The article describes international multicenter controlled studies of efficacy and safety of monoclonal antibodies towards interleukin 1β — kanakinumab — when treating cryopyrin-associated periodic syndrome and systemic juvenile idiopathic arthritis in children. The results of the studies show that the remission of the disease occurred in 90% of patients with cryopyrin-associated periodic syndrome and in 40% of patients with systemic juvenile idiopathic arthritis. The safety profile was comparable to that of other biological agents.

The paper presents the study of the association between sleep disturbances and mental retardation in children. Attention is paid to the instant connection between sleep neurophysiology and intellectual progress, as well as between sleep disorders and the pathogenesis of mental retardation in children. The data on characteristic forms of sleep disturbances, including bed-time resistance, frequent night awakenings, parasomnias, abnormal sleep structure, and notably reduced REM-sleep proportion are provided. The potential role of abnormal melatonin production in the origins of sleep disturbances in children with mental retardation is discussed. Certain approaches to pharmacological and non-pharmacological corrections of sleep disorders are outlined.

Background: Rate allergenic properties of the complementary food line based on grains, fruits/vegetables and meat in the diet of infants (0–1 years old). Methods: The study included children aged 4–6 months with natural, mixed or artificial feeding, who had not received any complementary food before. The children were almost healthy or had a burdened allergic history. Complementary foods (porridge, vegetable puree, meat puree and fruit puree) were administered basing on an individual plan depending on age, nutritional status and nature of feces. Tolerability of products and dynamics of mass-height and laboratory parameters were evaluated. At the beginning and at the end of the study, capillary blood was taken to determine the content of hemoglobin in red blood cells (MCH), the equivalent of hemoglobin in reticulocytes (RetHe), iron, ferritin, prealbumin, and specific E class immunoglobulin (IgE) to the proteins in cow's and goat milk, apples, pears, prunes, zucchini, broccoli, cauliflower, rice, maize, buckwheat, turkey meat, and rabbit meat (quantitative allergy diagnostics using an express method). In addition, a scatological study was performed. Results: 60 healthy children received complementary foods based on grains, fruits/vegetables and meat on a step-by-step basis. The level of specific IgE to food allergens in all children under the study was within normal range (0–135 IU/ml) both initially and after the administration of all the complementary foods studied. Conclusion: The investigated complementary foods have a low sensitizing potential, including in children with a burdened allergic history. This allows us to describe them as hypoallergenic products.

Background: Vitamin D insufficiency is a widespread phenomenon, having an adverse effect on human health. This problem is also actual in Russia, which most part of the territory is located above the 42nd latitude and is at risk for vitamin D insufficiency. Objective: Our aim was to evaluate the vitamin D sufficiency of the child population of a junior age group and the adequacy of a drug treatment/prevention of vitamin D insufficiency in various regions of the Russian Federation. Methods: Children of the first 3 years of life, who received in-patient treatment in medical institutions of Russia, were examined. When they were involved in the study, they took a blood test to determine a plasma 25(OH)D concentration. The study period: November, 2013 – October, 2014. Results: 1,230 children aged from 1 month to 3 years were examined. Vitamin D insufficiency (25(OH)D concentration in the blood plasma 21–29 ng/ml) is found in 300 (24.4%), deficiency (25(OH)D ≤ 20 ng/ml) — in 513 (41.7%) children. The prevalence of vitamin D insufficiency and deficiency did not depend on a geographical location and level of insolation of regions, where the surveyed lived. Conclusion: In the studied selection more than 2/3 of children of a junior age group have a vitamin D insufficiency or deficiency. In this regard, it is expedient to revise the current guidelines taking into account modern approaches to the prevention and treatment of a vitamin D insufficiency, to make the appropriate changes and to implement them in a clinical practice.

