibility and balance of vitamins and minerals complexes must be taken into account.

Key words: children, vitamins deficiency.
(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):172-176)