The results of historical and medical research of development of nursery system in 1930–1940 in the Soviet Union are presented in this publication. Large-scale involvement of women to creation of socialist society has demanded to get rid of house work, care of their own child, and as a result creation of network of maternal and child health institutions. The nurseries have become the most common. Thanks to dynamic building and construction work of child care facilities in 1932–1933 yy up to 80% of children had places in nurseries in large industrial centres, and up to 66% of children had places in seasonal nurseries in collective farms. The increase of nursery capacity in the USSR in1938 for previous two years was 30.5%. Despite massive success in the field of nursery network creation, there were some mistakes during construction and some drawbacks in health services for ill and healthy children were revealed. For instance: irrational nursery space planning, inability to isolate one group from another during quarantine in case of childhood infection, massive morbidity with childhood infection in nurseries, incompetence of medical staff, insufficient nurseries capacity management in case of high necessity of nursery care. High importance was given to creation of nursery isolation hospitals for patients and children on a quarantine for solving these problems.

Perinatal pathologies and foremost perinatal central nervous system injury are attended with delayed neurosomatic disorders frequently leading to disability. The success of realisation of individual compensation potential of every child depends on dynamics analysis of patient's condition on every survey stage, personalized choice of necessary and sufficient methods of polysystemic diseases correction. The contemporary view on ethiology and pathogenesis of main perinatal pathologies are presented in this review, main mechanisms of its development are also revealed. Recent non-invasive diagnostic technique allow to perform correction of vital signs and prevent cascade reactions of neuronal apoptosis. The sanogenetic importance of some therapeutic interventions (therapeutic hypothermia, erythropoietin, caffeine) is established in early neonatal period. The role of implementation of external factors causing epigenetic effects is clear: optimal nutrition, correction of intestinal microbiota, sensory and motional stimulation. The abilitation success depends largely on successive team activity of specialists and their collaboration with the family. Methods of multifactorial statistical analysis allow not only to prognosticate the outcomes of perinatal affection, but also to create effective mathematical models for personalized choice of facilitation measures.

International practice of immunization against pneumococcus in patients with systemic juvenile idiopathic arthritis (SJIA) receiving biological therapy is generalized in this review. High efficiency and safety of pneumococcal vaccines in children with SJIA is presented. Numerous researches show the adequate immune response after vaccination as well as alongside with genetically engineered biologic drugs therapy. Prevention of pneumococcal disease in patients with SJIA reduces the risk of development of pneumococcal diseases severe complications.

Background. The prevalence of symptoms of life-threatening events in infants was previously studied using hospital data. However, not all parents in the event of such symptoms seek medical help in the hospital.

Objective. Our aim was to identify the prevalence and risk factors of life-threatening events in infants in the first year of life.

Methods. In the period from November 2017 to February 2018, we interviewed mothers who have children in their second year of life who are registered at children's outpatient clinics in Syktyvkar. Respondents noted episodes of absent, infrequent or irregular breathing, blanching or cyanosis of the skin, changes in muscle tone (hypo- or hypertonia), changes in the level of responses that occurred in infancy. The prevalence of symptoms of life-threatening events was estimated based on the total number of infants in the first year of life (n = 3088) who lived in Syktyvkar as of January 1, 2018.

Results. At least one symptom of life-threatening events in infancy was reported by 43 (4.3%) of the 1001 mothers surveyed. The prevalence of symptoms was 429.5 [95% confidence interval (CI) 321–574] per 10,000 children of the corresponding age. Independent predictors of life-threatening events in children of the first year of life were sudden deaths of relatives under the age of 50 years [odds ratio (OR) 2.4; 95% CI 1.1–5.3], cases of pre-syncope or syncope in relatives (OR 4.4, 95% CI 2.1–9.0), artificial feeding of infants (OR 4.0, 95% CI 1.5–11.2). The sensitivity of the model, which took into account the presence of at least one of the three predictors, was 19% (8/43), specificity — 99% (2/958).

Conclusion. The issue of the occurrence of life-threatening events in an infant can impact every 25th family. In every fifth infant, the occurrence of symptoms of life-threatening events can be predicted based on risk factors.

Background. It is difficult to diagnose bronchial asthma (BA) in children under the age of 6 due to the limited ability to study respiratory function. Therefore, it is relevant to search for such diagnostic markers of BA that do not require the active participation of a child.

Objective. Our aim was to assess the diagnostic value of serum periostin levels in comparison with surrogate markers of eosinophilic inflammation (total IgE and blood eosinophils) for the diagnosis of BA in preschool children.