Objective: Our aim was to assess the association of perinatal factors with the early neonatal mortality in newborns with very low (VLBW) and extremely low birth weight (ELBW).Methods: The statistical data was carried out, that is analysis of 17 perinatal factors of 28 newborns with an ELBW with gestation of 23–27 weeks and 18 newborns with a VLBW with gestation of 28–32 weeks, who died in the first 7 days of life. The comparison group consisted of 25 newborns with an ELBW and 56 children with a VLBW with gestation of 25–27 and 28–32 weeks, respectively, who survived the early neonatal period. The association of risk factors with the early neonatal mortality was assessed by means of a multiple-factor logistic regression analysis. A critical p error level was set equal to 0.05. Results: In newborns with a VLBW the increased risk of the early neonatal mortality depended on a gestation term (OR 4.40, 95% CI 1.56–11.71; р = 0.002) and emergency Caesarean section (OR 7.48, 95% CI 1.28–43.74; р = 0.008). A vaginal birth increased the survival chance (OR 0.12, 95% CI 0.01–0.86; р = 0.032). Newborns with an ELBW had the following factors of the increased risk of the early neonatal mortality: gestational age (OR 2.86, 95% CI 1.06–7.73; р = 0.038), Apgar score at the 5th minute (OR 1.91, 95% CI 0.99–3.69; р = 0.050) and presence of chorioamnionitis (OR 5.45, 95% CI 1.0–29.53; p = 0.048). An elective Caesarean section increased the survival chance (OR 0.02, 95% CI 0.001–0.44; p = 0.048). Conclusion: Summarizing the obtained data, we can conclude that besides a gestational age the risk of early neonatal mortality in newborns with a VLBW may be increased due to the emergency Caesarean section, with an ELBW — due to a low Apgar score at the 5th minute and the presence of mother's chorioamnionitis. A vaginal birth in newborns with a VLBW and an elective Caesarean section in children with an ELBW increase survival chances.

One of the most important problems in the modern world is the papilloma virus infection. As is known, this is the most widely spread sexually-transmitted infection. The human papilloma virus is responsible for the occurrence of such a terrible disease as cervical cancer, which ranks third after breast cancer and cancer of the body in the structure of oncological morbidity organs of the reproductive system and mammary glands in women. The other manifestations of the papilloma virus infection are pointed condyloma genital warts, which occur frequently both in men and in women. The only reliable method of the prevention of the papilloma virus infection is immunization. The authors present new data regarding the use of bivalent vaccine, including a new scheme of immunization for girls from nine to fourteen years old. Foreign investigations showed that the double scheme of introduction of the vaccine in young girls is as effective as a triple scheme of introduction in the category of women over 15 years of age.

In recent years, the increase in food allergy morbidity is reported. The disease prognosis directly depends on the timely and correct diagnosis, as well as on the prescription of an elimination diet with the exception of a causally significant allergen. When managing patients the doctor should follow the recommendations formed on the basis of evidence-based medicine principles. The article deals with the latest recommendations of the European Academy of Allergy and Immunology, as well as with approaches articulated in the domestic guidelines «Food allergy».

The article covers modern approaches to the prevention of allergic diseases in children. We discuss the most common food allergens in the early childhood, main mechanisms of food tolerance formation and opportunities of dietary preventive measures in a risk group of the allergy development. One of the important issues, in practical terms, is the question of time and peculiarities of the complementary feeding introduction in this category of children. The own experience of use of hypoallergenic complementary feeding products in children from the risk group and with mild manifestations of atopy is presented.

The article describes the results of studying the effectiveness of vaccination of children with allergic disorders and frequently ill children against pneumococcal diseases. The effectiveness and good tolerability of the vaccine was detected. A follow-up study of the vaccinated children was performed. The positive effect of vaccination on the incidence of acute respiratory diseases, acute adenoiditis and acute otitis media in all groups of children was shown. The positive effect of vaccination on the degree of hyperplasia of adenoid tissue in the nasopharynx of frequently ill children was proved.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and it is characterized by a primary lesion of the joints, organs and tissues with the formation of multiple organ failure of varying severity. The article describes the results of studying the efficacy and safety of adalimumab in combination with methotrexate (n = 26) and methotrexate monotherapy (n = 17) when treating the patients with polyarticular JIA and uveitis refractory to the basic immunosuppressive therapy. It was shown that the combination therapy induced the remission of arthritis in children with JIA in a shorter period of time. After 1 year, the disease remission was recorded in 42% of children in the treatment group and in 18% of children in the comparison group, the uveitis remission — in 26 (54%) of 48 eyes and 2 (7%) of 28 eyes with signs of lesions, respectively. It should be noted that adalimumab in combination with methotrexate was well tolerated and no serious adverse effects were recorded. Thus, the introduction of adalimumab in the treatment regimen of children with JIA and uveitis refractory to the basic immunosuppressive therapy allowed for the rapid disease remission while preserving the effect in a significant number of patients during the following year.