Methods. A cross-sectional study included children 3–6 years of age with BA and healthy peers. The levels of serum periostin (ELISA), total IgE (chemiluminescent method), blood eosinophils (counted on a hematological analyzer) were determined. To study the diagnostic value of peripheral blood parameters ROC-analysis was used.

Results. Children with BA (n = 56) compared with the healthy group (n = 29) showed higher levels of serum periostin (median and quartile) — 5.7 (3.4, 8.0) and 2.7 (1, 7; 3.6) ng/ml (p < 0.001), total IgE — 180 (122; 622) and 55 (45; 87) IU/ml (p < 0.001), blood eosinophils — 6.1% (3.8; 8.0) and 3.6% (2.7; 4.1) (p < 0.001). The area under the ROC curve (AUC) for serum periostin was 0.81 (95% CI 0.73–0.89), for total IgE — 0.86 (95% CI 0.77–0.92), for blood eosinophils — 0.77 (95% CI 0.67–0.86). Independent predictors of serum periostin were total IgE and the number of exacerbations of BA over the past 12 months > 2 (R² = 0.527).

Conclusion. The level of serum periostin in preschool children with BA is higher than in their healthy peers. The diagnostic value of serum periostin in BA is in the range from moderate to good and is comparable to that for the levels of blood eosinophils and total IgE.

Background. Implementation of mechanical circulatory support and heart transplantation technologies in paediatric clinical practice is changing approaches of diagnostics and treatment of heart failure (HF) in children. The experience of carrying out such operations in Russian Federation is extremely limited until recently due to absence of legal mechanisms of people declaration of intention recording about postmortal use of organs for transplantation.

Clinical Case Description. The rare clinical case of drug-refractory (cardiotonic agents and cardioverter defibrillator implantation) chronic cardiac failure caused by post-myocarditis dilated cardiomyopathy (DCM) which demanded heart transplantation. Postoperative course, specific and non-specific complications, diagnostics and correction approaches are described.

Conclusion. In the absence of proper analysis of non-specific slight symptoms myocarditis can progress to DCM and be complicated by development of refractory HF. The only method of sustaining child’s life in such case is heart transplantation which is connected with high risk of numerous and life-threatening complications.

Background. Trichotillomania is one of the topical problems in dermatovenerology. Annually the number of people who visit dermatologists with hair loss problem is increasing and makes up to 8–10% in structure of dermatologic illnesses.

Clinical Case Description. There are patients with primary psychiatric disorders in practice of dermatologist. This disorders are accompanied by self-injurious behavior and secondary skin changes and/or its appendages. We are performing clinical survey of trichotillomania of hairy part of the head, onychophagy, trichophagy with following developing of trichobezoar in teenage girl. To treat this girl we have carried out surgical operation. Later we have performed complex drug and non-drug treatment under control of pediatric psychiatrist, psychotherapist and dermatologist. The prognosis and perspectives of pathologic process development have been estimated. Possible etiology, clinical signs and dermatological aspects of diagnosis and treatment of disease were discussed.

Conclusion. This clinical case has to draw attention of dermatovenerologists, paediatricians, psychiatrists to the problem of factitial dermatitis.

Background. Marfan syndrome is autosomal dominant hereditary disease of connective tissue with involvement of cardiovascular and musculoskeletal systems and eyes. Pregnancy in patients with Marfan syndrome differs with high risk of complications in mother and fetus, therefore it merits special attention from clinicians.

Clinical Case Description. Patient M., 16 years old applied to the maternity obstetric service at gestational age 19/20 weeks. From anamnesis: aortic dilatation at sinuses of Valsalva, subaortic stenosis, mitral valve prolapse stage II, mitral valve insufficiency stage II, tricuspid valve prolapse stage I. Patient height was 179 cm and weight was 60 kg. There is data in medical records on diagnosed lens subluxation, scoliosis, funnel chest, flat feet, dental crowding in different years. Considering all the mentioned symptoms we have thought of Marfan syndrome diagnosis. We have performed therapy for enhancement of uteroplacental blood flow (intrauterine growth restriction was revealed). The vaginal pessary has been implanted at 28th week of gestation dueto cervical insufficiency. The patient received beta1-blocker. Vaginal delivery at 37 weeks 3 days. The girl was born, body weightwas 2230 g and height was 43 cm, 7/8 on APGAR scale.

Conclusion. The patient was followed up by a cardiologist, orthopaedist, ophthalmologist and dentist with different symptom complexes from an early age. Though it was possible to determine correct diagnosis only at the age of 16 years during the examination due to unintended pregnancy. All clinicians have to remember that combination of cardiovascularsystem damages, lens subluxation and orthopaedic problems in tall and thin patients can be indicative of Marfan syndrome.