Background: A long-term plating of Pseudomonas aeruginosa in patients with cystic fibrosis is a sign of damage of the lung tissues with rapid progression of the disease and decrease in a respiratory function. The early pathogen detection is necessary for the timely prescription of an antibiotic for the purpose of a complete eradication of P. aeruginosa. Objective: Our aim was to determine the efficiency and safety of an inhalation form of the colistimethate sodium antibiotic in children with cystic fibrosis during the initial detection of P. aeruginosa. Methods: In a retrospective continuous study it was analyzed the results of inhalation use of the colistimethate sodium in a dose of 2 million IU/day in children with moderate cystic fibrosis with newly diagnosed P. aeruginosa. Results: The analysis included data of 25 children at the age of 2–10 years, 17 of them were treated with colistimethate sodium for 6 months, 8 — for 12 months. P. aeruginosa eradication was detected in 22 (88%) children. Children, who received antibiotic therapy for 6 months, at the end of the treatment showed an increase in forced expiratory volume for the 1st second (FEV-1) from 67.1 ± 2.2 to 80.4 ± 1.9% (р = 0.012), but in 3 months without inhalations there was a decrease in indicator values (to 75.9 ± 5.7%; p = 0.069). With the duration of inhalations of 12 months, the value FEV-1 indicator also increased: from 65.9 ± 3.8 to 81.5 ± 3.1% (р = 0.011). However, in the following 3 months without therapy these children did not have any significant decrease in FEV-1 (80.6 ± 3.4%; р = 0.073). There were no allergic reactions during the treatment; bronchospasm was observed in one child. For the entire period of management any P. aeruginosa strain, resistant to the colistimethate sodium, was not revealed. Conclusion: During the initial detection of P. aeruginosa in children with cystic fibrosis, a long-term therapy, including inhalations with colistimethate sodium, leads to a bacterial eradication and restoration of a respiratory function.
Key words: children; cystic fibrosis; chronic Pseudomonas aeruginosa infection; treatment; colistimethate sodium; inhalations.

The article describes a case of torpid course of oligoarticular juvenile idiopathic arthritis (JIA) and the successful use of soluble receptorsf or tumor necrosis factor alpha (TNF) — etanercept — during its treatment. After 4 weeks of treatment the patient returned to normal laboratory indices of the disease activity, and the duration of morning stiffness and severity of inflammatory changes in the joints decreased; after 3 months the acute inflammatory changes in the joints disappeared; after 6 months the patient's functional ability restored; and after 9 months the medically induced remission of the disease was recorded.

Farber disease (lipogranulomatosis, OMIM 228000) — is extremely rare autosomal-recessive disorder from group of lysosomal storage disorders, due to deficiency of acid ceramidase activity enzyme. Farber disease has a lot of clinical masques and resembles to different inflammatory disorders, such as juvenile arthritis, chronic urticaria, larynx papillomatosis and others. Most effective therapeutic method is bone marrow transplantation, which leads to minimization of disabling and improve quality of life. Currently a medication for enzyme replacement therapy of Farber disease is produced and it is under the clinical trials. We describe clinical course of two patients with different types of Farber disease. First case — 10 years old boy with II–III type of disease, and second — with fatal outcome in the age of 4 years 3 months of boy with I (classical) type of Farber disease.

The article describes a case of using methotrexate for subcutaneous injection in a rated dose of 12.5 mg / m² of body surface per week when treating a child with juvenile idiopathic arthritis. When switching to the parenteral route of administration, methotrexate ensured the development of joint syndrome remission, normalization of laboratory indices of disease activity, and improvement of joint functions. After 6 months the inactive disease stage was detected, and after 12 months — remission.

The pulmonary drug administration for the treatment of a pulmonary affection in cystic fibrosis is highly effective. This consensus document summarizes data on inhalation intake of bronchodilators, mucolytics, anti-inflammatory drugs, including glucocorticoids, recommended for use in cystic fibrosis patients of all age groups in the territory of the Russian Federation

Inflammatory diseases of ENT organs often complicate the course of acute respiratory infections in children and remain one of the most common causes of prescribing antibacterial drugs. The article describes the results of analyzing an antiviral therapy in patients with acute uncomplicated rhinosinusitis (n = 175) and non-perforated form of acute otitis media (n = 71). It was shown that, irrespective of diagnosis, the children were most commonly prescribed with rimantadine and homeopathic remedy produced by Boiron. The administration of antibacterial drugs was initiated in 38% of patients with acute otitis media. No deterioration on the background of receiving drugs with antiviral activity was observed in patients with acute rhinosinusitis. In general, a low patient compliance to antiviral therapy can be noted. This problem can be solved by prescribing short-course drugs.